Dr Bill Kirkup, a leading expert in childbirth safety, has accused Baroness Valerie Amos of altering the final report of her government-commissioned maternity care review by removing a section that criticized "normal birth ideology." Kirkup, who served as one of 12 expert clinical advisers to the review, resigned eight days before the report's publication, claiming that Amos "listened to the wrong voices."
Removal of critical section
According to Kirkup, the section outlining the potential risks of encouraging women to have a vaginal birth without medical interventions "disappeared" from the final version, despite having been approved by a significant number of people. "I don't think it's right that we should push this issue under the covers. This is a patient safety danger and I think it should be called out as such," he told the BBC.
Kirkup, a former obstetrician and gynaecologist who has led or assisted major inquiries into maternity scandals at Morecambe Bay and East Kent, emphasized that the dispute was about more than just wording. He stated that a version of the report that did set out concerns about normal birth was approved by many, but "eight days before publication it disappeared."
Normal birth ideology debate
Advocates of normal birth, including many midwives, believe women should give birth vaginally without drugs or interventions such as forceps or caesarean sections. However, doctors argue that interventions have increased to ensure the safety of mothers and babies due to rising childbirth complexity from older motherhood and maternal obesity. England has unusually high rates of both procedures by international standards.
Kirkup said research by the Amos review team found that normal birth ideology "was still an issue, at least in some places." He added, "I think she [Amos] has listened to the wrong voices on this particular issue," without specifying who. The Royal College of Midwives previously encouraged vaginal births but later stopped.
Amos report's findings
The Amos report, published on Tuesday, included a four-page section on "normal birth ideology," but concluded: "On the evidence available to us, we did not find that 'normal birth ideology' was currently widespread in the maternity services we visited [at 12 NHS trusts] in England." The report also stated that Kirkup stood down on 22 June 2026 due to disagreement on wording about normal birth ideology.
Amos did not respond to the BBC's request to reply to Kirkup's claims.
NHS pledges 24/7 triage for maternity units
In related news, NHS England has pledged that all 155 maternity units in England will offer a 24/7 telephone triage service within a year. This move aims to provide easier access to midwife advice for pregnant women with concerns. Some hospitals already operate such services, including Queen's Hospital in Romford, east London, which expanded to 24/7 and achieved a "good" rating from the NHS regulator.
Kate Brintworth, England's chief midwifery officer, said the service will give "every pregnant woman and new parent in England the comfort of knowing they will always have a midwife on the end of a call to answer their concerns if they are experiencing an emergency." She added, "This modernises maternity services so that pregnant women and parents who urgently need expert advice will no longer be left waiting for a call back or directed to a maternity unit voicemail."
