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Feminism: Sex and gender discussions

Shrewsbury and Telford Hospital Trust with significantly lower CS rate in scandal.

39 replies

RedToothBrush · 19/09/2018 23:30

Shrewsbury and Telford NHS Trust has got themselves embroiled in a huge scandal over their maternity unit. It now seems that 100 deaths are under review.

Why does this concern me particularly?

The main reason is because there is only now stuff coming out questioning this.

You see in 2016 the Royal College of Obstetricians and Gynaecologists published a report on regional variation on outcomes in childbirth based on information relating to 3rd / 4th degree tears and CS rates. This was based on data from 2013/14.

From this data it was glaringly obvious from the data that questions should have been raised.

Shrewsbury and Telford not only had one of the lowest CS rates:

Proportion of deliveries by caesarean section (ALL CS)
National average Primiparous deliveries: 22.1%
The Shrewsbury and Telford NHS Trust: 12.8%

But it also had one of the lowest levels of CS rates from induced labour:
Proportion of induced labours resulting in emergency caesarean section
National average Primiparous deliveries: 29.9%
The Shrewsbury and Telford NHS Trust: 15.1%

Annoyingly the site that had all this data has been taken down, so it can't be compared easily but its out there. (And I'm glad I took the time to make a note of this at the time).

Shrewsbury's rates were abnormally low against other Trusts. It immediately begged a simple key point;

Either they were doing something amazing that other hospitals should be following to improve their own outcomes
or
They were doing something VERY wrong

(It also raised the question of whether they had a population which was particularly low risk but there isn't really anything about the area in terms of demographics which makes it distinct from other areas, so its relatively easy to dismiss).

If this data was like this for a single year, it looks bad. If its part of a similar pattern, its worse.

Its the type of stat that you look at going WHY? What ARE they doing there.

And here we are:
www.dailymail.co.uk/news/article-6186371/Shrewsbury-baby-scandal-covers-100-deaths-Probe-NHS-trust-grows.html

And the following lines immediately jump out at me.
Yet a number of families insist their babies died needlessly because midwives missed treatable infections or complications.

Other women claim they were forced to have natural labours without the use of caesareans or forceps.

Telford CCG has also recently introduced a blanket ban on maternal request CS against NICE guidance. The CCG are a separate body to the Trust, but my question here in the context of things going on, is to ask whether the CCG introduced this after a steep rise in requests in the area - following traumic births or women hearing particularly troubling stories?

This stinks to high heaven, and I hope that if there are any lurking journalists out there, they look into this angle. If this pans out to show that there really is a scandal like Morecombe here, then there seems to be a case to answer by BigWigs higher up the NHS food chain. Did they ignore stats that jump out, shout and do a little dance whilst they invite some attention.

I really hope this inquiry does not turn out the way I fear it is.

I know this message perhaps should be in another section, and maybe its just shouting into the abyss. But it is relevant to feminism and frankly I'm sick to death of maternity services being one of the sections of the NHS which is most neglected in terms of political interest, in part because women have been so conditioned into accepting sub standard care and new mothers being one of the groups least able to advocate/raise a complaint at the time.

I am maybe just hoping that a lurking journalist bumps into this one, and keeps an eye on it, cos if this does turn out to be another Morecambe, the story isn't about individual midwives and managers.

It would seriously suggest that this would be about something very much bigger, indicating a systematic failure to ask simple questions at the highest levels of the NHS. I want to make damn sure that there something out there posing those particular questions whilst hoping that these cases are properly reviewed.

I hope to god, I'm wrong about this and my spidey senses are just malfunctioning.

OP posts:
PerkingFaintly · 20/09/2018 07:51

The Ockenden Inquiry's being run by a body called NHS Improvement, and here's their contact info:

improvement.nhs.uk/contact-us/

PerkingFaintly · 20/09/2018 07:49

It might be worth writing directly to the Ockenden Inquiry to highlight this. I'm not saying that will be enough, but it's an opportunity that's there.

I'm trying to find contact info for them, but you may get there first.

HotRocker · 20/09/2018 07:49

My sister gave birth to her two DC at Shrewsbury hospital. She lives in Telford but had to travel to Shrewsbury because she was a high risk pregnancy. One DC was born by emergency CS 11 years ago and the other by elective CS because of complications in pregnancy eight years ago. She had an awful time, with the first especially. It really set the tone for a difficult first year of motherhood for her. She’s also had to have two hernia operations because of complications with the Caesarian, although I don’t know whether that’s a normal-ish thing or not

FlorisApple · 20/09/2018 07:31

This is just horrific.

In 2011 I had my daughter by emcs in a struggling east London hospital. I was left to labour for days and days after my waters had broken and they had started inducing me. They were very reluctant to do a cs, but in the end, they did, and thank God my dd is healthy. I was quite traumatised by it all, though, and I do think it was close to being a catastrophe for my daughter. But I now realise that they were trying desperately to lower their c-section rate, as there were financial implications of having a high rate (and they had massive debts). There were other cost cutting factors too, like the midwives having to constantly go and get the drug keys for pain relief topups instead of a continuous drip, and the fact the monitor was broken, so not picking up my contractions properly. I have no doubt that women and babies are suffering because of this kind of economics, combined with an anti-csection ideology.

When I had my next baby, I had moved to Australia and chose an elective csection with no issues at all. My treatment (still in a public system) was a completely different world; kind, empathetic, empowering. Something needs to change in the UK for mothers.

scepticalwoman · 20/09/2018 06:55

I watched the BBC report on this last night. There's just a torrent of awful stories where women and children are being actively harmed - and deliberately it seems through the implementation of 'policy'.

Thank you for posting this Red.

arranfan · 20/09/2018 05:44

PMHull - that blog post is well worth reading, thank you for posting it.

This Trust is not listening to its maternity care patients (“No patient and public engagement has been completed in relation to these changes“), but it is listening to the RCOG and CQC inspectors.

The post explores some of the complexity behind the state of affairs in hospitals that are pushing to reduce the C-sections rates and its wretched to read how so many other preferences take precedence over the expressed wishes of mothers.

OrchidInTheSun · 20/09/2018 05:24

Thanks for this Red. It's terrifying though

CrackpotsArePots · 20/09/2018 04:53

The narrative in the media, , for as long as I can remember has been the aim to reduce the number of CS births .

CrackpotsArePots · 20/09/2018 04:50

Lass

I wonder about that too. Certainly when I had my two, 18 years ago, the message I got was to avoid CS. And indeed I did feel like a failure after the EMCS birth of DS1, and was determined to try VBAC after DS2 (it 'worked') I was really surprised when I Found out about the NICE guidelines only very recently. I now think CS should be available on demand.

LassWiADelicateAir · 20/09/2018 00:46

Why why why are so many trusts obsessed with low section rates even when the costs are so apparent?

Because for so long certain groups, often women's groups , have been banging on about natural births ; midwife led births; midwife only units ; the need to demedicalise birth; articles about "failed birth experience" because there was intervention; talking up how awful c-sections are; denigration of women who choose c-sections.

Nofilter · 20/09/2018 00:04

Thankyou OP for highlighting - I've just moved into this area and want another child!! Shock

WingingWonder · 19/09/2018 23:50

I know people who have delivered there and regrettably their experiences vs my own were shocking

SlothSlothSloth · 19/09/2018 23:47

Oh god, this is horrifying. The thought of knowing you need a section, being denied one and then having your baby die... unspeakable. Why why why are so many trusts obsessed with low section rates even when the costs are so apparent?

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