An overriding theme when conducting focus groups with English mothers about their traumatic childbirths was that while it was socially accepted to complain about their individual childbirth or an individual healthcare worker’s behaviour, it was generally frowned upon to complain about the National Health Service (NHS). In general, many mothers began their childbirth stories with a general statement or disclaimer, which highlighted their appreciation of the NHS. Then they would express concern about the ‘overburdened’ and ‘overworked’ NHS. In fact, some mothers even highlighted how they refrained from complaining or taking their claim to court, as they did not want to be ‘an additional burden’ on the NHS, or a drain on the NHS. For example, an English mother, Rose, did not want to bring her claim to court despite her son’s brain damage resulting from complications during childbirth. She recalled,
When I arrived at hospital, I was examined and found to be nine cm dilated. I was immediately hooked up to a monitor. At this stage a wonderful midwife was on duty at the hospital - but she was just going off shift - thought something was amiss with my son. They subsequently discovered he was an undiagnosed breech - it turned out that when the previous midwife was saying I wasn't dilated at all, they were actually putting their fingers up my son's bottom and thinking it was my cervix. The Obstetrician was bleeped. They explained my son was breech, but that the Obstetrician on duty was very experienced in breech deliveries and they felt they could deliver him safely vaginally. I was given an epidural and gas and air and out into stirrups in the bed. Foetal and maternal monitoring showed us both to be tachycardic. My son evacuated his meconium in utero. Within a very short time, I was fully dilated, and we were trying to deliver him.
Somewhere between 8.30 and 10pm, my contractions stopped, and people started to get concerned about the heart beat and decelerations. I had an audience of about five to six people between my legs at any one time. Something I as unable to do anything about because my feet were in stirrups. The obstetrician did some kind of oxygenation blood test and said I had about ten minutes of pushing left before they would have to take me to theatre. In any event, we called it and went to theatre straight away for an emergency caesarean. My son was born in theatre - after some violent pulling around because his head was wedged under my ribcage - at 10.40pm. They struggled to get him out and he wasn't breathing on his own when he was born. A paediatrician was called to resuscitate my son and after what seemed like forever but was probably only about 15 minutes - they got him breathing and I saw him for the first time. He didn't go to PICU…..And we only found out months later that he was brain damaged – cerebral palsy.
There are many unexpected expenses, and it would have been good with more support. Financial and emotional support. However, my husband and I we are civil servants interested in the common good, not being a financial drain on the NHS.
The mother described that the trauma did not end with her traumatic experience during childbirth but continued afterwards as she felt it was almost impossible to get the emotional, practical, and financial support needed for herself and her son. She would have potentially received financial support if she had taken her negligence claim to court but decided not to as she did not want to be a financial drain on the NHS.
Several of the English mothers in this research study seemed to have felt that it was almost too taboo to complain due to the near ‘sacred’ status of the NHS. The Canadian mother, Claire, for example, who criticised her midwife for failing to treat her UTI - proceeded to tell the focus group that when she passes the local hospital, she always flicks her finger and says, “Fuck you NHS.” However, instead of a sense of condonement among the English mothers, their facial expressions revealed upset/disgust/contempt, towards the ‘crass’ Canadian mother for her breaking the taboo and criticising the NHS. The term taboo itself is of Polynesian origin and was noted by Captain James Cook during his visit to Tonga in 1771, as the prohibition of an action based on the belief that such behaviour is either too sacred or too dangerous for ordinary individuals to undertake. The prohibition that is inherent in a taboo includes the idea that its breach or defiance will be followed by misfortune for the offender, such as lack of success in hunting or fishing, sickness, miscarriage, or death. In some cases, particular rules are the only way to avoid this danger, such as rules against fishing or picking fruit at certain seasons and against walking or traveling in certain areas (Steiner, 1956). Douglas (1966) highlighted that the notion of taboo is found in all societies, as all societies have different ideas about what constitutes taboo. Taboo, as rules of behaviour, are always part of a whole social system and should be analysed within their social context.
Melanie Phillips has stated that “the NHS sacred cow must be put out of its misery” but politicians remain reluctant to reform the NHS (Phillips, 2022). In fact, the British politician Nigel Lawson has famously stated that the NHS is the closest thing the English people have to a religion (Toynbee, 2018) which was clearly illustrated during the opening ceremony of the 2012 London Olympics. Numerous actors were dressed up as medical doctors danced around to swing music and hospital beds were arranged to spell out the letters N-H-S (Frayer, 2018) and as pictured below, a grand show of midwives among hospital beds and a sculpture of a giant baby.
This continued throughout the covid-19 pandemic as various events were organised to celebrate and show appreciation towards the NHS, such as the ‘clap for the NHS’ and children all over the country drawing rainbows to show appreciation towards the NHS (Mathers, 2020). The strong public sentiment towards the NHS has been clearly expressed by the former Prime Minister Tony Blair, who stated,
The Conservatives don't understand why we created the health service. They don't understand it. The health service to me is a living, breathing symbol of what a decent, civilised society should mean in practice, helping people on the basis of their need not on the basis of their wealth. (Pearce, 2001, p.215).
Several of the English mothers interviewed seemed to express a similar sentiment and despite any of their individual negative childbirth experiences, they seemed to perceive the NHS itself as a symbol of healthcare for all, as well as a cornerstone of a fair and equal society, hence, it was too taboo to complain about their traumatic childbirth within the context of NHS.
