How on earth midwives?

[Sleeplessem]

How on Earth are you doing your jobs? It must be bloody gut wrenching and terrifying!

Read this today (below)…. There are no words. It’s obviously not just that area either. I’m a pregnant lady with my 2nd and it’s really easy to get frustrated by the poor care (sorry but in some instances it is quite poor from a continuity point of view and at least personally a few things are getting forgotten or left off as a result, although obviously a result of severe understaffing and over working) but you read stuff like this and it just makes me so mad, it’s just a disaster waiting to happen and then all the ‘blame’ will fall on that one midwife who’s trying their best under impossible circumstances.

Also in my area, during the last 18 months inductions have increased a huge amount (the amount they ‘allow’ you to go over has also reduced from 14 days to 10 and 7 in some places, do we think that’s partly due to the fact the trusts are trying to ensure staffing?

www.itv.com/news/meridian/2021-10-15/unsafe-staffing-levels-found-in-east-kent-maternity-inspection

If it’s not clear it’s a post of admiration in what must be a near soul destroying environment

I’ve name changed for this!

I’m a midwife, I’m 28 and I started training in 2012 and let me tell you, it’s bad. The staffing is horrendous, we were down 4 midwives last week per shift. When articles like this are published, local news stations post them, the comments are vile. Utterly vile. You just have to come on mumsnet and venture over to the pregnancy section to see the degrading comments people make about their midwives, some women don’t realise that they are one of thousands and thousands currently pregnant within these trusts, they instantly turn to social media as they haven’t had a routine call back. Probably because the midwife that was meant to call has been called into the unit to make up the staffing numbers, probably without a break, a drink or a wee in 12 hours! There’s no respect for staff and it’s a bleak place to be currently, I don’t know how it will get better, I don’t see it getting better. My trust suspended home births for safety reasons, I’m so pro choice and I love empowering women and supporting them to birth their babies however they choose, but 80% of the comments were women encouraging each other to free birth, or encouraging each other to ‘just stay at home as we have to send someone’.. yeah, an ambulance, probably driven by a paramedic that’s never been to a birth before. No one goes to work wanting to cause harm, but the harm that can be caused is catastrophic and the psychological effect on the staff immense. This is just the tip of the iceberg and I could rant on all day, but I promise we are trying.

This is just a ramble but it’s nice to get off my chest and it’s lovely to know that some appreciate us.

I agree. Midwives are, by and large, doing an incredible job in increasingly difficult conditions. I think they’re wonderful people and I’m so grateful to those that have helped me in my pregnancies and labours. But there is such a squeeze on resources. I’d planned to have both my babies on a midwife led unit at a hospital. The first time the MLU was closed due to staffing issues, and the second time I gave birth so quickly there was no time to get me into any kind of delivery room. Which is fortunate because I was later told they didn’t really have one ready. Impossible fir MWs to provide the best levels of care in these circumstances.
On the induction question: in my experience the MWs are much less keen on inducing than the consultants, but the consultants seem a bit clueless about the realities of scheduling the procedures. So I’m not sure easier scheduling is the reason.

I now work in the community, and am a very happy midwife (most of the time!) compared to my 12 years as a hospital midwife. Horrendous staffing, constantly changing guidelines, with no time given to read and process said guidelines, breaks (proper ones) scarce, leaving late, constant begging to work extra shifts, poorly developed junior midwives, poorly supported midwives in general. I could go on.
Leaving the hospital environment has done wonders for my mental health, self esteem, work/life balance, just... everything really.
I did move Trust to go on community, but my glimpse of hospital midwifery in my new trust is no different.
I remember my last days on the wards, telling my old colleagues I'd never ever come back in to the hospital. If they take me off community, I'll apply for public health roles.
Not to say community is without it's issues, staffing issues are still the same, I still don't have enough time to give to women - at least the time I think they should have, being on call for homebirths - once I worked a full 8 hour day, immediately called to a homebirth, no time for home for dinner etc, and ended up doing an 18 hour straight day, which could have gone on longer, it only ended as we needed to transfer to hospital, in fact it could have been a full 24 hours if she had continued to labour at home, as you are on call from 5pm-9am. The hospital often want you to stay when you transfer due to staffing, it was only luck this time that they were okay. But the difference in not having to work in the hospital environment (toxic) is immeasurable.

Midwifery is about to his crisis point though with the implementation of continuity teams. Nothing is going to improve in hospitals any time soon. I'm only mid 30's, but I can see my midwifery career ending if I have to do a continuity model. So many others will be in the same position as me. I can go in to all the issues with it... but I don't have all day . Mass exodus of midwives will soon be upon us. More women, less midwives... what could possibly go wrong?!

I’ve just left midwifery as I would have lost my PIN! The blame culture from managers who sit in offices all day cracking the whip is disgusting, the bullying is horrendous, I’ve witnessed some horrendous bullying. Racism against women is rife, obstetric violence is real, coercive practice is real. Registrars and consultants are practicing so defensively they are making dangerous decisions which leaves the midwives who are actually doing the care at risk when it inevitably ends up going wrong.

Women need to educate themselves and realise they are autonomous and question the HCP’s more although this feels like patient shaming and we should have trust in the practitioner because “first do no harm” should be at the forefront of their mind.

The service is in crisis, women and babies will die. Midwives will be struck off or leave the profession in order to save their PINS. I fear for every midwife entering the profession and every woman who is planning on having a baby

I'm currently sat in postnatal, in absolute shock at how excellent the care has been this time around, compared with my last visit 2.5 years ago. I must say I was panicking slightly as I know my hospital is experiencing hugely increased patient numbers at the moment, but the staff have all just blown my mind, from triage, theatre and postnatal. We even have food being delivered to our beds! I am not the only grateful patient though - I can hear all the other mums and dads around me repeatedly thanking the staff and getting all the help they need. I will be writing a long thank you note when I get home! I know our poor community team are based mainly on Bank staff, several of whom have retired and been persuaded back. They have also been excellent the whole way through, despite the difficulties they are facing. I am loathe to read the article though, as my sister is due to give birth in the East Kent Trust in just 2 months, and it is making me very nervous on her behalf.

@Annonmidwife

I’ve name changed for this!

I’m a midwife, I’m 28 and I started training in 2012 and let me tell you, it’s bad. The staffing is horrendous, we were down 4 midwives last week per shift. When articles like this are published, local news stations post them, the comments are vile. Utterly vile. You just have to come on mumsnet and venture over to the pregnancy section to see the degrading comments people make about their midwives, some women don’t realise that they are one of thousands and thousands currently pregnant within these trusts, they instantly turn to social media as they haven’t had a routine call back. Probably because the midwife that was meant to call has been called into the unit to make up the staffing numbers, probably without a break, a drink or a wee in 12 hours! There’s no respect for staff and it’s a bleak place to be currently, I don’t know how it will get better, I don’t see it getting better. My trust suspended home births for safety reasons, I’m so pro choice and I love empowering women and supporting them to birth their babies however they choose, but 80% of the comments were women encouraging each other to free birth, or encouraging each other to ‘just stay at home as we have to send someone’.. yeah, an ambulance, probably driven by a paramedic that’s never been to a birth before. No one goes to work wanting to cause harm, but the harm that can be caused is catastrophic and the psychological effect on the staff immense. This is just the tip of the iceberg and I could rant on all day, but I promise we are trying.

This is just a ramble but it’s nice to get off my chest and it’s lovely to know that some appreciate us.

Hugs, you are appreciated for all you do!

I do get the concern, anger and frustration from a mums point of view sometimes (to a point) when it seems like the most basic things are being forgotten, especially as a first time mum, it’s bloody terrifying. But I get you must feel that way too, want to be able to give individual and stellar care to every mum, especially the ones you can see are struggling a bit but just not able to. I’ll never forget my community midwife with my first, she was so caring and kind, almost motherly, the love even came to pop by for a cup of tea 3 months pp to see how I was getting on. The trust she used to work at, in the end broke her, I think like another poster said due to bullying. It’s such a tremendous loss to the community team because she’s an exceptional soul. The trust now has a drop in clinic for community appointments due to mass resignations and as a patient you really feel the difference.

I’d love a home birth, unfortunately due to really poor treatment on the mat ward with my first, i imagine the situation is now worse than ever due to staffing. The home births like you said have been suspended due to safety reasons.

I’ve also seen midwives be basically barked at by obs. The midwife delivering my daughter called an OB to check spotting and the way he spoke to her was fucking abysmal, struck me as a regular occurrence too

It's the same at Addenbrookes. They're horribly understaffed and some are leaving because it's become so hard to do the job.

@ThisMustBeMyDream what’s the issue with continuity care? all the midwives were talking about it when I was pregnant with dd1 as it would be some amazing thing etc, would help with resourcing and patient care? (Sorry if that’s daft, I’m genuinely curious)

What concerns me about the plan to remedy the situation in East Kent is 'redeploying home birth staff to help in hospitals'. In reality does this mean that the on-call community midwives, who have already worked a full day, will be called in to work all night on delivery suite on a regular basis? And what happens to the women due to have a home birth?

Agree -its frustrating as most of us try very, very hard to look after the women we care about. I've had many a sleepless night......
It's getting harder. It's a different job from when I started many moons ago

@Maiyakat

What concerns me about the plan to remedy the situation in East Kent is 'redeploying home birth staff to help in hospitals'. In reality does this mean that the on-call community midwives, who have already worked a full day, will be called in to work all night on delivery suite on a regular basis? And what happens to the women due to have a home birth?

As I was one, it means you either free birth or go into hospital x

@Annonmidwife

I’ve name changed for this!

I’m a midwife, I’m 28 and I started training in 2012 and let me tell you, it’s bad. The staffing is horrendous, we were down 4 midwives last week per shift. When articles like this are published, local news stations post them, the comments are vile. Utterly vile. You just have to come on mumsnet and venture over to the pregnancy section to see the degrading comments people make about their midwives, some women don’t realise that they are one of thousands and thousands currently pregnant within these trusts, they instantly turn to social media as they haven’t had a routine call back. Probably because the midwife that was meant to call has been called into the unit to make up the staffing numbers, probably without a break, a drink or a wee in 12 hours! There’s no respect for staff and it’s a bleak place to be currently, I don’t know how it will get better, I don’t see it getting better. My trust suspended home births for safety reasons, I’m so pro choice and I love empowering women and supporting them to birth their babies however they choose, but 80% of the comments were women encouraging each other to free birth, or encouraging each other to ‘just stay at home as we have to send someone’.. yeah, an ambulance, probably driven by a paramedic that’s never been to a birth before. No one goes to work wanting to cause harm, but the harm that can be caused is catastrophic and the psychological effect on the staff immense. This is just the tip of the iceberg and I could rant on all day, but I promise we are trying.

This is just a ramble but it’s nice to get off my chest and it’s lovely to know that some appreciate us.

If you are working for the trust I think you are, then the from next week the ambulance won't necessarily be driven by a paramedic or emt or even am ambulance care assistant, it will be a soldier who isn't trained or allowed to drive on blue lights and the one paramedic (or emt) will have to try to handle the situation themselves, which statically will be okay, but if it's not, then that one paramedic (who may or may not have delivered a baby in the pre hospital environment before) will single handed handed to manage whatever complication they are presented with (breech, shoulder dystocia, neonatal resuscitation, major haemorrhage etc).

It's terrifying how naive some women are.

I was a midwife. I left after 4 years as I vividly remember going off for a night shift when all my family were going to a BBQ. On said night shift at 2am in a room full of blood after a woman had haemorrhaged I was told by the sister in charge that I could only go for a break after I warded my woman & then went to theatre with another woman who needed an emergency section. Another shift, I left late after wondering if my recently delivered woman would be alive the next day as she was short of breath after a section & the dr still hadnt arrived when I handed over.
I also literally had to put my hand across a woman’s vagina & tell a dr to stop attempting to suture her as she was screaming in agony that her local anaesthetic hadnt worked & take her to theatre for a proper spinal block.
It’s shit, the poor staffing, the poor practice, the bullying & the ever complex needs of an evolving population.

Honestly this is a major reason why I'm umming and ahhing over getting pregnant again. Resources seem so strained already, it feels unsafe. I don't blame the midwives at all, they're doing their best in a shitty system.

I gave birth on Sunday. I must say I’ve noticed a difference in quality of care. But I’m aware that my hospital is really busy and stacked out so I’ve just assumed that’s why.

I just can’t wait to leave. I fantasise about it every day. I’ve just totally totally lost my mojo. I wouldn’t say it’s too bad at our hospital, no worse than it’s ever been really, and on the whole women get good care. But they are often frightened and insecure about the level of care they might receive, and they can really lash out and be so hostile and challenging over every statement you make. They google things then call up and rant, are rude, demand things that don’t exist or aren’t protocol. I’ve been a midwife for a long long time and never know it like this before. I’m a good midwife too, nice manner, caring, organised, up to date, and I feel like I’m going into battle every morning at the moment.

Couple with a toxic senior team and the threat of moving to a continuity model and I won’t last another year. Just got to figure out what to do next.

Regarding home birth- my local hospital suspended the service last year ‘due to the pandemic’ however a different trust about an hour away actually boosted their home birth services in response to the pandemic and at the height of it something like 10% of their women (so a huge proportion of all low-risk mothers) were having home births, lots of women stating they’d chosen to stay away from hospital precisely because of covid. It just seemed very frustrating to have such contrasts not that far apart geographically and women in one trust being told it was necessary for home birth services to stop. Plenty of midwives seemed equally frustrated.

Back to the point of the thread, I’ve seen a lot on social media from midwives and it seems absolutely horrendous :( does anyone know what exactly is causing this and what can be done? Are the government listening?

@Sleeplessem many many problems with COC.

The main one I experienced is the community midwives now having to go in and become a hospital based high risk midwife at the drop of a hat. A midwife by definition is an autonomous practitioner in low risk birth who is trained to deal with emergencies which are few and far between in a low risk community setting with well women.

Now that midwife is looking after a lady who is high risk and has to deliver her baby in Hospital, the community midwife does not have the experience of high risk, drugs, hospital procedures, they suddenly have to give up their autonomy and become a nurse and do what the Reg/cons wants (even if they know it’s not in the woman’s best interest):

Not everyone in the unit is a COC midwife, so lots of eye rolling, derogatory comments to the midwife that they are not “good enough” know nothing about high risk care, the midwife who has looked after a lady from booking to Labour now feels she is letting the woman down, she wants to stand up when a doctor comes in and performs a vaginal examination without consent, she hears the women told “if you don’t do this your baby will die” even though she knows it’s highly unlikely the baby will die she doesn’t speak up, she knows if she does the next shift will be hell, or worse her colleagues will complain about her, freeze her out, she won’t get a break or worse she will be sent on one at 23.30 and then have to work until 08.30 without another one, no one will come to relieve her at handover.

There is nothing she can do, the managers will make excuses for their staff, the community matron will nod politely and roll her eyes as she leaves.

The woman ends up on a postnatal ward which is even more depleted in staff, she wonders what the actual fuck happened, the midwife has gone, she is traumatised and the whole COC sentiment has gone to shit!

When it works well and you have a great maternity unit it can be a wonderful experience but there are just not enough midwives to do it effectively and safely so it’s a lottery to which women get the gold standard and which get the shitty stick

It is probably mostly due to entirely broken system. However from my personal experience dealing with 10-15 midwives throughout my pregnancy.. I would say 2 were decent. It is a mix of not caring, doing really bad job and being rude/dismissive. Perhaps I was unlucky and amazing midwives are somewhere out there. I totally understand it must be a hard work low pay etc but on a personal level I would appreciate a basic level of human politeness, ability to manage expectations-don't say you should call us with any concerns if they don't intend to ever pick up a phone/answer emails. General impression is a complete lack of care for people they look after.

Oh bloody hell I'm due to have a section there next week. That's not what I wanted to see, especially as I chose Q.E over Lewisham due to a traumatic experience last time

encouraging each other to ‘just stay at home as we have to send someone’.. yeah, an ambulance, probably driven by a paramedic that’s never been to a birth before

How utterly selfish of them.

I have to admit I had a shit birth experience but it was not at all due to the midwives - I could see it was a lack of facilities, resources, training etc. They were doing their best in difficult circumstances.

@AndThenInTheEnd gosh what information are they taking from Google??

@Maiyakat

What concerns me about the plan to remedy the situation in East Kent is 'redeploying home birth staff to help in hospitals'. In reality does this mean that the on-call community midwives, who have already worked a full day, will be called in to work all night on delivery suite on a regular basis? And what happens to the women due to have a home birth?

I think it means moving them to work in hospitals. Which means fewer home births and less ante and post natal care at home.