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?

The post natal care for me was awful, the labour experience was fine. The midwife didn't turn up for the first home visit because I was registered with a GP in one county and lived in another, they each thought the other was taking care of me. I was then ignored when I said I felt strange/ill/off, tried to make a drs appointment when the midwife didn't take me seriously but obviously couldn't get one. My mum then took me to the maternity dept at the hospital, they left me in the waiting room until I collapsed. Was diagnosed with sepsis, spent ages in hospital without my baby and ended up with infected stitches.
The second time I tried to explain I felt disconnected and odd, no one listened because I was able to manage on a basic surface level. Fell apart when DS was 6 months and ended up on antidepressants. This might not have happened if they could have given me reassurance earlier that I wasn't a total failure of a parent.
Oh and no support with breastfeeding either time, I just needed them to help me but they just told me they were busy and to keep trying. Changed to formula when they told me DS needed food and I wasn't providing it.
Awful all round really and I'm not sure who was to blame. The systems just felt like box ticking exercises.

All public services in the UK have been driven into the ground. You’ll still get those who’ll vote for more pain though unfortunately.

Honestly everything with women is practically medieval. I had awful births and then recently I had to have a hysteroscopy. They shove a camera through your cervix and cut away bits from your womb with absolutely no pain relief. They would never do that to men

2 issues stand out for me from my experience.

A big part of postnatal care, especially for women who have c sections, would be improved if women were offered more than just paracetamol for pain relief. It seems to be a disgusting attitude towards women in this scenario that you get less if you have any other surgery.

A midwife I know also said one cause of staffing issues is culture. Young women are training to be midwives and then leaving the profession due to lack of support and mentorship from older midwives, due to an attitude of ‘we didn’t get this support in our day so you don’t need it now’,l. They are not considering that birth is more complex nowadays , with more high-risk women giving birth that wouldn’t have done so much 30+ years ago, including women age 40+ and women with diabetes.

Bollocks. I’m sure once if get a labour government next year, midwives will magically start believing women about their pain levels. Definitely.

I went into spontaneous labour and was denied pain relief (even gas and air) and offered an induction as my waters had gone but they didn't believe I was in labour (despite the machine picking up the contractions?!) or told I could go home.

I refused to go home or have an induction so they left me in a room with my partner without monitoring. Two hours later he went in search of a midwife as I was pushing, shortly after my baby was born.

All my labour notes were written retrospectively.

It's a horrendous service to work within and we can't retain staff because of it.

For every 30 new midwives that qualify, 29 leave.

There's things you know before going into it, like the shit pay and long shifts, that's to be expected. But you don't anticipate the awful all consuming stress and anxiety, lack of resources and constantly having to work over your contracted hours unpaid, it just does you in.

You do your best but it's like trying to run up an escalator. You give your all but you never win. It's just tiring and people give in eventually for their own sanity. We're all miserable.

Can you imagine having 11 unwell mums and their babies to look after on your own? All with a whole host of needs, observations and medications needed all at different times. Thats 22 patients all by yourself (the babies don't count in our numbers, despite us providing them care). It's well over the safe numbers. What about the first time mum who just needs you to sit with her for 20 minutes to help her learn to feed? The idea of that is almost dreamy to me, I don't remember the last time I was able to do that.

How would you feel if you haven't had time to provide your 12 hour post section lady a drop of pain relief for your entire shift because you've been busy with the lady having an emergency in the next bay, then the safeguarding lady in the side room kicking off and the next thing and the next thing and there's no one else to help you? Can you imagine how shit it feels knowing you've left a poor poor woman in pain for hours?

Even worse, imagine how she must have felt! Pained, upset, neglected and furious I imagine.

Who'd want to stay in a job like that? It's incredibly upsetting. That happened to me last week and I cried in my car on my way home thinking about her.

As for women not being listened to, I agree, it's awful. All women are different, and the majority of women come into triage thinking they're in labour and are disappointed when they're sent home to establish. There's always going to be the odd one or two who will labour extremely fast and unexpectedly. Thats the wonder of our bodies. But we can't keep everyone in! We can't start people on gas and air when it doesn't seem like they're in labour. We don't have the space, the staff, or the resources for that. We can only make an assessment of what we see in that moment and make a plan from there. You can't always predict what will happen correctly, but equally, we can't keep everyone in just in case.

The entire system needs massive overhaul from top to bottom. But it won't happen. We have mums and babies dying unnecessarily up and down the country due to poor care... and still nothing changes.

We have people on this thread saying midwives want natural births at the detriment to mothers. I see the exact opposite every day. Women being coerced into entirely unnecessary inductions which lead to emergency sections and horrendous birth trauma that stays with them for life.

The section rate at my hospital was 47% this month. Horrifying. There has to be a balance of keeping women and babies safe, and not just butchering and traumatising them because consultants are scared of litigation.

People probably won't like everything I've said but at least I've been honest.

I love my job and I love caring for women, when I am able to do a good job of it. If I am unable to provide basic care due to the system I am stuck within, then what's the point?

Both accurate points.

See my pp, my post section didn't even get paracetamol last week.

A lot of student midwives qualify and don't join the midwifery work force because they've seen how bad it is in their 3 years training. A lot do the first year then leave. A good amount go to Australia where conditions are much better. My unit has lost 7 great midwives to Australia in the last 6ish months.

I only learned recently that mothers and babies in the UK are put into a multi-patient ward, along with whatever total strangers might be visiting another patient. I know every country has its own flaws in its healthcare, but I found that one shocking. Such a vulnerable time in a woman’s life, and there she is, passing blood clots and trying to breastfeed and attempting to get fifteen minutes of sleep in a shared ward. If a hospital tried to do that in the US, it’d be a big news story.

Wait, hold on, back up. Do women in the UK just get paracetamol for pain during the C-sections?!

Because women's care is secondary to men's

Eh?

You get either an epidural or spinal block (i had 2 spinal blocks) during the c sections.

Then there is an issue with women not being offered adequate pain relief afterwards. That’s why I said ‘postnatal care’. They expect you to look after a baby by yourself after having major surgery and think paracetamol is ok. Paracetamol didn’t even help my headache this week.

Have you seen Friends? What was Rachel’s ‘semi-private room’ then? Where her and the other mum were just separated by a curtain. It’s the same thing pretty much.

you gets what you pays for, in the uk its a free service so beggers cant be chosers right. the problem is there is a snide culture in this sector as its publicly funded so very little accontability plus a massive shortage of staff, when your a paying customer in a private hospital you get the best care and service, the training is totally different, its customer centric, not poorly trained young girls trying to tell experienced mothers how to bottle feed, in the nhs free public health sector its a weird culture with people with their heads up their askes, nothing like that when you go private

I’ve heard stories on Mumsnet about maternity wards with four to six women all in one room. That’s unheard-of in the US, and even two mothers having to share a room is rare.

Phew, okay, I was worried there for a minute that there were no spinal blocks. You’re right, you did say postnatal care. I’ll read more carefully next time. 🙂

Yank-is that true in free charity hospitals. I don't know what they'd be called but someone who hasn't paid for their care at all in the USA. Would they get individual rooms?

Private /paying patients in the UK would get individla rooms/care.

@wednesdayaffairnc fwiw when I gave birth I could tell most of the midwives were genuinely amazing people that cared deeply (and were highly trained, despite what some people have said here)

I had an awful experience on the postnatal ward, like many, and wish I'd been paid more attention to. I don't fault the midwives, but the fact that women's health isn't a priority and is not properly funded.

I remember complaining about this on a similar thread previously and being told "women shouldn't expect all white gowns and attention / hand holding" while giving birth - but I honestly disagree. Giving birth can be dangerous to two people, and it should be respected as such; and the people expected to guide us through it should be provided with the time / tools to do their job properly.

Thank you for all you do x

I was offered codeine and morphine after my c section. I stopped that quite quickly though. That's shocking you were only offered paracetamol.

Yes that’s true. But the wards are like that for other departments as well. It’s not a maternity thing here.

Instead of paying for a private room, some hospitals are actually prioritising women for private rooms who have been through more complex or traumatic births (eg emergency c sections) and you can’t actually pay for one. I had private rooms both times after my c sections. It doesn’t make the actual care any better though.

According to the threads on here, it’s very common.

I was offered paracetamol and ibuprofen, which wasn’t enough. Especially as it was lockdown so they wouldn’t let my husband in to help me with my baby.

I eventually got codeine after making a massive fuss and crying for hours.

In the response to my complaint, they said the staff should be asking how you’re coping with pain instead of assuming that paracetamol is ok. So again, it’s a staff attitude problem. They claim to be run off their feet but they would have fewer buzzers going off if they bothered to give adequate pain relief in the first place.

@weeks112

Agreed. They act like they are doing you a favor.

However we are actually paying through our taxes

The UK has two health care systems. There are private hospitals where you can give birth and pay just like in the US. The facilities there are very similar to in the US.

However we also have free healthcare including maternity care - the NHS - and most people use this. Given that it's free,it's probably not really fair to compare it to the very expensive US option,especially given that is also available in the UK on the same terms ie if you pay.

The NHS has private delivery rooms - I've never heard of anyone giving birth in a shared room unless they unexpectedly give birth on the wrong ward.

Antenatally and postnatally there are usually a mix of individual rooms and bays with a few patients. Individual rooms are usually allocated based on clinical need or individual circumstances, though some NHS hospitals have individual rooms you can pay for (at a much lower rate than the US) while receiving NHS care. Where this US the case there is usually no guarantee that an individual will get a private room as you can only pay for one if there is one available, and patients who clinically need one take priority.

I have given birth 4 times and always had a private room both antenatally and postnatally. I never paid for this.

Just to add, as Brits we around usually be horrified at the idea of being expected to pay to live in a room with a stranger at uni - almost all uni rooms are private - yet in the US that seems like the norm.

I wish people would stop saying it's free. We do pay for it via taxes.

I would also happily pay more in tax if it helps improve the situation.