The most shocking thing about the maternity enquiries is how unshocked I am.

[GreyandWhiteBathMat]

Reading this this morning

https://www.bbc.co.uk/news/articles/clyn8n3nyrlo

Which prompted me to read East Kents enquiry, I'm maybe a third of the way through. While I am angry and frustrated reading it nothing has shocked me. It's completely in line with my own experiences in my local (not under enquiry) maternity ward 25 years ago. The arrogance, dismissal and casual cruelty of the midwifery staff there is well known. I didn't have issues with obstetricians who were, on the whole, great if not particularly visible.

Why is this? Why are these features so common? I lean towards it being a long standing issue with midwifery education. It just seems so pervasive in a way I haven't seen across other services.

@Wiltingasparagusfern thank you, your response and kindness is genuinely the first time I’ve smiled at remembering this ever, rather than felt tearful. I think that’s a massive change for me. I do remember her name

Staffing is a massive issue - nearly 18 years ago when I was in labour with my preterm baby, there was 1 midwife taking care of 3 labouring women in 3 different rooms.
and a family member who was a midwife for 25 plus years said she never worked a shift on labour ward without filling in an incident form about staff shortages but nothing was ever done about it

So many awful stories.. I wonder why, what is making so many midwives have an uncaring, judgemental or cruel attitude?

I’ve had both wonderful and terrible. A number of midwives during my difficult first pregnancy really went out of their way to be very supportive and helpful, one even came back to visit me on the ward after very long labour and EMCS, when she’d ended her shift, to see the baby and reassure me.

But when the test showed a “high” risk of downs (1 in 200 or something actually pretty low) one midwife was v v negative about it, put me under huge pressure to have an amnio (I refused, but she was so insistent it was essential, if I hadn’t known better I would have gone along with it) and basically acted like the sky had fallen in which was appalling.

Then I was booked in for ELCS for DC2, thanks to the failure to progress the first time round, by the very helpful and understanding consultant. But I went into labour a week early and had to wait in hospital for the ELCS until there was a surgeon available. During that time several midwives put enormous pressure on me to try for a VBAC and kept saying “we can always use forceps”. This is after a baby had died at that hospital from bungled forceps delivery when the mum wanted a CS - just a month earlier. And they knew I had a huge problem with internal examinations and smears etc because of history of sexual abuse, that was on my notes. Have a VBAC and forceps, go on go on go on!

The impression I got was that there’s an opposition between midwives and doctors, and midwives have absorbed the message that birth shouldn’t be over-medicalised and natural is best - so any situation where the woman does need more medical intervention is seen by some MWs as interfering know-it-all doctors sticking their oar in, or weak selfish mothers wanting an easy way out.

Except when it comes to amnios, then they’re all for medicalisation. A 1 in 200 risk of downs is terrible news but a similar or higher risk of miscarriage from an amnio is fine.

It may relate to education for MWs but I’m sure the culture and leadership at a hospital matters too. Almost all the MWS I saw at my lovely GP surgery/in non-hospital settings were great.

Reading all these stories makes me think the midwifery profession needs to look at free birthers insta pages then take a long hard look at themselves.

these stories are the reason some women seek to give birth entirely outside the medical profession, thus putting both themselves and their babies at risk.

My jaw is on the floor reading this.

I work as a Midwife in another country. It is not like this in terms of the level of cruelty described in this thread. Who are these monsters?

Bullying is rife in Midwifery. I've come up with my own theory that 2 types of Midwives exist. The one who cares deeply about women and babies, advocates for patients and wants them to have the experience they want and deserve. And then the Midwife who thrives on the power. Once you've had a baby you know that utter vulnerability you experience as a mother during labour/birth/early postnatal period. A certain kind of person can really thrive on being the one in control, the one who holds the power, in these situations. The 2 types of Midwives naturally clash. I found in my own experience the unkind type of Midwives really don't like the kind ones as it really highlights their own failings. And so bullying ensues.

If you've ever experienced workplace bullying you'll know how devastating it can be. The problem is that most in management are the not so nice type of Midwife so often nothing is done. Then comes the burnout, dissociating as a way to survive, and ultimately leads to disinterest in the job. Then you quit.

I had to take a step back completely and go into a less demanding role for my own mental health. The bullying and toxic working environments tend to be worse in the most demanding clinical areas - so labour ward and any inpatient ward really. Staffing is dire, facilities utterly lacking, dangerous ratios, no support, huge increase in documentation, more and more protocols to be followed but not enough hours in the day. And the big one is the huge complexity now seen in obstetric patients. The co-morbities seen now are tenfold what they were 20 years ago. The complex medical care required for these women is really specialised, often feeling like you need to give 1 to 1 care. But if you can imagine, nothing has changed for the Midwife. So she still has 10+ patients in her care, the same amount of time to complete her work, but 100 additional tasks. The pressure is often just too much.

So while bullying is the same in my experience (and I'd hazard a guess the same in lots of countries). And the increasing pressures are probably the same.. I still don't see the level of cruelty to women described here. I don't know why that is. I feel disgusted at my profession to read these stories and truly sorry that so many women have experienced this. I also don't know what the solution is, but in my experience conditions are only getting worse, so I don't like the thoughts of what's to come.

(Sorry I didn't intend for this to be so long).

As a midwife with 20 years experience it’s awful to read these posts and the stuff in the media, totally heartbreaking. I find it really difficult to comprehend how other midwives can treat women like this.

Ive only ever worked in one unit and have genuinely never seen treatment like this. I’m not saying it doesn’t happen where I work but if it does it must be behind closed doors and there certainly isn’t a culture of moaning about the women, etc.

when I was a student actually there was a midwife who used to tell women in labour to “stop making so much noise, etc”. I did report her to a Band 7 once as she upset a woman that I was caring for to the extent the woman begged me not to let the midwife back in the room again ….i advocated for the woman and didn’t let that midwife back in the room which as a student was hard to do. But I’ve always been firm in my belief that being an advocate for women is the main part of my role. Regardless of what they need/want.

I think the culture of a unit makes a difference and I would be surprised if any midwives at my hospital treated women poorly. Overall it’s a happy, supportive unit and that culture starts from the top. When we’ve had midwives come from elsewhere they remark how supportive and friendly it is compared to other places. Staff stay as well which makes a difference. We don’t have a high turnover of staff, we don’t use agency staff. We get on well with the obstetric staff and it’s very much team work. it should be like this everywhere.

@Upinthetreetops makes an excellent point about how the increase in workload has changed massively due to more documentation, more tests, more procedures, more comorbidities…and no recognition of that increase in workload so our staff/women ratios remain the same.

That needs to change. Sadly at the minute there’s a massive recruitment crisis but not for the reason you might think. The reality is that there are hardly any jobs being advertised, especially not for newly qualified staff. There are a lot of newly qualified midwives who can’t find jobs. Some who qualified a year ago and still haven’t got jobs! The trusts say they don’t have the money to employ them, trusts are tightening their budgets! They’re not filling vacancies.

and to be honest they need to be increasing staff not just filling vacancies.

Short staffing and indifference were the main issues I had at my first birth.

I had "pregnancy aches and pains" or more accurately undiagnosed disabling SPD that wasn't identified. I'd had to give up on supermarket shopping at 34 weeks and by 39 weeks couldn't get off the sofa unassisted, or stand at the sink longer than it took to fill a cup of water (sideways on because of the huge bump in the way- I weighed 50% more than normal!). In labour and post-natally the pre-exisiting immobility was totally disregarded. No one cared. After being ejected from HDU in the small hours of the morning to free up a midwife, I was expected to get on with it. Sod the fact that the walk to the dayroom to fetch a tray of sad beige carbs was the longest walk I'd done in two months even before the long labour, stitches in my undercarriage, EMCS and other complications, go and fetch it or go without 🤷‍♀️
Yeah great, you've got a baby with low blood sugars, the milk's not coming in and you're happy to let mums go without food 15 hours after the tea time sandwich was the last food on offer.

DS's blood pricks were being rushed and done badly affecting results. DH spotted one didn't seem to be done the same way as others he'd witnessed and made the MW re-do it and the result then came out consistent with the trend and DS avoided unnecessary interventions.

I gave up even retrieving the buzzer from behind the bed, there was no point in pressing it and joining the chorus of other buzzers being ignored.

I found out on the morning of day 4 when things had calmed down to a ratio of 1:8 and the MWs had chance to actually do some caring, that they had been running at 1:14. I'd been kept in because my blood pressure was still high and the MW coming on shift recognised me and made it her mission to get me discharged that day, recognising that my blood pressure wasn't going anywhere in an overcrowded hospital.

This was prior to austerity. The systemic, cultural problems are very deeply ingrained

I sobbed on DS's first two birthdays as the whole lot flooded back including the parts of labour where my needs were ignored. Second time I was pregnant again and rang the MW team in floods of tears at the prospect of having to go through it all over again, especially as a high risk labour which dredged up the worst parts of labour. Fortunately I was arranged an appointment on labour ward where I could go in a calm state and went through how to make labour more comfortable while practical.

My second birth was mentally healing despite shit hitting the fan again. The fundamental difference was an excellent, caring (recently qualified!) MW who listened to me. It was the details like saying quietly in my ear "I'm worried about the heart rate so I'm going to press the button and it's going to get busy" that made the positive difference between a difficult birth and a difficult, traumatic birth.

Communication culture is a relatively cheap and easy fix.

It's awful how endemic the problems are that keep causing so many tragedies, trauma and injuries and the lessons aren't really learned from one inquiry to the next.

@ElbowsUpRising i agree whole heartedly with your post. I’ve found this thread a really difficult read, and completely at odds with my own experiences working within maternity. I work in a small unit which is generally well staffed. We have a great working relationship with the obstetric team. Staff morale is generally good. I’m sure all these factors make a difference.
Of course, some of the experiences on this thread are inexcusable.

My experiences were nearly 2 decades ago and I agree Op.
I won’t read this thread though because I already know the accounts of negligence and cruelty will upset me too much.
The overwhelming sense I had when I staggered out of hospital as soon as I could (in a civilised country I would have been there a couple of days) was that birthing women were held in utter contempt. Maybe it’s something about women expressing pain that triggers the disgust, or being at their most vulnerable (when they should be made to feel at their most powerful) but the whole experience made me realise that mysogyny is very real.
It’s a national scandal.

My first pregnancy was tainted by the disgusting Dr I had. He definitely loved the power trip of being in control, infact he refused to induce me unless he done my internal examination after I asked if a female midwife could do it. I wrote a 5 page complaint and even my community midwife had expressed her concerns regarding him.

I had my 2nd and 3rd at a different hospital and 2nd time was absolutely brilliant. Most of my 3rd was amazing until a midwife tried to fob me off with no movement from baby. Told me to wait another few hours as it can be normal- I was high risk and being monitored for still birth. I pushed, was taken in for monitoring, they said everything was fine and I was to go home as I was back in for my regular monitoring on The Tuesday. I again refused and said something didn’t feel right, within hours was in high dependency labour ward. Baby was born not long after.

I dread to think what would have happened if I had waited or if I was a first time mum who didn’t know much about movements and what was normal. Baby was very prem and one of the reasons they gave for me not to go in was that at that gestation not to rely on a pattern. Which ofcourse is usually what they say, but zero movement at all and still no movement right up until delivery.

I literally start counselling today following my birth 5 months ago. It was fairly simple compared to other births, but still my care was so abysmal and I was treated so poorly I cannot bare to think about the day my son was born. It makes me feel sick and panicky and also devastated that I can’t feel the happiness about that day. I feel lucky I was already one and done because if I wasn’t I would NEVER have another child. They joked about seeing me again after they traumatised me. One of the worst experiences I’ve ever had. As others have said too, it’s the hardest time to advocate for yourself, so I dread to think where I’d have been without my husband and mother in law who fiercely advocated for me at every point.

What a cow she was to you , I’m sorry this happened, some people are just vile

I had to stay in after a c section. I was hoping to go home the following evening but there weren't enough staff to discharge me. At 1am a midwife came and said they had done my discharge papers now! I said ill leave first thing in the morning. She said " ill have to check that's OK as we might need the bed!" I said I can't go home now. It's 1am and my husband is at home with our 3 kids who are all in bed! I can't just drag them out at 1am! And I couldn't have made my own way as I was still in a lot of pain from the c section and struggling to walk. I think she realised it was unreasonable to expect me to leave in the middle of the night because I did in face stay until about 9.30am when my husband had seen our kids off to school

Yep the way I was spoken to and treated was worse than an animal. In comparison to how my dh was treated in the same hospital with abdominal issues it was like night and day. I got a discharge after two nights after a cs and haemorrhage even though they didn’t really want to because I was like what’s the point of me staying when the only medical care I’m getting is 2 paracetamol every so often? Absolutely barbaric. Midwives are evil in my opinion, no stressful work environment makes someone nice that bad - they get off on it.

I had a similar comment from a midwife, my baby was in nicu and on way down I walked out of my room and seen a baby going for their newborn checks. I started crying and turned back into my room, a midwife told me not to ruin other people’s happy moments. I highly doubt the other parents actually seen me crying, I was 2 days after birth and was getting constant bad news about my baby on ward rounds.

The same midwife always had a terrible attitude though.

Im so sorry you’ve experienced it as well 🥰

Maternity services here are nothing short of barbaric. It makes me so angry. Women are treated with utter disdain, often with life-changing outcomes.

Can you imagine the outrage if men were treated like that?

I did an assignment around freebirthers and the majority of freebirthers do so because they have no faith in NHS midwifery. Utterly heartbreaking.

I became a midwife because of the care I received with my first two. Whilst on paper my births were straight forward, the postnatal care I received after my first was a huge part of why I developed post natal anxiety and depression. They completely undermined my parenting and made me feel scared and that I couldn't care for my baby. I had to beg to get clean sheets, and they took my baby away from me when I asked for a formula too up as I should not do it otherwise I'd upset her too much. I didn't go to hospital with my second, the thought of being there again alone filled me with dread. I'm a confident assertive person and they broke me.

I'm lucky in the dept where I work, I am surrounded by passionate caring midwives who all go that extra mile to provide good care with the women and families in their care. We stay over to make sure things are sorted, we work in partnership with our ladies and make sure they understand what is being said and the implications of it. However I know through my work as a pma that there are areas where the care isn't as good and that we are causing harm to those in our care.

Someone said earlier that they felt it was the fact midwives are now direct entry and that compassion and care are not being taught unlike those who were nurses first. My experience is that those older midwives who were nurses first are the worst for bullying and being uncaring (not all, I have had great care from someone who was dual registered). Bullying is a real issue in midwifery, there's a saying that we eat our young. We burn out our NQMs and they leave in droves.

Yes there is a lack of staffing and there are a lot of other issues in the system but I don't think these excuse the attitudes I've read here. But it's hard to get people dismissed and whistle blowing still is seen as a negative.

I’m sure the majority of women have some stories about giving birth at hospital, I know I do.

Thank you for this OP. It’s SO important.

I agree about creepy in midwifery. Tales of midwives shouting at women or withholding pain relief are disgraceful. One Born Every Minute videos pop up on my social media feed all the time and they almost always show midwives being unkind or demanding of women in the middle of the worst pain they’ll ever feel.

I still live with a birth injury nearly 12 years after my DD was born because I wasn’t listened to by midwives. The trauma from the birth still haunts me today and contributed significantly to my PND.

We mustn’t stand for this. It’s not OK.

We can start with something easy - stop forcing women to give birth in dangerous ways.

Excellent post!

This is why the fawning and clapping of NHSA workers in lockdown did my head in.

My dc are 18 and 20. My community midwives were fine and the first midwife and student i had while labouring with dd1 were nice. Unfortunately I then swapped to a newly qualified cow of a woman for the rest of the long labour. My friend had her the year before as a student and found her and the midwife she was with to be horrible too.
Dd2 was a caesarian in a different hospital and the staff were fine

Is there anything expectant women can look out for when making choices about where to give birth to hopefully have a less traumatic experience? I’m guessing avoiding midwife led units but anything else?

Someone said earlier that they felt it was the fact midwives are now direct entry and that compassion and care are not being taught unlike those who were nurses first. My experience is that those older midwives who were nurses first are the worst for bullying and being uncaring (not all, I have had great care from someone who was dual registered).

I'd agree with this, that ime it's the older staff who were/are worse...though I expect I'm teetering on the cusp of being considered an older member of staff now and I'm not bad! 😀

Compassion and care is most definitely taught in direct entry midwifery courses. Recruitment is meant to be a valued based recruitment but obviously people aren't necessarily truthful in an interview so it's possible to get onto the course even if you're a total uncaring bitch I guess. And if that's the case then no matter how much training you give someone you can't change their basic personality. Hopefully if they're too bad they wouldn't pass training but again I imagine it's something they can keep a lid on until they aren't been assessed. Either that or it's a case of being burnt out causes some people to change

My first birth I had the loveliest and most incredible midwife with me for my most of my labour. Towards the end another midwife came and helped and I could sense a bit of an atmosphere between the two, like they definitely didn’t get on very well.

Second birth was mixed. Some lovely, some not so great.

I always feel slightly infantilised during pregnancy/birth care as well, often the way you’re spoken to is a bit reminiscent of being at school and can feel quite jarring as an adult woman.