Pregnant women and new mothers are being referred to social services by midwives for refusing to follow their advice, patient warning groups have warned.
Expectant parents who have declined care, including opting out of scans, refusing induction or failing to attend births, are among those who have faced threats from health care workers that are equivalent to coercion, according to the Association for Improvements in Maternity Services (Target ).
“Since the pandemic, our helpline has seen an increase in those who are threatened or referred to social services for refusing some form of medical care during their pregnancy, even though opting out of inductions, tests or scans is completely legal and valid choices,” he said. Maddie McMahon, a volunteer guide.
Although the problem has been long-lasting, calls to targets have increased since the Covid-19 crisis, with 5% of inquiries between April 2020 and March 2021 relating to concerns about a referral, either actual or threatened. Goal coordinator Nadia Higson said, “Often the threat of a referral is used to force someone to accept unwanted care.”
She added that since the start of the pandemic, there had been an increase in the number of cases where those choosing a birth had been threatened – giving birth without medical staff present at elections – after home services were withdrawn in some areas – rather than accepting what they saw as the more risky option of having their baby in a Covid-infected hospital.
The charity Birthrights says it has also seen the number of reports of referrals to social services more than double in the last financial year.
Rachel Ree, from Manchester, gave birth at home on December 23 without complications. But on Christmas Day, she received a call that blood samples taken from the umbilical cord for routine checks had been incorrectly labeled and destroyed, meaning she had to take her baby to the hospital that day for a blood test.
“I told them I would not take my newborn to the hospital during a pandemic for something that did not benefit her – but they said that if I refused, they would ‘get another agency involved,'” she said. “They even said the police would come and take the child to the hospital.”
Heather Spain wrote an open letter to midwives claiming she was “held captive” at a postnatal ward in Wales after her son was born in February. She had been asked to stay in the hospital for a repeat blood test instead of taking her baby home and returning later for the test. The 34-year-old said: “Waiting for the test would have meant another night in the hot, noisy ward, where I was completely exhausted and struggling to sleep and look after my baby without the support of my partner, who was unable to that visit due to Covid-19 restrictions. ”
But when she tried to leave, staff refused to unlock doors, called security and threatened to call police, she claimed. She wrote: “There is not a day goes by that I do not wonder …[why] you kept me and my then four-day-old newborn trapped on maternity leave when you started the child abduction protocol, which resulted in three male security officers physically blocking my path. ”
After negotiating with the department head, she finally managed to leave, but was warned that staff would be required to report her to social services. “Had I not been alone, I do not think I would have been treated that way,” Spain said. “I feel that women have become more and more vulnerable to such threats during the pandemic because they have not had their birth partners to support them.
“I knew they had no legal right to keep me there, but I was shocked to feel so powerless.”
Spain, which is a diplomat and read a lot on the subject of childbirth after learning she was pregnant, said she felt haunted at the thought that women were less able to defend themselves.
Shivalee Patel, from west London, had a birth after feeling that trust had been broken between her and midwives. She was reported to Children’s Social Services 36 weeks pregnant because those assigned to her home birth disagreed on how she intended to manage her work. “I ended up doing it alone with my partner, a friend and a birth coach,” she said. “I would also have preferred the support of a midwife, but I did not feel comfortable with them because they did not listen.”
Maria Booker, program director at Birthrights, said: “Referrals to social services are of concern to how a baby will be cared for once it is born. They are not a tool to force women and give birth to people to make different birth choices. ”
Leah Hazard, a Scottish-based midwife and author of Hard Pushed: A midwife’s story, said it was important not to quarrel for midwives. She said: “It is never okay to threaten women with social benefits because of different opinions. But I think part of the problem is a broader culture of defensive practice, and possibly for some people, that may cause them to make decisions that are not in line with their professional obligations. ”
The Royal College of Midwives (RCM) highlighted the role of the midwife in enabling women to make informed choices during pregnancy and childbirth. It said midwives’ ability to communicate the consequences of a particular choice was based on developing trust. But it added: “Severe shortage of midwives affects this ability, with little or no time to develop these important relationships. This is a major concern for RCM … The reality is pressure on time and resources means that communication is sometimes not as clear as it should be and unfortunately some women feel that their wishes have been ignored. ”
RCM has published guidance for midwives, including on how to support those who choose childbirth assistance. NHS England said it was up to individual trusts to adopt their own protection protocols.