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?

Nonsense. I had my son under a labour government and things were equally as horrendous then.

It's not useful for you to be spouting your unfounded propaganda. The NHS has been broken for many decades.

I had my son 21 years ago, induced then emergency c section. Ante natal ward understaffed, there were a couple of high risk pregnancies in, the midwife was short tempered , really unpleasant. When my contractions started I groaned and she rolled her eyes at me.

No complaints about the section itself, but the maternity ward was due for refurb. The shower in the post natal ward had mould growing in it, I was terrified. 2 different maternity units had just merged and during a long labour all I could hear was the 2 groups bitching about each other. As one midwife went off shift, she told the incoming midwife to keep using the ice spray to check how far the epidural affect had gone. The incoming midwife shrugged and said "we didn't use that at xxx".

Post natal, I was establishing bf which is harder after a section and I couldn't walk for a few days so went without food on occasions as it was delivered to a communal area and if I didn't remember to ask someone if they could get me some I missed the meal. Relied on visitors bringing food.

Looking back, a really horrible 9 night stay.

I had one of these without any anaesthesia- was told it would be a bit “bitey “. I nearly fainter and threw up due to the pain. Absolutely horrendous. This was via a private healthcare provider. I honestly think it’s misogyny in practice.

Yep, that was very similar to my first birth experience, including the lies in the notes from the midwife. And talking about it is not received positively!

We travelled 45 min away to another hospital for the second, and went for elected C-section so it went much better. Out in 24h, I overheard the midwife saying how I was one of the "good" ones: happy, positive, knew how to breastfeed, no trouble. They were coming to chat with me at the beginning of their shifts etc.
Of course they were avoiding and ignoring the crying lady next to me...

It's one of if not the highest risk activity a female can go through, combined with endemic staff shortages, 14 years of lack of investment by the government, and a tiny percentage of people in midwifery who really should have gone into a different profession (tax collecting, games teacher, bailiff, Russian prison guard).

My baby died because of feto maternal haemorrhage after 39 weeks of 'textbook' pregnancy. Nothing was picked up. I was seeing a consultant for low placenta - waiting for four hours each time for a five min appointment with her to tell me it's all great.
And then my baby died a few hours before my planned c section. I was at the hospital at 6am for my ec, it took till 10 for them to listen to her heartbeat.
A month later the consultant didn't even show to my meeting to discuss what had happened. The doctor meeting me had no idea what he was talking about. Original consultant popped in for a few secs as the dr asked for her help, and said to me she had saved lots of babies in similar position - no explanation as to why she didn't save mine- and went to say I'm a young 'chicken' and will go on to have lots of healthy babies! It was such a nightmare.

Have you looked at maternal and infant mortality rates in the US v Europe?

That’s appalling. I’m so sorry x

So many of pp’s experiences of not being believed by midwives resonate with me. I was not believed when I said I was in labour, denied pain relief, shouted at and, in the end, rushed to give birth in a panic when they finally realised I was not lying. This was not due to underfunding or staffing issues (it was a night shift on an induction ward with several midwives sat in their office and no other patients requiring assistance).

There really seems to be a mentality issue within the profession that leads to women’s concerns being dismissed. The midwife at my booking appointment with dc2 was very dismissive of my first experience even though I had to recount everything because their system showed that I had had a pregnancy but no live birth.

I’ve realised that the only way to make yourself heard is to be very assertive and not take no for an answer, although that is very difficult to do when you’re in pain and on your own. It’s shocking that in a first world country you have to worry about going to hospital to give birth for fear of being mistreated.

I think the fact that midwife and medical staff see birth plans as the "problem" is itself emblematic of the awful dismissive culture.

Most women with a plan would accept changes to it when the need for the change is explained and the emotional impact acknowledged. It's the dismissive, eye-rolling approach to birth plans, as though the mother is an idiot for having hopes and intentions for her birth, which stings so many.

Exactly. I was I A&E yesterday with my DC and the pediatrician was questioning whether my thermometer was accurate to check his temperature as it was 40

I can’t actual being to unpick all that is wrong with this post. Total ignorance

I am so, so sorry to hear it.

Mine has been a mixed bag. I feel the good parts were because I knew the keywords to say though and whilst it felt underhand, I think my youngest could easily have been stillborn if I hadn't.
I had an induction and they were so convinced it would take hours that they didn't take me seriously pain wise. I was offered a painkiller tablet and a hot bath when I asked for an epidural. I knew the baby was imminently coming and they didn't belive me until I said I really needed a poo (true but i wouldnt have said unless i knew it was a sign of imminent birth). They suddenly switched and I gave birth less than a minute after arriving on labour ward. The next birth I was also induced but only because I said I had been in previously for lack of kicks. I was a week over at this point and movements had slowed but it was only when I said it was not the first time I'd been in for that that they said to go to the hospital for a checkup and possible induction. They were oddly quiet when I had the scan and immediately put me on the induction pathway. When my waters broke there was barely a trickle (compared to a full gush for my first). I strongly believe that the low water level was causing less strong movements and if I hadn't have embellished a bit, my baby would have been in trouble as they originally didn't want to induce until 2 weeks over.
I cannot fault the actual midwives who assisted in labour though - they were great. The instincts of women should be listened to more though.

This is completely the nhs and governments fault. If there is a high number of midwives leaving they need to be proactive enough to find out why and make changes.

Also women should be able to trust 'professionals' rather than asking for a second opinion and waiting for it whilst they're in the most vulnerable and painful experience of their lives

So many of pp’s experiences of not being believed by midwives resonate with me. I was not believed when I said I was in labour, denied pain relief, shouted at and, in the end, rushed to give birth in a panic when they finally realised I was not lying. This was not due to underfunding or staffing issues (it was a night shift on an induction ward with several midwives sat in their office and no other patients requiring assistance).

I could’ve written this word for word.

The midwives in my case weren’t rushed off their feet. It was 3am, I was the only woman awake on the induction ward, the midwives spent a lot of time chatting which I could hear through the curtain. One of them reluctantly examined me and found me to be 5cm but didn’t think that was cause to move me to labour ward. I told her my last labour I went from 4-10cm in an hour and I was desperate for an epidural, but no 🤷🏼‍♀️ I was to wait apparently, and they had a tens machine if I needed it.

The next time she saw me I was vomiting all over the cubicle and so delirious from pain I couldn’t actually speak.

@wednesdayaffairnc when I had my first (4yrs ago), every woman who had post-birth issues had been coerced into unnecessary interventions. All had been pushed into having an induction and then ended up needing forceps or emergency CS.

My SIL has just had her first baby and a few weeks before the birth was contacted to book in her induction. She questioned it and was told that it's standard practice to book everyone in for induction so they don't go over their due date! Madness.
Of course she ended up with further intervention and later a CS.

My own experience was dire and both me and the baby almost died due to medical incompetence. The ward staff were dreadful, my midwives were amazing but they were repeatedly told by the consultants that they were wrong and it wasn't their decision to make about when my baby should be delivered. The consultants caused the issue and then caused further problems with the actual delivery.

My second birth at a different hospital wasn't much better but pretty much everyone had been put into a high risk category - that's just not sustainable.

Yanbu I had my first baby in January. There were parts I thought were fantastic for example the community midwives were fantastic so knowledgeable and friendly and reassuring at times I said I was nervous about the north etc.

But the bit on the hospital was awful. Some examples:

• I was induced as baby was measuring big so it was recommended I was induced at 38 weeks
• At one scan where baby was measured the sonographer asked me why I was there and I explained that because baby was measuring big on scans that they’d booked me on for more regular ones… she looked at me and said there was no need for me to be having a scan for that… but given I was there they’d scan and check baby anyway… I was really annoyed by this because we had a team day at work and I’d only been able to attend half of it
• at all appointments I said if I chose to be induced I wanted to only have the pessary and drip and that I did not want the balloon… the midwife and consultant I spoke to about this said that was absolutely fine (the concept of the balloon forcing my cervix open just didn’t sit well with me) BUT in reality after I had the pessary I was told by the midwife that next step was the balloon and that was that… I said that I’d been told differently and she was really dismissive… the balloon is a relatively new method of induction from what I was told in my antenatal group so I don’t know why they couldn’t offer me another pessary instead
• When she examined me to check how much I had dilated after the pessary was taken out I had a panic attack… she didn’t help matters as she kept telling me I looked worried and did I was gas and air and it just built up my anxiety so so so much that I ended up having a panic attack (I was under mental health team for my pregnancy so if she read my notes she would’ve known This could’ve happened)
• After refusing the balloon a consultant came to speak to me… about 18 HOURS after the pessary had been taken out! This was about 11pm at night… we’d literally been left there all day
• The consultant said there were three options c section, continue induction or go home and labour naturally because actually having a big baby was much of a risk after all… despite being told throughout my pregnancy it was a big enough risk to warrant induction. I was so upset by this as naturally I’d been so worried about what my options were for labour with a big baby
• In the end I opted for a C section… the actual C section experience and care I received during the procedure was amazing. I was scared of having one but actually it was all so magical.
• We stayed in hospital after baby for another 5 days… and that bit was awful
• Firstly no one told me about the importance of the first wee after my catheter came out so I didn’t drink water to try and pee so I failed the wee test and had to have a catheter in for another 48 hours
• Pain relief was supposed to be every 12 hours but it wasn’t. It was more like every 16 hours so I was in pain at times. In the end I learnt that you had to really advocate for yourself and ring the buzzer a lot.
• The pharmacy I got my regular mental health medication from mucked up my prescription so I didn’t have any in hospital but was told the hospital pharmacy could get me some. This took 36 hours and about 4 different requests to midwives. The consequence was that I started vomiting and couldn’t keep any food down… the moment they finally got my medication I felt better within half an hour
• They forgot to discharge us. We were supposed to go home Thursday but they forgot… when we were leaving on Friday I got a phone call from a midwife at our house saying we weren’t in and she was there for baby’s check. I explained we hadn’t been discharged and we’re just leaving… she said her records showed we had been discharged the day before…
• They wrote in my red book that I left breastfeeding… I did not baby had to go on formula because I wasn’t getting the support with breastfeeding. One midwife said “are your nipples always like that?” Which made me feel really insecure and that there was something wrong with me that I couldn’t breastfeed
• The community midwives organised for a breastfeeding specialist to come out and help me feed but the hospital ones just didn’t care or even mention this was a possibility
• I had a really horrible midwife one night in hospital who was like a matron demanding I get out of bed and walk and that she wanted to see me walking up and down the corridor all night. She also tried to give me an injection in my stomach without my permission when I said I wanted it in my leg (the anti clotting injections that I’d had in my leg the 2 days before)… she essentially told me off because I started to panic at the idea of having it in my tummy. She was awful. Fortunately I got her name from her name badge and fed back that her bedside manner was awful.

I just felt there was no consideration for me and nothing was explained to me properly throughout. I just know for baby no. 2 I want to advocate for myself more.

both the midwives I had during labour were absolutely fantastic the consultants ignored them both when they stated I needed a C-section and allowed ds and myself to go through terrible trauma that simply wasn’t necessary

A
combined attitude towards woman’s health (both physical and mental health) and that we now have accepted a healthcare system that in many areas is poor because so many are invested in hanging on to the NHS when we could have a system like France and Germany (not the US)

do not expect huge changes under Labour what will happen is other areas will improve that show better results on paper a woman’s experience isn’t a top priority no matter what the impact is on her or her baby/babies

About the time David Cameron came to power the midwives asked could they have some more resource please as they were a bit short. Clearly that didn't happen.

The BBC radio 4 programme 'child' has some great episodes on the change in power during births from mums and supporting friends and relations to medicalised over time

However there may be some cultural issues. The blaming emotional women thing is something I know of from the eighties. It would be like taking your car to the garage and the mechanics expecting you to know how to mend it - with just a bit of light supervision from them. Possibly part of British stuff upper lip culture gone awry??

The same reason all public services are on their arse. The Tories have defunded them and knackered the economy.

PrincessTeaSet, well go private then!!! See how long your money lasts.

Manly it is down to lack of staffing. For every 30 midwives who train the NHs gains 1 new midwife. Slightly old study but I'd assume still relevant especially after the pandemic and the burn out the NHS is seeing across the board.
Sadly midwives have to prioritise the care they give especially postnatally so those women who are generally fit/ healthy will be bottom of the list to be seen as the women who are ill had massive blood loss etc will need the one to one care which then reduces the staffing and it is just an endless circle. Midwives are always trying their best from my experience but fighting a losing battle against a system/ government that doesn't care.

www.rcm.org.uk/media-releases/2018/september/nhs-gains-just-one-extra-midwife-for-every-30-trained-new-rcm-report/

So much of it depends on the individual hospital you give birth at.

Every single midwife I've seen in both pregnancies has been incredible but they are clearly overworked and dealing with a broken system. Things get missed because Badgernotes is awful. Bring back the green notes!

There is one consultant at my hospital who is a huge fan of forceps. I know a lot of women who have been butchered by him and have needed a lot of private physio to recover. GPs aren't interested in birth injuries.

My main issue with my maternity care was the lack of being listened to. I’m not sure how women trained to help other women birth, in lots of cases having given birth themselves, don’t listen? There was no support at all the postnatal ward, I just discharged myself after three days as there was no point me being there. Community midwives ignored very clear signs of dehydration in my first in their insistence I kept breastfeeding. They kept trying to talk me into pain relief I didn’t want, told me I was wrong when I could feel crowning, told me there was no infection when there was. It was honestly a nightmare and I’m glad to never need or want to do it again!