I write this, as I always do, carefully perched in a particular position on a particular chair that I know will mean that even if I sit here longer than 20 minutes, I won’t suffer too much pain when I stand up. I plan my every sit down and my every rising, you see, and have done for the last 15 years since the doctors delivering my first – and only – baby broke my coccyx doing so.
It’s very painful, a broken coccyx. And it takes a long time to heal – they tend not to fully – partly because, of course, there’s nowhere to put a splint. Also because if you do it while having a baby, you can’t really afford the bed rest that would help it on its way because keeping a newborn alive means quite a lot of unavoidable moving about. And sitting up, if you’re breastfeeding, which I was. And if you haven’t been told that your coccyx is broken, which I wasn’t, you think you’re just making a monumental fuss about an odd bit of pain that won’t go away, carrying on through the screaming agony as best you can.
You wish you could feed your son lying down on your side, but given that nobody really showed you how to breastfeed while you were in the hospital for six days (despite it being so hardline breast-is-best that the nurses refused to get you formula from the locked cupboard when you knew your baby wasn’t getting enough milk because your traumatised body wasn’t producing enough), there was certainly never any suggestion that this is a possible thing you could do to alleviate some of the nightmarish suffering.
And the coccyx isn’t the worst of it. Nor is the tearing, though that is worse than the coccyx – but not in a way that can be explained in a family newspaper. Ditto the repair work six months later. The worst part is the memory of being ignored. I begged for a caesarean instead of the Ventouse delivery that caused all this (plus the two litre blood loss that nearly killed me as the baby was eventually tugged into the world). I was in the care of over 20 nurses (two per shift over six days) and only two of them were in any way kind. There were contemptuous dismissals of my requests for physical help, for a doctor to discuss what had happened (which I only gradually pieced together with the help of muttered exchanges between nurses, glimpses of my notes left accidentally in view and common sense, once that re-emerged over the coming weeks, months and years).
I’m sorry – I didn’t mean to go on so long. But that’s the thing about terrible memories – once you start recounting them, you can’t stop until you’re done. It was meant to be a few brief sentences establishing my bona fides for commenting on the 400 page Ockenden Report. A catalogue of the neglect of mothers and babies under the care of the Nottingham University Hospitals Trust, and its 100 “action points” to be added to the hundreds already identified by earlier reports about other trusts, with more surely to come when further reports and investigations occur.
On the other hand, maybe it’s time to dwell, in all the genuinely awful, gory, horrible details of birth stories. Because clearly the other way – the decorous way, the putting-up-with-it-way, the pretending-it-didn’t-happen-so-that-we-can-focus-on-keeping-our-fragile-offspring-alive way – has not helped us at all. Instead, it has allowed a culture in which maternity care is pushed further and further down the list of things to…well, care about. And, in which women are expected to put up and shut up after experiencing a process that even if it goes well, even if there are no complications, is like no other “natural” process the body undergoes at all.
It is not like a bad period. It is not like doing a really big poo. Yes, it is something the female body is “designed” to do, but – here’s the thing – it’s not designed well. What we have, at best, is a work in progress, that is still extraordinary painful and fraught with danger, and which needs to be treated with large amounts of compassion, respect and seriousness. Every time. Every time.
Nottingham’s failures run the gamut, from a litany of errors that led to the death of baby Harriet Hawkins in 2016 (followed by a cover up) down to problems across the entire trust with staffing, culture (including poor communication between doctors and midwives, and incidents of racism) and leadership (many senior NHS managers refused to provide evidence to the investigation). But speak to any woman who has given birth in any hospital and you will find at least some aspect of her story that speaks to some part of this one.
The time for individual investigations into individual trusts is long past. We need a statutory inquiry at least and more than that we need a government that will formulate a plan to raise maternity care standards. And more even than that we need a society that values women enough to insist that it be implemented, as fast and effectively as possible. The untold suffering must end.
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