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The NHS keeps failing pregnant women

Keep her away from the babies. (Maciek Musialek/NurPhoto via Getty Images)

April 21, 2022 - 7:45am

The deaths of pregnant women from Covid-19 were “preventable” according to a leading scientist. Professor Marian Knight, who lead investigations into at least 40 maternal Covid deaths, told Newsnight on Tuesday that pregnant women had been an “afterthought” during the pandemic. Professor Knight said that the benefits of the vaccine were not properly communicated to them.

This is not the first time in recent weeks the NHS has been found to be failing pregnant women — particularly in tailoring and explaining treatment to them. Knight’s comments follow the publication of the Ockenden report last month, looking into Obstetric services at the Shrewsbury and Telford NHS trust. The report examined nearly 1600 clinical incidents spanning the years between 2000-2019. The findings were damning, describing a paternalistic system that communicated poorly, diminished women’s concerns, and denied women choice and agency.

Women found they had natural birth pushed on them. They were not fully informed of the risks. Regardless of their wishes or the clinical situation, they were encouraged to avoid and in some cases, were even denied, caesarean sections. This practice lead to the avoidable deaths of almost 200 babies and nine mothers, with many more left traumatised, or brain damaged.

The report found that there was also a culture of blaming mothers for poor outcomes, with some women even being faulted for their own deaths. Not only that, but staff were advised not to speak out. For nearly two decades these issues were not challenged by the trust.

Then another scandal involving the NHS and pregnant women emerged. A Sunday Times investigation found that women are also continuing to be prescribed  a drug known to cause birth defects. Pregnant women are taking Sodium Valproate, with no warnings about the risks associated with it. Valproate, which is used in the treatment of epilepsy and some mood disorders has been known to cause birth defects since at least the early 1990s.

Despite this, women report being given the drug in plain packets, with no patient safety leaflets, and with no communication from their doctors about the risks of taking it in pregnancy. A government commissioned report, published in July 2020, found that the NHS had been “disjointed, siloed, unresponsive and defensive” when it came to the scandal. But it seems the practice continued regardless.

It has long been known misogyny is a major issue within the NHS. Only last year, a health minister admitted that sexism was rife in the health service, and that “women are not listened to”. The situation is often even worse when it comes to obstetric care — women can find themselves reduced to incubators, with their own wishes being viewed as an afterthought, or an inconvenience. By failing, yet again, to adequately communicate with pregnant women, and to inform them of the risks and benefits associated with treatment, the medical profession has callously stripped them of their autonomy, and has put lives at risk as a result.

It seems doubtful that these scandals will be the last when it comes to the NHS’s blemished history regarding women. What is more it remains defensive, with the Ockenden review team made to feel “fearful” for speaking out, and it is hard to see how any true change can occur when reform is so difficult. How many more scandals must the NHS endure before it accepts it needs to change the way it treats, and, fundamentally, thinks about women?


Amy Jones is an anonymous doctor who has a background in Philosophy & Bioethics.

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Jeremy Bray
Jeremy Bray
2 years ago

I complained elsewhere that there were too many articles by women about how women were affected by something that affects both men and women. I thought that at least an article about childbirth could not be accused of such a sexist focus being after all about an issue men are not directly affected by.
However, this sentence struck me: “It has long been known misogyny is a major issue within the NHS.” The source for this knowledge turned out to be an article written by the author.
I would agree that women have been failed by the NHS in their policies in connection with childbirth, but surely the problem is not that those running the NHS, which includes many women, have an ingrained prejudice and dislike of women which is what misogyny is. Perhaps she can cite some evidence of women-hating expressed by the leaders of the NHS.
The problems arise from the nature of the way the NHS is run and both men and women are failed in all sorts of ways by this.

Last edited 2 years ago by Jeremy Bray
Lindsay S
Lindsay S
2 years ago
Reply to  Jeremy Bray

Women haven’t been failed because misogyny, they’ve been failed because money. Just like everyone else who is failed by the NHS.

Johann Strauss
Johann Strauss
2 years ago
Reply to  Jeremy Bray

Well said. Indeed, the author completely ruins her argument by bringing up a complete phony issue (i.e. misogyny). In an organization where most of the employees are indeed women, where at least 50% of the doctors are women, and where the huge majority of nurses are women, it strikes me that the author is talking nonsense in regard to misogyny being the cause of what amounts to some very bad management.

Julian Pellatt
Julian Pellatt
2 years ago

“It has long been known misogyny is a major issue within the NHS … the medical profession has callously stripped them [women] of their autonomy …”
Really? What evidence (as distinct from sloppy anecdote) does the female writer supply to justify the assertion that the problems experienced by women (patients and staff) are attributable to the active dislike of women by callous men?
This notion of misogyny is now rampant in current affairs. It is distasteful, misleading and divisive. Indeed, this feminist-driven obsession is de facto evidence of a deep-rooted, expanding misandry that now prevails amongst the chattering classes.
I subscribed to Unherd to access better journalism than this silly article which reflects prejudice and stereotyping.

Last edited 2 years ago by Julian Pellatt
Julian Morgan-Jones
Julian Morgan-Jones
2 years ago

Whenever I hear the word mysogyny my heart sinks and I feel the whole of what otherwise might be a good article becomes immediately discredited. Rarely is it supported by any evidence.

It has become one of those throwaway words like terrorist, racist, homophobe or the current flavour of the time “transphobe”, that we are somehow expected to agree with as though it was obvious when it is anything but.

Last week on the BBC news it was reported that the waiting list for Gynecology had risen from 66, 2 years ago to over 24,000 today. The only reason given for this was, as articulated by the Gyne expert rolled for a 5 second opinion slot, was the ‘well known mysogyny’ of the NHS.

This was a shockingly unimaginative piece of reporting. Is there any chance shutting down all the hospitals to treat COVID patients might have had something to do with this? What about the waiting list of 66, 2 years ago? Is this also due to mysogyny or is it that the NHS has become particularly mysogynist over the last 2 years?

In the waiting list stats https://nhswaitlist.lcp.uk.com/ I tried to find what the waiting list was for male specific health issues. I couldn’t find a category for it. Is this because of anti-male discrimination or God forbid, ‘misandry’ in the NHS?

Since women make up 50% of the population and are just as capable of sinning as the rest of us, where are the articles on misandry? Can’t say I’ve seen a single one on Unherd. Happy to be put right on this, but if you do please point out the balance.

What happened to competent editorial oversight? I don’t mind robustly held differing views but allowing this kind of factually baseless commentary without challenge brings this otherwise very good publication into disrepute.

Last edited 2 years ago by Julian Morgan-Jones
Stephen Walshe
Stephen Walshe
2 years ago

The NHS needs to change the way it treats and feels about the people who rely on it. The NHS exists for the benefit of its patients, not its staff.

Francis MacGabhann
Francis MacGabhann
2 years ago
Reply to  Stephen Walshe

Once they become big enough, ALL arms of state exist for the benefit of the staff. It’s an immutable law. To some extent, the same is true in the professions, though in a somewhat mitigated form. Only in those areas where the public has direct, day-to-day control in the form of being able to pull their money from one area of the market and invest with a competitor is the service at all responsive to people’s needs. That’s not the NHS.

Doug Pingel
Doug Pingel
2 years ago
Reply to  Stephen Walshe

Who told you that? You have been misinformed, even lied to.

AC Harper
AC Harper
2 years ago
Reply to  Stephen Walshe

It’s not misogyny – it’s systemic incompetence.
I have a theory that any large organisation that doesn’t regularly replace senior managers will gradually come to be run for the benefits of the staff. The NHS is one such example, teaching another, some charities taken over by politics. Dare I say it – the BBC.
Even so there are many fine nurses and doctors, teachers, charity workers and workers in broadcast media. They just work in industries where their activities are subordinated to the ongoing comfort of the system, not their patients/students/charitable targets/audience. Which is why I say that it is systemic incompetence.

William Shaw
William Shaw
2 years ago

“Scandals in the health service reveal its underlying misogyny”
So the NHS has a hatred of women? A hatred? Really.
Ridiculous assertion.

Last edited 2 years ago by William Shaw
Dominic A
Dominic A
2 years ago

99% of midwives, and 60% of obstetricians are female – how is it that misogyny such a big problem, are there many self-hating women?
Midwives have consistently been criticised, found wanting in the various reports on poor outcomes, which one would expect as they are the main carers. I’ve heard several accounts from Drs, both male and female, and mothers, all female (!), of terrible midwifery ‘care’, and in particular an apparently misplaced attitude of superiority and competence over the Drs.

Last edited 2 years ago by Dominic A
Emma Curran
Emma Curran
2 years ago

You have to go along way to find a mother who hasn’t had a bad experience with NHS maternity services. Time and time again you hear about women having a horrible experience, intending on making a complaint and then never getting a chance to because they’re too busy raising a child, or in some cases grieving one.

What doesn’t help is the belief that a complaint will only be ignored anyway.

I find it depressing that – from the looks of the comments below – this isn’t well known in the wider world.

Lindsay S
Lindsay S
2 years ago
Reply to  Emma Curran

I never had a problem when I had my two kids but I have heard of people who have had problems with maternity services. I had issues with A&E with my son, my mum and her cancer and my Dad picked up hepatitis when he went in for a hip op. The NHS is a mess full stop and refuses to acknowledge it because it’s sick of being sued but neither does it sort itself out! The comments on here are stating that it’s not misogyny but incompetence that’s the problem!

Jeremy Bray
Jeremy Bray
2 years ago
Reply to  Emma Curran

I think you will find the facts you mention are reasonably well known. The criticism here centres on the suggestion that this is all down to the fact that those running the NHS and working in the NHS hate or despise women. On the face of it given the number of women in the service this seems highly improbable.
If you approach the problems of the NHS on the basis that by dismissing those who can be shown to hate and despise women the service will be magically transformed you will be disappointed. In any case you are unlikely to find many who hate women in general as opposed to having some inaccurate stereotypes about women in general. If you believe Misogyny is the problem you just end up spending a lot of money giving workshops to combat unconscious biases about women alongside the unconscious biases about skin colour, sex, gender etc etc which will drain the NHS of funds to actually take practical steps to improve the service.

Mike Wylde
Mike Wylde
2 years ago

The NHS lets everyone down, OK, mostly everyone. It’s not got a hatred of women so much as it hates patients in general and feels that it would work much better if there were none.It therefore treats patients as if they were an irritant rather than a customer and part owner.

Justyna Mignotte
Justyna Mignotte
2 years ago

It seems that many readers before me have an issue with the idea that NHS could be misogynistic, while consisting of many women. That this is not contradictory is rather very possible, as being a woman doesn’t exclude being a misogynist; why would it? It happens that a man hurts another man, and we don’t consider it impossible because of their sex. Women are not free from aggression, and they are not free from aggression against their own kind. There are also many interesting researches of society’s attitudes toward mothers, constituting whole branch of Humanities, called Motherhood Studies, which happens to be my personal area of interest and research. I can recommend among them “Motherhood: Manifesto” by Eliane Glaser, or “Mothers: Essay on Love and Cruelty” by Jacqueline Rose, who mention and confirm mistreatment of mothers by health care systems, among others. These are a tip of the iceberg though, as feminism produced tons of documents upon mistreatment of mothers-even by feminists themselves! For example, the so called second-wave feminism was almost whole heartedly against domestic women – and mothers- believing them to be the safeguards and perpetrators of old structures and patriarchal beliefs. The very begging of suffrage came with many questions how are modern and emancipated women supposed to be mothers. These are very complex issues that contemporary research tries to tackle, barely scratching the surface, as the society changes so fast, while mankind doesn’t. The names and adjectives might be annoying, as they came to symbolise something hard to pinpoint, but that’s why exist: to name the phenomena hard to grasp that permeate the culture. And misogyny doesn’t not exclude mistreatment of men, too, I believe. As a mother of a son, and a wife, I do care deeply about rights of men, and my opinion is that hatred against women often means mistreatment of men, too, as lack of respect towards people often doesn’t discriminate between the sexes. Someone mean and disrespectful towards people in general is likely to be against men, too. In fact, and some of my scholarly colleagues agreed with me, the so called patriarchal system does hurt men, too, as it creates a society in which lack of equal rights hurts also men of weaker positions, as the history of the mankind confirms. It’s only recent idea that men who are not on the top of the social ladder have rights, too. The author simply describes the mistreatment of mothers, and that’s her choice.

Last edited 2 years ago by Justyna Mignotte