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?

This happened with my catheter too!

I told them it wasn’t working as I needed the toilet. I was extremely rudely dismissed and told that wasn’t possible. No one was available.

I thought my bladder was going to explode, so I said they could remove it or I was going to pull it out myself. Suddenly someone was found.

Conclusion? It wasn’t working and hadn’t been for several hours.

I had issues with my bladder for months after and suspect that was a factor.

The dismissal of you when describing problems etc was very surprising and quite disturbing really. I have quite a senior job so am used to people respecting me and listening when I speak - in the maternity ward I was basically just seen as a stupid little girl who had gotten herself pregnant.

Regrettably they behaved like that in 1994 too whilst constantly whingeing they were overworked. There were four women and babies in my bay. About six midwives; too busy to assist or advise too busy yapping. I recall getting my head blown off because I reported a blood smeared bathroom, including the bath and was instructed to clean it with green paper towels and vim.

They were excellent at the mantra, breast is best, yiu must do it. Woeful at providing any help or constructive advice. Mine missed the red flags for mastitis which could have been prevented if they hadn't. Postnatally, by five midwives and two students over 7 days. Three of them bleated about overwork. They all had 25 to 40 minutes to do a visit that could have taken 10 minutes due to their innane chatter and regrettably from a clinical perspective three were very poor and didn't listen. They did jump to conclusions about things that had nothing to do with them. Whilst visits for 10 days are nice in principle the midwives were so useless they were a waste of my time and NHS resources.

When I brought dd home I wrote to the Director of Women's and Children's Care at the local Trust, copying my GP and requested I be visited by no more than two community midwives and noted that I expected them to focus on clinical issues and not their personal observations about my family's lifestyle.. My request was observed and the care was much better.

Further to the earlier message- in my 1.5 years on the postnatal ward I had one neonatal collapse. It came completely out of blue, I had checked that baby 10 minutes earlier. Baby required full resuscitation, spent 6 days on neonatal intensive care unit, no cause was ever found, baby made full recovery. I also had a woman suddenly developing severe sepsis a few hours post completely straightforward delivery. I checked her over at 08:30 temperature 36.5. I spotted her shivering at 12:00 during routine drug round - temperature 38.5. She was given iv antibiotics and taken to high dependency unit straight away. I lost count how many "minor" incidents there were. As a postnatal ward midwife you are always on the lookout for potential signs of danger, the stress is immense. Please don't bash us out, we are hanging out the best we can and many of us are researching other career options

Yeah they are bad at medical notes and drugs. I definitely learned my lesson from my first c section and took my own painkillers into hospital for my second c section. I also had a drugs nurse try to give me an extra dose of blood thinners as she hadn’t read that i’d been given it earlier.

I would really recommend anyone to bring their own painkillers and to keep a note on their phone of what medication they have been given and at what time.

Jeremy Hunt identified the causes and the solutions when he was out of Govt and chair of the commons health committee.

Lack of staff, training, retention and funding, he was spot on.....

Unfortunately, as Chancellor, he has chosen tax cuts over maternity care.

The public know this about our public services, hence the election results, most people no longer want a tax cut, they want better services, especially health.

The inability to listen and not record things accurately in the notes was concerning.

They recorded the wrong dates for miscarriages and the death of DS2 - quite pertinent as DD was born 51 weeks later.

Also I had a hellish time feeding DS1 - not helped by crap and inconsistent bf advice from midwives and HV. I specifically said I did not know if I would bf and it depended on the support I felt I might receive. The twit wrote "we discussed feeding - confirmed will breastfeed".

She handed me my notes back and I read them before I got up. I insisted on seeing a consultant. Which I did within 10 minutes and he picked me up from there and I didn't need to speak to another midwife until I was in labour. He made sure I received excellent care. He was bloody marvellous.

This

And three days after my admission I was still there, feeling quite well, so I asked the midwife why I hadn’t been allowed to go home.

She said that as part of the bloods tests I’d had done the previous day, they were having to check the serum levels of my epilepsy drugs to make sure they weren’t high and that once they’d come back I could go home.

I inwardly laughed as I explained to her that the checking if serum levels takes about 3 weeks, so were they intending to keep me there for that long?

She simply said, “oh. Ok then. You can go” 😂

@Kosenrufugirl regrettably the money was pissed up the wall on the advice of Whitty, Van Tam and a collection of scientists peddaling skewed statistics, to shut the country and the NHS to everything but Covid. Bits of it are still not operating at full tilt with admin very behind because admin staff are still working from home. We clapped whilst mothers laboured alone and the dying died alone.

I am 63 now and I am not prepared to pay more tax to be shouted at by NHS staff, dismissed by NHS staff, messed about by NHS staff.

We need a system of social insurance for healthcare like they have in France, Germany, Austria, Australia, etc. Every Aussie I employ is horrified by the inadequacy and inefficiency of the NHS.

The NHS is an hierarchical mess that does not even regard the patient as an equal stakeholder. How many times, have you as a midwife called the consultant Mr Jones whilst calling the woman Love, Mum or her first name? It hardly indicates much respect or indeed any equality.

If women's services have time and resources to produce chest feeding leaflets and to refer to mothers as people with uteruses, they have time to provide pain relief and to treat women with dignity.

The NHS was under funded long before Covid, maternity care especially affected.
Its just worse now, Hunt wrote his reports before Covid.

However, i do agree we were conned with Covid, whether that was deliberate or accidental i don't know but if politicians and it wasn't just in this country, ignored their own advice, then its clear the people making the rules weren't concerned about CV.

@Alexandra2001 I don't disagree necessarily but Covid has bankrupted the country.

The problems of rudeness and lack of care and attention in maternity units is not however new. It prevailed prior to 1997 and in the period 1997 to 2010. The real issue is the underlying culture and money will not heal that.

Or in the 10 minutes since she’d dealt with a multitude of other things. Unfortunately I would be that midwife, I can give someone my full attention but when I move on to the next thing it goes from my mind. It’ll come back but I have shocking short term memory from dyslexia. TBH I’d be more likely to remember the details than the person. Once I’d matched the two up I’d be able to provide the care needed.

My birth was 1999, at home, the NHS provided 2 midwifes, afterwards, as a precautionary, taken to Derriford, apart from some shitty BF advice, the care was v good.

Now those services i experienced would have been as a result of Tory spending and staff levels, Blair's policies wouldn't have kicked in by then.

That level of care is simply not available anymore, people haven't changed, what has happened, as in many aspects of health, there simply isn't enough staff & those that are there, are underpaid and have low morale.

That doesn't excuse poor note keeping etc

CV didn't bankrupt the country, have we turned to the IMF yet?
we still have very healthy tax revenues and Hunt recently cut taxes by £31 billion.

He could have directed that 31billion to maternity care, its all down to political choices.

When I started in 1992 we were told to not call patients “the stroke in bay 5” because it dehumanises people. Shocking that this is still happening.

I don't think NHS midwifery services are safe. I paid for a private homebirth with savings (and I do absolutely accept not everyone is in a position to be able to so). It was also at the height of lockdown when we were told no f2f appts so blood pressure checks/urine checks etc would not be done. I wasn't OK with that.
I had exceptional care both antenatally and postnatally.

I had severe preeclampsia which started at 32 weeks during lockdown. 4 phone calls over 2 weeks before I was admitted. He was born by c section 36 hours later. Luckily we're both ok now but that would have likely been picked up earlier with face to face appointments. I only knew what to look for as my mum has preeclampsia when I was born.

@bradpittsbathwater I'm so pleased you're both OK. The care we received during Covid was absolutely unacceptable.
I was struggling to eat at one point during my pregnancy due to severe anxiety (something devastating had happened - not related to my baby) - and I am so grateful for my Independent Midwife as my ketones were all over the place when I did my urine samples. This can be really serious but with support we sorted it.

To any midwives on here, I bet you feel so happy and appreciated in your job. To the people posting on here, the answer is simple, go private.

Dd was born 17 years ago in a major London teaching hospital. All the poor care issues were the same, so this can't be a funding issue. More a culture issue.
Dd was breach so I had a planned section, which was all lovely until post natal care which was incredibly poor.

Luckily I was well cared for when admitted at least. Still traumatised 4 years on though! I had bought protein self test sticks and that was the only reason they took me seriously when I told them I had protein in urine. God knows what would have happened otherwise. I was like a balloon. Things have improved since fortunately. Due to health issues and complications I couldn't have a home birth nor would I want to. Glad you managed to have a birth at home! Much better than being admitted to hospital

Firstly, having already had 2 babies, my births are very straight forward with no complications: I pushed the 1st out in 12 mins, 2nd in 5mins, physiological 3rd stage minutes after delivery, minimal blood loss, no stitches. So I think it’s fair to assume I’ll be ok 3rd time round.

Secondly, I have more than enough money to pay for every eventuality. And if an emergency were to occur, at least going private I will be in full control, which is really important to me.

The UK, has under funded healthcare compared to EU averages for decades, all Blair did, was a for a decade, bring funding up to these averages, which then stopped again from 2010 onward.

e.g in my area, our last major hospital build was under Thatcher, we ve either stood still or had cuts ever since.

Quite likely your care would be even worse now.

And yet you mocked me over the potential cost when I said exactly that…

Not everyone can afford to go private, and why is it that that is the only solution to shitty care, neglect and severe trauma?

Basically what you’re saying is that only the wealthy deserve dignity and compassion.

The objective of healthcare isn’t to make the practitioners feel appreciated and happy.

I had 1 good midwife in all of my care. The rest were a mix of disinterested and scatty (one spent a full 15 minutes of one of my rare appointments telling me about her off the rails teenage son).

You can’t go private for emergency maternity care anyway.

I won’t be having a 3rd but if I did I would have to opt for a high risk home birth. Both times I believed you’d have to be really selfish to do that and hospital is the best place for the baby, but after my son was left in distress for hours and then born poorly due to the midwives forgetting to administer very basic medication when I was in labour, I honestly feel it would be dangerous.