Fatal failings in UK maternity care(53 Posts)
First off, can I say that I'm not an NHS basher. I am a Registered Nurse and I've had two fantastic deliveries on the NHS but my last delivery was horrendous. Awful to the extent that one of my healthy (7lb7oz) twin boys died during labour.
'The Times' today ran a front page article about failings in maternity/delivery care, and my particular view is that salaries are being withheld for key clinical staff, while funding seems to be limitless for layer upon layer of 9-5 middle managers with seemingly meaningless job titles and duties. I know that I'm not exactly a ray of sunshine on a Sunday evening for starting this thread but I'd be interested to hear your views.
It scares me. I was extremely fortunate with my first (and only) birth in that the labour ward wasn't full by a long way (very unusual for a London hospital) and I had two midwives with me at all times for my waterbirth.
However, I am pregnant again and the idea of taking my chance on the staff who happen to be on duty when I go into labour is, to me, a little like playing roulette. I do not want to be left to labour in a room by myself while "my" midwife attends four other labouring women, I do not want to be told somebody else is in the pool or that they are understaffed and I cannot have access to it.
As a result, I am hoping to have a homebirth.
Bubble, I think this is a very important thread to start - it shows that there is a swell of feeling, an undercurrent that will support your campaign xxxxxx
Yes I read this and it terrifies me especially as I am having my second baby in a couple of months.
I am at a good maternity hospital but even so have noticed a fall in care since my first child. Have been told there is a shortage of staff and apart from inital appointments, all ante-natal care will be with GP so I won't know my midwife, whilst before I had one midwife who dealt with me. Don't feel so bad as this is my second, but what about first timers?
those two points - taking pot luck as to who is on duty at the hosp and not having the same midwife for ante natal care as for labour are standard in Spain. The UK system would be one of the best in the world if they would only pay key staff more and therefore keep more of them.
will most likely get shot down for saying this as it seems so drastic but here goes... I had my dd by elec section as I had grade 4 placenta praevia so had no choice in the matter. The birth was calm and lovely and a very positive expereince. Again this won't be popular, but dh is a theatre nurse and we had 'hand-picked' our anaesthetist as someone dh worked with and trusted implicitly and I'm sure dh working at the hospital helped with some of the treatment I got. Now I am pg with number 2 (26 wks). I am hoping against all hopes that I have another elec section (have requested one and it seems to be ok so far).
A very big factor in my fear of a natural labour is the shortages I know there are in midwives in our hospital. A friend of a friend has a little girl with brain damage from being left alone during a very difficult labour at our hospital and this is not the only case I know of. I simply don't trust that I will be given the same amount of attention and support with a natural birth as I will be with a c-section, where a whole team of people are there and monitoring mine and the baby's every breath. I don't blame individual midwives AT ALL, but I know they are only human and the circumstances under which they work must be extremely stressful and demanding.
There is a massive shortage of midwives in the london hospitals and I experienced the bad side of this for both my pregnancies and births. For my first, I did not see the same midwife twice throughout my entire pregnancy and 40 hour labor. During labor I was left completely unattended for 12 hours and when I did finally get a midwife, she was also attending four other women all in the last stages of labor/delivery. After delivery, having had a cs, there was 1 nurse/midwife (or whatever she was) looking after 40 women.
Moomin, I am 100% with you. Although I had a VBAC with my second, in retrospect I think that if I knew that I could have booked an elective cs and had an anesthetist of my choice 2nd time around, I would have done it that way.
Think the bottom line as always is money. There needs to be far more money poured in so that the wages can be higher, which will attract more mw's and the best ones can be picked to work rather than people that seem like they'd rather be anywhere else but with you (some of my mw's). And the fab ones already working will get a good wage and hopefully stay with the NHS. Money isn't everything but it would stop the really good mw's leaving because of bad conditions and attract more people to train as mw's. And there's loads of places to get more cash from - cut the number of idle people behind desks, make smokers take out their own health insurance, charge the people who clog up casualty just because they got too pissed, or whack it on tax.
Also, I don't know what sort of training mw's get but IME its not enough. Very few that I've seen (and I was in for 2 weeks so saw ALL the ones in my hosp several times) actually care about you and although the best way to get that is people who are naturally caring it can be taught and drummed into new mw's. But also the technical knowledge is appalling - take one little example, an experienced mw at mine didn't know the right way round to put a light jacket on, and even I worked out as soon as I saw it that it was the wrong way round. But she didn't believe me and had to check the instructions!!!! There were far more examples of things they should have known but didn't have a clue about but won't bore you.
The point is that if mw's are being allowed to practice without caring about the patient or fully knowing what they're doing then what are they doing there???
Marcia Fry from the Healthcare Commission was just on BBC Breakfast - is she someone you can contact, Bubble? She sounded very keen to change things.
Here's the original article - I hope you didn't not post it for a reason, btw, Bubble:
July 17, 2005
Official alert on deadly baby units
Jonathon Carr-Brown, Health Correspondent
MOTHERS and babies lives are being put at risk by substandard care in maternity units, the governments National Health Service inspectorate will warn this week.
The Healthcare Commission has uncovered evidence that chronic staff and equipment shortages or management failings have contributed to the deaths of mothers or babies. Sir Ian Kennedy, the commissions chairman, now wants all trusts to review their maternity services because of huge discrepancies between the performance of the best and the worst.
He said: "This is an area where the consequences of things going wrong are very great. And there is growing evidence that in some places maternity services are not as good or as safe as they should be. Our work has shown that there is too much poor practice that needs to be rooted out."
It is the first time Kennedy has issued such a strongly worded warning about the state of NHS practices since the commission was created two years ago. A Department of Health source said: "We will be taking it very seriously."
Kennedys report was prompted by the commissions investigations into three maternity units. Each found examples of healthy mothers and babies dying or being put in jeopardy because they were not treated properly.
At one, Northwick Park hospital in northwest London, Kennedy took the unprecedented step of ordering a team of experts to take over the maternity unit after 10 mothers died in three years five times the national average.
Premalatha Jeevagan, a healthy 27-year-old mother, died at the hospital in February when doctors failed to realise she had suffered a womb haemorrhage.
At New Cross hospital, Wolverhampton, a review by commission inspectors of 20 deaths of babies between 2001 and 2003 found that half might have survived with better care.
Trinity Reynolds died there in March 2003 when she suffocated in her mothers womb after mistakes by medics. The inspectors concluded: "Staff either failed to recognise that the babies were seriously at risk or there were delays in taking action."
The third investigation, at Ashford and St Peters NHS Trust in Surrey, found no evidence of unnecessary baby deaths, but concluded that "feuding" between consultants was jeopardising standards of patient care.
Britain has the worst infant mortality rate in Europe at 5.3 deaths per 1,000 deaths. Only Poland and the Slovak Republic have worse rates, according to the Organisation for Economic Co-operation and Development.
There is evidence that standards may be declining, as the number of deaths in pregnancy and childbirth has risen from 30 in 1999 to 45 in 2003.
Kennedy, who chaired the inquiry into the scandal of bungled baby heart surgery at Bristol Royal Infirmary, is concerned that many of Englands maternity units may be in crisis because of staff shortages, dilapidated buildings, poor staff training and weak management.
He acknowledged that giving birth was safer than it had ever been and few mothers and babies died or suffered serious damage. However, he said: "The numbers could be smaller if we threw the spotlight on maternity more often, and not just in the aftermath of a serious problem."
He added: "We want to bring all units up to the standards of the best. We need a fresh co-ordinated effort to raise standards and get the risks as low as possible."
Kennedy will use the publication of the commissions annual report to highlight his concerns with Patricia Hewitt, the health secretary. He wants NHS trusts to provide more detailed information on their performance. Those that fail to do so will face spot checks by inspectors.
Liam Byrne, a health minister, said: "Im concerned that not enough maternity units are reaching the best standards. Ill be announcing on Wednesday plans to bring the best brains in maternity care together and by the end of the year we will have audited every unit so we can improve services."
I've only had time to scan the thread so sorry if I'm being totally irrelevant.
This is a really important issue. What I'm instinctively concerned about however is that it's only being raised now in the arena of party politics as a stick to beat Labour by the Tory's who, as far as I can ascertain, have absolutely no interest in increasing funds in this area. I'm not sure anyone is served well by this sort of media squabble. It's all just rhetoric, nothing ever gets done and it will disappear again when the next scandal hits the news.
So sorry about you tragedy Bubble. x
the failings of maternity care in the UK (NHS and private) is a major factor in me not having a 2nd sprog.
i saw this on the news this morning and said to dh, rather matter-of-factly, "next time, home birth".
its sad, depressing and i hope with this now something will be done.. but i wont hold my breath and i worry for those directly affected by this short-coming...
Thanks HM. I will contact her to see if she can help me.
I saw 4 different midwives for my ante-natal care, and during labour the midwives had to keep leaving me to check on other women. The midwives themselves were lovely and I can't fault them, but the doctor was horrid and didn't explain anything to me even though DS heart rate was all over the place. The toilets were dirty and everyone seemed rushed. Bubble you should definately contact this woman and tell her your devastating experience.
Bubble I sent that email for you this morning, sorry it took me a few days. Thought I'd better act quick hoping she might see the extensive coverage today, I CC'd you so I hope you are happy with what I sent. Maybe she will want to contact you directly, although I am more than happy to carry on on your behalf as I'm sure all this must be keeping you very busy. Lots of hugs to you all. xxx
Fingers crossed, Bubble. As always, anything I can do, just shout xxxxxx
My experience is the same as a lot of peoples on here, never saw the same midwife twice, one I did see spoke appalling English no one seemed that bothered to be honest. Not enough midwives available, more than an hours wait at antenatal clinic.
DD's birth was OK in that it was fast (took midwife by surprise) she had left me with the gas and air and gone for a break when I was screaming I needed to push. Post natal care left a lot to be desired as well. Hoping for a homebirth this time.
One of my best friends is in the middle of an inquest over the death of her baby. Quick summary she had scans every week from 20 weeks not one picked up placenta previa. Surgeon who performed the c- section cut through the placenta leading the baby to lose 60% of her blood volume yet there was a delay of 2 hours 40 mins taking her to SCBU by which time her organs had failed, she died 3 days later. Everyone at the hospital is blaming everyone else
I agree that improvements are desperately needed.
I finally sent off my NHS complaint letter today regarding my delivery.
I had an horrendous first experience with my daughter. Dont and cant really go into detail, but as a result (i belive) she has special needs, quite severe. She will be six in November and every avenue for a diagnosis for her has been shrouded by lies. We moved county last year and the previous county are refusing to send on her notes. it is so distressing for us and we have had to take the eventual step if getting a lawyer involved and having her looked at by an independant consultant as we cannot stand the pressure of this any longer. the hospital down here have been fab but agree legal action is the only thing that will help us.
I dont feel bitter but i wouldnt wish what happened to us on anybody. My husband most probably(likely def) will never walk my daughter down the aisle (corny i know) and we will never see her grow into the woman she should have become. We will never get that independance in our middle age we imagined, we had children young for freedom later. Life isnt perfect i know but a few extra pounds on midwives, i think is a necessity
Fio2 it is not corny. It is heartbreaking. I had a terrible experience during birth of my son and wrote a letter of complaint which was largely ignored. Hopefully tho he will have no long lasting damage, unlike some here. I cannot believe UK has the highest infant mortality rate in Europe only behind Poland and Slovakia. That is truly terrifying. all the other Eastern European countries new to the EU have better rates than us. And i told my husband i wanted to have he baby here, not in Czech Republic, cos i thought it was safer. My God.
maybe we should start a petition? Or organize a demonstration?
Yes, the 1,000 Bump March - has been talked about on here before. To Downing Street, maybe? With a petition from women who want better maternity care and more spent on ensuring safe deliveries.
Shouldn't be too hard to find people willing to sign it...
i feel very strongly we should march. All the nice journalists on MN should cover us??
Come on, let's sort this out - it shouldn't be too hard...should it? Any experienced marchers out there?
it's quite shocking to see the sheer number of women who had bad experiences of car during childbirth (partic in london) i to had a rather traumatic birth with dd the cord was round her neck twice and when the heart rate dropped dramatically the midwife said oh dear and ran out of the room to get help (you can imagine how that made me and dh feel) anyway she was born instrumentally and thankfully perked up quickly and was fine, the post op care however was atrocious - i was put in a room alone at 5 am and left stuck in ed with dd bfding and a drip in so i effectively couldn't move then i started to haemorrage, luckily a nurse came in at 8am to inform me i had missed breakfast and found me in a state of confusion otherwise god knows what would have happened to me or dd
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