This morning's big health story is the latest Healthcare Commission report. Towards Better Births looks at maternity services and the news is not good. It suggests that there is a lack of choice around how and where a woman can give birth, a lack of beds and a lack of staff.
This report follows on from a King's Fund paper in February, which itself came hot on the heels of an earlier Healthcare Commission review. Both were rather negative (the review presumably provided the basis for today's report).
All this hoo-ha reminded me of article by Rowan Pelling, published in the Independent. This was early last year and speaks of a "midwife crisis". The article refers to a programme Ms Pelling made on this same topic back in 2004, when the view was no rosier.
Also in early 2007 the BBC ran a story on choice, reminding us that the government pledged in 2005 to offer choice to all expectant mums on place of birth (home, midwife-led unit or hospital) by 2009.
It is not just services during birth that are being criticised. Last March the National Childbirth Trust said there was a lack of support for pregnant women and new mothers.
I've mentioned CEMACH before. This organisation (the Confidential Enquiry into Maternal and Child Health) produces regular statistical reports on maternal deaths and perinatal mortality.
UNICEF has some comparative figures (from the early 1990s) on maternal deaths worldwide. The UK is shown as having 9 maternal deaths for every 100,000 live births. This compares with just 7 deaths in Sweden and Spain, and 6 in Switzerland and Norway. The other end of the scale in Europe shows 130 deaths in Romania. In the rest of the world Sierra Leone is at the bottom of this league with 1300 deaths - ten times the Romanian figure.
For more information on pregnancy care there is the Royal College of Midwives, the Royal College of Obstetricians and the NLH's Women's Health library.
Campaigning organisations include One Woman, One Midwife and the Independent Midwives Association. The anthropologist and campaigner Sheila Kitzinger also has a website. NHS careers has information on the varied role of midwives - a lot more to it than attending births!
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