I just finished the book “Closure: How the flagship Albany Midwifery Practice, at the heart of its South London community, was demonised and dismantled” by Becky Reed and Nadine Edwards.

I found Closure a gripping and soul-stirring book. It peels back the layers surrounding the downfall of the Albany Midwifery Practice, a ground-breaking continuity of care model, which ran from 1997 to 2009 in Peckham, South London. 

Defying the official narrative that safety concerns were the reasons for closing the practice, Closure exposes and challenges motives rooted in control and suppression. Meticulous research, first-hand accounts, and interviews with key figures paint a vivid picture, demonstrating that the model provided safe and effective care with positive outcomes well above those achieved by local hospitals. They also leave little doubt that the closure was not a mere unfortunate occurrence but a deliberate ploy orchestrated by influential forces.

Using powerful storytelling, Closure unveils the profound connections and trust that existed between the Albany midwives and the community they served. It portrays the impact of the practice’s nurturing approach on expectant mothers, birth and postpartum experiences, families, and the wider community. The Albany Practice did not just provide exemplary maternity care, it provided a space to build and nurture communities that lasted beyond the childbearing years.

Closure delves into themes of community, power dynamics, and the complex web of interests that shapes the fate of medical services. It empowers readers to question the narratives imposed by those in authority and to champion the preservation of institutions that nurture the health and well-being of communities. Closure is a catalyst for change, inspiring us to fight for the rights of families to birth where and with whom they choose, and for a maternity care system where connection and compassion prevails.

Closure stands as a testament to the indomitable spirit of the Albany Midwifery Practice. The time and effort the midwives and their supporters spent trying to prevent the closure of the practise and to raise awareness about the amazing results the practice achieved, is truly inspiring. Sadly their efforts were not successful in preventing the practice’s closure. I couldn’t help but wonder, if the situation had happened ten years later, whether the impact of a powerful social media campaign might have led to a different outcome.

Reading Closure left me reeling with a mix of intense emotions. I felt a deep sense of outrage as the book exposed the web of deception and incompetence surrounding the closure of the practice. My blood boiled at the realisation that the supposed safety concerns were nothing more than a smokescreen masking a hidden agenda. I also felt familiar rage towards the belittling attitude of medical management professionals towards the midwives and the families who tried to challenge the closure. 

I kept asking myself: how did a medical institution lose sight of its fundamental purpose—to serve patients and the community? Sadly, this scenario has become all too familiar. For let’s be clear: it wasn’t safety concerns that caused the demise of the Albany, but the fact that it challenged the status quo so deeply. Whenever a ground-breaking and successful model emerges, challenging the very foundation of an existing institution, the response is often one of silencing and destroying the individual or practice behind it, rather than engaging in introspection and self-improvement.

I also felt a deep sense of empathy and sadness as I read the poignant stories of mothers, families, the dedicated Albany midwives, and the witch hunt against midwife Becky Reed. The testimonies laid bare the devastating impact of losing this wonderful midwifery practice—a sanctuary of care, support and empowerment. My heart ached for the mothers robbed of a trusted support system during their pregnancy journey, and for the midwives whose passion and expertise were trampled and discarded. 

The rollercoaster of emotions continued, weaving indignation and compassion. Alongside the anger, I felt deep admiration for the unwavering resilience displayed by those affected. They highlighted the strength that can arise when a community unites to fight against injustice.

Reading Closure made me revisit and confront the realities of power imbalances within maternity care and the impact they can have on individuals and communities, echoing my own experience supporting families as a doula. It stirred a renewed commitment to raising my voice to advocate for change in support of models of care that prioritise connection, informed decision making and evidence based transparency. The book also highlighted how deeply embedded the belief that birth is inherently dangerous is within our culture, and how most of the professionals within healthcare have no understanding of the concept of informed choice.

Upon finishing the book, it became clearer than ever to me that the current maternity care system is beyond redemption, incapable of self-transformation from its dehumanising model of care. 

But I also felt hope, as if a turning point had been reached. I have been seeing the signs of transformation everywhere, especially since the pandemic has led to soaring rates of medical interventions such as induction of labour, that simply cannot be justified by logic or evidence. Families and birth professionals are reclaiming their rights to birth as they wish, stepping outside of a system that inflicts harm.  Change is brewing, fuelled by a collective refusal to accept the disempowering and controlling attitude of the current maternity system, and to reclaim the autonomy and sacred nature of the birthing experience.

The pendulum, when pushed too far in one direction, inevitably swings back the other way. 

PS:  Closure has also inspired me to write a future blog called The Myth of Birth Safety in Hospital.

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