Yet another maternity scandal in the NHS

I am totally opposed to litigation as a method of improving things. I think it just leads to cover ups and defensive practice.

A no blame system with the purpose of learning lessons and improving practice would be better for women and babies. The focus needs to be on what has gone wrong and how to avoid it happening again.

Staffing levels are vitally important but I do agree about the bullying cultures that can develop in some units and the consultants who think they are Gods, and the “mean girl” cliques. This is not the case in every hospital. It would be interesting to know what makes the difference... I am pretty sure that where staff are bullied, women also will be bullied. Places where the staff are free from bullying no doubt have a more collaborative approach where any staff member can suggest changes that might improve the safety and well-being of women and babies. In toxic cultures staff will feel unable to voice concerns. Midwives must listen to women obviously and take women’s concerns and instincts seriously, but in order to advocate for women midwives must feel that they can speak up and say “actually this mother knows something isn’t right we must investigate further”.

Caseloading isn’t for everyone due to the commitment required. For reasonable caseload size we need to look to Independent Midwives who are the experts in sustainable caseloading and continuity of carer.

You raise an interesting point there too about aftercare. With my first section I was discharged after 48 hours and with my second after 36 hours. I had no help from anyone in the night with my first, it was horrendous. I couldn't reach the call button for a midwife, my daughter had been screaming for about an hour and I could barely move to get her. When I did reach her she wouldn't latch and I was just crying on a ward with two other sleeping mothers and babies. It was so, so awful.

Sorry for typos. Blame my age I am a great granny now

I am an old hand on various boards about this subject.
Fifty and forty eight years ago I had both my children by what is now called crash caesarean sections. I almost lost my life along with my DS1 the first time, my second son was brought out almost dead as well.
While I have stated at the time that now things looked like changing for the better now, reading this I am really grateful I gave birth then and not now!
While I am not going to comment on the terrible complications I had in the labours, I must admit the car I got afterwards was second to none.
Ceasarian mothers were kept in for 10-14 days and not allowed home until all stitches were out and you were just about back on your feet again.Babies were kept in special care for the first two days, which while not ideal for the mothers, was to ensure they were healthy with no breathing problems or other side effects from their traumatic births before being transferred to the post natal wards
First time mothers having had vaginal births were in for 5-7 days, second and third time mothers wee aloud home after 48 hours if no complications.Mothers having subsequent babies were usually kept in a bit longer in case of possible complications e.g. heammorages which multiparae were at risk of
This was the NHS then. There was no need to go private.
What on earth has happened?

apric0t, if it's any consolation I think women are sometimes given a bit more credence when it's their second/not their first. Plus I know I was more confident in my own decisions the second time - I refused to comply with everything until I was genuinely happy I was making the right decision.

I would suggest arming yourself with a good advocate/birthing partner, if at all possible, someone who can talk authoritatively and isn't afraid to piss the staff off.

Have you considered a home birth, if you're maybe inclined to precipitous labour? A couple of friends opted for that after having unexpectedly fast 1st labours.

I have personal experience of doctors standing up and lying at an inquest. I don't know how to fix it. I am retired now and worn out.

I'm feeling very nervous pregnant with my 2nd. Had my 1st at a hospital in London with brilliant care. Have since moved and now live 1 minute away from one of the scandal hit hospitals. The other nearest hospital is over an hour away.

So far the difference in care has been quite shocking to me. I have had to pop into maternity triage day care a few times and it's a total shambles. I wasn't informed about my 20 week scan and has to call them to find out it was the following day! Not sure if it's to do with COVID or the hospital but feeling very nervous about my impending labour and birth. The midwives seem very disorganized. There has been a culture of women not being believed at this particular hospital (when they're in labour, baby movements etc) and I had a very fast labour last time, 58 minutes, worried I may end up giving birth without assistance at home because they don't believe in in labour.

To be honest wish I could go private.

Interestingly, the nhs spends a fortune on insurance and their legal departments. Unfortunately a fair chunk of that money goes on investigating fraud. Yet it all still goes on.

@endofthelinefinally, there is one part of the American healthcare scene which if embraced would make a massive difference, and that is litigation - sue midwives, sue trusts, sue doctors, sue administrators.

Not shilly-shallying around with official inquiries, and reports, and hand wringing about "lessons learned'.

The only way to make things change is to hit everyone concerned where it really hurts.

@vaccinationstation thank you. I still think I'm not allowed to complain as I have a healthy child. I was "lucky" in comparison to so many.

This is so awful. I didn't realise things were so bad.

This is shocking. I had an awful time having my son, they let me labour for days, wouldn't examine me, were so rude, then they couldn't get him out, his heart rate was dropping and had the suction cup and forceps. His heart rate was half what it would be, he was on the cusp of oxygen deprivation, so I spent a year worrying he had cerebral palsy. They also said they'd done a blood test when they hadn't, so I had to have a blood transfusion after days of severe anemia unnoticed. I was also having a mental health crisis and told someone I wanted to go without my baby or jump out of a window. Nothing was done. They discharged me in the cold dark evening while I was crying. I've had to have EMDR therapy for this and nearly had to go inpatient due to the PTSD I developed.

It’s not just about funds. It’s about staff - well paid ones - who don’t care and who close ranks. The NHS is such a sacred cow. Parts of it are
rotten to the core but no one dare criticise it. I worked there and saw for myself: the bullying, the cliques (often based on nationality) and the doctors who thought they were god

Agreed I used to work in the NHS and found a culture of bullying, I even complained a few times about others being bullied and nothing happened or the bully would be moved up the chain and out of reach of the victim. The cliques were strong and kind of mean girls esqe. And those drs that thought they were God were always moved on up the chain to eventually make the big decisions hospital wide. The thoughts were at least they didnt have to meet patients and make things worse.
Basically the worse a person you were, the more rewarded.
I will never go back.
Although I believe the NHS is a great idea, but how do you stop the rot that leads to mums/babies dying unnecessarily.

@BackwardsGoing

I am so sorry this happened to you. Horrific. I cannot believe medical professionals are so dehumanised that they think this is acceptable.

Hearing about this on Radio 2 this afternoon really made me think properly about my two emergency sections several years ago. I was pushing for about four hours following induction, and have very little memory of any of my labour with my first. My mum and husband told me afterwards that the midwife was absolutely insistent that I could do it naturally and was very reluctant to let the doctor in. My daughter ended up with scratches on her head and arms, and the doctor sprained his wrist as she had descended quite far so he pulled her back up essentially.

I hadn't ever considered that the care I received was poor but I really did have to go back over it in my mind today and wonder if my situation was actually avoidable. With my second, I was a bit more lucid and insistent because I wasn't 26 hours into a horribly painful labour, and she ended up being an emergency section before I did any pushing. Something to do with the way they were both sitting and pelvis shape or something. Not sure whether it should've been picked up, you don't really ask questions after you have a baby I guess.

@teezletangler

It must be very distressing for you.

In my experience, it is getting worse - am pregnant again and the younger midwives are so pushy about me trying a VBAC and keep saying things that are biased and/or not supportable with evidence (like "having had one big baby doesn't make any difference to the the second one being big" - well, no it doesn't guarantee a big baby but as there is a strong correlation, noted in all scientific papers I have read on the subject of larger babies, it's probably a good thought to factor this in to our thinking, no?! Why venture a view that is at odds with the ducking science?!). The older midwives who have had kids are SO much more supportive and pragmatic, but they are often the ones working in the community and then the younger ones are in the hospitals, so in my view this is one reason why the cycle continues.

My (young) midwives the first time around couldn't tell that the baby was stuck and would not descend and initially refused me access to a consultant to discuss when I knew some hing was wrong and I was dismissed because they thought I was in transition and just being negative about what my body was capable of. I was continuously gaslit and shamed. Once I had access to a consultant, they were immediately overruled. Then, they gave me the cold shoulder after my emergency section, didn't check on me at all, then came in to berate me for falling asleep for an hour (hadn't slept in 3 days) rather than feeding" ("you could have killed your baby"). Finally, no one told us when the meal trolley came (at 4.30!!), so I had eaten one sandwich all day and had to order a takeaway because the canteen was also closed.

It astonishes my friends from other European countries that there is so little use of data to try to inform birth choices in the NHS as standard. I mean, if in your specific situation, your chances of a non intervention led vaginal birth would actually be likely to be less than 50%, 20%, why is this information not given to women unless high risk? It would save the system money to avoid lengthy and fruitless inductions in favour of sections if this is what women want with all the information available, surely. A consultant obstetrician friend said he tried to propose writing an article about evidence based interventions/sections in the BMJ, but that no one would publish it, because the midwife lobby for natural birth is so strong in the U.K, so he has given up.

Second time around, I do have a lot more support from the older midwives at least and the system allows me a genuine choice of birth option. I seem to be treated more as someone who is capable of weighing her options. Why the hell are first time mothers assumed to be so incapable of having a sensible view on what is happening to them?

@katmarie I did find the midwives there provided compassionate and wonderful care there, with the odd exception. But consultant decisions rule, which I think contributed to my experience.

I gave birth twice in t&s hospitals, in the past 5 years. I think the women and families who have come forward and pushed for this review have a strength and a dignity that is so humbling. I knew it was rumbling when I had my son, the local papers had been covering the efforts of the families to get the inquiry heard, so it was pretty worrying knowing that I was going to be giving birth there. My care, however, was good on the whole, and at times excellent. The staff were truly wonderful, and in both cases I generally felt listened to and respected. I can only hope that my experience becomes the norm. No one should have to cope with what these families went through.

I know that some of the local mlu units have now been closed, and at telford hospital a brand new mlu has been set up right next to the consultant unit, which will make for quicker transfers. Of course none of that makes a difference unless the culture itself changes. But I deeply hope that these lessons will be learned, and quickly too.

@MoltenLasagne thank you. Just read the report and the overuse of oxytocin, lack of compassion (not from, in my personal case, midwives but consultants/registrars) and allowing a long labour to avoid section at any cost are all very familiar to my experience this summer. Cannot believe that lessons are still not being learned here.

I lost 3 litres of blood in a severe haemorrhage during a crash section under GA. Had several transfusions. Had an extreme fever and acute kidney injury. Was kept sedated for so long afterwards I didn't meet my DC until the next day and I was so out of it on morphine I don't even remember it. Have flashbacks of the moment I came round and PTSD. The review was ongoing then and still no learning. Wonder whether I should say something?

I didn't get the growth scans I needed thanks to Covid either. I even questioned this. My baby was 10lbs. I measured on the 99th percentile and should've received regular growth scans.

Privatisation is one thing, but please God not the American system. I worked in a posh private hospital in the USA and saw more serious birth injuries there in a year than in 5 years in the UK.

My husband still cries when recalling the birth, he found it so traumatic. When they pulled with the forceps they pulled my whole body down the bed and he had to hold onto me and wedge his foot against the wall to keep me from being pulled onto the floor.

People who enabled the culture and practice there should be prosecuted.

I think that's a really powerful and insightful post @teezletangler, thank you for it. I've read that the evidence is strong for more continuity of care but I don't see it how could be achieved without much more money in the system (or banning midwives from taking holiday or having their own lives...)

My personal negative birthing case introduced a specific positive system to our area in the UK.

It was just heartbreaking.

Women like me, staying silent, saves the successive UK governments multi-millions when we don't sue.

However, after many years, we start to use our £ and voices to 'throw in' with other girls and women.