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?

I'll give you a clue: stop voting tory!

what the fuck have I just read? I had a hysteroscopy last week and was under full general anaesthetic. I am so sorry this happened to you.

That's disgusting, of course midwives are properly trained medical professionals.

Yes there have been scandals but there are also scandals with doctors and the care they've provided to patients who've died etc, and you're not criticising their profession

The irony of the number of people that were horrified at me wanting a homebirth at the time and how "dangerous" it would be - I was monitored through my labour by a midwife rather than the women in this thread who were left with just their partner having to do it. I had a midwife that was looking after just me, not 10 others. I had the space and freedom needed for a natural delivery. There's not a chance my long back to back labours would have gone anything like as smoothly as they did if I'd been in a hospital.

I paid for a private midwife for those births. I did it because of the awful experiences I'd had with hospitals previously. Worth every penny. Unfortunately, the government has all but made them illegal now.

I don't know why the comparison is always "be grateful for the NHS otherwise you'll get US style". There are a lot of other countries in the world where you don't have awful healthcare and you also don't have to bankrupt yourself for treatment....

A lot of the care seems to be based on trends and statistics based on a very small range of frequently difficult and inaccurate measurements.

Add to that, there's a built in culture that labour is painful and women should put up with it that is hard to shift.

For example, I was pushed through two GD tests because my son had a large belly. He still has a large belly - because his back is very broad, like his dad. But I struggled through HG with very little support because "women are supposed to get sick".

They were treating the stats, not the patient.

I had a precipitous labour (which I'd repeatedly asked about as they run in the family). I wanted to be prepared, but they wanted to discuss what they thought from the stats.

I was "lucky" to be in hospital already for pre-eclampsia - because they failed to prescribe the recommended preventative aspirin despite me clearly meeting the thresholds. Otherwise I might have had a risky birth at home or in a taxi.

And I don't believe one second that this is due to funding.

Because my MIL had the same experience with pre-eclampsia, and my mum had the same experience with precipitous labour.

They've had decades to get their shit together.

I really wish it was that easy. The NHS had a good crack at killing me for standard appendicitis in the middle of Brown's time. The NHS was just as bad then. Surgeon had to assess me in the night using his mobile phone light because the cubicle light didn't work. Left with a cannula with empty drip for hours. Couldn't get a scan for literally days leading to emergency surgery. I could go on and on.

Because women don't matter.

There was once a post on here from someone who worked in a hospital complaint dept who wrote that they only received complaints about lack of pain relief from maternity, literally no other dept.

Obviously funding and stress are part of it but the ideology of birth is wrong. It's treated as a basic procedure that we should just get on with . Don't arrive till last minute and leave almost immediately after. Something that should be endured with minimal intervention.

When the reality is women can die in childbirth, it's extremely painful and can be complicated.

Nhs staff need to stop being dismissive of pregnancy, birth and postnatal needs.

I had two traumatising births, one in 2012 and one in 2021. My last birth, the midwives were not actually that busy (ward was actually empty when I left with baby) but little-no aftercare after a emergency c section. Tried to send me home with paracetamol when in significant pain, no wellbeing checks in hospital even though I had a catheter in and looking after a newborn.

I blame the profession, and the lack of training. NHS staff get away with so much, in my job role there no way we could treat people so poorly and get away with it.

Yes all of this. I had my first at home and had a midwife in the room with me. At one point three were there.

my second was at a birth centre and I should have sued. I was ignored and not believed until i nearly died.

I think one of the problems is going into labour with a birthing plan. Mums to be have an expectation of how their birth will be as they planned it, but in lots of cases, it can’t be adhered to because things change (and quite rapidly) so plans have to change.

Understanding this can change a lot of preconceptions.

There are poor professionals in every walk of life but thankfully not so many, and those that are left are being weeded out.

if you think you are struggling, ask for a second opinion - there will always be a senior band 6 or band 7 on to manage the department. But please remember, they may not come quickly - there may be others whose needs will come before yours. Examples may be emergency CS, removal of a newborn, PPH. These do take time and happen on a more regular occurrence than many think.

As for short staffed, as with any job, people go sick - there’s no unlimited supply of midwives to fill those gaps.

We need plenty more funding for the NHS. Staff are trying their best under difficult circumstances.

Why on earth would an NHS employee tell you the cost of your care in America would be £50,000 and what was the relevance of the comment? Your care might have cost £50,000 in the UK where it was received free at the point of delivery, funded by the people for the people.

And you think anything will change? It’ll be exactly the same as most politicians are the same. Filling their own pockets.

Completely agree. The point that the midwife got the aromatherapy kit out was the point I knew my DC's birth was going to be a shitshow (ventouse, forceps and haemorrhage later, I was proved right). My experience at a MLU of being dismissed as not in labour because I was too calm and stuffed into a room for ages before being examined (and SURPRISE, I was fully dilated and ready to push) made me feel that I could never trust a midwife fully again and I had an ELCS with my second DC.

In the UK, health professionals seem to spend a lot of time not believing their patients and actively ignoring their medical needs. It's like their first thought is that the patient is 'wrong'.

Nothing new here at all. This happened to me FORTY years ago!
Middle of the night; Denied pain relief, DH sent home 'as it will be hours yet'; left on my own, etc.
I kept calling using the buzzer (as I was crying in pain), but was told off, as the Dr 'had 2 caesarean sections down the corridor and was too busy', etc.
I was frightened and on my own.
When the midwife appeared, they finally realised I was about to give birth, and after frantic phone calls to DH, who (after driving like a maniac), arrived as baby just about to be born (fewer speed cameras then).
This was my second baby and I now can't remember where my first DC was at that time (probably with my DP).
When my third DC was born, my main concern was being left on my own. I told my DH, whatever they said he was to stay with me.
With three DC, I should add that this DC was probably the most 'normal' of births in that the first was breech and the last had the cord around his neck, but my experience of the second was far far worse, due to the attitude of the staff.

This is one thing the government can’t be blamed for - unfortunately. The NHS has never had so much money pumped in to it.

The issue is severe mismanagement of money allocation. Vast amounts of money being given to management instead of it being filtered to more midwifes, doctors & nurses. This is actually criminal. Vast amounts of money going to hospitals suppliers on contracts. You would be appalled at what the contracted suppliers charge the NHS even for simple things like toilet rolls. I have a clinic and in the NHS brochure to buy equipment - a little trolly with racks on was £95 I bought the same thing from B&Ms for £15. A curtain on wheels was £600 - I bought similar of eBay for £100. Just look at what they did with the face masks in covid.

The NHS is being ripped off big time it’s a huge scandal that no one wants to talk about.

This causes hardly any money for actual
staff that help people and it filters through as management giving the absolute bare bones of care for women birthing - because as usual we are expected to ‘just get on with it’

women have always drawn the short straw when it comes to pain relief management often being called hysterical or difficult and it’s a difficult pill to swallow when it’s other women do it.

So OP, for me is misogyny and a NHS system that’s being robbed blind.

My DC were born in 1994, 1997 and 1998.
In 1994 in particular (the worst experience), there were more midwives than women. They did not behave well: socially, professionally or clinically. What I shall always remember were the constant complaints about being overworked. I was in hospital for three days, few fingers were lifted and there was a lot of giggling and squealing at the station.

I would venture that midwifery might be compared to the boy who cried wolf. There was much complaining a few decades ago, it was unnecessary, so people stopped listening.

Regrettably, even in a fully staffed, if not overstaffed, unit when I had my first baby care neither excellent nor respectful: antenatal, in labour and postnatal. Thereafter I was a much better advocate for my care. My second pregnancy was high risk and consultant led, as was the third by virtue of the second. I found those pregnancies much better managed and midwives much better when there was a middle aged, male consultant, leading my care and advocating for me.

That is a shocking insult to midwives who are highly skilled and qualified want the best for women. 😦

I had an absolutely awful experience with my first pregnancy and labour, it was extremely traumatic. But at no point did I think midwifery care was sub-par. My midwives listened to me, fought in my corner and cried with me. My issues were with the doctors and anaesthetists who didn’t listen to my needs at all.
The midwife bashing on here is disgusting.

Absolutely this. Resources have been intentionally limited and it’s not a surprise that it’s women’s healthcare that has uniformly suffered the brunt.

I think they’re trying to force together 2 pieces that don’t fit.

Yes birth is a natural and physiological experience that in theory should go well without intervention.

But this isn’t the 1970s any more, we don’t have first time mums who are 21 and mainly thin/healthy. Plus we are much more likely now to induce or perform caesareans because we have scans and more tests and can pick up on more warning signs or risks.

I feel like there needs to be complete reevaluation based on how to ensure non-textbook deliveries go as smoothly as possible.

For example when I was induced I told the midwives the only time I had the urge to push (and therefore pushed effectively) was when I was sitting up and leaning forwards slightly, but there was only a bed in the room and I was hooked up to drips so I couldn’t get off. You can’t give birth perched on the edge of a bed because the bed blocks the exit! So they shrugged, lay me back down again, and I ended up with an instrumental as I could no longer push effectively.

There just seems to be no curiosity about how they can problem solve, it’s just rigidly sticking to ‘just leave them there, the baby will have to come out eventually’.

I think that wasn’t real life, it was necessary for the story line otherwise how could she have had the conversation with Janice?

I don't think maternity services push natural birth. What I've experienced first hand and witnessed with friends is quite the opposite.

Women pushed to have inductions as soon as they hit 41 weeks now! And then all the interventions that brings with it.

I had my first 15 years ago. I'd always believed that I'd have an epidural and no way would I be going without super strong pain relief! I thought induction wasn't a big deal and you just did it. Midwives chuckled to themselves when I filled in my birth plan paperwork, barely glanced at it, saying not to think that any of it would go to plan. I was pretty naive.
But when my waters broke and labour began, luckily I avoided induction and had a water birth. I did have pethadine in early labour as the baby was back to back and the pain was excruciating. My amazing midwife stayed with me all night through labour and even stayed 2 hours past her shift finishing (just as a support, 2 new midwives were on shift) to be with me when I finally gave birth in the pool. I was immensely grateful to her.
The aftercare wasn't great, I was stuck trying to breastfeed for 3 days on the ward with minimal support and eventually gave in and gave a bottle so I could leave.
My second, 12 years ago, I educated myself massively and had a homebirth. Zero pain relief. I had planned on pethadine again, but didn't need it. The best birth experience ever!

My third was 2 years ago. The pressure was immense to be induced at 41 weeks. My other two hadn't arrived until nearly 42 weeks both times, spontaneous labour, so why would I agree to induction so early on when clearly my body and babies get to term a bit later?! I was getting hounded by phonecalls to attend induction, or meetings with consultants to tell me I was risking my babies life, all because I was 'post dates'.
However this time I was older and wiser and pushed back.
I had horrendous SPD and was in a wheelchair as couldn't walk even a few feet without pain. Eventually I gave in to the coercion and agreed with the senior midwife that I would have a planned csection. Once in hospital, I told them I wouldn't go in to theatre until my birth plan had been read and agreed. The consultant doing my csection was lovely and came into the room with all her team and made sure they all knew what I wanted with the csection.
The midwives who were on shift then were far less gracious and couldn't hide their frustration that i was exerting my rights to have personalised care.
After the csection the postpartum care was horrendous. They knew I'd been in a wheelchair when I'd arrived and now had had major abdominal surgery, but pushed for me to be mobile and care for the baby and myself solo. They forgot to give me painkillers regularly. And by painkillers I mean paracetamol and ibuprofen. They didn't answer buzzers. I heard them moaning on the ward about how they hated their job. They were very rude to my husband when he asked for help on my behalf.
There was a LOT of things that were shocking which I witnessed towards myself and other mums on that ward.
I discharged myself 23 hours post section - would have been 20 hours but they took ages to sort it.
I can honestly say that I am still traumatised from the lack of care I received on the postnatal ward.
I put in a very big complaint with all the facts to Pals.