There has been much interest in the fact that the Royal College of Midwives (RCM) is no longer running its Campaign for Normal Birth. After 12 years of focusing on “normal birth”, the end of the campaign is not a kneejerk reaction to a specific event, but rather a natural progression. In any organisation – commercial or public – campaigns need to be revitalised and adjusted to serve a changing social and cultural environment.
It is also not a recent change as the Better Births Initiative had already succeeded the Campaign for Normal Birth in 2014. However, the RCM did not remove all references to the campaign from the website until May this year.
One key question is why the campaign was necessary in the first place. While appropriate interventions save lives, there is considerable evidence that too many women are having unnecessary interventions in childbirth. The consequence is disparities in care, with very high rates of intervention in some countries while in others women cannot get the interventions they need. For example, the caesarean section rate in urban Brazil exceeds WHO recommendations, but in others, such as rural Nepal, too few women can access this life-saving procedure.
So what do we mean by a “normal” birth and who gets to decide what normal is? Normal is a socially constructed concept and therefore will be interpreted differently depending on the context. Normal can be seen as cultural – how a specific culture expects a person to…