After 15 years of offering personal care to mothers-to-be in deprived areas, the Deptford-born Albany midwives practice has been forced to close.
The emails are bouncing back. The answering machine is on autocue. The website still talks of midwives who are on call for women 24 hours a day, seven days a week; but today, the mothers-to-be of Peckham and Camberwell will have to go elsewhere.
Kings College Hospital have brought their historic contract with the Albany Midwifery Practice – the first, and only group, of independent midwives to offer continuous, personalised care to women via the NHS – to an untimely end.
Exactly why remains under dispute; in a statement, King’s College Hospital said they terminated their contract with the Albany for patient safety reasons, and that the hospital believes strongly in giving women the right to choose a home-birth, but the methodology of the review that prompted Kings’ decision have been contested by midwives across the board . Amidst this furore, however, one thing remains indisputable: the quality of care the Albany brought to midwifery will not be easily forgotten.
“You cannot appreciate how incredible it is until you’ve experienced pregnancy with them. I can’t imagine giving birth without that level of support.” Eilidh Morgan’s son was delivered in August, 2001. Eilidh can still remember the name of the midwife who delivered him, and the warm friendship that led to her having two more ‘Albany babies’ the following year: Maisy, a little girl who tragically passed away before she was born – “the difference in being able to have a home birth – to have my daughter at home for a few hours – it helped enormously” – and Fergus, the little boy whose gurgles echo down the phoneline as we chat.
They are just three of over 9, 000 children who have been delivered by the practice since its own beginnings in Deptford 15 years ago. Writing in the Midwifery Digest, founding member Becky Reid describes how, in the early 1990s, a group of six midwives working in south-east London began dreaming a dream – that the “choice, control and continuity of care” offered by independent practitioners might be available to women free of charge within the NHS.
What made this vision so revolutionary was not the method itself – well-off women have of course been commissioning their own personal midwives for hundreds of years – but the place; a run-down health centre situated in one of the most deprived and unhealthy areas in the country.
The significance of this cannot be overestimated, according to Salford’s Senior Lecturer in Midwifery, Sarah Davies. “The women in these deprived areas have some of the highest risk of perinatal mortality in Britain – yet the actual mortality rates in the Albany practice are extraordinarily low.”
Their good work continued when financial difficulties led to them moving to Peckham to form a sub-contract with Kings Hospital: a mortality rate of 11.49/1000 in Southwark borough compares with only 4/1000 for children born under Albany’s care. At the Albany breast-feeding is more popular, the popularity of home births is unprecedented, and the number of cesarean sections has fallen by over 50 per cent since the service began.
“It’s interesting that the Albany have been forced out on grounds of health when copious amounts of research shows that it is much safer and much cheaper and everyone involved is much happier,” says Emma Beamish, second time Albany mother and chief spokeswoman for the 700-strong ‘Albany Mums’ movement.
Off the record, another mum is more outspoken about Kings’ motives: “I can’t imagine an obstetrician taking kindly to giving advice to a patient only to have her turn round and say, ‘well, actually, my midwife says this and that’s what I’m going to do.'”
Her comments echo the assertions of Sarah Davies and the Association for Improvements in the Maternity Services (AIMS) chair Beverly Beech that the question of independent midwifery is ultimately the old feminist chestnut of ‘power, and control’.
‘Empowered woman threaten all kinds of professions. Albany empowers woman. That was the problem’, explains Davies. If that is true, as indeed woman from the Royal College of Midwives to the ex-health minister Baroness Cumberledge are suggesting, then Kings College Hospital have seriously underestimated their opponents.
The Albany Midwives have been self-employed and self-managed for over 15 years. They have supported thousands of pregnant women, and their children, in what is one of the most deprived inner-city areas in the developed world – and they have done so in such a caring, dedicated way that their model has become the blueprint for reforms aimed at addressing the national crisis facing maternity care.
“Midwives leave for a variety of reasons and one of them is the system in which they work – they don’t feel they can provide good care for women,” says Eleanor May Johnson, an independent midwife who chose not to work in the NHS for fear of the centralised and impersonal “baby factory” conditions in which she would have to practice. She wants to see Albany-style practices contracted through Primary Care Trusts rather than hospitals, and, like the Albany mums the National Childbirth Trust, AIMS and the Royal College, she wants to see it nationwide.
“Ever since we started campaigning we’ve had groups of women around the country clamoring for an Albany,” Mrs Beamish says; many of them have been campaigning for over 30 years. It’s unlikely that they’ll win the fight against Kings – when I ring, they tell me that “their decision is final” – but really, the whole CMACE saga – the report that prompted the closure – has been outgrown.
The Albany Mums are taking their midwives national – and these ladies are not for turning.
Our very own video feature about the Albany Centre’s closure can be viewed here.
Related Source: BBC Woman’s Hour