How To Submit an FOI Request for Maternity BMI Policies

If you’re pregnant or trying to conceive, you might want to know how to submit an FOI request (Freedom of Information) to your local maternity providers. It’s worth finding out as much as possible about your likely treatment beforehand, and it’s pretty simple to do.

How to Submit an FOI Request

  1. Find out which NHS Trusts cover your local area

    Quickest way to do this is to use the postcode location service on the NHS website. This will list all the local services, sorted by distance. https://www.nhs.uk/service-search/Maternity-services/LocationSearch/1802

  2. Check out the Trust websites you’re interested in.

    Mostly clicking through to the individual pages will display the website at the top under the name, if not, just Google it.

  3. Find the page on Freedom of Information requests.

    There always is one. Easiest way is to type “FOI” into the search box, usually found somewhere near the top. Somewhere on that page will list the email address you need to send queries to.

  4. Send your questions/request for relevant policies to the FOI email address.

    If you don’t want to write your own, feel free to use/adapt mine:

    “I would like to know with regard to your fertility, maternity, childbirth and post-natal services:
    1. Do you have a policy for the management of larger women? If so, what is the BMI cut off (or other criteria) where this policy comes into use?
    2. Please attach a copy of the above policy.
    3. Please could you attach any other policies/guidelines/protocols relating to fertility, maternity, childbirth and post-natal which address the management of higher BMI women. This could include (but not be limited to):

    Inclusion/exclusion criteria for use of midwife led unit, hospital birthing pool, home birth, IVF etc.
    Glucose Tolerance Testing and Gestational Diabetes,
    Clexane prophylaxis
    Pre-Birth Anaesthetist referral
    Additional growth scans

    Digital copies/pdfs preferred.

    Kind regards”

  5. Wait for a response

    The authority must reply to you within 20 working days.

    Anyone has a right to request information from a public authority. For your request to be dealt with according to the Freedom of Information Act, you must:

    Contact the relevant authority directly
    Make the request in writing, for example in a letter or an email
    Give your real name; and
    Give an address to which the authority can reply (postal or email)

    You do not have to:
    Mention the Freedom of Information Act
    Say why you want the information

    They can charge you for the costs of sending the information, such as photocopying and postage if you request a copy by mail, but not if you request copies by email. They must let you know any cost beforehand.

    By law they must provide the information unless there is good reason not to; e.g. if in the interests of public safety or security to withhold the information or they do not record that information. See the Information Commissioner’s Office page for more info.

  6. Send the documents to Big Birthas for inclusion on the website!

    If you do get copies of your local policies, please contact me via the form on http://bigbirthas.co.uk/about-big-birtha/contact-big-birtha/ to let me know, and I’ll email back (stops me being inundated with spam!). Then you can send me the documents so I can add them/update them here for the benefit of all.

We’ve got to do our own research…

While there is no denying that there are excellent caregivers in midwifery services, there are unfortunately those for whom the magic of childbirth has been subsumed by the sheer hard work and for whom midwifery seems to have become ‘just a job’.

Even the most caring of midwives have procedures and protocols to follow, and delivering truly individualised care amidst the pressures of understaffed units and the highest birthrate for decades is nigh on impossible.

Talk to any woman who has given birth, and there’s usually an element of their birth stories which runs ‘I had to do XYZ / have XYZ / go to XYZ, because of hospital policy on…’

Whether that’s being told you have to go home again for the third time, despite having been in labour for 6 days because you’re not dilated enough (seriously?), or being told you can’t be in established labour because your contractions aren’t regular enough (yet it turns out you’re 4cm dilated), or being told that you need to have your labour augmented because it’s not moving quickly enough (for who?), or you can’t use a hospital birth pool because you’re not thin enough and would be difficult to rescue in the case of a collapse (yet you’re allowed to have as many baths as you like – in tiny room far more inaccessible should the much-feared collapse occur), or your husband/partner/father of your baby can’t be by your side because visiting hours haven’t started yet (don’t get me started on the Bounty lady being there when husband/partner isn’t), most of us don’t challenge what we’re told.

It takes a strong person, while in labour, attended by the experts to say ‘hang on a minute – what are my options here? What if we don’t do XYZ and just wait and see? Or I’m not going anywhere until someone takes me seriously and listens to what I want to happen here.’ It takes a strong birth partner to do it too. I quote this:

The Mule: Stop Googling Your Birth Options, And Hop Up On The Bed, Dear.

If you are faced with a choice about procedures and interventions in childbirth – ask yourself – who is this most likely to benefit, reassure, or make comfortable – me, or my carers? We must not be deterred from learning as much as we can about our rights and our options in childbirth, no matter how much it may inconvenience midwives or doctors. We do not have to comply with their suggestions, unless we wish to. We are allowed to be powerful in childbirth. What’s more, birth is not simply a means to an end – our birth experience matters, and is of primary importance, not just to us, but to our babies, our families, and the whole human race.

The midwives themselves don’t even necessarily agree with the official policy they have to present to us. When I spoke with the Head of Midwifery about my desire for a home birth and my belief that it was a safe, sensible, viable option for me given my previous birth experience (and that frankly, I’d been pushed into a corner because home birth was the only way I’d get to labour in a pool due to their hospital’s policy on BMI) she couldn’t have agreed more. She was very supportive, but still had to sign off my birth plan with ‘against medical advice’ because that was her job, no matter how unfair, discriminatory and ridiculous she felt it was.

She said she felt that midwives hands are often tied these days into following policies they don’t believe in.

But WE don’t have to follow those policies. It is our right to research, and choose, and question, and challenge, and while some professionals don’t like it, be rest assured others are smiling inwardly because they actually agree with us… they just can’t say it.