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?

Oh dear

I have absolutely no trouble believing you work in NHS maternity services.

Its extremely difficult for pregnant women when their concerns and questions based in fact are dismissed casually as wishes.

Women make birth plans because NHS staff tell us to. Nobody has ever told me to "make a plan for us to ignore" when in hospital for other reasons. Women in labour need an advocate with them because so often we are ignored and dismissed - only women after all.

Ethel dying of ovarian cancer should also have been able to have a designated visitor to advocate for them (and frankly, ensure they were actually fed - geriatric care and especially record keeping is pretty hit and miss in NHS hospitals). That was an NHS choice for most of the pandemic.

Trust me...everyone's priority in antenatal, during birth, and post natal.. is the safe delivery of your baby.

Haha - tell that to women induced in the latter half of the week to ensure they didn't go into labour over the weekend, women whose symptoms are ignored because "the machine sez no" (machine wasn't working) and obviously a silly woman couldn't know better.

Maternity services in the UK are amongst the worst in Europe, particularly for black women and disadvantaged women.

Ethel dying of ovarian cancer should also have been able to have a designated visitor to advocate for them (and frankly, ensure they were actually fed - geriatric care and especially record keeping is pretty hit and miss in NHS hospitals). That was an NHS choice for most of the pandemic.
This is very true. And ongoing. My very old grandma is currently very sick with cancer. Her treatment in 5
the hospital was appalling. Very little personal care and you are a constant inconvenience. I told them she had terrible pain in her lower body area and she was given gaviscon for indigestion. I repeated where her pain was. Ignored. Two days of pain later a different nurse discovered her catheter was in wrong. The environments of the wards themselves was appalling. People receiving treatment in corridors. You need someone in hospital with you to ensure you get fed or to brush your teeth.

Regarding PFI - in my view that is down to the voters. John Major (the accountant) brought PFI into government spending in the 90s. It wasn't a million miles away from the buy today, pay tomorrow schemes which were very popular in large organisations to fund investment. Brown/Blair continued the trend started by Major.

In both cases the alternative was to ask voters to pay more tax for public spending. When voters are presented with the black and white choice of "2% on tax to spend in public services/benefits" they have historically voted against it or for tax cuts instead.

Very few people have a clue of the actual costs of services - if they knew the costs involved there would be more interest in effectiveness of spending. This is especially the case in health care where large sums of money are pissed up the wall as fiefdoms refuse to cooperate whilst the public struggle to see a medic.

@C8H10N4O2 I agree John Major brought in PFI but unlike Brown and Blair it was on a very small scale and he never pretended to have socialist values. Brown and BLiar were spectacularly disingenuous about the whole thing.

I've nc'ed for this post because there are details.

My best friend is a midwife. We trained together actually, but I no longer practice because the working conditions are appalling and it was soul destroying giving poor care all the time.

I'm coming back to this thread because she's just called me from work upset.

Yesterday she worked in one area of the unit 7am-5pm, she had a really busy day and as is the norm, didn't get a break. She got home at 6pm, started cooking tea for herself and her family, and was called back into the unit at 7pm because she was on call and they needed staff.

She didn't have time to finish cooking her tea, never mind eat it, so she just had some toast when she got into work. She worked until 1am and then was allowed home. She was told she was expected back in at 7am for her next shift.

She walked onto the ward this morning with too many women to care for safely. Which means she's going to have a terrible, terrible day, I know, because I've been there. Yet even when she tries her absolute best, at the detriment to herself and her family, she probably won't be able to provide good enough care.

She's just rang me from a friggin cupboard, upset, telling me she can't do it anymore. Her words were 'I'll have to work at Tesco until I can't find something more permanent'

This girl hasn't seen her children or husband properly in 2 days. She's had a piece of toast and a packet of stolen hospital biscuits to eat since 6pm on Monday.

Does that answer your question OP?

How do midwives have it in them to be fucking nice to everyone and care for people safely and make people feel looked after when they're on the verge of a breakdown, haven't seen their kids, haven't eaten, haven't slept, haven't WASHED. Ffs! It's not acceptable.

I don't care that this kind of thing 'isn't the norm' and 'doesn't happen regularly' it's the culture! It's the whole 'midwives are heroes/angels' no they aren't. Not at all. They're normal, degree educated women, trying to get through the day doing a really tough job. They aren't mythical unicorns with superpowers who can be abused and neglected because the system isn't working and women still need to be cared for.

Sorry that that's such a big rant but that's just the reality. I'm so mad. She's such a great midwife and her leaving is a huge loss.

Also while I'm here, why do we have ratios for childcare settings and not for healthcare staff?

I don't mean trust policy which regularly doesn't get followed because nobody asks or check how many women you have.

I mean it should be written into a law or act or meaningful policy or something similar.

That would be something that could be changed, and that would make a difference to staff and women.

@midwiferyhasfallen regrettably because for generations now, women have been silenced because they should be grateful for, rather than formally complain, about poor standards of care.

I am sorry for your friend's situation but she was on call and presumably being paid for being on call, with the expectation that if she was called, she'd be right back.

Vive la revolution.

Op a long tome ago on here I found out that someone had recorded conversations of midwifes.
I think it made the news and some high profile women commented.
Unfortunately the tone was that women can and should birth without being wimps and just get on with it.

When I was a midwife, the on call was paid at £10 for the whole 12 hour period!! Obviously paid when called in, but £10 not being able to relax, rest properly, go out for a walk, have a glass of wine!
I think people underestimate what a huge responsibility it is to care for so many women and babies at once. The absolute exhaustion of running yourself ragged and yet still not providing good care.
In the postnatal ward, I had 10 mums and 10 babies - 20 patients who all needed me! As soon as a woman was discharged, another was in her place! No let up at all.

There absolutely should be staff / patient ratios as in childcare plus safety for hours worked like the pilots!

In Australia, a friend of mine has 4 women on the postnatal ward. What an amazing standard of care she can provide! Women deserve this!

I had really positive experiences giving birth on the NHS. Very personalised care and very attentive to my needs. But I chose the team I birthed with, the second time around all of my antenatal care was at home except for scans, I had 2 midwives just for me during both of my births. It was excellent.

I come from a country that has very expensive private health care, including for maternity. Most of my friends there have had dire experiences, some with lasting birth trauma, plus on top of that, they've had sizeable medical bills to pay after.

Yes but that's not even legal. Aren't we supposed to have 11 hours rest between shifts, by law?

Only if you "work", being on call doesn't count as a shift & even then, there are employer get outs.

For those that say "well, you re being paid for it" not really, call out rates are often less than a £1 an hour, you cannot do anything, you re basically tied to your phone.... plus you ve already worked a full day, get home, whilst making tea etc, phone rings, got to drop everything and go out again.

UK opt outs from the EUs WTD, make people on call do very long hours, i ve done 18 hour days consecutively, with one manager once saying to me, when i said i was too tired to drive "if you don't go, collect your p45" no union (company wouldn't recognise them, all legal) so i went.

My DD left the NHS for Australia to escape how the NHS/Govt treat staff and its exactly how a pp says in Aus, high staff to patient ratios, far better care, better pay, less stress and a better work/life balance.

But what we will get on here is NHS staff are fat/don't do anything & Filipino nurses are soooo much nicer....

Yet I had both my DC’s under a labour government and both times it was a terrible experience.
I nearly gave birth to the first one in the hospital toilet as I had been told I wasn’t in labour.

No one has said Maternity care was perfect under Blair.

But its undeniable that Healthcare generally has got far worse in the last 14 years, underfunding to keep up with demand and terrible staff shortages.

RosesAndHellebores, get stuffed!!

I don’t think nearly losing two babies because of incompetence counts as ‘not perfect’. If I was being polite I would call it diabolical.

YANBU. I can't believe I survived two absolutely awful births, plus a miscarriage. I had hoped things had changed for the better in the past 18 years, but obviously not.

Exactly.

Natural birth dogma is emphatically a problem. The fact that it came into being partially as a response to other problems demonstrably hasn't stopped it from becoming a monster all of its own.

This seems to have happened across healthcare.

People are assumed to be doing it because it’s ’their vocation’ and therefore are expected to not be bothered about a low salary / crazy hours / personal sacrifice etc.

Because they’d never be able to hire the staff to fit the ratio so failing from the off! It’s awful. And the removal of funding for midwifery & nurses degrees was the cherry on the top. children are precious but causing midwives to cry in closets and mothers to have ptsd due to sub standard care is apparently fine!
Being worked to the bone for very average pay in a highly skilled area- it’s no surprise most students that train end up doing another job.
I started a nursing degree 20 years ago, but after doing placements and saw how poor the work conditions were, and how they weee treated I changed my course after a year. My friend carried on nursing and seeing her work/life balance, I’m sure it’s one of the best decisions I ever made.