Why do Women Sue?

Statistics published by the National Health Service Litigation Authority relating to ten years of maternity claims provoke a sharp intake of breath. The total value of these claims over the first decade of the 21st century was £3,117,649,888 (NHS Litigation Authority 2012). The United Kingdom is not the only country to witness an astronomical increase in the level of litigation relating to maternity services. As far afield as Saudi Arabia (Henary et al 2012) and the United States (Berkowitz 2011), reports are being published of the demands on maternity budgets as a result of dissatisfaction with care received during pregnancy, labour and birth. The papers referenced above attribute adverse outcomes to negligence, misdiagnosis, surgical blunders and inefficient administration. Berkowitz(2011:7) suggests that what is needed is wholesale and whole-hearted adoption of ‘…electronic fetal monitoring [EFM] certification for all staff working on their Labor and Delivery floor, protocols for managing common clinical scenarios, simulation drills for dealing with uncommon dangerous events, and pre-procedure checklists’. The NHS Litigation Authority (2012:5) recommends that Trusts ‘…engage with the risk management process at all levels; provide suitable learning and training; ensure appropriate supervision and support; have in place up-to-date protocols and guidance with which staff are familiar; learn lessons from claims’. It is relatively easy to ensure that staff are sent on fetal heart rate (FHR) training days (although whether use of EFM produces better outcomes has, of course, never been clearly demonstrated (Alfirevic et al 2013) and that protocols for managing events during labour and birth are drawn up and even put into practice. It’s uncertain, however, whether doing so will make the problem of maternity litigation go away. There is something ‘rotten in the state of Denmark’ that is fuelling women’s dissatisfaction and which ‘the system’ has not been able to get its head round.

‘The Emergence of the Operatic’

The chapter discusses the notion of the ‘operatic’ with particular reference to movement. Through observation of singers in rehearsal and through interviews with singers over two years, the research posits that ‘operatic’ movement may be identified and explored as a discrete quality of movement in performance and recognised as an, albeit underappreciated, aspect of the artistry of the opera singer. The paper explores the effects of the demands of singing on the dramatic expressivity of the body and the strategies employed by singers to navigate, the sometimes conflicting demands of the composer and the director. ‘Operatic’ movement is regarded as that which is not generated through character or narrative (positioned as a normative approach to acting) but through the negotiation of the physical constrictions and artificiality of breath associated with operatic singing, combined with sensitivity towards opera’s non-normative performance conventions. This position is aided by an interrogation of opera through the lens of gender theory. The chapter makes two propositions, that the ‘operatic’, which does not form part of the formal pedagogy of singers, is an emergent property, especially evident at the intersection of the various creative disciplines that contribute to opera, such as when the orchestra is introduced to the rehearsal process, and that ‘operaticness’ is acquired and passed on through a process of kinaesthetic empathy.