Why is maternity care so crap in the UK?

[Oohooh]

I’ll start by saying I’m sure some of you have had good experiences, but virtually everyone I know seems to feel their care was substandard, and not just due to pressure on the system.

Particularly if you are induced or have some kind of risk factor it feels like women aren’t listened to or believed if they’re in pain, are denied pain relief, are left to labour for hours without any kind of proactive support or help to avoid instrumental deliveries. Then ignored on the postnatal ward as they struggle to care for the baby.

My first experience was okay-ish although the pain relief took hours to come and they just shrugged their shoulder when it didn’t work rather than offer me anything else. Second time was utterly dire - induced, left in a tiny cubicle behind a curtain until I was 10cm because ‘you’d be making more of a fuss if you were in labour’, midwife lied in my notes (for which I received an apology and she was allowed to carry on), denied pain relief, crucial medications not administered resulting in a poorly baby - just awful. The whole thing felt completely out of control.

And obviously some maternity units are so bad they’re subject to public inquiry.

What’s going on?

A huge amount of it comes down to system pressures - stressed, burnt out staff can't give good care. It affects everything. Same as nursing

The government are at fault. People stretched to their limits are not able to provide the best care people deserve

I do believe it's health care for the masses get them in and out as quick as possible .

Most of the NHS is crap. Maternity care is no different.

Unfortunately women's care and issues have never been taken seriously.

I have no experience of this other than having had children in the UK over the past 10 years but I needed a section each and every time due to a physical abnormality, and they refused to give me a planned section each and every time resulting in 2 emergency sections and an emergency forceps. The NHS tries to scrimp on maternity care because it’s women’s health and doesn’t really matter.

Midwives have far too much influence on policy and practice. Every single inquiry has found that the midwife-driven pursuit of "normal birth" has been detrimental to women and babies. And the health service promotes this nonsense because it's cheaper than proper medical care, as long as you ignore the negligence payouts

Doctors are actual knowledgeable professionals. Most midwives are more like aromatherapists with pretensions.

I have to say my care was exemplary. Although I think part of that was sheer luck from a series of fortunate and unfortunate events which all just seemed to play out in my favour.

Previous mental health section - flagged as high risk for post partum psychosis - specialist mental health nurse supported through out. Moved to experienced multidisciplinary midwive team. Then ended up consultant led due to oblique lying baby and transferred to the better CCG. Planned c with the best surgeon team. Specialist mental health & midwife care for 2 weeks daily, 6 weeks weekly and on call for 6 months. It was exceptional. I feel incredibly lucky.

Because the nhs has been bled dry and is running on the ever fading good will of its shrinking staff force. And unfortunately that leads to poor care

I’m so sorry you had such an awful experience 💐

I don’t think it’s helpful to just say all healthcare is poor now so maternity will be the same. There aren’t other areas of healthcare rated inadequate in such vast numbers. Our outcomes for things like stillbirth are far worse than comparable countries. Maternity is about two patients as well, one - the baby - that couldn’t be more vulnerable.

Medicine as a traditional profession is inherently misogynistic.

I give you birthing experiences, menopause care, endometriosis underdiagnosis, pain denial (and there's there's strong element of intersectional racism with all these things too). I could go on.

Until this is recognised nothing will change.

I had great experiences.

And classism too.

Mine born in last Labour gov and was shit then, so not entirely a funding issue (although that of course doesn’t help). The biggest lie being the pretence that a birth plan was in any way meaningful or that you had any control once you set foot over the threshold of the maternity wing - as pp said, to the extent someone else got to decide how much pain you were in!

I think there a lot of flaws, but I still think we're incredibly lucky to have the NHS. My birth experiences and the continuous care both myself and my children have received for our disabilities have been, on the whole, excellent. I'll never forget being told that the first week of one of my children's care (SCBU, surgery, intensive care) would have been around £50000 in America. And that was years ago. It does seem to be the luck of the draw!

It's not just women's services men have not even vasectomies for over a year in our health board either .Just been fobbed off .

The last 14 years of government basically. Same as everything in the uk is shot at the Minute

It's not all down to staffing and funding. It's also the ideology of natural birth imposed by midwives, it's also the incredibly low expectations for maternity services.

I moved to France after giving birth in the UK and whenever I told French women about my UK birth experience they were absolutely horrified.

Says someone who has no bloody clue what they are talking about.

THIS!

With bells on.

I'm in the US, where midwifery is training you embark on after you've first graduated from nursing school, passed your boards to become an RN, and worked in nursing for a minimum of one year. Then you embark on your masters level midwifery studies, which will take you 2-3 years. In all, you'll have spent 6-8 years studying and at least a year working full time before you can practice.

There is no substitute for rigorous, comprehensive education and training of midwives.

Britons sniff about the litigiousness of the US, but litigation and large payouts keep HCPs on their toes. OB/Gyns and neurosurgeons pay high med malpractice premiums.

It's not as simple as underfunding, there are issues with the culture within midwifery. For example it's ingrained and accepted that "natural" birth = good and interventions= bad - this is part of the basics taught at uni, for example. It's also deeply paternalistic, there are stories every day about women not being listened to or believed because midwives think they know best, this type of attitude is normalised and unchallenged in obstetric departments. I'm not bashing individual midwives who I know are doing their best under very difficult circumstances but there are major systemic issues within the profession.

You are talking absolute rubbish.

20 years I have worked in maternity care, aromatherapy my arse.

You clearly have no idea of a midwife's role or practice

From my experience, and the experiences of my friends (we all gave birth between 2016-2020 so not very recent but fairly recent) the common factor was not being believed by midwives. Not being believed that we were in pain, and not being believed that the baby was coming.

I truly don’t understand that. If you’re seeing labouring women, and babies being born, every single day, surely neither thing is a surprise.

The midwife I had with DC2 sent my husband back to my room when he went to get help because my labour was progressing quickly, and he was rudely told “she can’t be”. The second time he went to get her, and she begrudgingly came, she had to call for help quickly. Why not trust what your patient / your patient’s loved one is telling you?
I was also rushed out of bed mere hours after giving birth, and when we didn’t move quick enough, my stuff was dumped in the nurses break room - but they were clearly desperate for my bed and that one was a funding issue.

On the flip side, the team of doctors who rushed in to help me deliver DC1 were professional and efficient, and were the reason I knew I’d made the right choice choosing a hospital delivery. Me and my baby would not have survived otherwise.

Because capitalist patriarchy. An entrenched culture of misogyny in medicine and maternal care, combined with chronic underfunding of the NHS. It's a disgrace.

This. You said it better than me.

You're not wrong. Thankfully I had a relatively uncomplicated birth but my birth plan was completely ignored, I didn't have the birth that I'd wanted. The midwifes were also quite nasty at times as well. I do remember the bad bits, sadly bit try not to focus on them.