Yet another maternity scandal in the NHS

It's really sobering and distressing to read these reports (sadly, again and again) as a midwife. I absolutely agree that women are not listened to. It's exhausting to be pregnant and feel like you are fighting a battle (I felt like this in my first pregnancy, and I was a midwife at the time!

My personal opinion is that the entire system is misogynistic. I don't believe that any midwife goes into the job not caring. Everyone starts out wanting to do their best for women. What I think happens, is that midwives go into a system where they are eventually beaten down- overworked, undervalued and underpaid. In some units, those conditions lead to a toxic culture of lateral violence, which is what always happens between people at the bottom of the system. That lateral violence between midwives spills over into lateral violence against patients. It's terrible, but actually not that surprising in a system that is underfunded and set up all wrong.

The best outcomes are achieved when women are listened to, informed and in control of their care. There is so much gatekeeping, both of Caesarean section on one hand, but also of low intervention birth on the other hand. I agree with the OP who said we need fundamental reshaping of services including continuity of care schemes, which we know lead to better outcomes. We have all the data to prove that! Unfortunately it is exhausting being a caseloading midwife (it brought me to my knees while also caring for a young family so I had to step back) but I think it's one of the key elements in improving the mess we're in.

NC as outing, but I personally nearly died there in childbirth this year and am entirely unsurprised.

Yep, that is my experience of the NHS maternity services - try to avoid c section at any cost, no listening to the mother, little kindness. I am sure it is understaffed, but there is still no excuse for treating women like this.

This is just awful. When I think how hard I used to work, the shifts when I ended up staying for 18 hours or more so I could deliver a lady who needed me. We had a lot of military families, prisoners from the local prison, women who had nobody to stay with them. We tried to be supportive and kind to the women in our care.
I remember a lovely man sharing his sandwiches with me because I wouldn't leave to have a break.
When did it all get so bad?
I have a box of cards and letters from women I cared for; I have kept them for 40 years.

Plussize - I think we must have listened to the same interview.

It's horrific. I don't have children so it's not like it's just something mum's find horrific. Yet again it's women not being listened to. I heard a mum of a baby who died talking on radio 4 this morning. I was sobbing listening to it. I was also fucking furious. Yet it keeps happening.

At root, the problem is how women are seen and treated - that they are not respected, not listened to and not cared for, despite various drives to try and do that because everyone knows it massively improves outcomes for mothers, babies and families. Of course this leads to PND, PTSD, etc.

I completely agree with this. Of all the experiences I've had with medical care maternity was the only one where I was completely ignored and told that I was just not feeling what I said I was. I was told off like a school child for coming in, shouted at for not lying still enough for the CTG, told that I didn't need to push, that 'you'll know when you do and you'll realise then how silly you're being now' and left to labour alone in a triage ward (without the curtains even drawn) for two hours until DH finally convinced someone to examine me and they finally realised that DS was near crowning and rushed me to a labour room, he was born 20 minutes later. I think it's probably why I tore so badly, and it really scares me looking back because it was classified as a high risk pregnancy, I was told that I had to be monitored throughout and so wasn't eligible for a water birth, and then in practice was left completely alone until that last 20 minutes (and if I'd listened to them I'd still have been at home then).

Eight months later I had to have (minor, but under GA) exploratory surgery for suspected cancer and the contrast in how I was spoken to, treated, attitudes to pain killers, etc. really brought home that it wasn't the hospital or the NHS, it was specifically maternity services that had the attitude that you don't need to listen to the patient. Absolutely I think it's a feminist issue.

The interview on R4 Today this morning with the woman whose poorly baby died in her arms at home was harrowing. I was crying for her when I pulled into the car park at work. The losses these families have experienced are heartbreaking. 😞 As someone said upthread, their tenacity in pursuing this is humbling.

And when they look at outcomes, I wish they'd look further in. Look at the lifelong issues women are left with because they had risky "natural births". Trauma, injuries, incontinence, PTSD, PND, etc.

But they never do. We're not encouraged to raise birth injury issues afterwards, just expected to shut up and get on with it and 'aren't you happy you got a baby out of it all, be grateful and stop complaining'.

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 .

This is awful. The NHS treats women appallingly and has done for years. Particularly young mothers.

I was left for far too long with my first (over 2 days) when I was young. It took my mum marching to hospital and demanding they listened to me for them to realise baby was in severe distress, I was in theatre 5 mins later. Whilst in theatre I told them the anaesthetic wasn’t working and I was screaming because I could feel everything, they called me a baby. I kicked the surgeon. I ended up in intensive care and baby.

Even all these years later I desperately wish I’d complained.

They don’t listen. Funnily enough with all of my subsequent babies, when I was older, I was treated with far more respect.

I read about this in The Times today. Well done to those brave, tenacious parents who didn't put up with being blamed for their own babies' deaths and collated evidence. I see the people running the show in both cases failed upwards into consultant type roles. Sick.

That is horrific.
Even the person I worked with who was an awful bully to the staff was kind to the mums.

Not strictly on this heartbreaking story...

Generally though I think that the Conservative government have deliberately starved the NHS of funds leading to understaffing and inadequate ongoing training. The idea being to run down the NHS so they can say it is not fit for purpose/those who can pay give up and go private. Although private options for maternity care are limited the NHS as a whole has been seriously underfunded which impacts on all areas.

Not so long ago any mother having a Caesarean section would be in hospital for 5-7 days being looked after and supported. After a normal birth in hospital a mum would be in for 2-3 days and could elect to stay in a midwife led unit to rest and recover for up to a week if she chose to.

Community midwives used to visit daily for the first week, and at least three times in the second week, more if required. Then at least once usually to sign off in the third week. Midwives could continue to visit mums up to 28 days after the birth of a baby if they felt that a mum and/or baby needed it.

We need more midwives who have more time to spend with women and more care assistants to support midwives.

Best practice is impossible in a situation of constant crisis.

With enough midwives we could have a caseload system for those midwives who want to practice that way. Mothers and midwives both benefit from such a system where a relationship can be established during pregnancy and care can be tailored to women’s particular needs and circumstances.

The stories from this enquiry have been shameful. Sadly too many women (including myself) have dismal stories of poor quality care, bullying of women and downright dangerous practice. Maternity care has proved time after time to be inadequately funded and too often staffed by poorly trained staff lacking in understanding and empathy. It's a tragedy and must be awful for all the well trained caring staff to see scandal after scandal being reported.

The sister of a friend's partner died this year after giving birth.

She endured an insanely long labour (iirc around 40 hours) and was denied a CS. She died a day later.

I was astonished when I heard about it. I don't know how much of this is because Covid has fucked everything, but it's frankly an absolute scandal that maternal mortality is happening at all in a country with supposedly advanced healthcare.

I heard the dad of baby kate on radio 5 live this morning. His wife and he and one other family had fought to get this to Jeremy Hunt. They collected 23 family’s evidence and presented it and he opened the enquiry.... within weeks it was over 600 cases and ended up in thousands.
I’m not a very emotional person but as he spoke about what happened to his wife and daughter in the hours and days after her birth I felt physically sick and I welled up.
I despair at governments (of all sides) at times and their insistence arbitrarily measures that encourage all the wrong behaviors but that said, the behaviour of a couple of the midwifes was shocking. And when he described having to phone round Birmingham hospitals trying to find out which one had his daughter it was just unbearable.

yep, you get what you measure. if you measure for low rates of c-sections then that is what you'll get, regardless of the effects on mothers and babies

Yes, what they should measure is outcomes not processes. In the case of S&T, the outcomes were dead babies, but they were too busy boasting about their low c-section rate for anyone to notice.

So much wrong with what was happening at S&T - failure of midwives to escalate to obstetricians, failure to warn mothers of risk in transferring from MLU to hospital, inability to read CTG trace correctly, misuse of oxytocin, altering medical notes after the event, blaming women for their babies' deaths...I could go on. Absolutely disgraceful. In any other situation where there were this many deaths, people would do something about it but apparently in maternity no one cares.

And none of it picked up by the regulator who are, frankly, worse than useless.

Yes, of course this is absolutely a feminist issue.

I saw this in the news and was thoroughly saddened and depressed by it. My thoughts with the mothers who've lost babies, and the women who have died.

At root, the problem is how women are seen and treated - that they are not respected, not listened to and not cared for, despite various drives to try and do that because everyone knows it massively improves outcomes for mothers, babies and families. Of course this leads to PND, PTSD, etc.

It's shocking how bad some maternity provision is. I would go so far as to call it actively harmful and abusive. (I've also experienced excellent woman-centred care, so I know that it's possible and does exist in some trusts.)

From the sound of it, Covid precautions led to some absolutely inhuman situations.

Reading between the lines, and from listening to Jeremy Hunt yesterday, I am guessing that there was one or more very senior person in the department who had a bee in their bonnet (s) about avoiding CS at any cost.
This is increasingly rare these days because of evidence based practice and the green top guidelines. It is easier for junior staff not to be compelled to pander to unsafe foibles, but I can see how it could happen.

yep, you get what you measure. if you measure for low rates of c-sections then that is what you'll get, regardless of the effects on mothers and babies

the news reports on this have been harrowing

and yes, it is a feminist issue. dealing with medical professionals while pregnant shocked the life out of me. i've never had a problem making my wishes known, and yet all of a sudden it felt like no one could hear me

lPl
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