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

I’ve given birth in this trust twice in the last two and a half years. The first time was horrendous, long induction process and was just treated with no compassion by the midwives or doctors. Nothing was explained to me properly, I was left for hours when I should have been monitored in the labour ward and postnatal unit, I was ordered about and terrified by being told my baby would die if I didn’t go along with what they were suggesting. I felt utterly helpless. I had professionals arguing over me when I was on the table in theatre. I wasn’t believed when I had said the epidural hadn’t worked and the consultant was about to perform an episiotomy. Thank god for the anaesthetist who intervened. Everyone was stressed and overworked but as a patient it was a traumatic experience.

However I gave birth 10 days ago and the care was so different. Every midwife and consultant I spoke to was incredibly compassionate and explained everything to me listen to my concerns and just genuinely really seem to care. But it was clear that they were hamstrung by how shortstaffed they were. They were short of six midwives that shift and had to go around cancelling loads of inductions. Obviously all these inductions had been scheduled for medical reasons so it’s quite scary to think that they wouldn’t take place. Mine had to continue as it had started but I was warned that there might not be an anaesthetist around for an epidural (there wasn’t in the end) and that they wouldn’t break my waters yet as they might not have the staff around to deliver the baby.

Well I went into labour anyway and thankfully I did have a Midwife to attend but she’d been called in especially to make up for the shortage of staff. She was wonderful but you could tell she wanted to be at home with her family. I was supposed to be monitored every three hours but it was more like every six hours because they didn’t have the staff. My induction was also delayed because they didn’t have the staff to administer the gel etc. All in all it was more inconvenient than dangerous but I could clearly see how it could quickly become dangerous and how absolutely knackered everyone was. Everyone loses in the situations and it drives a wedge between patients and Midwives which is so sad to see. I don’t know if or when it’ll get any better but it’s heartbreaking and terrifying to think that children have actually died because of this and that women are being compelled to use this trust just because of their geography, it makes me shudder.

Nc for this also. I work in a hospital Trust and I'm the executive support to the workforce lead for maternity services. Maternity services across the region and on a national level are all under pressure.. Every single day there is a crisis where units go on divert or there is a dangerously low staffing level.. There is also shameless bullying by senior staff that has led to a whistle-blowing to the CQC.. The band 5-7 midwives are those who are particularly under pressure.

I didn’t have the same midwife through my pregnancy but I couldn’t fault anyone of them. I felt soo soooo sooo supported at every appointment (through Covid lockdowns) and all through the actual labour. I even had a trainee midwife who was fabulous who stayed with me the entirety of active labour. So I’m very sorry that some people just don’t appreciate how wonderful you are and how important your job is!

@FluffMagnet We even have food being delivered to our beds! where else would your food be, its a hospital. I have had 8 babies in three different decades and every time had food bought to my bed.

Thank you for explaining continuous care ladies one of those things that sounds great on paper, unworkable in practice.

Speaking as someone who's 18 weeks pregnant currently and is currently classed as high risk due to baby having what very may turn out to be fatal abnormalities (we are in limbo/waiting period of results) two things have become abundantly clear.

1. All MWs I have met are fried, on their knees trying their best in awful circumstances. I'm grateful to them all but also terrified for what may happen and they are also terrified for what may happen. We both look at each other hoping for the best knowing things may slip. Both would rather not be in the situation.
2. The blame doesn't belong with the MW re standards of care but the system that not enabling them to do their jobs, that doesn't risk women, babies or the HC professionals mental health that care for them. It's clear this current government doesn't care a scrap for these issues, not surprising as we aren't their demographic

I think we should be very frightened of a USA approach to healthcare and privatisation of the NHS. Having worked dealing with USA healthcare and insurances, it's very very common that people die needlessly due to financial constraints or lack of insurance.

Thank you ladies for all you do. I couldn't do your job and I'm grateful to know that regardless of the outcome of my pregnancy, I'm in a privileged country that has universal healthcare which it sadly seems to be built the blood sweat and tears of workers that do a job I couldn't do.

Do you think the situation could be improved by having dedicated training schools for nurses and midwives rather than the university route currently on offer? I did a access to nursing and midwifery course to enable me to apply to university to become a midwife. About 1/2 the people on my course couldn’t get a place at university including me. The universities don’t have enough places.

@Sleeplessem

I’m Birmingham *@Somethingsnappy* xx

Hi OP I had a Homebirth in Birmingham earlier this year.

The home birth team in south Birmingham have kept going throughout the pandemic.

The midwives I came across were amazing. Very knowledgeable, kind and respectful. I am so grateful to have been cared for by them. I can’t express in words how brilliant they were.

They did have some issues with staffing. It was my first baby and LO came faster than any of us expected so we did have paramedics out as the midwives were at another birth. In the end a Midwife arrived 15 minutes before my baby was born.

Next time I will go through the Homebirth team again but will consider hiring a private midwife to be sure that I won’t have to birth unassisted.

I’m not worried about me but want someone there who could help if baby is born not breathing.

Another point though. I will never apologise for having a home birth and will 100% have one again, to the point that I would go against medical advice to have one. I’ve been in hospital fairly often in the past for unrelated reasons and I don’t find them a safe place to be.

@BanginChoons

www.change.org/p/sajidjavid-support-urgent-government-investment-into-maternity-services-to-solve-the-staffing-crisis?recruiter=false&utm_source=share_petition&utm_medium=facebook&utm_campaign=psf_combo_share_initial&utm_term=psf_combo_share_initial&recruited_by_id=24703d20-18b7-11ec-8510-3bfc9f2be5e2&utm_content=fht-30710057-en-gb%3A6

Can we please all sign and share this petition.

Signed it, thanks @BanginChoons. It's important there is more funding, maternity services are dangerously overstretched.

There we go, one quick check on the pregnancy board and I knew I could instantly find a derogatory comment about a midwife, it’s almost laughable.

It just honestly makes you feel like ‘what’s the point’, this is why people leave. Thank you for all the lovely messages though, I’ve found this thread somewhat therapeutic🧡

@BrumBirth I’m north and know what trust you are referring to and they can’t take me on 2 counts, too far into pregnancy (not enough beds) and I fall
Outside their area for a home birth. Pretty gutting xx

@Annonmidwife

There we go, one quick check on the pregnancy board and I knew I could instantly find a derogatory comment about a midwife, it’s almost laughable.

It just honestly makes you feel like ‘what’s the point’, this is why people leave. Thank you for all the lovely messages though, I’ve found this thread somewhat therapeutic🧡

💜 we value you more than you know!

Makes me sad that the ‘good’ midwives, you know the ones that deeply care for the women they look after and want to go the extra mile are just driven to breaking point, then it’s the so-so, don’t really care ones that are left, made even worse by a crappy system, and you really feel it as a patient.

@hellywelly3

Do you think the situation could be improved by having dedicated training schools for nurses and midwives rather than the university route currently on offer? I did a access to nursing and midwifery course to enable me to apply to university to become a midwife. About 1/2 the people on my course couldn’t get a place at university including me. The universities don’t have enough places.

It's not just about university places it is also about having placement spaces as well. Local university has tripled the number of places for student midwives, but there just isn't the capacity to have them in practice. We have had to send students home from placement as there is no-one for them to work with. I would be so pissed off knowing I'm getting into thousands of pounds worth of debt, and missing out on valuable placement time.

I will never apologise for having a home birth and will 100% have one again, to the point that I would go against medical advice to have one.

Why would you need to apologise? And would you go against medical advice even if you had something like placenta previa?

It’s crazy how different two areas next to each other can be.

The team I was under went above and beyond to make sure that women don’t try and birth outside the system. At every turn I was reassured that they would still support me to birth at home regardless of the outcome of any tests, scans or how long my pregnancy lasted.

I saw on their Instagram the other day that they attended and had extra training to support a lady who had a breach home birth.

@Glassofshloer

I will never apologise for having a home birth and will 100% have one again, to the point that I would go against medical advice to have one.

Why would you need to apologise? And would you go against medical advice even if you had something like placenta previa?

I’ve had some judgement because we needed paramedics.

Placenta previa is an interesting one, I’d probably plan to birth at home but watch it closely, my understanding is that in the majority of women it does move as the pregnancy progresses. If it doesn’t move then I suppose I would have to have a c-section.

I don't know whether this will provide any reassurance to anyone but with the birth of my daughter after a 5 day hell induction process, this lovely MW who was there day one, came back to see me day 5, she knew the consultants had just been in were trying to bully me into breaking my waters or being induced again round 2 (and wasn't anywhere near the clinical guidelines cm/progress wise to break waters) came and said that contrary to what the consultant was saying, I had a choice and if I didn't want to be induced round two again I didn't have to be and to not be frightened, that they couldn't force me to have waters broken.

I was a first mum, high risk and exhausted after the week of induction and i was tears fearing if I didn't comply my baby would die (which is what the consultant had hinted) This lovely women had come along and quietly reminded me that even though I was at a hospital I had a choice, she didn't do it when they were there which shows really the hospitals culture.

I think about her a lot that MW.

Ah well that’s not quite 100% then. I thought you meant you would HB under all circumstances and thought that was alarming 😂

Interesting (and heartbreaking) to read about CoC being seen as a big problem- my perception is/was that a dogged commitment to CoC by the decision makers in my trust seems to have caused the whole thing to crumble (it's another one that's been in the news).

I had no CoC in my first pregnancy as there wasn't anyone allocated to my GP at the time, she was on extended leave, so I saw loads of different people. I didn't care, they were all lovely and professional and I'd had it explained to me at the start that's how it would be so it was absolutely fine. No complaints about my care at any point (apart from one not overly pleasant consultant during my induction but she was literally the only one).

This pregnancy was 'promised' continuity of carer and sold as a big thing. Then they changed my midwife at 16 weeks- not the end of the world as things change BUT they didn't tell me they were going to, so immediately that put me on the negative. As it happens I've seen the same fab lady a few times lately and all the others I saw we're just as good- but because I'd been 'sold' CoC despite it appearing unworkable to my untrained eye it left a sour taste for a while.

That and the fact they use that app which is absolutely shite for patients, every single professional that I've encountered says it's shite, yet the management again seem doggedly commited to it even though it's quite clearly not working.

I feel so sorry for all the midwives and HCAs I've met during this pregnancy as you can tell it's not just the challenges of a pandemic that are getting them down yet they do their best for you at every turn. I'm really nervous about going back into hospital for an induction again, last time they had a few shortages of equipment to navigate but there were at least enough staff and they seemed comparatively happy with things so it was ok and I always felt safe. This time, not so much.

@Annonmidwife

Just to say my friends baby was delivered by the paramedic at home (not deliberately... her third child came too quickly to get to the hospital).

She said he was wonderful.

He told her he'd delivered a baby the last thing the day before and she was his first patient that morning!

Someone asked upthread about what women could do to help - write in to the General Managers of the Hospital or the Director of Midwifery. If your care wasn't good, or if you had brilliant care - write in with your experience. It doesn't have to be long or detailed but get your voices heard. The cakes and chocolates are lovely too

There are midwives who are absolute weapons - burnt out, angry and lacking in compassion. I think it is because sometimes some areas (like delivery suite) can feel like a war zone. We are working with women who are in pain and who are scared sometimes and it is work that has a huge emotional toll. After months and years of never getting breaks, never getting time to recoup and feeling under attack, they become hard. Some midwives thrive on the adrenaline and are just absolute Goddesses on the Labour Ward. And if you get 2 of those on the same shift it just lifts the whole unit.

Good luck to everyone reading who is currently expecting, congratulations to this who have recently had babies and solidarity to all my Midwifery sisters.

I left midwifery last year, after it destroyed my mental health. I couldn’t keep being left in dangerously understaffed situations. When I escalated it, the response was invariably framed as being a problem with my “resilience”. There is no level of resilience that makes caring for 3 women in labour acceptable or safe. There is a massive culture problem- lots of bullying; matrons who haven’t worked clinically for years so have no
idea of the impact their ill-thought-through policies have; managers all so focussed on climbing the career ladder, they don’t want to hear or address issues because they only want to present the CEO with a rosy picture; that attitude of pretending all is fine to your seniors, while shitting all over your juniors is ingrained. It’s grim.

[quote MyDcAreMarvel]**@FluffMagnet* We even have food being delivered to our beds!* where else would your food be, its a hospital. I have had 8 babies in three different decades and every time had food bought to my bed.[/quote]
Not in my hospital! New mothers get up and queue for it in the corridor.

These comments are really sad to read. It’s really concerning what is happening to maternity services. The entire NHS is exactly the same. GPs are currently suffering from all the bashing at the moment and they also are working under horrendous conditions and are also being blamed for it. I’d suggest you write tto your MP too