While this has been vigorously taken up in Third World countries it has largely been ignored in the developed world. Yet developed countries need midwives too. Unfortunately the majority of countries in the developed world have maternity care dominated by doctors and as a result have seen an epidemic of caesarean sections and operative deliveries with no corresponding improvement in outcomes. Indeed, judging from our case files the outcomes are far worse, but while maternal morbidity is largely ignored and unreported it will continue to be nearly impossible to change this domination. No longer can women expect to be cared for by a midwife they know throughout their labour, instead they are attached to fetal heart monitors or epidurals and left, with their partners, to get on with it.
Many midwives are in despair about the sub-standard care they are forced to offer.
Women are unaware that many of the interventions to which they are routinely subjected are often undertaken because the staff cannot cope with a woman who is slowly and gently labouring at her own pace. They need not worry. If the woman in hospital does not conform to the timetable she will have a forceps, ventouse or caesarean section and then be further conned into believing that it was all for the best because her body did not function properly and could even have presented a danger to her baby. Some interventions can be lifesavers for the few women and babies who really need them, ironically, those women who most need obstetric care occasionally do not get it because the medical staff are busy involving themselves in labours of women who had no problems until they arrived at the obstetric unit. Repeated studies have revealed women's needs.