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 have had very positive experience in delivery suite with both my children it was post natal ward that was the issue just left with no pain relief I had to go and ask for some paracetamol and then got an eye roll from the midwife which made me feel like I was being pathetic. I asked for help with my baby was told well this is you second you should know what to do. I am due to give birth in next 2-3 weeks with my 3rd but different hospital I have everything crossed it’s not the same.

I definitely felt like I was treated like a nuisance when in labour. My labours went like this:

• call up hospital to say you're in labour: stay at home, don't come in.

• turn up at birthing centre reception: they roll their eyes and say no room, can you wait, urgh such an inconvenience.

• spend half an hour labouring in reception. Can you sit down quietly and wait? Er no, not really

• given a bed in labour ward: no pain relief offered. Husband asks can she have some gas and air please. Urgh god, I suppose, such an inconvenience.

• pushing stage is taking a while with the first birth: midwife stands around picking her nails and huffing and checking her watch.

• pushing stage nice and quick with the second one: oh well done, aren't you brilliant not taking up too much of my time.

It was just a shit experience all round. I learned my lesson with the first one and had the absolute minimum to do with them second time round. Literally just went in long enough for them to catch the baby and send me home again. Should have just had a home birth but wasn't brave enough.

Felt the same vibe with the midwife care during pregnancy as well - like you're just an inconvenience. To be fair the health visitor didn't act bored, she was just absolutely clueless 😂

As a former midwife of over 20 years, THIS ... I left a profession that I love (and that I studied for years to achieve - plus a masters once I was qualified and working full time).

I left because I could no longer continue to drive home crying, knowing that I'd done my absolute best for 12+ hours and still failed every one of my patients and not given any of them the care they needed or deserved. And not because I couldn't be bothered or didn't care, but because I had one pair of hands that just couldn't do what was needed. This means the absolute basic minimum is often missed because someone else's basic minimum has to be done first.

The vast majority of midwives are broken by the system that does not allow them to give the care they know is needed and that they want to give (there are far easier ways to earn the same amount of money, they're there because they care).

I'm not making excuses, the care women receive is dreadful and it's not good enough but it's not because the staff don't care and are ignoring you, it really isn't.

I had a mixed bag but was supported by a fabulous midwife - she was in her last week, retraining to be a health visitor.

It's not just the NHS, it's similar in the Republic of Ireland. My consultant prescribed morphine for me post section but on the ward after the midwife tried to tell me that they didn't have any , I told her to stop being ridiculous. They refused to give me formula (hospitals here provide formula) any more than every 4 hours and my son ended up with low blood sugars , it was actually a student midwife who noticed it, I hadn't a clue. The pediatrician went wild once his blood results where back. After 48 hours id enough and wanted to go home and the head midwife threatened my dh with social services if we left, despite two drs saying both me and baby where fine and ready to go.
Countless women have similar stories and worse . A few years back a woman with epilepsy was left alone in a private room with her 4 hour old baby, she had a seizure while holding him , collapsed and crushed him, they didn't notice either for quite some time. It was an absolute horror show and there was put rage but the standard of care is so poor that the same thing could happen again tipsy.

I’m so sorry, that is horrific x

There's not enough money. The funds they do have are spent on things that make the most difference - life and death, serious impairment.

Women having a horrible time (and being traumatized, injured etc) doesn't make it in the spending priorities when it's up against patients dying in other areas.

Maternity staff have hard, stressful jobs and get compassion fatigue. If they let themselves care deeply about every patient who gets substandard care, they'd be unable to do the job pretty quickly.

I think it's partly due to funding but it's also due to misogyny.

Agree with this. A woman I know is in the process of training and doing well ( posts her assessment feedback on social media). I can not think of anyone worse to have next to me in labour. She’s completely barmy.

I had mine abroad but my obstetrician had worked in the NHS, she was absolutely paranoid about pre-eclampsia and was constantly checking my blood pressure and giving me detailed notes about what to do in the event of x y and z down to which hospital to go to in an emergency because they will have the right equipment. My pregnancy was healthy apart from HG.

She told me once that she was routinely called too late by midwives when she was working in the NHS. I assume something really awful had happened somewhere she worked. Also we don’t have midwives only nurses specialising in maternity and paediatrics.

I think there is more of a push now to finally listen to women. I also think the biggest part is just the lottery of who you happen to have looking after you.

my first labour was 36 hours of screaming and vomiting from pain but still being denied an epidural. being left in the waiting room fit hours in active labour after being told before arriving that I would have a room. Being scolded that I would need a C section if I didn’t dilate more quickly and told I was delaying the birth by not allowing myself to have contractions because I was afraid of the pain (as if that’s possible…).

My second and third at the same hospital were much better - given pain relief and antiemetics when I asked, waiting for consent. I really felt listened to.

Have a read of Matrescence by Lucy Jones. It doesn’t focus too much on the birth itself but the aftercare and expectations of women as mothers in a capitalist and patriarchal society. It’s a good read!

My maternity care was awful too but unfortunately the NHS is struggling.

I think this is having an impact on falling birth rates. It’s one of the main things that puts me off having children, and two women I know will only have one because the care they received was so poor.

I went private for this very reason and had excellent care and aftercare. I'm so sorry for those who had awful experiences.

This is what I imagine and seems v. accurate. This also sounds a lot like teaching. And probably what it’s like working in other public sector frontline settings. Sadly I don’t know what the answer is - I don’t think a labour government will be able to improve things either. There are just so many toxic societal and also systemic reasons why the public sector is mostly in dire straits. I think it can only get worse sadly!

“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.”

I have seen so many times student midwives or newly qualified midwives saying they are leaving/have left because there’s such a toxic bullying culture where they work amongst midwives, to the point where they are depressed from work. Why is this so commonplace?

Also worrying that these same people are then caring for women.

I just wish everyone with a bad experience mad a proper complaint. I wish I had.

I'm so sorry 💐that is absolutely appalling

It's interesting to see discussion of 'natural birth' dogma being the problem, because I think there is also a lot of medicalisation which inhibits natural birth and makes a C Section more likely. I think the issue is a chronic lack of funding which feeds into some over-worked emotionally burnt out midwives with no time or inclination or resources to listen to women and support them in their choices. Not all midwives are like this, and not all midwives are like this all the time. For what it's worth, my experiences were mostly positive.

My experience was utterly shit 21 years ago, we both nearly died due to neglect and as a result I never had anymore children. I dread to think what it’s like now.

I agree with this. The 'natural birth' dogma is NOT the problem, it's an understandable response to the medicalisation of childbirth and the problems of misogyny and underfunding that have been discussed.

I had 2 C sections.First with my husband, second one - alone. After second one I had terrible reaction to medication and literally had the worst diarrhoea in my entire life. I was still in bed and you could smell that diarrhea 2 miles apart. However, I had 3 members of staff checking me and saying "there is no diarrhea" until doctor came to check me and I was literally floating in shit.
I made an official complaint and guess - did they respond to me? Of course no.

But how many births can be ‘natural’ when mums these days are a totally different profile - more likely to be older, overweight no have pre existing health issues? You can’t expect the care to be the same as the 1970s when a first time mum was 21 and likely thinner.