At nearly 42 weeks pregnant, she and her husband Steven had been sent home by midwives at Poole Hospital, who dismissed her elevated heart rate and signs of bleeding.
Without warning, Barr felt a sudden rush of warmth. Pulling her hand away, she saw bright red blood and immediately understood that her daughter Marnie was in grave danger. She called 999 and was rushed back to hospital, but it was too late. Marnie had already died. Barr believes her repeated requests for induction and interventions to start labour were ignored due to the midwives’ focus on achieving a normal birth.
A decade of inquiries into thousands of baby deaths across Britain reveals that 65 per cent of maternity units still require improvements in safety, according to the care watchdog. A Sunday Times investigation exposes deeper issues in the universities training the next generation of midwives. It found that many institutions promote an ideology of natural birth, prioritising vaginal delivery while avoiding instruments, drugs, and caesarean sections. Experts warn this emphasis can compromise the clinical skills needed to care for older and more medically complex mothers.
An analysis of university curriculums shows that 66 per cent explicitly mention the promotion of normal birth. The NHS has moved away from this ideology after scandals linking it to deaths and poor care. The chief executive of the Royal College of Midwives, Gill Walton, warned that universities should not promote an ideology and has raised concerns about the quality of midwifery education.
The Nursing and Midwifery Council has been criticised for insufficient oversight of teaching standards. Donna Ockenden, senior midwife leading the inquiry into the largest maternity scandal in the UK, has expressed concern that students are not receiving essential skills. Health Secretary Wes Streeting is working with the NHS to overhaul midwifery training, acknowledging a deeper systemic issue that includes outdated ideas around normal birth.
In response to the investigation, the NMC warned universities against promoting normal birth, demanding reports within a month on any courses that deviate from its standards.
The risks of overemphasising normal birth
While many women aim for natural births to avoid medical interventions, the overpromotion of this ideal can prevent staff from intervening when necessary. Investigations have linked the ideology of normal birth to midwives’ reluctance to involve doctors or comply with women’s requests for induction or caesarean delivery.
The normal birth movement emerged in the 1970s to counter perceived overmedicalisation. Following scandals, NHS England abandoned low caesarean targets, and the RCM acknowledged the campaign may have gone too far. Yet concerns persist.
A report from the East Kent maternity scandal warns that staff are trained in silos, creating professional tension between doctors and midwives. This can result in delayed interventions and prioritising ideology over patient safety.
Alex and Steven Barr feel this contributed to Marnie’s death. Following her loss, Barr was forced to give birth naturally, despite her wishes for a caesarean. Postmortem results showed Marnie had been starved of oxygen, possibly due to placental abruption. The couple received a six-figure settlement from University Hospitals Dorset NHS Foundation Trust.
Barr says her pleas were repeatedly dismissed. Aromatherapy and walks were suggested instead of medically indicated induction. Her solicitor, Jennifer Janes of Enable Law, warns that normalising abnormal findings and avoiding medical intervention is a cultural issue beginning with midwifery education.
An ideological crisis in education
In 2023-24, over 13,700 students at 62 universities pursued midwifery degrees. Sunday Times analysis of course materials revealed that two-thirds of institutions emphasise normal birth. While most universities also offer complex care training, critics argue that ideological focus persists.
Experts caution that older, heavier, and sicker mothers are now the norm. Maternal and child health researcher Professor Marian Knight highlights gaps in training for managing complex pregnancies. Donna Ockenden confirms students fear they are not being adequately prepared for real-world clinical challenges.
James Titcombe, chief executive of Patient Safety Watch, warns that midwifery education overemphasises normal birth while failing to adapt to modern maternity realities. Students report being assessed primarily on skills related to normal birth rather than essential interventions, leaving them underprepared.
Universities and funding pressures
Funding cuts of £1.4 billion across universities in 2025-26 have reduced midwifery staff numbers, and many educators lack postgraduate or teaching qualifications. Gill Walton stresses the need for consistent, evidence-based education that prioritises safety over ideology.
The NMC continues to review curriculums, and health authorities aim to ensure training reflects contemporary maternity care, respecting both maternal choice and clinical necessity. Universities including Nottingham and Middlesex reaffirm that their programs comply with NMC standards, while Ed Hughes of the Council of Deans of Health emphasises evidence-based midwifery education with safety as the top priority.
