Guest post: “Midwives and maternity teams are working hard to make sure maternity services continue to be personal and safe”
With recent data suggesting that pregnant women are more anxious about their pregnancy and birth due to coronavirus, Jacqueline Dunkley-Bent, the Chief Midwifery Officer for the NHS in England is on hand to reassure women that the NHS is still there for them.
Chief Midwife for the NHS in England
Posted on: Tue 16-Jun-20 10:30:04
(40 comments )
I know that many of you are feeling anxious about being pregnant and giving birth during this uncertain time. But I want to reassure you that midwives and maternity teams up and down the country are working hard to make sure maternity services continue to be personal and safe during this period.
We know that the NHS is under pressure at the moment due to COVID-19, so some local teams are making adjustments to keep you and your baby safe. Some appointments may now take place over the phone or by video call. Some women may need to have their babies in a different place to where they had planned, and they may see staff wearing protective clothing.
As anyone who has ever given birth or worked as a midwife will tell you, when a baby is ready to be born, he or she will never wait - our midwives continue to always be prepared , willing and very able. Since 30 January, I have seen first-hand how midwives have encouraged women who feel nervous about attending appointments to do so.
Every maternity unit has amplified their efforts to engage with women above and beyond their usual practice, such as the midwives at the Royal Cornwall Hospital, who, despite wearing masks, smile with their eyes to reduce the anxiety that PPE may create for some women.
But, whatever the changes made, I really want to address some of the concerns that I know are worrying many of you.
If you're worried about your health or that of your baby, or you have a concern, no matter how minor, please contact your midwife.
Firstly, it's vital that you have a midwife with you when you are birthing, to ensure that both you and baby are safe. I want to reassure you that maternity services are completely separate to general NHS services in hospitals treating coronavirus patients, so the risk of catching coronavirus from these patients is minimal, as well as from other pregnant women with coronavirus symptoms, who are cared for in another dedicated area in the maternity unit.
We also know that having a trusted birth partner present throughout labour is known to make a significant difference to the well-being of you in childbirth. At times like this, when coronavirus is heightening anxiety, that reassurance is more important than ever. While we support decisions to restrict access to birth partners who have, or are suspected of having, coronavirus in order to safeguard both the health of the woman and the maternity staff supporting her, NHS Trusts should continue to follow guidance allowing asymptomatic birth partners access to the maternity unit during labour and birth.
But most importantly, I want you to know that the NHS is still here for you and has gone to great lengths to ensure the safety of you and your baby. If you’re worried about your health or that of your baby, or you have a concern, no matter how minor, please contact your midwife just as you always would, and if you’re asked to come in for a planned or urgent check, it’s vital that you do so.
If you get coronavirus symptoms, they are likely to be only mild or moderate, such as a cough or a high temperature, and the rate of contracting the virus is no higher than the general population, so please contact your midwife or maternity team who will advise you about what to do next. If you have coronavirus symptoms when having your baby, then you will be cared for in a dedicated area in the maternity unit with a midwife. This is to keep you and everybody who uses or works in our services as safe as possible.
Don’t forget to go to keep up-to-date with all the latest coronavirus pregnancy and birth advice at www.nhs.uk/pregnancy-and-coronavirus, which has links to helpful resources, including a range of leaflets and an animation.
Good luck and don’t forget - your midwife is always there to help you!
The Chief Midwifery Officer's team will be able to respond to some questions next week.
By Jacqueline Dunkley-Bent
Apart from our midwives aren't there to help us are they?!
I am disgusted with the lack of input from maternity services during my first pregnancy.
RCoG states that women will need "at least as much input" as before the pandemic. So how does not bothering with 16 week appointments & going 9 weeks between contacts sound like that is providing as much support as pre pandemic?
Why then have I had an appointment lost and had to wait 40 minutes to be seen for booking bloods? Why then, have I had those blood tests wrongly labelled and lost? Why is it OK to miss the checking of BP and urine at the 16 week appointment? WHY have my hospital changed their rules to allow partners in the 12 week scan but made no exception for partners to attend the 20 week scan when they were forced to miss the 12 week scan - but they think it is acceptable for me to sit in the same waiting room as the couples being allowed something that I have been denied?!
I do not feel like anyone gives a flying about my care or my wellbeing.
Stop telling me you care. Show that you care.
I'm sorry but being told the first face to face appointment I am going to have with my midwife is likely to be my 28 week appointment isn't good enough. I understand the risks around COVID-19 but this is my first pregnancy which is higher risk due to autoimmune issues I have. I haven't had any blood tests yet which according to the NHS website should be done before 10 weeks and I have to wait till my nuchal scan to have the bloods next week at 12w2days
I am 26 weeks pregnant and last saw my community midwife at 8 weeks for booking in. That was also the last time anyone checked my bp or urine. I have never heard my baby's heartbeat.
I'm hoping to see my midwife at 28 weeks.
The only thing that has stopped me completely panicking is that this is my third baby and I can now feel him move and am well educated in what to look for in case of pre-eclampsia or obstetric cholestasis.
If this was my first I would feel completely abandoned and overwhelmed.
No one has checked my mental health or my risk of domestic abuse...perhaps now women are attending hospital appointments alone it would be a good opportunity to have these conversations away from partners?
Unless its Covid the NHS bluntly isn't interested
I was referred to the antenatal mental health unit at my scan, not heard nothing since and now 25 weeks. As I'm not medicated (yet) my concern now is post-natal depression.
I have told numerous people but no one seems interested.
I would like the help before baby arrives but it appears I will need to battle my demons alone!
On the flip side of my pregnancy, I have received great care from the NHS, given the circumstances. Other than the fact I didn't see my midwife at my 16 week check and I can never get to speak to her, the maternity assessment unit have been amazing the two times I've been in to see them. The nurses and midwives on that ward are beyond lovely and caring and the sonographers at my scans have been brilliant too! Telling me everything, letting me know what they are seeing etc. It's the system that's gone to pot not the staff, they are doing their best for us given the circumstances.
I think that pregnant women should be a priority for the NHS without a shadow of a doubt but as other pp's have said, it appears that if it's not COVID-19 they don't want to know, despite what they have put out on the media about the services still being there. From everything I have read and people I've spoken to, they really seem like they aren't! 😐
Fingers crossed things start to improve soon!
I don't know... I didn't really know what to expect as this is my first, but I have been surprised by the lack of support/engagement. I'm around 19 weeks now, and the only contact I've had has been a perfunctory over the phone booking appointment and a brief 10min dating scan (which I of course had to attend on my own). I think I have a midwife appt booked around the 22 week mark, when they want me to take in any medications that I'm on - a bit late in the day, surely?! I'm pretty sad that my partner isn't allowed to attend at all - I want him to feel engaged with this pregnancy. I rather feel that the risk associated with partners attending needs to be balanced with the benefits of their attending. As with other posters above, I agree - if it's not covid, it's not important.
Agree with other posters. I feel abandoned and alone.
I'm 12 weeks and have had a phone call to fill in a form.
I'm terrified for the scan as have had previous losses, making it even worse is the fact in my trust I have to go alone and masked. It's terrifying.
I suspect I will need a c section which means self isolation for two weeks prior. As it happens that's likely to fall over Christmas. So my 4 year old will be alone with me over the festive period missing all school stuff.
Covid is important but it's dominating so much
I’m really shocked and disgusted with the lack of midwife contact I have had. I am 39weeks with my first and I have not had contact with a midwife since 16weeks, no phone calls or anything despite being told I would. Iv had appointments cancelled, bigger gaps between consultant appointments (consultant led care for a few reasons) fewer appointments than the guidelines state, even those guidelines updated for Covid, I won’t be seen by anyone until I am in labour (I last saw a medical professional at my 36 week appointment) Anytime I phone the hospital with a concern about reduced movements or possible preeclampsia I am made to feel stupid and unsupported. The lack of consistent care across all parts of the country is atrocious
I thought it was just me expecting too much as a first time mum, and with a surprise pregnancy after being diagnosed with early menopause, so while I'm saddened to read these other comments, I'm relieved I'm not alone.
So far my maternity app, which has been used to replace ordinary notes, is showing two different due dates, almost a month apart, and neither of which are the due date I was actually given at my dating scan. I have been given all my blood test forms for the remainder of pregnancy, sadly all issued with a due date three weeks later than my actual due date, so none would be taken at the correct time.
I'm now 16 weeks pregnant, and have not yet been given a date for my anomaly scan. I won't see a midwife until 28 weeks, and although I have a named midwife, I've never spoken to her or been given any indication that she will be the one to do any of my upcoming appointments.
I'm also supposed to making decisions about where and how I would like to give birth. Seemingly the answer "with the support of a midwife I know and trust" would get me nowhere.
At my booking appointment I was apparently being referred to both the maternal medicine team (due to conceiving on HRT), the pre-term birth team (previous cervical biopsy) and the maternity counselling service (anxiety about the outcome of this pregnancy as a result of and ectopic, failed fertility treatments and being told I'd never have my own child). I've heard from none of them.
Fortunately I am a capable, confident, educated woman with the support of friends, family and my husband. I dread to think of the experience for women who are less fortunate and more vulnerable than I.
A friend of mine who thought she couldn't have children is having her first in her mid-40s (total accident). She has had no midwife input for many weeks now. She is due at the end of August. She is high risk. I worry for her.
rosabuddy. I'm a community midwife. Why haven't you been seen for 23 weeks. This is highly irregular. Why haven't they measured you? Checked BP and urine?
In my local trust we are seeing women for booking, scan x 2, 28, 32, 36 and 40. If they are consultant led they see us or cons at those times (not both).
We also do phone calls at 16, 25, 31 and 34
The consultant has been doing growth scans of which I have had 3, one at 28, 32 and 36 weeks and a nurse has checked my bp and urine at these appointments so that has been good. However I have had no contact with a midwife at all even though I have been told I would. If I wasn’t being consultant led I don’t know what I would do. Communication has been extremely poor and my mental health doctor was very surprised that I was not being seen between 36weeks and 40weeks, especially as it’s a first baby. Online antenatal course I was told to watch was pathetic, did not prepare me in any way for what’s to come and I’m relying on friends for info on breastfeeding etc I am very lucky to have close family and friends to advise me
Should have also said my 25 week appointment was cancelled, I was not going to be seen between 28weeks and 34weeks as they were going to combine the 32 and 36 week apt’s but my mental health doctor told them not to do that. I haven’t had birthing options explained and I have no birthing plan In place although I know this goes out the window during labour but I would like to have felt some way prepared
Hi rosabuddy. I'm glad you have been seen. We've been told that women should see one or the other so as to minimise contact and reduce risks for staff and women. You haven't seen a community midwife because your medical checks are being done by the consultant and the midwife would have nothing to add.
However, I do feel that you should have at least had phone calls from midwife at the very least just a quick courtesy 'hi, how are you, is there anything you need' type of thing. You could then have agreed between you where there were gaps in information given to you.
My women have my mobile number and can phone or text me if they need anything. This is given out at their first contact.
Perhaps you could give your team a call and schedule something in?
Are you in a position to pay for AN classes? NCT are doing theirs via Zoom. We also have an organisation in our area who are private but very cheap and we receive brilliant feedback from our women who undertake their programs. Perhaps you midwife could advise if there's anything similar near you?
I have to say, I'm shocked by comments on here. Where I work there's not been huge changes.
Yes, the 16 and 25 week face to face appointments have gone but they are of little relevance anyway and can be done over the phone. Generally our women have the same number of face to face appointments they would have anyway.
I'm a ftm but had two previous miscarriages. Didn't know quite what to expect. I think staff have been trying but they are stuck with system. Most appointments have been on phone where you feel like you're going through a script with a call centre.
My 12 week scan was really difficult, partner sat in car. I burst into tears in front of two strangers at beginning of scan. They were nice and understanding when I told them that I had never seen a live baby before and lost my previous at last scan, all was well this time but really missed my partners support and doubt he will be allowed to come to 20 week which is hard for him.
Got phone call at 15 weeks and told to stop my medication without conversation on alternatives. I had to point out that stopping the medication that kept my asthma in check at time of year when I got bad wasn't good idea. Midwife then had to ring off and go speak to consultant who had given instruction. Fortunately I had already discussed with gp so felt confident in questioning this.
I know it's difficult time, but I've heard negative experiences from others. I'm a confident, educated women with no problems in my life. Not everyone is and I worry how many people are falling through the cracks.
Having given birth in lockdown my experience was that the midwives did as well as they could do but woefully understaffed and under prepared
I’d advise everyone who is pregnant now to check what the post-natal care will be like. I’ve been disappointed at how little support has been offered after the event - no physical check for csection scar, no HV appointments, BCG info missed entirely etc. Find out what you need to know for when the baby is actually here, now.
Interested to hear further responses
I hate to be anti-NHS at a time like this and have honestly tried so hard to be positive, but my experience very much echoes others here. I'm another first-timer and have been shocked by the poor standards of care.
Aside from a 15-min booking-in call that was basically a hurried, impersonal questionnaire with no time for questions, I've not really spoken to anyone in a couple of months apart from a couple of sonographers - one of whom was in a really bad mood.
I've had problems with all my urine samples coming back as inconclusive, which I wouldn't have known about if I hadn't spent ages chasing up and repeating of my own accord. The problem still hasn't been resolved and it's been months now. Every time I call, my community midwives are clueless and try and get me off the phone asap. They sound so busy and frequently give the wrong information. The last midwife I spoke to told me my sample was fine and clear; info which was contradicted by my hospital the next day when I checked. Another told me that if I was asymptomatic I should forget about it and not bother with another sample (again, info that was contradicted by both my hospital and GP) I'm usually pretty easy going but I have very little faith in the quality of care I'm receiving and am surprised how much I have to advocate for myself. Like others, my 16-week phone appointment for which I was saving all my questions was cancelled, but nobody told me this.
Like another poster here, I've also been given conflicting info about my due date, which was changed without explanation at my 20-week scan. I've tried to find out why and nobody can offer an explanation. I dropped the subject immediately, as it feels too much hassle to engage with my midwives. I'm hoping it's not a big deal.
It's tough being pregnant during a pandemic and I've had COVID anxiety on top of standard pregnancy anxiety/hormones - esp back in March when less was known about effects on pregnant ladies and we thought maternal outcomes might be similar to SARs ie. very poor. Nobody has once asked how I'm doing. In fact, I've encountered a fair number of staff who are rude and grumpy! The last time I went to my clinic to give a sample, nobody even returned my hello when I walked it! I sympathise to the extent that staff are stressed and scared too, but there's a well-documented link between pregnancy and mental health issues, so I don't think this should be acceptable.
I'm sad and sorry to hear of everyone else's experiences. I thought this might be unique to my own part of east London. I hope everyone gets the care they deserve.
One of the best parts about my pregnancy has been the amazing community here on MN. In the absence of reliable NHS care, I've asked lots of questions here and used the forums extensively. Women here have been so generous with their time and responses.
I have seriously considered hiring an independent midwife to obtain some frequency, and more importantly, continuity, of care. However, as there is currently a limit to one birth partner and this may not change before my due date, I'm reluctant to incur the cost if they can't support me at the hospital. The alternative would be to give birth at home, which isn't my preference, but at the moment feels like a more reassuring and familiar environment.
I honestly think the only way to access care is by private means. Same for schooling as well actually. But what if you can't afford that
It makes me really sad to hear these stories. I don’t think it’s the same in different areas - I’ve had no issues with my care so far (Kent). My booking in appointment was in person - it was originally going to be by phone with me having blood tests in hospital on a separate date. When I said I would rather skip the blood tests (not my first child, so some of the tests I already knew the results for, I’d had a full blood panel with my GP 2 weeks before I conceived (by coincidence) and I judged it wasn’t worth going into hospital to get the other results as they wouldn’t change any decisions I’d make), they phoned back and said if I did my booking in appointment in person they could do my blood tests at the centre. At my 12 week scan, it was found that I am expecting monochorionic twins, and a midwife came to speak to me straight after the scan, and I’ve got regular follow up appointments. I’m very glad that I’ve received good care so far. I’m really saddened to hear that this isn’t happening for lots of other people.
Just to add to earlier post on this thread, my
Cousin had her baby in April and she hasn't seen anyone! No check ups in her or the baby! No midwife or nurse round to check on them both, nothing!
My other friend had her baby and is suffering with severe postnatal depression and they've slapped her on tablets and no one has bothered with her! Absolutely disgusting! The mental health was strained before the pandemic and I have known women to take their own lives because of PND so I'm super concerned for her and her overall wellbeing.
She also had a C-Section and I don't believe anyone has been checking her over either!
I'm due September and whilst everything has been ok for me (physically) so far, as I said earlier due to my ongoing mental health issues I'm terrified I'm just going to be left and have no help! Where's the support?
You can't have your partners with you in the hospital so you are just totally alone! So sad 😢
lockdownpregnancy the mum and baby should have been seen on day 6 (counting day of birth as day 1) as the baby has to have the newborn screening bloods done. This is a national screening programme and cannot be missed.
They should also have been seen to discharge them from care around day 14.
Where I work we're also doing 2 or 3 calls in between. The health visitor also calls as does the BF support workers
I would urge you all to contact your local Maternity Voices Partnership (if you have one) to give feedback on these experiences - Maternity Voices chairs and representatives are working really hard at the moment to represent the voices of parents within maternity services.
Google your area plus Maternity Voices or have a look on Facebook - in Dorset we have a Facebook page and a new group and are currently running a survey to capture feedback, many other areas have the same.
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