Last year the LGBT Foundation published the Improving Trans and Non-Binary Experiences of Maternity Services (ITEMS) study. This research, which explored the experiences of 121 trans and non-binary users of maternity services in England, claimed that 30 per cent had received no care at all during pregnancy and urged the use of ‘more inclusive language’ in the NHS such as ‘chest feeding’ and badges displaying pronouns.
In response to the ITEMS study, the NHS allocated £100,000 of funding to retrain maternity service staff. However, when clinicians and the maternity workers’ group With Woman raised concerns, implementation of these changes was paused.
In an important new research paper, Kathryn Webb from the Oxford Institute of Clinical Psychology Training and Research, and her co-authors, have looked in detail at the ITEMS study, using it as an example of how poor research practices can influence significant policy change in the NHS and why good healthcare policy development is so important.
In their critique, Webb et al., point out that the NHS overlooked many ‘methodological issues, biased assumptions, and unsubstantiated recommendations’ in the ITEMS study. They also make the important observation that adopting ‘inclusive’ language could be detrimental to women using maternity services who have a learning disability, low health literacy, or who speak English as a second language.
While Webb acknowledges here that the authors of the ITEMS study had ‘good intentions’ she notes that that they did not have ‘scientific intentions’. She argues that ‘this harms everyone by setting a dangerous precedent’ and that ‘all groups are equally deserving of evidence-based care’. Webb maintains that while the NHS has been seen as a global lead in medical standards, there is now a battle to keep it so, and to ensure that its treatments are evidence-based.
Here at Critical Therapy Antidote, we share the concerns of Kathryn Webb and her colleagues, particularly in view of the ideological capture of training institutions which are required, by NHS England, to decolonise their curricula. As Western scientific enquiry comes under attack for being ‘WEIRD’ and oppressive, the future of evidence-based care in the NHS appears to be under threat.