Jude Dockray

This isn’t an apology I feel able to accept, and I’ll explain why. (This isn’t about singling out Keith, but a wider issue in how we debate maternity care.) 1. Keith’s original tweet claimed that if people understood how invasive C-sections are, fewer would request them electively. This is flawed. Medical doctors, arguably the most informed and best equipped to advocate for themselves, are among the most likely to request elective C-sections in the absence of medical necessity. That alone should prompt us to reconsider assumptions about who’s making “informed” choices and why. 2. Keith says his eyes have been opened to the risks of vaginal birth and to practices outside the UK. But this isn’t an issue limited to other countries. It is very much a domestic one. Multiple UK inquiries into maternity scandals have highlighted how “normal birth” ideology has led to preventable infant and maternal deaths, as well as catastrophic injuries. 3. Keith writes: “As a man who would never have to personally face this hardship, I had no right to comment.” This frames maternity safety as a kind of identity-based grievance conversation. That’s disingenuous. This isn’t a woke-vs-anti-woke culture war, it’s life and death. Men are also affected by these failures. It’s their babies. Their partners. They have every right, and arguably a responsibility, to comment. Those with scientific or medical training especially should feel empowered to contribute meaningfully. IMHO maternity care would benefit greatly from robust, respectful, external scrutiny and critique grounded in evidence and expertise. 4. In my view, Keith was just wrong. Women who request elective C-sections aren’t poorly educated. And no one is choosing a CS “for fun.” You don’t get to choose between an elective CS and a smooth vaginal delivery. You get to choose between an elective CS and an attempted vaginal delivery—which may result in an emergency CS, instrumental delivery, prolonged labour, or a number of other complications. It should be up to each woman to discuss these options with her doctor and make her own informed decision. And perhaps what I said here is also not quite right, because most women do not get to choose at all. They are steered down the path of attempted vaginal delivery, with little (or no) awareness of the potential risks that course of action involves. Keith doesn’t need to apologise. He needs to decide whether he stands by his original argument and make the case - or explain how and why he has changed his mind. But please, no more grievance theatre. No turning this into a free speech issue. Say what you mean. Make your case. I will do the same. So will others. And the debate might actually get somewhere.