Before we speak for women about birth, can we listen to what it means to them?

Imagine being pregnant and hoping to give birth with as little intervention as possible. You have thought about it carefully. You know that circumstances can change. You want skilled people around you who will recognise when you or your baby needs help. You also hope to have the opportunity to move, find your own rhythm and discover what your body can do.

Then you hear a former health secretary say that “‘normal birth’ ideology is killing babies”.

How might that feel? Would you feel comfortable explaining what you hoped for at your next appointment? Would you wonder whether wanting a physiological birth made you irresponsible? Would you begin to feel that your wishes were something you needed to defend?

This is why the language used by people with influence matters. Jeremy Hunt’s headline carries political weight. It helps shape how birth is understood by the public and how women may feel about their own choices.

Having supported women as a doula since 2002, I find myself thinking about everything that can be lost when a conversation about birth becomes so narrow.

There is a woman inside this conversation

A woman arrives at birth with a lifetime of experiences. She may feel comfortable in her body or have spent years feeling disappointed by it. She may have experienced abuse, pregnancy loss, fertility treatment or a previous birth that left her frightened. She may be looking forward to labour. She may be quietly terrified.

Her hopes will have been shaped by things we cannot know unless we ask. For some women, the opportunity to give birth physiologically carries deep personal meaning. They want to experience labour unfolding, to respond to their body and to feel supported through something demanding and unfamiliar.

There can be an extraordinary sense of strength in that experience. A woman may feel astonished by herself. She may discover confidence she had not expected, or feel a new tenderness towards a body she has previously struggled to trust. Those feelings deserve space.

We understand that other physical experiences can change how people see themselves. We listen when someone describes what it meant to climb a mountain or regain movement after illness. We recognise the significance of discovering a capacity they had not known they possessed.

I would like us to offer women that same understanding when they speak about birth.

They should be able to describe a positive physiological birth without feeling they must apologise for valuing it.

Who has the power to shape the story?

Jeremy Hunt and James Titcombe work together through Patient Safety Watch, where Hunt is chairman and Titcombe is chief executive. The February 2026 parliamentary register also lists Hunt as chair of the Patient Safety All-Party Parliamentary Group and Titcombe as its public enquiry contact. They have established routes into political and professional discussions about healthcare.

Titcombe’s son Joshua died following failures in care. His loss deserves compassion and the failures that led to it deserve scrutiny. Families have had to fight for answers that should have been given openly and their persistence has exposed serious harm. We can recognise that contribution while questioning the conclusions drawn from it.

I am troubled by how much authority two prominent men can have in defining a conversation about women’s bodies, particularly when women’s positive experiences receive so little attention within that framing.

Men have an important contribution to make as fathers, clinicians, researchers and policymakers. With that contribution comes a responsibility to listen beyond the experiences that have shaped their own understanding.

Hunt and Titcombe will never experience pregnancy, labour or birth in their own bodies. They can witness it, study it and be profoundly affected by it, while their understanding of what it feels like for a woman will always depend on listening to women themselves.

They cannot personally know what it means to feel a baby moving inside them, to approach birth carrying memories of what has happened to their body before or to discover an unexpected sense of strength as labour unfolds. They will never have to live in that body afterwards, with its tenderness, injuries, recovery and memories. These experiences are intimate and their meaning differs from one woman to another.

That places a particular responsibility on men who have the power to shape maternity policy. They need to remain curious about experiences they cannot have themselves, including those that sit uneasily with the conclusions they have already reached. A woman who describes physiological birth as joyful, healing or deeply strengthening deserves to have her account taken seriously. So does a woman who describes fear, injury or relief that medical help was available.

When two influential men repeatedly frame the conversation around the dangers of “normal birth”, I want to know how much room they are making for women to explain why it matters to them. How willing are they to allow those accounts to change their thinking?

Women have spent generations having the meaning of their bodily experiences explained to them by people with greater authority. We should be able to expect those shaping maternity care to recognise the limits of their own understanding and give women meaningful power over decisions they will live with for the rest of their lives.

Political access and a public platform bring considerable power. A woman preparing for her first birth has far less opportunity to influence the language being used about her.

Yet she is the person who will live with the experience.

What a positive birth can give a woman

We often discuss birth in terms of what might go wrong. Women need honest information about those possibilities. They also deserve to hear what may go well and why that can matter.

A positive birth can leave a woman feeling that she was capable, respected and supported. She may remember being frightened and finding her way through with help. She may remember the reassurance of familiar voices, the freedom to change position or the moment she realised her baby was coming. For some women, those memories become a source of strength during the uncertainty of early motherhood.

There is something worth paying attention to when a woman says, “I didn’t know I could do that.” We need to be interested in what she has discovered about herself and what that discovery means to her. She may carry it into the first difficult nights with her baby. She may draw on it when she feels uncertain or overwhelmed. She may find herself looking at her body with greater appreciation after years of criticism.

These are possibilities that women describe. They deserve to be heard without being turned into an expectation that every woman should feel the same.

For other women, a positive experience involves choosing a caesarean, receiving an epidural or feeling fully involved when the plan changes. A physiological birth can be distressing and a medically assisted birth can be deeply affirming. The meaning belongs to the woman.

What concerns me is how easily we dismiss the particular value some women find in physiological birth. Their accounts are part of the knowledge we need when designing maternity care.

The World Health Organization recognises a positive childbirth experience as an important outcome. Its guidance includes psychological safety, kind and competent care, continuous support and involvement in decisions. It also recognises the value many women place on physiological labour and birth, alongside achievement and control, including when interventions are needed or wanted.

Women’s experience deserves that seriousness.

There is evidence behind supporting physiological birth

Physiological birth generally describes labour beginning spontaneously and progressing towards vaginal birth through the body’s own processes. Supporting those processes requires skill. It involves observing, listening, assessing and responding, with access to additional care when needed.

The Birthplace in England study followed more than 64,000 women with low-risk pregnancies. Women planning birth in midwifery units experienced fewer interventions than those planning birth in obstetric units, without a statistically significant difference in the study’s combined measure of serious outcomes for babies. Women who transferred remained within their original planned birth group, so access to obstetric care formed part of the service being studied.

NICE’s guidance gives these findings practical meaning. Among low-risk women having their first baby, its tables show approximately 813 spontaneous vaginal births per 1,000 planned births in freestanding midwifery units, compared with 688 in obstetric units. Unplanned caesareans and episiotomies were also less frequent. The combined measure of serious medical problems for babies was approximately five per 1,000 in both settings.

NICE also identifies a small additional risk of serious problems for babies when low-risk first births are planned at home, estimated at around four additional cases per 1,000 compared with other settings. Women deserve to have that information when considering their options.

These figures concern particular groups and planned birth settings. They cannot promise an individual outcome or isolate the effect of physiology from every other aspect of care. They do give us substantial grounds for protecting services where physiological birth is supported alongside assessment and access to treatment.

Recovery continues after everyone else has gone home

When we discuss interventions, we need to follow the woman beyond the delivery room. There is the first night at home. Getting out of bed to reach a crying baby. Finding a comfortable feeding position. Going to the toilet. Managing stairs. Trying to rest while another child needs attention.

A straightforward vaginal birth usually allows faster recovery and a shorter hospital stay than caesarean birth. Avoiding surgery also avoids an abdominal wound and surgical complications such as wound infection or internal adhesions. RCOG estimates infection following planned caesarean birth at between two and seven women in every 100. For a woman with limited help, differences in mobility and comfort may have considerable consequences.

There can also be implications for future pregnancies. Caesarean scars increase the risk of placenta accreta and affect decisions about subsequent labour, with some risks increasing after repeated operations. Vaginal birth carries risks too, including perineal injury and pelvic floor problems, while planned caesarean reduces some of those risks.

Each woman needs an individual discussion that takes her circumstances and preferences seriously. These are decisions about a woman’s body and the life she will be living afterwards. She deserves support with her recovery however she gives birth. She also deserves an honest discussion beforehand about what that recovery may involve.

Babies benefit from attention to physiology

The circumstances of birth also matter to babies. A Danish cohort study involving more than 34,000 babies found higher odds of respiratory problems following planned caesarean before labour than following intended vaginal birth. The association was strongest at earlier gestations and remained detectable at 39 weeks. Because the study was observational, it cannot establish that mode of birth alone caused the difference.

Early contact deserves attention too. A 2025 Cochrane review involving 7,290 mother–baby pairs found that immediate or early skin-to-skin contact probably improves exclusive breastfeeding and supports newborn temperature and blood glucose regulation. The review supports this care following vaginal or caesarean birth when mother and baby are well enough.

Understanding physiology helps us protect these opportunities across different birth circumstances. It also encourages us to ask whether routine practices are helping a mother and baby and whether there is a good reason to interrupt their early time together.

Women need people who have time to care

A frightened woman needs someone with the time to hear what she is frightened of. A woman whose labour is changing needs someone who notices and responds. A woman facing an unexpected decision needs an explanation she can understand. Relationships and attention are part of good maternity care.

A 2024 Cochrane review found that midwife continuity of care probably increased spontaneous vaginal birth from around 66% to 70% and reduced caesarean birth from around 16% to 15%. Women generally reported more positive experiences. Effects on rare outcomes such as neonatal death remained uncertain.

A separate Cochrane review, including trials involving more than 15,000 women, found that continuous labour support may increase spontaneous vaginal birth and reduce caesareans, assisted births and negative feelings about the experience. The evidence was generally of low certainty, but it supports taking the human relationships around a woman seriously.

As a doula, I know how much attention women can need when they are feeling vulnerable. Sometimes a concern comes out slowly. Sometimes a woman needs to ask the same question again because she was frightened when the answer was first given. Sometimes she needs someone to notice that she has gone quiet. Care needs enough time and continuity for those things to be recognised.

I would like to hear these findings discussed with the same political attention given to claims about ideology.

We owe families careful explanations

Serious failures in maternity care have caused devastating harm. The Morecambe Bay investigation identified unsafe pursuit of natural childbirth among several failures at Furness General Hospital. It also identified deficient clinical skills, poor risk assessment, dysfunctional professional relationships and repeated failures to investigate incidents properly. Families deserve an understanding of what happened that is detailed enough to produce meaningful change.

In July 2026, Baroness Amos told Parliament that her national investigation had been unable to establish the national prevalence of “normal birth ideology”. Her team acknowledged delays in necessary intervention and described problems involving recognition, escalation, staffing and access to medical review. They also heard from women who felt encouraged towards intervention when they wanted vaginal births.

That finding does not mean unsafe beliefs have never influenced care. It means a broad national claim requires evidence that establishes its reach and its role.

The causes matter. We need to know whether a woman’s care failed because a concern was dismissed, a complication was missed, a doctor was unavailable or a necessary intervention was deliberately resisted. Each requires an effective response. A familiar explanation should never become so comfortable that we stop looking closely at what happened.

Can we make room for the whole woman?

I would like Jeremy Hunt and James Titcombe to listen publicly to women who describe physiological birth as a source of strength and to engage fully with the evidence supporting it.

I would like them to consider the woman who reads their words while pregnant and wonders whether she can still speak openly about her hopes.

I would like their influence to help secure skilled staff, continuity, timely treatment and services that offer women meaningful choices.

Women’s experiences are varied. They include grief, fear, relief, joy and pride, sometimes within the same birth. We need a conversation spacious enough to hear all of that.

A woman should be able to ask for a caesarean and have her reasons heard. She should be able to ask for support with physiological birth and receive the same respect.

She may be carrying hopes she finds difficult to explain. Someone needs to make time to ask, then stay long enough to understand the answer.

Before deciding what women should value about birth, those with the greatest influence need to hear what women already value, what they fear losing and what they need from the people caring for them.

The woman giving birth deserves to recognise herself in the conversation.

References

1. Hunt, J. (2025). ‘Normal birth’ ideology is killing babies. Published on 10 November 2025, following publication in The Sunday Times on 9 November.https://www.jeremyhunt.org/news/normal-birth-ideology-killing-babies

2. Patient Safety Watch. Our team. Details of Jeremy Hunt’s and James Titcombe’s roles.https://www.patient-safety-watch.com/ourteam

3. UK Parliament (2026). Register of All-Party Parliamentary Groups: Patient Safety. Register dated 23 February 2026.https://publications.parliament.uk/pa/cm/cmallparty/260223/patient-safety.htm

4. World Health Organization (2018). WHO recommendations: Intrapartum care for a positive childbirth experience. Executive summary.https://www.ncbi.nlm.nih.gov/books/NBK513802/

5. Birthplace in England Collaborative Group (2011). Perinatal and maternal outcomes by planned place of birth for healthy women with low risk pregnancies: the Birthplace in England national prospective cohort study. BMJ, 343, d7400.https://www.bmj.com/content/343/bmj.d7400

6. National Institute for Health and Care Excellence. Intrapartum care: NICE guideline NG235. See section 1.3, “Planning place of birth”, including tables comparing interventions and outcomes by planned birth setting.https://www.nice.org.uk/guidance/ng235/chapter/Recommendations

7. Royal College of Obstetricians and Gynaecologists. Considering a caesarean birth. Patient information covering benefits, risks, recovery and implications for future pregnancies.https://www.rcog.org.uk/for-the-public/browse-our-patient-information/considering-a-caesarean-birth/

8. Risk of respiratory morbidity in term infants delivered by elective caesarean section: cohort study (2008). BMJ, 336, 85–87.https://www.bmj.com/content/336/7635/85

9. Moore, E. R. and colleagues (2025). Immediate or early skin-to-skin contact for mothers and their healthy newborn infants. Cochrane Database of Systematic Reviews, CD003519.https://doi.org/10.1002/14651858.CD003519.pub5

10. Sandall, J. and colleagues (2024). Midwife continuity of care models versus other models of care for childbearing women. Cochrane Database of Systematic Reviews, CD004667.https://doi.org/10.1002/14651858.CD004667.pub6

11. Cochrane (2017). Continuous support for women during childbirth. Review summary and findings.https://www.cochrane.org/evidence/CD003766_continuous-support-women-during-childbirth

12. Morecambe Bay Investigation (2015). The report of the Morecambe Bay Investigation. Published on 3 March 2015.https://www.gov.uk/government/publications/morecambe-bay-investigation-report

13. House of Commons Health and Social Care Committee (2026). Oral evidence: Maternity Reviews, HC 525. Evidence session held on 15 July 2026. See questions 25–32 for discussion of “normal birth ideology”, intervention and the findings of the Amos investigation.https://committees.parliament.uk/oralevidence/17971/html/