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What does the CQC report say about over-medicalised birth?

Anna Vincent - Writer & Researcher

A report published in September 2024 by the Care Quality Commission (CQC) has evidenced a troubling reality in UK maternity services: over-medicalisation of birth is causing unnecessary harm to both mothers and babies. As alarming as this might sound, it definitely isn’t something to panic about.
What does the CQC report say about over-medicalised birth?

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Instead of being allowed to lean into the body’s natural ability to give birth, more and more women are automatically subjected to interventions that can end up causing complications rather than mitigating them.

This ultimately leads to physical trauma and long-lasting emotional damage, both of which are avoidable. The report comes as a provocation to rethink how we approach birth, with a focus on supporting physiological delivery and the need for more midwives who are comfortable facilitating it.

Is birth dangerous?

The problem with over-medicalisation

The CQC’s report, which analyses maternity services across the UK from 2022 to 2024, highlights the urgent need for change in how maternity care is delivered. Amid concerns about staffing, racial inequality, communication, and leadership, there’s growing worry that unnecessary interventions during birth are becoming routine. These procedures, meant for specific situations or emergencies, are often administered when they aren’t essential for the mother or baby’s safety, and even if the birth is progressing without cause for concern. It’s a bit like deciding to give everyone a full-body MRI scan just to check for a common cold – more likely to cause stress and confusion than be of any real help.

Of course, when used appropriately, medical interventions such as induction and c-section can be life saving. But over-reliance has become the new normal, and it’s having serious consequences. This “just in case” mindset, where labour is augmented to meet arbitrary timeframes or ideas of convenience, undermines the natural process of birth. It seems we’ve reached a point where policies and guidelines designed to prevent harm are, in fact, causing harm.

One mother, interviewed in the CQC report, recounted her experience of feeling rushed into an induction. She stated “it did feel as though I was being ‘told’ that I had to be induced”, and that healthcare staff didn’t attempt to help her understand the clinical rationale of induction, or the risks versus benefits of waiting for spontaneous labour. “I felt this could have been explained more thoroughly and would have helped me to make an informed decision rather than feeling forced”. 

The overlooked cause of birth trauma

The problem with birth trauma

Earlier this year, a report from the All-Party Parliamentary Group on Birth Trauma titled ‘Ending the Postcode Lottery on Perinatal Care’ highlighted the significant rise in birth trauma across the UK. The findings are alarming: one in four women now report experiencing trauma during childbirth, but the conversation around the cause of this trauma remains inconclusive. Much of the focus has been on the lack of mental health support for mothers post-birth, and this is undeniably important, but the root of the problem – over-medicalisation – is too often ignored.

As the report itself acknowledges, “women frequently felt they were subjected to interventions they had not consented to, and many felt they had not been given enough information to make decisions during birth.” Yet, rather than questioning why this augmentation of birth is becoming so common, the conversation often skips straight to post-trauma care. While support of this nature is vital, we must also address the fact that many of these interventions could be avoided altogether if maternity staff were willing to trust the process of physiological birth.

The true cost of unnecessary intervention

The true cost of unnecessary intervention

Treating birth as a problem to be solved rather than a process to be trusted introduces a host of risks. In the British Journal of Midwifery, Claire Davison writes that unnecessary intervention during birth “has several disadvantages: it has the potential to turn a physiological event into a medical procedure, and it interferes with the freedom of women to experience the birth of their children in their own way and in the place of their own choice”. 

This takes a significant emotional toll on mothers. The Birth Trauma report highlights how a sense of powerlessness during labour is a key factor in the postnatal trauma that many women experience. One woman shared her story: “whilst contracting and alone a doctor came to examine me. She did a vaginal examination and without consent broke the rest of my waters”. Of course, the problem isn’t just the physical act of intervention, but the emotional damage caused when women feel stripped of their autonomy.

And the trauma extends beyond the mother; babies born via unnecessary interventions may experience respiratory distress, difficulty breastfeeding, and other issues related to their birth experience. The ripple effect of over-medicalisation impacts entire families, creating a legacy of trauma that is entirely needless. When birth is allowed to unfold at its own pace, without the pressures of hospital efficiency or fear of litigation, the likelihood of complications decreases, while birth satisfaction increases.

Reframing the conversation: it’s not physiological birth that’s the problem

Unfortunately, the media has often misrepresented the debate around birth practices. Articles like the one published by iNews, which critiques hospitals that promote “normal birth”, miss the point of the CQC report findings entirely. The issue is not that hospitals are promoting natural birth as the article suggests, but rather that the support needed to ensure safe physiological birth is often lacking. Instead of blaming the promotion of natural birth, we should focus on why the medicalised approach has become the default, often without real justification.

Without enough midwives trained in supporting natural deliveries, or hospital policies that give women the time and space for their bodies to labour naturally, it becomes easy to see why medical intervention might seem like the safer, more convenient option. But just because something is routine doesn’t mean it’s right. The real question we should be asking isn’t “why are we promoting normal birth?”, but instead “why has medicalised birth become the norm when, in most cases, it’s unnecessary?”

The solution: more midwives, more support for physiological birth

It could be argued that the key to reversing the trend of over-medicalisation lies in increasing the number of midwives who will champion physiological birth. The CQC’s findings underscore the importance of midwifery-led care; women who received continuous care from a midwife reported fewer interventions and a more positive birth experience.

Physiological birth, when properly supported, is not only safe but empowering for mothers. The problem arises when maternity facilities fail to provide the staffing, training, and time needed for these births to happen naturally. The shortage of midwives who are comfortable supporting physiological birth has led to an increase in interventions, as staff often feel they lack the resources to support non-medicalised deliveries. As the International Confederation of Midwives asserts in its recommendations, there is a need to “ensure midwives’ education facilitates development of skills and competencies in normal childbirth”.

The Birth Trauma report also highlights the role of midwives in reducing birth trauma. Continuous midwifery care, where the same midwife is present throughout labour, has been shown to significantly reduce feelings of powerlessness and trauma in mothers. 

Looking ahead

The CQC report should serve as a wake-up call, prompting both healthcare providers and society as a whole to reframe our understanding of childbirth. Hospitals and healthcare policies need to revisit their guidelines to promote non-interventionist care as the first option, rather than rushing to augment labour for the sake of perceived safety.

This isn’t about rejecting medical care – it’s about making sure interventions are only used when absolutely necessary. It’s about restoring trust in the body’s natural ability to give birth, and acknowledging that, for the vast majority of women, physiological birth is not only possible but also safer when properly supported.

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