Midwifery staffing crisis

[Madwife123]

For those of you who are not aware there is currently a huge midwifery staffing crisis in the U.K.

We are losing staff faster than we can train them and almost half of midwives currently in practice are looking for ways out. Sadly myself included.

This means pregnant women are simply not getting the care they deserve. We are desperately trying to fix this and are calling on the government to help tackle this issue before services become completely unsafe.

Please have a look on Facebook for a group called March with Midwives U.K.

Don’t think I’m allowed to post the link sorry. There is a vigil planned which would be great if we can get as many people to join as possible. Or if not then it helps sharing your story of poor care you’ve received, delays in appointments etc. any adverse outcome you have had so we can evidence the effect this is having on women.

Please help us make maternity services safer!

I have heard rumblings of this. I will look up the Facebook group. My appointment yesterday has been moved to tomorrow morning because midwife was ‘called into the hospital’ I assumed to work on one of the wards even though she’s a community midwife. But in any case it didn’t sound good! Are people leaving because they’re rushed off their feet for poor pay? Sorry I’m ignorant!

Midwives are leaving because they simply can’t cope anymore. The demands are unrealistic.

It’s now normal to work a 13 hour shift with no break. No food, no drink and not even time to go to the toilet. Then on top of this you are on call. So when it’s short staffed (which it always is) you are called in. This could be after you’ve already worked a full shift so you are working dangerously tired.

I’m a community midwife. I work apparently “family friendly hours”. This was my last working week.

-Mon - 8.30 - 6pm.
-(Only paid from 9 as that’s my start time but my first patient arrives at 9 so if I don’t get there early they are arriving to a locked building).
-Worked through my (unpaid) lunch as running late as 15 mins per patient is not adequate.
-Finished an hour late as running late (again unpaid).

• Tuesday same again

• Wednesday same again. Arrived home at 7pm. Got a phone call at 7.30 saying I need to come in and work on labour ward as they are short staffed. -Still not had any food at this point.
• Worked on labour ward from 8pm until 4am when I was so tried and faint from hunger I was no longer providing safe care.

• Thursday. Had the morning off to make up for being called out but still had to start my afternoon clinic at 1.30pm so I arrived at 1pm. I had less than 5 hours sleep.
• Finished 20 mins late (unpaid).

• Friday. Again 8.30 start (paid from 9). Worked through lunch.

-Finished on time 5pm (very surprised). -Was driving home 5 mins away from home when I got a call. An essential home visit has been missed as admin error. I drive back to do the visit. Baby has jaundice and needs admission. Takes me over an hour. -Get home at 8pm

Sat - My day off. I spend 3 hours doing paperwork I didn’t have time to do during the week. Safeguarding records, mental health referrals etc. This time is unpaid. I’ve raised this with management to be told it’s my fault for not being efficient enough to do it in my working hours.

37.5 hours I work.
I actually worked 54 hours
I was paid for 40 hours

This is why they are leaving in droves. This is the new normal. And although we are working ourselves to death we are still providing substandard care as we are too tired, too hungry, too burnout to be on top form.

Dd is just 24.

I was asked by the midwives on the ward to complain about shortages at Macclesfield then as they all complained and nothing was done. I was on a static monitor for over an hour on arrival and was left alone to get frightened in labour, when you tense up.

By the time they realised how far along I was they said they couldn't give me any pethidine and so threatened me with a section.

1 woman had a section because the midwife with the key to the drugs cabinet had gone to lunch. She'd done a nursing degree and so overheard.

I always regret bitterly not staying at home and ringing the community midwife - there were 3.

Each time there was a school do we all talked about how awful Macc was and many of us stopped at 1 because they were so dreadful.

The midwives were, however good.

@newtb That sounds awful. From what I know of Macclesfield they are a tiny maternity unit so these staffing issues will affect them even more as they have less staff to pull from when short.

Nothing @Madwife123 says shocks me.
It’s utterly horrendous.
Midwives leaving in their droves or off sick with stress and burnout.
I am 58, been a midwife for 34 years and have never seen such demoralised staff.
I work in an area of very high social and economic deprivation, our patient population has been very affected by 11 years of austerity, we have more complex pregnancies than ever before plus a high increase in MH and social problems.
It’s utterly exhausting for the staff and becoming increasingly unsafe for women… women are having sub standard care as routine.
I have also been abused and screamed at by 3 relatives this week because they deemed themselves above Covid regulations.

@Tootyfilou I’m sorry you are experiencing the same but sadly as you say this is now the new normal.

I love being a midwife and I have had a wonderful career. Met the most amazing and inspiring women, both patients and colleagues. Worked in every area of the job semi retiring after working in a specialist role. I am back at the coal face now, part time, but I don’t envy the midwives beginning their career. Sending you solidarity @Madwife123

@Madwife123
Thank you so much for posting this. Fellow midwife getting on for 30 years. I have never known morale so bad and yes we have midwives leaving to. Not just older midwives retiring but NQM's that didn't realise how difficult the job is and unable to cope with the huge amount of responsibility they suddenly find themselves with.
Yes no breaks during a 12.5 hrs shift very very common and just shrugged off by management.
Our unit is often on divert but we have nowhere to divert to as other units near us in same situation.
I took flexi retirement but honestly feel like just leaving but then feel guilty leaving my colleagues, of many years to struggle on.
Heard of two midwives in my unit resigned this week.
The government want to implement continuity of care so we all work in teams so have to work in community and in the hospital in low risk and high risk. We are a stressed out about that as have community staff that have not looked after a high risk lady in labour for years and likewise I would need retraining in community practice.
Are we really giving these women informed choice?
Surely you would rather an experienced high risk midwife look after you in labour than a community midwife that has not worked in the unit for years.
We are all experts in our own fields and I think we need to keep it like that. We can provide continuity in ante and postnatal care but intrapartum is different with many complex medical conditions being catered for.
I will let my colleagues know about this.
We all came into this job to be with our women but we are being abused and used by this government who consistently deny any major problems exist.
They do and it has reached crisis point.

Thanks for raising this issue. I was wondering why I had to ring a couple of times with little response - in order to obtain a community appointment (now approaching 36wks and not had appt in 6wks). It does make a lot of sense now and right behind you! Best wishes and support.

@Thedogscollar

Echo every word you have said!

Midwifery was already struggling and the pandemic plus the introduction of continuity of carer has killed it off.

The ironic thing is in my trust it’s made it worse! When I was full time community I saw my own women for their whole antenatal and postnatal care. Now that I also have to be on call and cover labour ward my own women are forever having to see a different midwife!

@Namenic You should be seen every 2 weeks from 34 weeks. Please make sure you are demanding the appointments you are entitled to. It’s wrong that women are starting to accept substandard care.

Can I ask, what sort of salary do you get for those hours? Would higher pay help? Or are we beyond that?

Sorry to hear this.

I have mixed feelings on midwifery due to my experiences of giving birth in 2008 and 2010. I felt (and was) far safer with obstetricians and other doctors.

That's why I completely support proper funding and adequate training of midwifery professionals. Women and infants deserve better.

@dreamingbohemian I’m band 6 (more experienced) so I get £34k yearly. Those who are new to the profession (but doing the same hours) are band 5 and get £25k

It’s gone way beyond higher pay. The service isn’t safe. Paying midwives more might prevent some from leaving but for many it’s the working conditions and inability to care for patient like we trained to do.

@dreamingbohemian
Nothing to do with salary. We are so far beyond that. Without sounding rude you have to experience the pressure to fully understand where we as a profession are coming from.

We are responsible for two lives. Sometimes it all goes smoothly and sometimes medical events take over and you can be on the brink of life or death.

When you have been in theatre seeing someone have their entire blood volume replaced not once but twice then the job really hits home as to the responsibilities we undertake.

Asking for safe staffing levels and a break is all we want right now. At least it's all I want

This is ridiculous

More staff is needed and midwives mental health and physical health need to be seen to. No break in 12.5 hours and all this unpaid hours is shocking. How can this care be safe?

Out of curiosity how many woman at one time would one community midwife be generally expected to see and how many appointments theorist a woman's pregnancy would she expect to have with her community midwife ?

Throughout not therorist

I had my first nearly 27 years ago and the hospital was very quiet. They tend to be on Christmas Day. There were more midwives than women. The midwives literally did not stop moaning about their workloads. Neither did the 6 who visited me at home for the next 10 days and just wanted to spend time gassing.

I suspect there was so much whingeing for so many years the people in charge stopped listening and then crisis hit.

Women have also been their worst enemies due to the eternal gratitude because the NHS is free. It is not. It is free at the point of delivery and every bit of sub-optimal maternity care, every single bloodstained toilet, needs to be called out along with every heavy handed midwife who makes inappropriate and insensitive comments.

The service has been a disgrace for years. It needs tearing asunder and turning round to an ethos of providing a professional service like a super tanker

Some of the directors of children's and women's services also need to take some blame for continually stretching a smaller budgetary envelope as a cv building exercise.

But on the whole do I care if the midwife who visited me first at home after a distressing birth and decided to hold her left elbow in her right hand and wave her hand backwards and forwards declaring "if you don't do the pelvic floor exercises from today this is what your man is gonna say sex feels like", has now to work her socks off and doesn't have time to eat or wee. Not particularly. I feel sorry for the women she may look after but not for her or her kind. Sorry.

I'm so sorry to hear this. I know a lot of women starting out on the training pathway yo become midwives through my job.

I worry about lots of them because their circumstances, MH and home lives aren't conducive to the stress of midwifery at all

Same for nurses best thing I did was leave the profession.

@Strangevipers

It’s impossible to answer really as it doesn’t quite work like that. Technically I am the named midwife for 32 women. However some I haven’t met as the continuity system really doesn’t work. Likewise I see many patients that are not ‘mine’.

In a typical day on community I will either be doing antenatal appointments (1 lady every 15 mins from 9-5pm) however if the clinic is full they overbook them and so I can have 2 ladies arrive together.

15 mins isn’t enough to do blood pressure, test urine, ask about movements and listen to baby without any added extras of bloods needed doing or a woman concerned about something.

If I’m doing postnatal visits I will have around 15 to do in a day. They ‘allow’ roughly 30 mins a visit but don’t consider the time to drive from one to another and I cover a rural area where they can be quite far apart.

A day 5 visits consists of checking mum over, maybe a blood pressure check if she had high blood pressure in pregnancy, maybe some bloods if she’s feeling anaemic. Maybe look at her stitches and check they are healing. Ask about her mood etc. Then check baby over. Strip and weigh baby. Do the heel prick blood test on baby. Discuss feeding and offer breastfeeding support. Discuss safe sleeping. Guidelines say we should observe a full breastfeed around this point but realistically I’m already been there an hour and the baby isn’t even latched on yet. If someone is feeling some baby blues and needs extra support you can imagine how it’s very easy to be running hours behind.

Then you spend all day being moaned at because you’re running behind and women have to wait and you finish late yet again.

Because of the new continuity system I now also have to work on labour ward and be on call for home births or for when the unit is short staffed (always). So I can be called in to work up to 12 hours ‘on call’ after my full day shift. The maximum working hours in law don’t apply to ‘on call’ hours therefore managers use this as a way of forcing people to work over the safe hours.

This country is a mess. Midwife staffing crisis, early years staffing crisis, teacher staffing crisis. Minimum wage increase which will close many small businesses.

What are these midwives leaving to do? What jobs? Abroad??

This is awful OP and other midwives. I'm sorry conditions are so bad. No wonder you're all exhausted and demoralised.

The continuity teams here have much smaller caseloads and visits are allocated 90mins (including travel time as it's a large area).