Julie Graham

Audit midwife lead | Women's QI everyday | Informed consent, safe birth, safe staff | 🐾🐾

[Julie Graham @JoolsGra]

So important to ensure a fully independent panel in any future review @jamesmurray_ldn

[Julie Graham @JoolsGra]

@emilyltownsend Were there any other conflicts of interest? How truly independent was the panel?

[Julie Graham @JoolsGra]

Respectfully, therefore, no evidence of a national 'ideology' amongst maternity staff. Much to do in the way of antenatal discussion/informed consent.

[BirthTrauma @BirthTrauma]

From today's Observer. This tallies with our own observations: that some women are denied interventions while others are pushed into interventions they don't want. But the fact that a particular problem isn't universal doesn't stop it being a problem.

[Julie Graham @JoolsGra]

@catherineroyuk Scrutiny, absolutely. But no pointing towards a national ideology of maternity professionals without evidence, please.

[Julie Graham @JoolsGra]

@catherineroyuk Most trusts will have regularly updated their guidelines according to evidence base since then. Suggest also looking at NHS funding, staffing & resources. BW

[Julie Graham @JoolsGra]

@shineonlovely @catherineroyuk Reviewed by NMNI. Dr Kirkup's 'in some places' not much to go on - need evidence to back it up. Pretty offensive to hardworking maternity teams to imply a national ideology. Clearly disastrous issues at localised trusts. Open to the data.

[Julie Graham @JoolsGra]

@shineonlovely @catherineroyuk Hi Tara, Dr Kirkup has not evidenced a major problem with an 'ideology of normal birth' amongst maternity staff, as far as I'm aware. Happy to look at the data if the taskforce can provide it, for local improvement actions in some places.

[Julie Graham @JoolsGra]

@glurcher @DrLKVaughan They typically go straight to C section depending on gestation/risk assessment.

[Julie Graham @JoolsGra]

@DrLKVaughan 2007. The RCM lost a lot of the midwife membership because of this (myself included) and they have since apologised.

[Julie Graham @JoolsGra]

@catherineroyuk Hi Catherine, hardworking maternity teams of midwives, doctors & anaesthetists are working together day and night across the UK in tough conditions to provide safe & effective care. From the review, Dr Kirkup did not evidence issues at most trusts. Many thanks.

[Julie Graham @JoolsGra]

@emilyltownsend Were there any other conflicts of interest? How truly independent was the panel?

[Julie Graham @JoolsGra]

@parthaskar Thanks Partha. In relation to NBI, we currently have evidence only 'in some places'. Suggest the Maternity Taskforce release the data for identifying the extent of the problem at the 12 Trusts reviewed for local action implementation.

[Julie Graham @JoolsGra]

@EmilyJBarley @cduffin1 @DailyMail @jamesmurray_ldn The Taskforce could supply the data as a solution to identify the extent of the problem for local improvement. Until then, it's guesswork, not helpful for maternity staff and families.

[Julie Graham @JoolsGra]

@hannahsbee We currently don't know how widespread 'NBI' is. 'In some places' is not good enough for a national review. The review panel have the data. Is it present at one or 12 trusts? Sounds a local rather than national problem - share the data. Follow up, not cover up.

[Martyn Pitman @MartynPitman]

Thank you @Jeremy_Hunt for your timely and forcefully intervention in this very troubling issue. I feel certian that very many health professionals working in Maternity will be deeply concerned by the revelations about the @ValerieAmos Report which do most certainly challenge...

[Julie Graham @JoolsGra]

'..unsafe care in some places' - which places? What are the local actions?

[Sir Jeremy Hunt MP @Jeremy_Hunt]

Harmed families deserve confidence that lessons from past maternity tragedies are learned. I’ve written to James Murray following Dr Kirkup’s resignation from the Amos Investigation, seeking assurances that the role of “normal birth” ideology will not be swept under the carpet.

[Emily Barley @EmilyJBarley]

Now that they've had time to get into the detail of the Amos reports on the 12 individual Trusts, I am hearing from families who have found their evidence has been misused.

This is deeply, deeply distressing for those involved and also raises further serious concerns about the validity of the investigation.

I am hearing of:

- a quote about a different NHS Trust being placed in / applied to the report on the *wrong* Trust.

- a family being selectively quoted, with the middle part of what they said being *edited out* - the removed part coincidentally does not suit the DHSC/Amos agenda.

I would encourage all families who contributed to the investigations into the 12 Trusts Amos focused on to, when they feel ready, check if their evidence has also been misused in this or a different way.

[Julie Graham @JoolsGra]

@autinveniamviam I get it. Many of us rejected it from the start. However, attempting to shame is widely considered toxic and counterproductive. Suggest focusing on constructive feedback and clear communication/collaboration for improvement.

[Julie Graham @JoolsGra]

@autinveniamviam Yes. In the meantime, 'normal birth shame' doesn't help anyone.

[Julie Graham @JoolsGra]

Me too. I suspect it's a typo - can you clarify, @ShaunLintern.

[Dr Claire Hetherington @hetheringtoncd]

I find the conflating of normal birth with the concept of ‘normal birth ideology’ and conspiratorial language really worrying here.