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?

Exactly. Absolutely shocking attitude to have about health care. We should not be expected to accept mediocre care. Things do bot improve if everyone has that attitude.

@Oohooh What would make your home birth "high risk"?

I work in antenatal care.
It is extremely difficult when a patients wishes are not the best thing for the baby.
I will say that the people I have met whilst working in this area are some of the most knowledgeable, competent, caring individuals I have ever come across. They will be having sleepless nights over certain patients and their unborn babies. They will have stayed beyond their paid hours and they will have told their kids school they cannot make it to pick their poorly kid up because they are run ragged and there isn't enough staff (done this numerous times myself).

Pregnant ladies also are NOT ill yet are sometimes some of the most demanding patients I work with.

I've worked in urology, gynaecology, GI etc. when people are having their kidney stones blasted they do not have a written plan of wishes so they have a lovely experience.

During COVID we had ladies shouting and abusing us because they were only allowed one person in for the birth but "Ethel" on the gynaecology ward who was dying of ovarian cancer wasn't allowed anyone in at the time...

Maternity care in UK does sometimes fall short of what it should do and things go wrong, but also people's expectations and sense of entitlement is also much higher than it used to be.

Trust me...everyone's priority in antenatal, during birth, and post natal.. is the safe delivery of your baby.

Actually the answer isn't to go private although I shall be paying for DIL and DD to do so and they are my skin in the game.

The answer is for the gratitude to cease for sub-optimal care because people have been brainwashed to think the NHS is free. It is not. If a solicitor or accountant was rude to a client do you think their fee would be paid? Absolutely not, or not without a fight.

The Blair government spent millions on an extra layer of bureaucracy in the form of PCT just as GP fundholding was working properly because Labour's dogma was against them. Labour also escalated and encouraged the roll-out of PFI to take credit for bright, shiny photogenic facilities. They did very little to address the underlying dysfunctional cultures and hierarchies. It is the debt arising from Blair's and Brown's PFI initiatives thar is strangling the NHS.

In the context of GDP the UK is not very far behind Northern European social care models who have significantly better outcomes and whose services are delivered with greater dignity. What is not costed in the UK is the patient time wasted. 90 minute waits for appointments, rearranged surgeries and appointme lots at the last minute, the failure to get people well and back at work. All of that comes with costs attached but they are not calculated because the British public has been trained since 1947 to put up and shut up and to be grateful for a paternalistic and excruciatingly inefficient behemoth

Does this not mean that if a woman rings the buzzer and has a question about medication, discharge, feeding etc you won't be able to answer?

Honestly some of these responses from midwives explain why we sat there for 3 whole days for "feeding support" and only one midwife came once despite the fact baby had literally never latched. The midwives probably had forgotten we were even there or why we were there!

My expectation was not to almost give birth by the side of a rural road because I was fully dilated but noone believed I was in labour and made me leave the building, and then be injured to the point of incontinence.

What a whiny bitch I am.

I had a really lovely midwife with my second baby. I went into Triage at midday with what I thought was a kidney infection but it turned out to be labour.

The midwife assigned to me was great but things veered of course and by 8pm things were getting a bit hairy and even though her shift was over at 8.30pm she still stayed with me.

I eventually had to be taken for an emergency section at about 10.30pm and she came to theatre with me and stayed with me during that too.

Even though she’d been on shift since 7.30am she stayed with me until gone 11pm to make sure me and my baby were okay. It was wonderful care.

Sadly I didn’t see her again before I went home but I left a card and a gift specifically for her because she showed me suck kindness.

@Eyupspadge do you think it's entitled to expect a midwife to read the notes, to record important information inaccurately, to notice when the baby is in trouble with the cord wrapped round his neck and blame the dropping heartbeat on a faulty monitor. I'll add further is it entitled to expect not to be shouted at on the post natal ward for getting some blood on the sheets, to be able to ha e a clean bathroom, to be brought pain relief promptly. Was it entitled not to expect to be laughed at on an open ward behind a curtain because pain was unbearable at half a centimetre and the midwife hadn't noticed the baby was posterior.

Do you think it entitled to expect community midwives to be polite and not take their left elbow in their right hand and waggle their forearm backwards and forwards whilst blasting "if you don't do your pelvic floor exercises starting today, your man is gonna say this is what the sex feels like? Notwithstanding not advising utter sh1t in relation to breastfeeding and the prevention of mastitis and not recognising it when it did emerge.

I could go on but I regard all of the above to be execrable and every single woman is entitled to better in the UK in the 21st century.

Kidney stones by the way are Considered to be a clinical disease, women have been told for generations that pregnancy is not an illness. Of course expectations will be different.

Chelsea & Westminster and St George's by the way. 1994/5.

If I had £15k or so in my savings I’d have a private c-section and aftercare, if only to guarantee my own room to get proper rest in.

there is a dangerous shortage of midwives, strange MW vs Dr (in my experience) mentality and a historic attitude that women should just cope and crack on with horrific pain and any after effects that affect their lives.

Even weird basic stuff like not being provided with food or drink.

After saying I could go home that day after giving birth late previous night there was weird muttering about keeping me in to establish bf despite no concerns - in early 2000s - happened to a few friends most of who gave a bottle of formula just to get out.

I had no food entire time in hospital despite promises, extremely limited access to water despite it being really hot, no sleep, no pain relief and getting access to toilet was hard and it was so noisy lots of loud male visitors - we walked out after being kept waiting for hours for some paper work.

It was awful place and terrible start to motherhood - said to DH on way out they must be awfully overworked - he looked at me odd we walked two floors it was just us 4 - and staff has said in way in it was unusually quiet to him. Getting home was bliss - 24 hours of no food- I'd thrown up in labour as well- and was feeling ill with no food and bf.

Recent years had older family in hospital struggling to feed themselves and it's been completely ignored - most relatives have had to try and get in and do it and often advocate for pain or their routine medication and even liquids - then staff think nothing to waking patients up for routine tests. It''s not all wards but depressingly common - sleep deprivation, noisy stressful environment no concern about food liquid access and yet people are there to get well.

Hospitals are awful for sleep deprivation. It's ridiculous as you're meant to be recovering. As soon as you can crawl out you so should. No wonder so many elderly people die unnecessarily when they're not given food or water.

@GingerAndLimeCurd i remember bringing my own food to hospital. I had a backpack full! As a coeliac I was worried about cross contamination or being something awful to eat. I then had to argue with the discharge team to go home because although I’d said I’d brought a range of food with me and staff saw me eating, my notes said I’d refused all food!
I also got told off for not drinking enough, when my jug was empty and out of reach and I couldn’t refill as I couldn’t walk. Delightful nursing muttered this isn’t a hotel!

PFI allowed the building of new hospitals and maternity units, without it, we'd now have an NHS without these new facilities, so we'd be far far worse off.
The contracts however were badly negotiated both by the Tories and Lab.

In terms of GPD % the UK is close to EU average (though still below) BUT that doesn't matter, our health spend per capita is very much lower & thats what does matter.

We ve less staff, buildings and equipment than almost any other EU country...
My DD left the NHS because of work stress and unable to deliver the patient care she wanted to do, patient lists so long that she simply couldn't see the people who needed help and those she did, got sub optimal care, as she had to get to the next one!!

She now works in Aus, still has the bureaucracy and shoddy management etc but the staff levels are just so much higher & she can do her job.

Regarding food….

I had a c-section at about 11pm at night and come 6.30am I was woken up and told by the HCA that the breakfast trolley was by the nursing station and I could help myself.

I told her I’d only had my CS seven hours ago, that I was still partially numb, and feeling very sore and hadn’t even been out of bed yet and then asked if she could just get me some toast. She said to me that was fine and she’d be right back.

An hour passed and she still wasn’t back and so I pressed my call bell as I was feeling unwell / lightheaded as I hadn’t eaten for just over 21 hours by this point.

Another HCA came and I explained the situation to her and she said she’d pop to the staff room to get me some breakfast and she’d “be right back”.

After 50 minutes that HCA still wasn’t back and so I had to ring another department in the hospital, which I worked in a a nurse, and I spoke to one of my colleagues and begged her to bring me some food.

Thankfully my colleague was went to the staff canteen and got me a fry-up which she then bought to me in Maternity.

Throughout the day I saw both of the HCAs and not one of them apologised or asked if I’d manage to get my breakfast etc. It was like they’d completely forgotten who I was and had no recollection of our conversations earlier that day. I felt so irrelevant.

From my experience, the women (and their partners) in the postnatal units (6 mothers to a bay) took better care of each other than the midwives did. It’s a good job we all had each other to rely on when any of us needed anything.

Agree absolutely- my labour was 16 years ago, no major pressure then but my care was appalling. DD and I both could have died if a consultant hadn't recognised what three midwives had no clue about for hours.

During my labour while DD was stuck in a very dangerous position, I was induced making the situation worse because they said my contractions were weak and two of them stood their gossiping, passing judgement on a local doula who ended her own life without ever stopping to consider someone present might know her. She was my sister's doula and very close friend and I could see my sister getting distressed while I was in agony with DD stuck - it was awful.

They was just the start - my care went from bad to worse and post natal care was atrocious too.

Still traumatised 16 years later.

I had two brilliant experiences, couldn't have asked for more. Probably the only time the NHS has been half decent.

The NHS is actually one of the best-funded, in terms of the percentage of GDP, in the developed world. And one of the wkrst performing. It's the die-hard commitment to a state-run system that means it can't function.

Without the Brown/Blair PFI, money would have had to be found from elsewhere or taxes raised further. That wouldn't have looked so good though. So the kicked the can down the road and left the pieces to be picked up.

Regarding food in hospitals, if people are in hospital they aren't paying for their food. Why therefore for those not on benefits can't a charge be made. I guess because once people see the money pass hands, they insist on acceptable standards.

TBF my mother was in hospital last week and the care was exceptional. The nurses were on the ball and very polite. Cardiology unit. All the nurses were Philippino/Taiwanese and lovely. There was no understaffing. One thing we did notice was that deliveroo drivers were constantly coming in and out of the hospital so people seem to be sourcing food alternatively.

Don't even think to give birth near bank holiday or go to hospital for any reason near a bank holiday ,let alone Christmas . Meal offerings at Christmas time are very paltry . They do VERY much like their bank holidays in the NHS .

I have to say, and it may well be different on postnatal wards, but my care when I went through emergency surgery on the NHS for an ectopic pregnancy was exceptional. It was a slightly traumatic New Year's Eve for me that year...found out I was (very, very surprisingly) pregnant at 10am and being rushed to theatre for urgent surgery at 10pm as a significant internal bleed and almost ruptured fallopian tube 😢
I was given a private room as there was one free, and the HCA that cared for me over night (supported me to the toilet etc as my mobility was badly affected) was nothing short of phenomenal. I suffer from anxiety and she was there throughout the night to chat and reassure. I will never forget her kindness ❤️

I know @RosesAndHellebores doesn't like the NHS not least UK staff but i ve always had great care as have relatives, aside from MH, which is truly dire.

I'm pleased you had great care in relation to an ectopic. When I had an MMC, and cried as I was told the sac was empty, the sonographer peremptorily noted "did you want it".

Later that day when dh couldn't get away until after 4pm, the ward sister asked why and when I said he was in court, shook her head and said that must be very stressful for me.she went away and came back half an hour later to discuss further with a concerned and patronising look at which point the penny dropped and I told her he was in court as the defending barrister. She then shouted at me that I had wasted everyone's time. I had not, she had made an assumption. I think in those days husband's occupation was on the notes.

That was under a Labour government.

So no, @Alexandra2001, I can only speak as I have found and I have generally found NHS services to be beyond the pale.

Nobody believed me when I was in labour because my trace wasn't showing my contractions and I didn't really seem like I was in labour. Tbf I didn't think I was in labour either, I was sat on the chair chatting with my husband how I was semi annoyed at being in hospital at 11pm because I had a big presentation at work the next morning and I didn't want to be tired for it. It was my first baby, I was 35 weeks pregnant and just assumed it was Braxton Hicks, so did the midwife

To the midwives credit though when she did eventually get round to examining me and realise I was in established labour (and my baby was breech) they got me up to delivery suite ASAP. She apologised after and said "Most women don't usually have a conversation during their contractions at 8cm dilated..." I imagine internally she was shitting herself that she could have accidentally had a woman delivering a prem breech baby on the assessment ward

And this is exactly the problem. No it's not an illness but it is a medical condition that if it goes wrong two people can die from.

This dismissive stop whining, just get on with it attitude is the reason people don't trust maternity care to have their best interests.

Actually pregnancy can make you very ill, you should know if you work in antenatal care. I was hooked up to machines on a magnesium drip during my first pregnancy and was very unwell and had unstable dangerously high bp for an extended period. I miscarried and had to deliver my last pregnancy at 20 weeks. Thankfully I was shown more compassion than being seen as a nuisance even though staff were busy. Many women have caesarean sections and can't get up to pick up their babies. I'd say they need help too.