Would you like to be a Birthrights Associate trainer?

Do you have human rights expertise?

Are you a healthcare professional who puts human rights centred care into practice?

Birthrights is looking for experienced trainers to join its Associate Trainer team as either a Legal trainer or a Healthcare Professional trainer. We will give you the training you need, ongoing support and pay you for the training sessions you do. You will need to be available at least twice a year to deliver training sessions and be willing and able to contribute to the development of our training programme. The full role description is here and the application form is here.

The deadline for applications is the 9th November and the next Associate training day will be held in London on the 7th December. If you would like more information please contact us on info@birthrights.org.uk.

‘Child of Mine’ documentary, showing parents coming to terms with the stillbirth of their babies

Tonight True Visions’s ‘Child of Mine’ documentary, showing parents coming to terms with the stillbirth of their babies, will be shown on Channel 4 at 10pm on Thursday 18th October 2018.

We absolutely understand the potential benefits of a sensitively made documentary on stillbirth and the importance of raising awareness of what bereaved parents go through. However we do have some concerns about how this documentary was made and in particular how consent was obtained, which we shared with the Cambridge University Hospitals NHS Trust, that includes The Rosie Maternity Hospital, following an enquiry from a member of the public in the area, and you can view this letter here. The response from the documentary makers can be seen here and we understand filming ended shortly afterwards.

If you were affected by the filming at the Rosie or UCL and have any concerns about how this was conducted, please do get in touch on info@birthrights.org.uk.

If you have been affected by stillbirth or miscarriage there are a number of national and local organisations you can contact for support including:

SANDS, the Stillbirth and neonatal death charity

The Miscarriage Association

Antenatal Results and Choices

Birthrights appoints new Chief Executive

We are thrilled to announce the appointment of our new Chief Executive, Amy Gibbs, who will join Birthrights at the end of November 2018.

Amy is a health and human rights campaigner and senior leader with over 12 years experience in national charities, local government and Parliament. Throughout her career she has led teams and organisations to secure legal, policy and practice change for vulnerable adults and children denied their rights by services and society. Amy was a Director of child rights organisations Unicef UK and The Children’s Society, and earlier spent 5 years leading policy and campaigns on social rights and healthcare at mental health charity Mind.

Amy served for 8 years as an elected Councillor for the London Borough of Tower Hamlets, including two years as Cabinet Member for Health & Adults Services and Chair of the Health & Wellbeing Board, which oversaw integrated services including maternity care transformation. She has held various non-Executive positions including Vice-Chair of East End Citizens Advice Bureau and Governor of East London Mental Health Foundation Trust. Amy has an MSc in European Public Policy and MA in English Literature and German. When not working for Birthrights, she is kept on her toes by her lively toddler!

Amy says “I’m delighted and honoured to join Birthrights as Chief Executive. Protecting women’s rights and dignity in childbirth is an issue very close to my heart and I look forward to working with the staff team, trustees, partners and funders to deliver this ambition for even more women.

Recruiting for Chief Executive Officer

Birthrights is looking for a leader to join us as our new CEO. You will lead develop a dynamic and influential young charity which is changing the conversation in maternity care and putting human rights and respectful care high on the agenda for women, healthcare professionals and policy makers.

Birthrights champions women’s rights to dignity, autonomy, humane treatment and non-discrimination. We believe that human rights principles have the power to transform maternity care in the UK and to ensure that women’s needs are met and the most vulnerable women are equally enabled to access safe, high-quality, respectful maternity services.

We reach thousands of women and health care professionals through our advice and training. Our influencing work embeds a human-rights approach in NHS Trusts and central government maternity policies. Our research and publications highlight the challenges faced by women from vulnerable backgrounds and our strategic legal interventions give pregnant women a voice in the courts.

Our successful candidate will be a dynamic and experienced leader with a strong understanding and commitment to human rights in maternity care. You will have a track record in growing organisations, developing and implementing strategies and building income streams. You will empower and inspire staff and create partnerships with a diverse range of stakeholders to influence policy. You will understand charity governance and work effectively with the Board to ensure strong financial and organisational management.

We believe strongly in flexible working. We operate an employee-led working schedule and a flexible holiday policy. Our staff work from home with regular meetings in London and the south-east. The Board is open to increasing the CEO’s working hours if funding permits.

If you believe you have the commitment, skills and experience to lead Birthrights at an exciting time in its development we would welcome your application.

For further information, please download the appointment brief: Birthrights CEO appointment brief

Recruiting new Legal Officer

Birthrights is the UK’s only organisation dedicated to improving women’s experience of pregnancy and childbirth by promoting respect for human rights.

The Legal Officer is a new and critical role at Birthrights to manage our advisory and legal work, including running the advice service, overseeing strategic litigation and providing legal policy input with core stakeholders.

This is a part-time home based role, with a pro-rata salary of £15,000. To find out more and how to apply please download the Job Description.

Closing date for applications is 5pm on Wednesday 27th June 2018.

New research: Disabled women need to be heard and respected as experts about their bodies

Research published today and commissioned by Birthrights shows that disabled women are generally not receiving the individualised care and support they that they need to make choices about their maternity care.

Today’s publication includes and builds on the survey research published in 2016 which found that more than a quarter of disabled women asked felt that their rights were poorly or very poorly respected.  A quarter felt they were treated less favourably because of their disability, and more than half (56%) felt that health care providers did not have appropriate attitudes to disability. Some found birth rooms, postnatal wards, or their notes and scans “completely inaccessible”.

The new report published today presents data from in-depth interviews with disabled women.  It highlights the need to treat disabled women – as all women – as individuals with their own specific needs.  It emphasises the need to recognise that disabled women are experts in their own conditions and what they mean for their bodies and choices in childbirth.  Participants described distressing scenarios of having to prove that their choices were suitable, undermining their dignity. In one very concerning case, one participant described not being given all the information she needed to make an informed decision about her care during labour, and being denied the choices she would have made as a result.  Respecting women’s dignity means respecting and trusting women’s individual needs and knowledge.

Participants also described having to explain themselves repeatedly to each new care provider; at times feeling as if the focus was on their impairment rather than their needs as a person: “You’re not a pregnant woman you’re just a body. Because if I was a person to them, if I was a pregnant woman they would have read my file”. Women who had experienced continuity of carer spoke very positively of their experiences and of experiencing more dignified care.

All women had some poor experiences of postnatal care.  In some cases participants did not see the point in raising issues when continuity of care was lacking and midwives were short of time; something the researchers suggest “must raise questions of safety of practice”.

Participants had mixed experiences of antenatal and parenting support: some women were provided tailored support early on but others felt that they were expected to take the lead in asking for what they wanted or found that activities or information were not offered in an accessible way.

Throughout the study, women felt that they had to be empowered, enabled, informed and supported to advocate for their rights.  They emphasised the need to be listened to and treated as individuals.  Not doing this has a long term impact: women who were not listened to and whose rights were not respected lost confidence and felt undermined long after the birth.

Birthrights’ Chair, Elizabeth Prochaska commented: “It is fundamentally important that disabled women – like all women – receive dignified maternity care that respects their human rights. The research published today highlights that much more work is needed by maternity services in order to provide high quality individualised care to all disabled women.  This must include ensuring that all women are given all the information they require to make decisions about their care, in a way that respects their own knowledge about their bodies.”

Professor Vanora Hundley said: “The National Maternity Review, Better Births, highlighted the importance of personalised maternity care that focuses on the needs of the woman and her family. Good communication is a key to achieving woman centred care, and our findings suggest that this remains a particular challenge for women who have a disability.”

Dr Bethan Collins added: “The findings highlight the importance of communication: service providers need to both respect women’s knowledge of their own bodies while also providing the expert support to enable women to make informed decisions about their care.

“Continuity of carer was so important to many of the women, but does not seem to be common practice. As a researcher and as a disabled parent myself, I empathise with the experiences of women in our study. There is a job to do to raise awareness of disability and enable women to have a dignified experience.”

The research suggests that maternity services need to adapt to provide high quality individualised care to all disabled women. This includes improving both attitudes and knowledge of disability and disabled women among maternity professionals, ensuring all disabled women receive continuity of carer, allowing additional time for disabled women to discuss their needs, preferences and choices, auditing access and ensuring that reasonable adjustments as required under the Equality Act 2010 are made available.

The research was conducted by Jenny Hall, Jillian Ireland and Professor Vanora Hundley at Bournemouth University and Dr Bethan Collins, Senior Lecturer in Occupational Therapy at the University of Liverpool.

With thanks to the Matrix Causes Fund for supporting this work.

Home birth – what are a Trust’s responsibilities towards midwives and women?

What are the responsibilities of midwives to care for women who have requested a home birth? And how can Trusts best support these responsibilities?

Midwives owe the women they care for a legal ‘duty of care’. They are obliged by the NMC Code to ‘put the interests of people using midwifery services first’ and to ‘make their care and safety [their] main concern’. Under human rights law, all Trusts and their employees are obliged to respect women’s decisions in childbirth and cannot compel a woman to receive care in a hospital.

If a woman has stated her preference for a home birth and informs the NHS Trust or home birth team that she is in labour, the woman can expect the midwife to attend her at home. Trusts that prevent midwives from attending a home birth for a woman under their care present their midwives with a difficult dilemma – to defy their employer and put the woman first, or obey their employer and neglect their duty of care. If a midwife does not attend a woman, and the woman or her baby die, there is a real risk that the Trust could have breached the right to life (Article 2 of the European Convention on Human Rights).

In recent weeks, a small number of Trust home birth policies have been brought to our attention, which have suggested that a home birth will only be offered if women agree to any interventions or examinations midwives propose, and in some cases that midwives should leave the labouring woman should their “offer” of an examination or intervention be declined. Legally speaking, women at home have as much right to decline an intervention or examination as in any other birth setting. And making a home birth conditional on this “agreement”, or threatening to leave constitutes bullying and it is very likely to be an unlawful interference in a woman’s right to make decisions in childbirth. If she were to consent to an intervention as a consequence of a threat to withdraw support for her home birth or abandon her care, her consent may not be valid, and the midwife could be liable for criminal assault/battery.

Some Trusts will argue that these policies are designed to protect their midwives from being put in a difficult position and a particular concern has been raised about situations where midwives are asked to wait outside the room while a woman is in labour. It is important to distinguish between a couple who asks for some time alone in labour, and asking a midwife to remain outside of the room for the duration of labour and birth and only be on hand in an emergency. If a woman makes the latter request, it may indicate a lack of trust for the midwife, which will not be assisted by a blanket policy prohibiting the midwife from providing care in those circumstances. Relationship building and individualised care planning are much more likely to lead to safe and positive outcomes.

Midwives are also under a duty not to exceed their scope of practice and their experience. Trusts should be open with women about any concerns they have about their staffs’ expertise to attend more complicated births, whether at home or in hospital. This conversation needs to be managed with sensitivity and while risks must be carefully explained and contextualised, the woman must not be threatened or pressured to accept any particular course of treatment.

Whilst dealing with a home birth that doesn’t go to plan can be stressful for the midwives involved, it is women who ultimately bear responsibility for their own informed decisions. Midwives who give women the best available evidence about a recommended course of action and any reasonable alternatives, document their explanation and discussion and then support a women’s informed decision to decline are upholding professional standards and their human rights obligations, and have nothing to fear from lawyers or regulators.

Finally, as NHS resources become more stretched, home birth services are too often cut back by Trusts. While Trusts may rely on staffing shortages for failing to send midwives to a home birth they should only do so if there is a genuine and unforeseen staffing shortage. If they are withdrawing the service on a regular basis, they can be expected to make alternative arrangements. In a recent case, the NHS Ombudsman accepted that an NHS Trust that refused to make contingency plans after it suspended its home birth services was acting unreasonably.

Trusts’ home birth policies should be based on respect for women’s informed decisions. Any policy that makes care conditional on acceptance of interventions, or threatens suspension of the service due to staffing shortages, does not respect women’s right to make informed decision, fails to put their interests first and risks their safety.

Our email advice service (info@birthrights.org.uk) is available to any woman who feels she is not receiving respectful maternity care and any healthcare professional who is concerned that they are being prevented from delivering respectful maternity care.

 

Letter to Shropshire CCG about permanent closure of Midwifery Led Units in Shropshire

On 7th December, we wrote to Shropshire Clinical Commissioning Group to express our strong concern over the recent decision to permanently close three Freestanding Midwifery Led Units in Oswestry, Bridgnorth and Ludlow.

After the units were shut on a temporary basis last summer, we wrote to the CEO of Shrewsbury and Telford NHS Trust reminding him that the closure of the units ran contrary to national policy, most recently confirmed by “Better Births” to offer women the full range of choices in terms of place of birth and to increase the number of births taking place in midwifery-led settings in line with women’s wishes. We also advised them that choice of place of birth falls within the right to respect for private and family life conferred by Article 8 of the European Convention of Human Rights/Human Rights Act 1998.

In his response dated 4th August 2017, Trust CEO Simon Wright claimed that the temporary closures were caused by short and long term staff sickness. It is therefore very disappointing to hear that the CCG have come to a decision to permanently close the units.

You can read our most recent letter, dated 7th December 2017 here.

Recruiting for New Legal Professional Trustee

Birthrights are recruiting for a new trustee from the legal profession. The role offers an exciting opportunity for a lawyer to get involved in our cutting edge work on women’s reproductive rights and bring further legal experience to our board providing invaluable advice and support for the work that Birthrights does.

Download the role description here for more information. Closing date for applications is 29 November 2017.