Baby love

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!

(c) creative commons attributed

Sometimes it's hard to be a woman

Women. Despite regularly being lumped together with minority groups, we actually outnumber men. Although there are more boys born than girls, women are somehow more robust and live longer.

It's not easy being a woman, however, especially when health stories seem to suggest that if we would only behave like 1950s housewives, doing our own housework, barely touching alcohol and having babies in our twenties, we could be happier and healthier.

At least we need never be ignorant about our health as there are lots of resources dedicated to the fairer sex. Starting with patient information, NHS Choices has a whole section on gynaecology - everything from periods to STDs - and on pregnancy. The BBC's women's health site covers a range of issues from sexual health to mental health. Medline Plus ranges wide in its selection on women's health, including alcohol problems, travellers and heart health.

The National Library for Health has a separate Women's Health Specialist Library and even Bandolier has a page that collects together issues gynaecological and obstetric.

There is an Association of Chartered Physiotherapists in Women's Health (ACPWH), the Royal College of Obstetricians and Gynaecologists (RCOG) and the Royal College of Midwives, all dedicated to looking after women. (Spare a thought, please, for Midwives, who are no longer supported by their own library.)

There are resources for women's cancers. Breast cancer has its own charity, website and pink ribbon, but other websites also cover the condition. Ovarian cancer is less glam - no Kylie - and doesn't seem to have a dedicated charity. Uterine cancer also lacks a dedicated website.

There are websites for menopause (but not menarche), for pregnancy, lack of pregnancy, unwanted pregnancy and postnatal depression.

There isn't (other than breast cancer) a separate women's health section on our current awareness page. Want one? Then contact me and say so!! Journal Watch (from the NEJM) gathers together items from various journals covering women's health, while a medical librarian in the States has a blog on this topic.

It's rather disconcerting, looking at all these sites, to find that in health terms being a woman is all about sexual organs and pregnancy. You'd be forgive for thinking women didn't have kidneys, livers, legs, eyes and all the other bits that make up a human being. That's why many of the books in the library with "women's health" in the title end up in the Obs and Gynae sections, because they really do only cover what used to be coyly referred to as "women's bits" or "women's troubles." If you are dealing with a woman, and happen not to be one yourself, please remember that women are people, too.

In the interests of avoiding gender bias the next post will cover men's health!

Image (c) creative commons attributed