Everyone knows that cats need to give birth undisturbed in a dark, secluded place - perhaps preparing a softly lined box in the darkest corner of the furthest room underneath the bed. And everyone who knows about cats understands that you must never disturb a cat in labour or a newly delivered cat and her litter of kittens. Otherwise the cat's labour will stop or she may reject her kittens. Everyone knows this.
But just imagine that one day, quite a long time ago, a group of well-meaning scientists decided that they wanted to study how cats give birth. So they asked anyone who had a cat, that when she went into labour to bring them to their laboratory - a brightly-lit, noisy, modern scientific laboratory where scientists could study them, by attaching lots of monitors and probes, surrounding them by strange technicians constantly coming in and out with clipboards.... In the laboratory, the labouring cats could hear the sound of other cats in distress, and there were no private dark corners for them to retreat to, but only rows of brightly-lit cages under constant scrutiny of the scientists.
And the scientists studied the labouring cats in their brightly-lit cages for many years, and saw that their labours were erratic, how they slowed down and even stopped, and how heart-breakingly distressed the cats were. Their mews and their cries were terrible. They saw how many of the the kittens were deprived of oxygen and were born shocked and needing resuscitation. And, after many years the scientists concluded: 'well, it seems that cats do not labour very well'.
Then, because the scientists were caring people and wanted to help the poor cats, they invented lots of clever machines to improve the cats' labours, to monitor the oxygen levels in the kittens; they invented pain-killing drugs and tranquillisers to ease the poor cats? distress, and drugs to make labour become regular and stop it slowing down. They even developed clever emergency operations to save the distressed kittens' lives.
The scientists wrote scientific papers which told everyone about the difficulties they had observed and how cats do not give birth very well, and all about the clever feline birth technology they had invented. The newspapers and television spread the word, and soon everyone started bringing their cats to the laboratory in labour, because of all their clever feline technology and of how many kittens? lives they had saved. Looking round at all the complicated technology, people were heard to say: ?This must be the safest place in the world for cats to give birth in?.
Years passed, and the workload at the scientists' laboratories grew busier and busier. They had to take on new staff and train them in their feline labour techniques, and slowly the original scientists grew old and retired. But sadly the new up-and-coming technicians didn't know about the original experiment; they didn?t even know it was an experiment. They had never seen cats giving birth in softly-lined boxes in the furthest, darkest corner of the furthest room ? why, what a dangerous idea! They were absolutely convinced that cats do not give birth very well without a lot of technical assistance - why, think of all the years of scientific evidence they had collected - and would go home at night feeling very pleased with themselves for all their clever and good work in saving cats' and kittens' lives.
Sadly most midwives and doctors working today have trained and worked for most of their lives in that laboratory: and in that laboratory ? which is of course, a modern consultant maternity unit - childbirth is in a mess.
In this day and age of evidence-based practice, we talk so much of the importance of evaluating every intervention, and yet no-one is saying that we desperately need to evaluate the biggest intervention of them all ? asking women in labour to get into their cars and drive to a large hospital where they are cared for by strangers.