to just be appalled and feel utterly powerless

[Misstomrs]

The BBC news today has an article that 1 in 5 births have an incident or near miss that could result in harm (including terminal harm) for a mother or her baby at birth.

My own birth was appalling mis-managed and since then (18 months ago) I have met with the hospital and the University that provided the trainee who was involved in our care and who almost killed our DS. It’s been genuinely draining and traumatic for me to keep going over what happened, but I have because I don’t want anyone else to go through what we did as a family. It was all completely avoidable.

I’m left feeling that maybe it wasn’t worth it. The system just seems so broken. What’s the point?

The lottery of care is one of the main things that puts me off having any more DCs. Both the hospital consultant and Univeristy team were appalled when I explained that to them, but it’s true.

AIBU? And more importantly, what can WE do about it?

As a side note MrsDV I was checked every month with my son, roughly three years ago so it must be a bit of a postcode lottery again. Good thing as well as sometimes issues (albeit minor) cropped up.

Reborn you're being a dismissive and patronising git.

JackietheBackie is also a midwife and echoed some of your comments, but the attitude is completely different and doesn't make me think 'thank fuck I don't want another'.

This sort of attitude, plus some other concerns meant I opted for an ELCS and it turned out it was 100% the right decision.

To be fair, it has been quite bad for decades. I was told by a nurse that I was not her responsibility, just after a c section, still hooked upto drips, having just got to ward after going into shock.
Luckily I had the forethought to ask her which nurse I could ask for assistance. She checked her list, and found she was responsible for me, after all.
She wouldn't have checked on me or my baby all night if I hadn't happened to ask. He developed low blood sugar, and had to be moved to nicu - that would have been missed, and I was completely immobile and couldn't have checked on him.
It all seems a bit down to chance

Yes midwives are leaving in droves. The Government has to understand that if working conditions are not good, people will leave. And that will inevitably mean that you have to employ people who while they might be fine at the medical side, may not be the most compassionate.

And when people are stressed, under appreciated and harassed at work, they are more likely to make mistakes.

What I found hard when in labour/giving birth was how vulnerable I felt & how anxious I was. For many woman it’s the first time they are not in control & it’s scary.

Of course midwives do an amazing job & most of the ones I met are fantastic but some are lacking in compassion & empathy. I don’t understand why they are in the job frankly & I don’t think it can all be blamed on morale.

I wouldnt say people are working against midwives on here at all, There have been plenty of positive stories but their are also negative.
As pp said Jackiethebackie managed to convey herself fine and get her points across. Reborn lost any points in her nasty aggressive dismissive rants. She also lacks any empathy.

Lalaloopy you are totally right on the feelings it can evoke and how scary it can be, Always helps to have a really caring midwife who can guide you through.

Maybe nhs would get blamed for issues if they were more up front with people. Like for eg the GD as it is known that this can be caused/worsened by maternal obesity. So saying that to the mum and you could reduce complications in next pg by getting to normal bmi.
Same with people whose epidurals dont work.
How much of these complications are actually our bad health habits.
Us all choosing to have kids later is clearly increasing the pressure on maternity services.
Nhs as with most jobs staff seem to want to do the least amount of work possible. Which is unfortunate for patients when you are completely at their mercy like in labour or even more on post natal.
A service that makes you cry/want to cry at the thought of going in isnt that great. Mainly as you know the simplest thing will take all day/night. But also because you have lost all trust.
What % of woment give birth without the pain relief they wanted? My sister decided not to give birth in uk due to horror (true) stories. And having had 2 here I completely agree. It may not be Africa but neither could it be decribed as good. It actually feels like they hope you will accidentally have a home birth.

Without the pain relief they wanted.... Or, as in my case. First baby, no pain relief at all, whatsoever.

I truly believe a massive part of the poor care is due to attitude. The midwives I saw were amazing - supportive and respectful and caring.

I've had many friends give birth at one of the earlier named hospitals for poor care and mortality. Their care was absolutely shocking. Honestly horrific.

A caring midwife won't necessarily save your life, but she's very likely to stop debilitating PTSD.

I think you have been a little harsh on reborn.

Although some of the complaints surround wanting "something to be done" earlier in the process, midwives know that interventions can have knock on effects, on later births. Sometimes very serious.
You can have a c section "as a precaution" and end up having problems with your next pregnancy due to the c section scar.

People forget that no one can guarantee perfection - to perform in a job 100% perfect 100% of the time I think is unachievable.

There are a lot of unnecessary interventions - trouble is unless you have the benefit of fortune telling you can not guarantee that each intervention is needed. It's only with hindsight you find out.

And staff respond to the most likely outcome.

In my case having a full on reasonable discussion with only Gas and air at hand meant that staff were caught unawares that I was actually giving birth as I appeared calm and not in the throes of labour at all. I don't blame them - why would they know?

With the greatest of respect @RebornSlippy you are being a bit of a dick. Feeling like you are going to die in labour is terrifying whether you are in a mud hut in Ethiopia or in the swishest new birthing centre in the UK. And yes, sometimes, childbirth is a terrifying experience even with the best care, but there are too many stories of women whose experience was made much more frightening because no-one properly communicated to them what was happening. And that’s ignoring the cases where an error was made. The Birth Trauma Association exists for a reason.

I don’t agree that the news story linked to is sensationalised. In one in 5 births there are avoidable errors. Some may not cause harm because they are minor or purely due to luck, but a 20% error rate is unacceptable.

Your 2nd degree tear example is nonsense by the way. That wouldn’t be recorded in those stats unless, on review, there was a clear indication to perform an episiotomy, or there was a negligently performed instrumental delivery causing the tear. Or it was actually a third/fourth degree tear only sutured as a second degree with potentially awful future consequences for the woman. I’m sure women in Ethiopia are eternally grateful to be shitting out of their vaginas post childbirth, but I don’t think it’s unreasonable to set our sights a little higher.

Generally I don’t think the fault really lies with the individual HCPs involved (though there are undoubtedly exceptions). Maternity services are stretched to the limit. Funding and staffing are certainly part of the problem, but equally there are cultural and structural issues in the NHS which need to be addressed.

It's not always funding though. I don't know how but my Hospital provided 1 to 1 care, I was never without a midwife. Never.

At one point I had two because one was returning to the profession (qualified but re training) - she was a grumpy, condescending bitch (also tried to refuse me gas and air for absolutely no reason - the other midwife just instructed her to get it, and wouldn't believe me when I told her it had run out) in the end I asked for her to leave.

Now that wasn't a resourcing issue. I was at that point on 2 to 1 (and it wasn't a risky birth or anything, I assume everyone else got 1-1 too)

Resourcing is definitely an issue but some people are also just knobs

I agreeblue2014. As in any profession, some people are just in the wrong job.

slippy Having read the full thread, I think you are out of your depth in this discussion.

You have clearly formed judgemental opinions about women having unrealistic expectations of their birth experience, then being disappointed because they felt that they were let down, put at risk, the baby suffered injury etc.

Your bad language and rude attitude are exactly what many people find hurtful and unprofessional, which compounds their suffering and trauma.

I blame the stress you are clearly under, and the bad experiences leading to the headline article linked by the OP on : demographic changes as discussed, poor education over the last 3 decades leading to variable HCP quality, advantage-taking at medical consultant level leaving people at your level to take too much responsibility, and lack of appreciation by people at your level of the importance of appropriate and effective communication.

I would like to see a return to the days when doctors and HCPs received respect because they had earned it, and demonstrated professional integrity, which would take some of the terror out of giving birth in the UK in 2017.

This is nothing new, two of my dc nearly died because of things that weren't picked up. Both are teenagers now.

I’m glad people have been using the thread to share experiences and I really hope it’s been helpful.

I’m still not sure what we can do about this situation though. At the end of the day we’re the ones giving birth and using the services so I feel there should be something we can do, other than cart of political vote a different way depending on what argument you find most persuasive.

Do we need different preparation? Should the NCT get engaged in this debate?

Should we all be encouraged to be pushier about the standard of our care (and supported to do so)?

There are too many of us that recognise this because it happened to US. How do we stop there being another US?!

*cast our political vote

Do we need different preparation? Should the NCT get engaged in this debate?

My initial gut reaction was “yes” but my concern is that they’re not neutral enough. Yes, they are supposed to be impartial but many who’ve used their service have found a bias towards the “natural birth” agenda...and that’s why there may be other agencies in a better position to campaign for improvements in maternity care.

I feel there should be something we can do, other than cart of political vote a different way depending on what argument you find most persuasive.

Imo this isn't the answer. No party handles the NHS well. An honest discussion has to be had leaving party politics to one side.

I think honest discussions around risk would be good.
And being more open about things going wrong, whatever the cause.

I do think that things have improved since I had my first many years ago. Then, c sections were done a lot more and no one was keeping tabs on whether they really were necessary.

Until people accept that taxes need to rise to pay for good public services that can keep up with demand, we’ll continue with strained public services. This is why it has been so frustrating that the mystery £1bn was found for the DUP and Northern Ireland after the last pointless election.

The NHS does very well with the money it has and is actually one of the most efficient systems. The problem is that funding is now lagging and choices re care have to be made. Staff are not being valued and those two things together do not make for a comfortable situation.

My own experience of maternity care was very mixed. There was excellent care (I had 1:1 care throughout my labour and a room full at the first incling that my baby was distressed and needing to be out quickly). But there was also piss poor care post natally. This seems to be a common theme and possibly a reason why complaints are not as frequent as they should be. It almost seems accepted now that post natal wards are hideous. That shouldn’t be the case and that low expectation seems to culturally support a crapper service.

I feel continuity of carer is key to improving outcomes and individual woman's experience of the care they recieve. Relationships with trusted hcps do not happen in minutes they take time. A midwife who knows the woman in her care, knows her expectations and knows how she normally behaves is better placed to meet that woman s needs when she is frightened or in distress. She knows the woman's level of understanding and how to keep her informed of what is going on.
I had the sane midwife look after me antenatally and attend ne at birth. It is possible and Scotlands recent review of maternity care has put continuity of carer at the centre of its implementation of the results of the review.
'With woman' doesn't mean just in active labour it means with her on the whole journey to motherhood. That is what has been lost.

Yes with one birth I had the same midwife for antenatal and birth - at home. Really helps.

From my discussions with the univeristy I know that this is the intended direction of travel, and that they feel midwifery has got into a bad place where women are ‘allowed’ to take part in their birthing process, rather than that being the natural perspective.

Personally, I think it would have been really helpful. I think I had a better relationship with my NCT leader than my midwife - I certainly saw more of her and she knew more about my issues than any of the midwives that cared for me in labour. Some coped without knowing me, others didn’t. Perhaps there’s also something about the expectations of midwives going into the job? Like most careers, it isn’t necessarily how you envision it.