As the party conference season draws to a close, the International Stillbirth Alliance has also concluded its far less well-publicised annual meeting in Birmingham. There, Professor Jason Gardosi presented the grim results of a 10-year study: 25% of each year's average 4,000 stillbirths are thought to be the result of overwork and/or understaffing.
This is on the back of a leaked report last week showing £4.5bn worth of outstanding negligence claims against the health service relating to childbirth, three-quarters of which were for children who had developed cerebral palsy as a result of oxygen starvation during labour. This, likewise, has been attributed to a lack of experienced staff. These findings may be new, but they are only revelatory in terms of scale. Midwives and doctors have been saying since the beginning of this government's tenure that shortages were putting lives at risk.
When in 2001 Naomi Wolf published her book Misconceptions: Truth, Lies and the Unexpected on the Journey to Motherhood, she remarked that only when you got on the maternity conveyor belt did you truly know how the medical profession saw women, specifically "its telling, subtle but distinctive lack of compassion". This simply isn't borne out by comparison with other areas of female medicine - women, if anything, get the lion's share of medicalised compassion.
Female cancers, for instance, are much better resourced than male and unisex ones, and as a result have better survival rates. Furthermore, for all the idiocy distributed throughout the media about what constitutes a "women's issue" (Child-rearing? Really?), at the coalface of obstetrics the professionals seem fairly cognisant of the fact that babies come out both male and female. However, there are features of medical negligence that are specific to the maternity landscape. And if it's not misogyny, what is it?
It is undisputed, now, that understaffing costs lives. Amazingly, according to Save the Children findings in 2006, the UK isn't even in the top 10 for a newborn's chances of survival. (We are at 26, below many countries that are much poorer than us, and yet are capable of prioritising their public spending in a humane and meaningful way.) This isn't like the debate over Herceptin or Aricept: nobody is quibbling over the effectiveness of proper staffing. The government is simply not paying for it. Why not?
The first is straightforward New Labour blarney, in the form of "initiatives": in April Patricia Hewitt, the then health secretary, says all women can have a home birth by 2009; the professionals respond that there aren't enough staff for the service as it stands, let alone for such a promise; and Hewitt comes back with some smoke-and-mirrors nonsense about how "high-quality services that support genuine choice must not be the sole preserve of the articulate middle classes", when nobody for a minute suggested they should be.
The argument gets boring, Hewitt is shunted off and, by the time conference comes around, there's a different health secretary. The agenda has shifted to some Brown-Thatcherite vision of super-clean walk-in clinics where decent people with jobs can get their ears syringed on demand. Apart from "they lie, they lie, they lie", the other thing to remember about politicians is that they have the attention span of gnats.
The second problem is atmospheric - people talk about how maternity has been "medicalised" when it's the most natural thing in the world. A lot of functional sloppiness slips in under the parapet of this back-to-nature feel-goodery. There is immoderate weight given to new-age National Childbirth Trust notions of how labour pains are "good" pains and anaesthesia is for sissies. Well, sure it's natural, but it's also incredibly dangerous. And, sure, women did it before epidurals, but cancer sufferers died before we discovered morphine.
Third, women are so ceaselessly bombarded by the myriad ways in which they have failed their unborn babies - with poor diets, stress levels, moderate drinking, insufficient vitamin intake, passive smoking, active smoking, excessive intake of Rennies (seriously) - that we have lost our pioneering spirit and impetus to act collectively.
In the absence of a ready solution to the nature of politics, and with a grudging respect for the feel-goodery because every now and then it's true, we should be concentrating on collective action. Frankly, instead of sitting at home reading the back of the aspirin packets and Googling "brie + birth defect", instead of filing lawsuits, we should be campaigning against these unnecessary deaths. The problems may be systemic, but they are also very simple.
