Have maternity services at the Royal Free Hampstead improved?(98 Posts)
This thread is a spin-off from this discussion about north London maternity hospitals.
A lot of mumsnetters have been critical of the Royal Free. I don't think the RF's problems are unique or the worst in London. But it has had a bad reputation for several years and women report the same repeated concerns.
Personally I had a ghastly experience of antenatal and postnatal 'care' there in 2006. It was comforting to me to discover on mumsnet that I wasn't the only person who felt so miserable about the place.
A RF consultant (SympatheticConsultant) contributed to the old thread, saying that staffing levels and organisation had lately improved, and hoping that positive comments would start appearing.
Perhaps the RF now has a user feedback mechanism so that they take on board the comments of the women who birth there. But just in case they don't (!) how about we do it here?
What do recent and current users think? Is the RF getting better?
What improvements do you feel most urgently need to be made? What's going well there?
Here is a summary of my son's birth at the RF in December 2009.
I was hoping for a natural birth and, as such, intended to use the Birth Centre pool room and take along a doula. I went into early labour at about 10pm on 17 December. By 3am, we decided that it was time to transfer to the RF because my contractions were coming at least 3 times in 10 minutes and were increasingly intense. We arrived at triage at about 3.15am, having phoned ahead. Unfortunately my experience in triage was pretty appalling. The midwives said that they would not admit me unless I had a vaginal examination as they could not otherwise tell whether I was in labour. I understand that there is sometimes some ambiguity, but it was quite clear to anyone with any medical experience that I was in established labour (I could not speak/sit down/lie down, the contractions were increasing in frequency and intensity etc). I did not want a VE due to (a) the risk of infection and (b) the fact that it is very unpleasant and I felt they should have been able to tell that I was in labour just by looking at me. The midwives took complete exception to this and insisted that we had to speak to the doctors. The doctors were in theatre, so I had to wait an hour and a half in intense pain, and labouring essentially in public, for the doctors to appear. I honestly thought that I would deliver my baby on the floor of triage. At one point the midwife even suggested that I would not be allowed in the pool as I had not attended the workshop. As you will know, you do not need qualifications to sit in a birth pool. Another midwife seemed to be stuck in the middle and was at least cheerful and friendly.
When the doctors turned up, my husband explained the situation and they again insisted that, due to the NICE guidelines, I would have to have an examination. I find this astonishing, especially as the NICE guidelines in fact do allow for some discretion. Neither doctor asked to see me. Rather than judging with their own eyes, they just parroted the standard line about the guidelines. I note that a friend who had her baby at UCH was asked whether or not she would like a VE, and at no point was she forced to do so. By the time that my husband was arguing with the doctors, I was so desperate for privacy that I agreed to the VE. My consent was not freely given. I felt that I had been backed into a corner, and if I had not agreed I would have been sent home and, in all likelihood, given birth in a taxi.
At about 5am, I was finally permitted to move to the Birth Centre where a new midwife performed the VE. Unsurprisingly she said that I was far gone enough to be able to get into the birth pool immediately. I am pleased to say that as soon as we got to the Birth Centre, things changed for the better. I cannot praise the midwife enough. She read and adhered to my birth plan, and was very supportive. She monitored the baby's heartbeat and quietly took my blood pressure, but otherwise let me get on with it. She was wonderful. My baby was eventually born at 8.45am with just 2 paracetamol for pain relief. Unfortunately I tore a bit during labour, so needed stitches. These were carried out by consultant Alison Wright, who was great. Very kind, professional and a great communicator. I felt that I was in good hands. Because of the stitches, I was told I would need to be in for 2 nights instead of 1, which I was fine with.
The post-natal care was not great. The key reasons for this were:
- A number of staff members complaining to me about (a) how understaffed the ward is, (b) how badly they are treated, (c) how badly the patients are looked after. This was completely unprompted by me. The last thing I wanted to hear was about the political in-fighting on the ward.
- The fact that I had to stay in an extra night entirely due to the lack of staff to discharge me. This seems ridiculous, given the need for the beds. I was therefore in for a rather excessive three nights.
- No-one changed my bedding during my stay, so in the end my husband had to do it.
- The fact that my baby was jaundiced was not picked up in hospital. The midwife who visited the day after we left noticed it (and he had not changed colour between times).
- We were made to feel very guilty and irresponsible for opting for the oral vitamin K over the injection by the paediatrician. If the NHS is offering the oral drops as an option, why make people feel bad for choosing them?
On the positive side, most of the staff seemed very nice but just completely overworked.
My experience shows that there are a lot of areas that need improvement. That said, the majority of my birth was just as I wanted it, and that was thanks to the staff in the Birth Centre, who I would recommend to anyone. I feel that it is very important to cut out the triage element of the experience or at least educate the labour ward midwives in how to deal with those women who want a natural birth.
I hope this helps anyone considering giving birth at the RF.
NWThree - slightly concerned by what you wrote - I have just taken the decision to change from the RF to the Whittington as your experience in triage is exactly what i want to avoid.
When i arrived to have DS in May 2006 they didn't have the triage system and so I went straight to the birth centre.... and the midwifes there were fab - and i got discharged home directly from birth centre after 6 hours. No suggestion of a VE at any point & birth was fab in every way.
When I called at 28 weeks this time to book into the birth centre. I was told no longer possible as need to go via triage... they offered me water birth workshop - i asked is it necessary as DS born in their pool 4 years ago they said no, then tried to have conversation with them about possibility of not going via triage and realised a waste of time can't avoid it, so started looking for alternative hospital, whittington allows you to book in directly to birth centre. meanwhile i haven't actually been there yet to discuss anything.... so am inbetween hospitals so to speak, not ideal at 34 weeks - i hope transfering not a mistake .
re: the discharge - the same thing happened to me in 2003 when i had my daughter - they lost my notes and couldn't discharge me. after 24 hours both me and DD had been checked out so just told them I was leaving without being discharged. i left my mobile number and told them i'd pop back to be discharged when they got round to finding my notes!
re: blue team - was kept waiting for over an hour at 28 week check. i always go to GP - just i am Rh- so have to endure 28 weeks and 34 weeks with community midwifes as GP can't do anti-D. they promised to post me my blood test results and didn't
ds was born in the RF in Dec 2006. orignially wanted to go to the birth centre but when my waters broke at 37 weeks it was not to be. I was induced on the labour ward, 1st midwife was fine, supportive and funny. next mw was a right bitch (don*t remember the name). birth then by ventouse. baby didn*t breathe properly but recovered quickly. didn*t go to the ward immediately but was under observation in the MWs office (is it still like this?) where I heard all of the handover, mws slurping tea, them not helping me up to go to the loo, as I was still on the drip following the pph. I was not able to take ds because they put him to far for me to reach and the IV was on the other side of the bed...
never felt better beeing at home after 2 nights.
dd was born in the RLH dec 09. opposite experience - rooms shabby but my mw was fab. No intervention no complication and home next day.
DD2 was born at RF 2 weeks ago. I was really happy with the experience, especially given that I was terrified about all aspects of labour after a long and painful birth with DD1. I arrived at the hospital at about 11pm and barely had to wait to be seen by the triage midwife. I had seen the midwife a couple of times previously as the hospital was monitoring me in the day assessment unit every other day due to high blood pressure so it was good to have a bit of continuity. I was delighted to find out that I was already 3cm dilated, having been told last time when in much more pain that I wasn't yet in established labour and had to manage without pain relief. I was soon in a labour room with gas and air, pethidine on its way and the promise of an epidural. I had a midwife who stayed with me pretty much for the whole labour (plus a medical student).
The pethidine really helped but I still wanted the epidural. Given that my waters hadn't broken, they suggested that they do this before I would have the epidural to prevent things from slowing down and given my dislike for internal exams and having waters broken (a necessity because last time they didn't break on their own either), they were happy for the triage midwife I had seen a few times before to do this for me to make me more comfortable with it.
Overall things went very well, I didn't feel rushed during or after the birth. It did take some time for the paperwork to be done - I get the impression that RF midwives can't really multitask, but then it's also a positive that they take their time to get one thing done at a time.
Aftercare was ok except I didn't really want to be there and ended up discharging myself (got home 10 hours after birth)because there was absolutely no need for me to stay there. This took quite a bit of time and next time I think I'd get on with discharging myself sooner.
Despite being impressed overall, I think each person's experience during labour is down to how busy the hospital is at the time of admittance and how well they are staffed. It's also down to each individual labour and whether you have any previous experience (first labours are worse because above anything, you don't know what to expect - at least I think this was a contributing factor for me). I know someone who gave birth to DD1 at RF about 2 weeks before me and she had a difficult time, spending quite a lot of time in triage without pain relief having been induced. I don't think she would contemplate returning to the hospital.
Just to add, all the registrars I saw were generally good except for one complete arse in the day assessment unit - no other way to describe him, except to say he was one of those 'I am a doctor therefore godlike' sorts.
also wanted to vent here my frustration with the community midwifes... at my booking in appointment they took my bloods and said they'd post... they didn't, and I didn't follow up and didn't end up seeing community midwife again until 28 weeks - during his "gap" i was only supposed to have one ante-natal appointment & i saw my GP.
anyway at 28 weeks got told off as i didn't have my blood test results - apparently i was supposed to make an appointment to discuss (although they said they'd post!) - anyway they took more blood at 28 weeks, and again said they'd post them as next appointment wasn't supposed to be until 34 weeks. i gave my address but didn't chase the results when they didn't come (mainly as the community midwifes so elusive).
Anyway was slightly taken aback today to find that iron is "borderline" and i should be taking multi-vit with iron - or other iron supplement. i mean - might have been nice to know this 5 weeks ago!!!!!
Oh yes the blood test...I had the same. And beeing a naive first timer, I did not follow up. They told me that if there is any concern they will ring me. At 34 weeks was anaemic and high dose iron did not bring levels up enough so went into labour anaemic
Sonilaa - yes would not be surprised if I was not borderline anaemic.. although 34 week test results a bit irrelevant now as will start taking iron supplement regardless, have no confidence in the care they provide at all... - am v annoyed because they should have posted me the results like they promised, could have taken action earlier.
Anyway, have decided to change hospitals, due to see midwife at Whittington next week for booking in there (at 35 weeks!), amazingly she had been chasing me for an appointment rather than the other way around.
MumNWLondon, my community midwife did that several times, I mean, promising to call me, or to make an appointment with the doctor, and then she would never call me back.
My iron levels are also low but no one seems too concerned about that (I'm taking iron tablets, they don't seem to work, they make me contipated but hey, that's the way life is).
I also have to put hospital departments in contact with each other, otherwise things don't usually move along. However, I have a feeling that when I chase people they do things properly.
I've been well treated by some people and everything seems to be going well, so I plan just to keep chasing people and insisting on the bookings they forget.
Hello every one
It's my first pregnancy. Am still waiting on my appointment for my first scan. Am so so so very scared, i was too anxious about the hospital i should go to, but the choices i was given i chose Royal Free, but since the day i have been reading the reviews about the midwives and etc, i am just so scared. I am thinking to change the hospital from royal free to something else, i thought people were encouraged to breast feed but it seem's royal free is not a big fan of breast feeding, and you need support for it. Am not sure what to do, can some one advice me on this please if i should just change the hospital, in good time.
Hi Uzj you can certainly change your hospital, up to the last minute if you want. But what are your other options?
Hi Uzj, i changed at 34 weeks to the whittington - its the nearest hospital, only a couple of miles from the RF, away they have a lovely new MLU.
There is a tour on a saturday pm the time is on the website, you can turn up look around and ask questions etc, and there is also a self referal form on the website so you don't need to go back to GP.
i had a great experience, and if you can give birth in the MLU the aftercare is fantastic.
I had wanted a homebirth but due to going overdue and a late (36 weeks) failed gtt I had an induced birth on the labour ward at the RFH about three weeks ago.
Overall I found the midwife care excellent, both my community team and those on the labour ward. I also met with the consultant midwife as I had been unhappy about my treatment by obstetricians in the run up to labour, she was very helpful indeed. I only came acroos one midwife who was disrespectful, I think I will complain about her. While waiting for a room
on the labour ward to become available, I was given a sweep (I asked for no prostaglandins as already dilated and effaced enough for ARM only) and sent off for a long walk on the Heath. I returned to the hospital several hours later, still no room. At 8pm I stated if there was no room I was going home as I was not going to be able to sleep in a room full of women whimpering away on their prostaglandins and needed to sleep in order to be fit for labour after a 4 hour walk on a hot day. The MW on duty said they were prepping a room now. Two hours later at 10pm I packed my bags and asked DH to get the car, while he was getting the car they magically found a labour room. The MW on duty took me over and said 'we are now going to take your bloods and put the drip in while we do it' I said I am the most common blood type, it's in my notes and I am not having synthetic oxytocin. She said 'do you know what induction is?' I said yes, have you read my birth plan? She said 'forget the birth plan, this is induction' I asked her if she was going to be my midwife during labour, she said no, rosie was and so I asked to leave. I don't think the conversation was an acceptable part of my care.
I had several issues with obstetricians over the last six weeks of my pregnancy, one who insisted I must be induced at 38 weeks due to my failed GTT not taking into account that there is no precident to diagnose GD at 36 weeks as all women suffer from impaired glucose tolerance in the last few weeks, also ignoring my self monitoring that showed I could eat my normal diet with no raised readings (the only cause of raised readings was stress- there is a link between cortisone release and blood sugar levels - the 'flee or fight' response) or that all my scans showed a normal size or slightly small baby. Despite continuing to have excellent blood sugar readings right upto 42 weeks, I still had to use the labour ward rather than the birth centre gor my induction, which displeased me, I would have preferred MW led care. The obstetrician on duty for my labour firsts words to me were, 'you don't like doctors do you' not very helpful.....I didn't see him again until I was 8cm
dilated when he said 'if you are not pushing when I come back in one hour I am going to give you an epidural and a c-section. Four hours later I had a succesful VB (no pain relief) did not congratulate me, but every MW did.
Despite these issues I felt overall the standard of care was excellent, it's the attitude of staff that's the problem. Women are not breeding cattle, we certainly care more about the safety of our unborn children then any MW or OBS, hence our feelings and our decisions should be respected at all times, especially during labour.
I feel many women do not get the treatment they deserve because they do not insist upon it, both my husband and I have degrees from imperial college and do not see doctors as gods, we are capable to read the NICE guidelines and draw our own conclusions from the evidence quoted, if it weren't for this I feel I may have been bullied into decisions I was not comfortable with.
The RFH can definately improve, but I wouldn't discourage anyone from a birth at the hospital, as long as they have a strong birth partner to help and support them.
Sorry for typos,using iPod whilst BF baby.
Sympathetic Consultant: Just wondering if you are still at the RF?
Sorry I've only just come across your last post! I am currently sitting on the labour ward at the Royal Free after a fairly busy morning, so in answer to your question yes I'm definitely still here, how can I help?
First of all, thank you to all the mums who have given birth at the RF (or decided against it) for taking the time to share your experiences. I can only guess that you must be very busy after the birth - but your testimonials are really helpful!
Thank you also to SympatheticConsultant for his open minded attitude and nice comments.
I am 10 weeks pregnant (first baby!) and was referred to the RF by my GP. Some of these comments have made me worry and I was wondering if anyone has had a more recent experience of the RF Maternity Unit. I am going to try to visit the RF and the UCH (which seems to have more consistent positive feedback) to help me decide, but any comments / advice would be very appreciated!
Thank you very much,
I hope you are all happy and well!
I'm currently at RF - 2 weeks off birth of DC3. I chose to go back again. I think I mentioned earlier in this thread my negative experiences at UCH. From the people I know, it doesn't matter which hospital you go to, it depends on what's happening at the time in terms of how good your care is. RF were brilliant when I was in labour both times. That's the most important thing.
For antenatal care, they respond well to complaints - if you have a problem, make a fuss and it will be sorted out quickly.
They are also very good at sorting out slightly more complex situations - we've arranged NHS cord blood collection which may be needed for DD1 in the future and the hospital has been very organised to ensure that this all happens on the day.
Well I had a recent experience at the Royal Free when I had a medical termination due to fetal abnormality. First the positive: Anne-Marie (the genetic midwife&counsellor) was incredibly helpful and supportive and I can only recommend her. Also, the pre-natal care on the ground-floor was good, if slightly impersonal as every time I had a different midwife. The scans were also done professionally and quickly. Equally so for the Amniocentesis.
Now the negative: The labour ward is a shambles. A 4 hour wait to get a room that had been booked two days before; I was actually left alone with my partner for the whole proccess with the hourly "check-ups" being the nurse putting her head through the door; when we pressed the call-button at the critical moment, the nurse only turned up 10 min later, then left to get the doctor without doing anything, ie with everything hanging between my legs!
Elizabeth, the doctor on duty (another one to recommend) had to send to one of the OPs to get tools needed to stop my excessive bleeding (which took over 20 min); The nurse assistant was actually more helpful than any of the nurses (don't ask any of them for drinking water - it's obviously beneath them!), some of them seemed to have a problem with me having a termination too (well at least until they had seen the foetus).
The nurses were very intent on getting rid of my partner afterwards while I was still in danger from loosing too much blood. I was supposed to be discharged in the morning, even with Anne-Marie talking to the male on-duty doctor he only turned up at 12 with the excuse he was doing rounds (I suppose not having had a live baby I wasn't part of those rounds? Being one of the two excessive bleeding cases that night also didn't seem to qualify for some attention). Then he discharged me without pre-scribing antibiotics (which apparently he should have) or doing another vaginal check which Elizabeth had said would happen in the morning.
Because this was not done, I had an intense bleeding episode and had to have a scan, clean-out and then a course of antibiotics three weeks later.
After all this, I'm seriously considering private maternity next time.
A friend of mine recently alerted me to the fact that there have been discussions regarding the standard of care at The Royal Free hospital, until then I thought I was alone in my experience. I had my daughter at RF in October 2007, my first and only child.
Whilst I would prefer not to go into details, many of the stories that I have read here cover the same ground...trauma post birth, post natal depression, an immense feeling of isolation and a total loss of dignity, in my case resulting in a decision not to have any more children...
In a sense it is comforting to know that I am not alone (there were times both during and after psychotherapy that I was so traumatised I almost convinced myself that I had imagined it, however my husband was also witness to it all and thankfully persuaded me to continue with therapy), I also find it immensely sad that we have shared such terrible experiences and also very sad that my daughter will grow up an only child when we had previously planned a larger family.
I have every respect for how under staffed the NHS is, and the pressure that this can put on individual staff members and units, but if any of the people who 'cared' for me during my stay at RF had any idea of the impact there lack of compassion and professionalism had on my future life then I would like to think they may have behaved differently of found another career.
Dear AESR & Leseratte PD,
This sounds like a truly awful that you have experienced,I am so sorry.
2007 was the year before I joined but I would hope that there are significant changes that we have put in place to meet the needs of our expectant mothers since then. As earlier posters have written we are a much more responsive service than in previous years and I would hope expectant mothers looking to book would try and base their decisions on where to have their babies on recent experiences rather than out-dated experiences. A number of the old staff have been removed and we have made conscious strides to try and improve our user experience. We achieve 1:1 care in labour and our postnatal surveys are getting consistently good feedback. We have only last month launched the first free NHS Cord Blood Stem Cell Collection Service in North London as a partnership with the Anthony Nolan Trust (who were being publicised on GMTV only yesterday for the fantastic work they are doing).
The effects of birth trauma have profound effects on families and it is very tragic when such experiences lead to mothers deciding against future pregnancies. If at any time you feel it would be helpful to meet me or another member of our staff to go though what happened then please do get in contact, you seem as though you might benefit from an opportunity to have a debrief, even at this stage.
Leseratte PD :
I work with Anne Marie in FMU on a regular basis and she is fantastic and a credit to her profession and our department. Her kindness,empathy and compassion have helped so many parents at the worst of times of their lives.I am perturbed however at the attitudes of other staff that you came into contact with. When you say nurses I am suspecting you were possibly not cared for by our Midwives and possibly were managed on the gynaecological wards. Again if you feel it would help to talk through any of these issues with either myself, Anne Marie (or others) please do also get in contact. It may help you moving forwards and if we can do anything to improve a poor aspect of our service for others then we would welcome the opportunity to do so.
I am only 8 weeks and this will be my second pregnancy. ( Having had a girl prem at 6 mths, over 8 yrs ago and her not surviving SCBU).
I am new to London. (Previously gave birth in Cheshire, where I used to live after coming back from abroad for a brief visit and going into labour 2 days before departure)
( My experience there is another story!)
No idea how the system works here, not having experienced it with the last pregnancy. Registered with GP and had nurse check. Waiting for MW contact for first app.
Having read reviews on the RF and lots of other hospitals, I would love some advice!
Im based in Ladywell but will travel for peace of mind with treatment.
Please ladies, and SympatheticConsultant, any advice and recommends would be gratefully received!
(Ps. Having checked reviews for University Hospital Lewisham, I WONT be going there! :S )
Hi really glad I found this board, I'm currently 17 weeks with baby no.2 had my ds in dorchester in dorset and was a really good experience. My meetings with mw so far have been good however when I went for my 12 week scan the treatment was useless. Was made to wait 3 hrs for my scan! Got told to go and have some lunch even tho I wasn't hungry as otherwise they wouldn't be able to see the baby (this is the 3rd scan I've had and never been told that before) then everyone from the scan area left for lunch so basically an excuse for him to go to lunch. This made my husband really late for work and just ruined the first time seeing my baby. Also he was moody and rude... Really considering transferring as not the kind of experience I want for my birth x
to continue, that didn't really make me want to leave as thought its not really part of the natal group. however since then have spoke to quite a few mums who are making me nervous about rf. I chose it as its were me and my brother were born and quite like the idea of my child being born there but not nervous, and generally just need some reassurance. thanks xx
I had my first child at the RF in 2005. I sincerely hope things have improved since then.
I was in hospital for around 9 days (induction, then a stay post-emergency section). I was bullied into an induction when I was barely overdue, by a doctor who told me I was irresponsible and would be putting my baby at risk if I didnt agree (I was 7 days overdue and had a risk-free, straightforward pregnancy).
I felt I was treated like a dog during my time there. Both midwives and doctors spoke to me with contempt, as if I had done something wrong or was annoying them . Nobody spoke to my husband the entire time I was there - staff literally ignored him.
I was subjected to a series of horrible internals, including one in the middle of the night, when a doctor literally woke me up by shaking me and then doing an internal without even speaking to me.
One midwife shouted at me when I rang my buzzer at 3am because my milk had come in and my breasts were so painful and inflamed I thought I would pass out.
One midwife told me I wasn't 'doing it right' (breastfeeding) and took my baby away without my permission and fed him formula when I was asleep.
They completely forgot my anti-d injection, which could have potentially caused me to be unable to carry future pregnancies.
My bed linen was only changed once during my 5 days on the postnatal ward, and that was only because my mum asked a midwife if she thought it was hygenic for me to be sleeping on a blood-soaked sheet.
I wish to God I had complained officially afterwards, but I became severely depressed and was in no fit state for many many moths afterwards.
There is just no excuse for the way I was treated in the RF. I had my subsequent children at UCLH and what a difference!
If you PM MSG me with your details I can get in contact with your MW's and let them know how you are feeling. I am sure they can provide you with the support you need. Do you have an appointment for your anomaly scan yet?
If there are any pregnancy problems I'm am happy for you to come and see me in clinic.
I would advise you to go and visit 2 or 3 neighbouring units and get a feel for each. I don't think you should be booking at a unit too far from home in case of another preterm labour it would be safer to get to a nearby unit in such an eventuality. As you will find through word of mouth and forums/chat rooms every single maternity unit in the UK will have its nightmare stories and good stories. In SE Guy's/ St. Thomas' (if you fall in their catchment area), QUeen Elizabeth (in Greenwich) and Lewisham are all reputable units.
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