From: Midwives, Doulas, and Educators across the UK (written by The People's Birth Tribunal)

To: Parents, Professionals, Politicians, and the Press

Date: October 2025

Introduction

This open letter has been written and signed by midwives, doulas, and educators working across the United Kingdom.

Together, we represent those who stand beside women and families through pregnancy, birth, and the postnatal period - the people who have witnessed both the miracles and the failings of our maternity system firsthand.

We are speaking out because the public conversation about birth in the UK has become dangerously distorted. Misleading headlines, sensational stories, and selective statistics have created a culture of fear - fear of birth, fear of accountability, and fear of trusting women, birthing people and midwives.

It is time to set the record straight: Maternity care must prioritise the health and well-being of the whole family, ensuring good mental, physical and emotional health and protecting reproductive rights, thus creating a foundation upon which parents and children can thrive.

Clinical safety is just as important: preventing mortality and severe morbidity is, of course, crucial in high quality maternity care. However, prioritising clinical, risk-focussed management over holistic, community and relationship-based care can, and does, introduce other dangers to the well-being of the whole family, both in the short and long terms.

We write as midwives, doulas, educators, and advocates for families - united by our terror for the future of birth in the UK.

We have watched with growing alarm as midwives and the concept of “normal birth” have been scapegoated for the failings of a broken maternity system. Recent headlines have twisted complex truths into simple soundbites, heaping blame and shame on midwives, doulas and the families we support. This is eroding public trust and demonising and demoralising the very people who dedicate their lives to supporting women and babies safely.

Let us be clear: there has never been a campaign for “normal birth at any cost.”

This phrase - coined by journalists - is a distortion. It ignores what midwifery actually stands for: individualised, woman-centred, evidence-based care. The Royal College of Midwives’ 2017 decision to retire the term “normal birth” was not a rejection of physiology, but a response to relentless media misrepresentation (RCM, 2017). Yet the damage has continued: each new article fuels the myth that advocating for natural birth is dangerous, even extremist.

Here is the reality:

The safest maternity systems in the world protect physiological birth while providing excellent access to medical care when needed (Hollowell et al., 2011; WHO, 2018).

Induction, instrumental delivery, and caesarean section rates have risen sharply — yet outcomes for women and babies are not improving (MBRRACE-UK, 2023).

Over-medicalisation carries its own risks: physical, emotional, and psychological (NICE, 2021; Walsh, 2020).

Midwives today are working under impossible pressures — short-staffed, over-regulated, and afraid to trust their skills or their intuition (RCM, 2022; Ockenden, 2022).

And here is the human cost:

Parents are entering labour frightened and uninformed. Families are grieving the loss of agency and dignity in birth.

Midwifery students are leaving the profession, feeling that their education no longer reflects the art and science of physiological birth (NMC, 2023).

Midwives themselves - once the guardians of safe, calm, supported birthing - are burning out, leaving, or being silenced (RCM, 2023).

We are tired of seeing care distorted by fear and litigation. We are appalled as we watch policy being driven by headlines instead of evidence. We are tired of the false divide between “safe” and “natural,” when safety has always meant right care, right time, right place.

It is time to reclaim the truth:

Physiological birth is not ideology; it is biology.

Trusting women’s bodies and choices is not reckless; it is human rights-based care (WHO, 2018; White Ribbon Alliance, 2011).

Midwives and doulas are not the problem; we are part of the solution to a system in crisis.

We call on the media to stop vilifying midwifery and start reporting responsibly on the evidence.

We call on policymakers to listen to the voices of women, families, and front-line professionals.

We call on the NHS and education providers to restore balance - to teach and protect physiological birth alongside life-saving medical skills.

And we call on the public to join us in demanding maternity care that is safe and kind, modern and humane.

Birth is not a battleground between ideology and intervention

It is a moment of profound human vulnerability and strength - a time when every woman and birthing person deserves to be seen, heard, and supported in their choices.

We stand together - midwives, doulas, birth educators and lactation specialists - for truth, for trust, and for the future of birth.

To our readers

If you share our concern for the future of birth in the UK:

Share this letter widely — with journalists, MPs, and community leaders.

Ask your maternity service how it supports physiological, evidence-based care.

Listen to and believe women’s experiences of birth.

Together, we can rebuild a maternity system that values safety, compassion, and autonomy in equal measure.

References

Hollowell, J. et al. (2011). The Birthplace in England Research Programme: Perinatal and maternal outcomes by planned place of birth. Oxford: National Perinatal Epidemiology Unit.

MBRRACE-UK (2023). Saving Lives, Improving Mothers’ Care: Lessons learned to inform maternity care from the UK and Ireland Confidential Enquiries into Maternal Deaths and Morbidity 2019–2021. University of Oxford.

NICE (2021). Intrapartum Care for Healthy Women and Babies (NG190). National Institute for Health and Care Excellence.

NMC (2023). The State of Midwifery Education Report. Nursing and Midwifery Council.

Ockenden, D. (2022). Final Report of the Independent Review of Maternity Services at Shrewsbury and Telford Hospital NHS Trust.

RCM (2017). RCM Statement: Discontinuation of the Campaign for Normal Birth. Royal College of Midwives.

RCM (2022). Midwifery Workforce Report. Royal College of Midwives.

RCM (2023). State of Maternity Services Report. Royal College of Midwives.

Walsh, D. (2020). An ethnographic study of normal birth in an obstetric-led unit. Midwifery, 88, 102755.

White Ribbon Alliance (2011). Respectful Maternity Care: The Universal Rights of Childbearing Women.

WHO (2018). Intrapartum Care for a Positive Childbirth Experience. World Health Organization. https://www.who.int/health-topics/maternal-health

Health Equity and Maternal Health psnet.ahrq.gov