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've joined.
Over 6 months since birth and I'm still haunted by being on antenatal ward, in transition, on my own (no partners due to covid rules) in a closed room, in tears and agony and fear with face between knees unable to move or even get call bell or phone to chase up help, it was a long I think at least 45 mins from asking for pain relief when I could still move and being told the midwife was off the ward, until she came. I can only assume she had been called to an emergency on delivery suite. I haven't chased up the birth review I was expecting because they don't have enough staff to even support home births let alone birth reviews. But I still think about it in the small hours. The whole labour and birth was horrible but it was that period of utter desperate helplessness that haunts me more than any of what followed.

Are there any stats on how many midwives from the EU who worked here before Brexit have left as a result of Brexit?

I'm so sorry to hear this OP and glad you have brought it up. I'm currently 37 weeks on first pregnancy and fortunately have been seeing the same midwife throughout. I have had great care from her and I have always appreciated it but never even imagined the hard work that goes on behind the scenes from her and everyone else in the hospital. I'm also aware that not everyone receives this kind of experience. I dont have anything particularly useful to say except I genuinely want to say thank you to all the generous people who dedicate themselves to caring for pregnant ladies and their newborns. You are so crucial to the process and definitely deserve recognition and quite frankly fair employment rights. I stand with you all !!!

What would you like the government to do I suppose is the biggest question? Most of the issues aren't central government led but driven by the midwifery council and local CCGs aren't they?

Joined. I can't believe how low the pay is! I could be tempted into becoming a midwife, but not at that pay, or with those hours!

Unfortunately this story echoes my experience this week.

I called when contraction were every 3 minutes to be told that they couldn't take me as they were short staffed and that their divert hospital was also full. They gave me two options

1. Stay at home for as long as possible, then call back when I felt I really couldn't cope. At that point if they could take me they would otherwise they'd have to call an ambulance.
2. They'd call around other hospitals out of county and see if one could take me, but this would potentially mean a 1-2hour drive.

I spent the next couple of hours in agony without pain relief. Before luckily making it to a staffed maternity ward, just in time. The baby ended up being born within 10 minutes of me walking onto the hospital.

The staff shortages were pretty apparent on the ward too. There were two labouring ladies in my bay who were mid induction and told they couldn't be moved into the next stage of induction because there was no one available to deliver the baby.

As a pregnant woman, this is scaring the shit out of me.
What do I do when the time comes!? Do I turn down induction? Ask for a ELCS? Hope and pray for the best?

39+3 here and a FTM. And have seen this first hand during this pregnancy, in fact this factored into my decision making to have an ELCS which is taking place tomorrow…

In my area they have cancelled all post natal home visits due to staffing shortages. Which means on day 3, 5, and 7 or 10 after my C section my husband has to drag me and my baby out of the house in the car for 20 mins to a postnatal hub in the next town. I’ve complained to my midwife about this but there’s nothing she can do… they’re just chronically understaffed.

The government do provide the funding but the training regime needs to change.

It's the same scary pattern as we see with GPs, there are not enough GPs and midwives to do the work so those left are being burned out and leaving and it's a self-feeding spiral down.

It's especially worrying when you look at application rates to get onto he courses to start these careers, the people working in these roles didn't fall into these jobs, they really wanted to do that job yet the pressures have pushed them out.

The fix is more staff and not possible to have that quickly, the only answer I can see to this is hope, the government need to act in such a way that gives staff a secure hope that conditions will improve so they can hang in there until the reinforcements arrive.

I am no expert but I have been wondering about the GP situation for a while, the only idea I have been able to come up with is a vastly expanded physician associate programme, a 2 year 'on the job' masters degree - possibly with a route then on to medical doctor after a time in practice. Likewise midwifery associate training to get staff in there taking some of the load off with a path available to be a midwife. Some of those staff already looking for a way out of being a GP/midwife would be willing to change role to become a teacher for the associates so their skillset and experience won't be completely lost to the profession.

I've requested to join the group. I had my two children a while ago now but the delivery of my first was dreadful (in part due to an agency midwife).
I'm actually looking (and have been for a good 10 years) into training to be midwife but that won't happen for at least another 4 years as I need my youngest to be at secondary school. These stories scare me into wondering if I would be able to cope and the job as well as I would like to if the system is so broken.

Unfortunately it’s the vicious circle of people leaving due to pressures, leading to understaffing and low morale and more staff leaving.

I was nhs worker (non midwife) and left for similar reasons. This has been known about for a long time but govt have not done anything about it (even with a growing population).

Thank you OP for your perspective. I had been positive with my experience of the continuity model with my initial midwife (she also had seemed positive about it as had another that i asked). But if there is not enough staff to viably give this continuity service then it should be stopped - as I can see things can be made worse (real life effects of policies might differ significantly from study conditions).

The way to stop it is to fund 1. employment of enough staff (immigration, return from retirement and agency staff) 2. at the SAME time as training new staff (pay off student loan if give nhs 10-15yrs service) 3. With pay rise to retain existing staff. It is going to be much more expensive than if the govt had acted earlier.

Joined. I’m so sorry OP and others on here. Please know that you are valued, fwiw - I still think most weeks about the wonderful MW who delivered my daughter four years ago (a professor of midwifery who happened to be doing her one shift a month that day).

I was in again more recently (I’m a few weeks PP with twins) and it was OK-ish, but 1) I had to do a lot of advocating for myself and 2) I ended up with a semi-elective section because the conditions for induction (which I began with) seemed so unlikely to succeed that that seemed the better of two bad options. I thank my lucky stars that I have a MW friend that I could WhatsApp / speak to at points during my pregnancy for a frank conversation about the delivery of twins, because no one else was interested.

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.

That is utterly inhumane. I am so shocked!! My current midwife is one I’ll see from booking to postnatal, due to the new continuity of care thing (new since I had my last in 2017). As a patient this is really fantastic, I was soo pleased. I can text her whenever (obviously I don’t but it’s nice to have the option if I can’t get through on the maternity line). Really fantastic for me. BUT. I didn’t realise she would also be working in the hospital too and on call with hours like this. How is that legal??

This is awful OP- is it true that there are long waiting lists to train to be a midwife but it’s also very expensive? I heard this and then saw a documentary about the nhs going to Manila to recruit new midwives- angered me immensely

My sister has just had a baby and was seen only 3 times by a midwife with 1 extra phone call. She was supposed to be under a consultant but never received an appointment, didn't see anyone until she was 20 weeks (so no 12 week scan) and the number she had been given was just a ward number. Now she's had the baby she's been given emergency contact numbers but the NHS are very lucky she had a smooth pregnancy and there was nothing else going on that a midwife could have spotted (had she had the proper appointments).

My sister is a midwife and she says it’s the worst she’s ever known it- she qualified in 2006. She said she was very shocked to go in a few weeks ago after annual leave and find that seven people had quit. They’re massively understaffed and they’re all on call all the time. It’s killing them. She feels lucky because she’s only part time, but that’s still a lot of work and a lot of unpaid time on almost every shift.

@immersivereader
They are leaving for other jobs and leaving the profession, some go abroad, some don’t fully leave but reduce their hours right down and work another job alongside, some approaching retirement take early retirement. And yes as @LogsAndSquiks mentions some were EU midwives who have gone home after brexit.

@OnlyFoolsnMothers Yes there are loads wanting to be midwives and training courses are always full. We can’t train more as there isn’t the experienced midwives to support them. Training isn’t the issue. The issue is we can’t keep them once trained as they quickly realise they can’t cope. The stats show we have to train 30 new midwives to gain 1 in the NHS.

@Strangevipers

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 ?

My midwife told me she normally splits 60 pregnant women with another midwife (I think essentially working opposite shifts).

She currently has 120 women to cover alone due to shortages. I’m no longer seen at my local surgery as she physically can’t be in multiple places at once so I’m driving miles for every appointment. And I say my midwife but frankly everyone I’ve seen tells me they won’t see me next time as they’re leaving so I’ve had no continuation of care.

@immersivereader

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

IME just leaving healthcare completely. So admin jobs, retail work, go back to uni, setting up business as a nail technician.

@LogsAndSquiks

Are there any stats on how many midwives from the EU who worked here before Brexit have left as a result of Brexit?

This article is 3 years old so probably even worse now.

www.theguardian.com/society/2017/nov/02/european-nurses-midwives-leaving-uk-nhs-brexit-vote

Fab find @CovidCorvid but yes I suspect much worse now.

It’s funny with these nursing and midwifery shortages, GP shortages, HGV driver shortages. It’s almost like brexit was a bad idea 🤦🏽‍♀️

Having just looked up the entry requirements: BBC with an A'Level in a science at B minimum (biology, physics, chemistry, psychology sociology!, they seem incredibly high compared to the salary (and dare I say some of the utter and conflicting rubbish some of my midwives advised, together with the fact that if one asked anything more than the most basic questions, the response was "we'll have to refer you to one if the Dr's about that"), there seems to be some dissonance between the level of graduate qualification and on the ground reality.

Perhaps we need the equivalent of advanced practitioner midwives and a more practical workforce of apprenticeship/access midwives who understand a little more about high quality nursing for women whose bodies have undergone the equivalent of trauma or who in pregnancy largely need a urine test and reassurance. With the advanced practitioner midwives stepping in where complications arise or births are not atypical.

It would also be helpful imo if every labouring woman were scanned on arrival to check for breech and posterior presentations/cords wrapped around tiny necks so a measured decision could be made early in labour rather than 12/14 hours later when a Dr is called and it is at that point realised there is an issue that should and could have been dealt with by caesarean hours and hours earlier and not when the woman was already exhausted and becoming traumatised. (Bitter, yes, and heard too many times "a midwife can always tell the position of the baby" - when lived experience, mine and others indicates they can't).

I would also say the university fee element needs to go to be replaced with an agreement whereby the loan reduces over 10 years for every year the job is done in the UK post qualification. That also should apply to medicine, teaching and nursing.

IME quite a number of women become interested in training to be a midwife after having their own children. I looked into doing it as a postgrad years ago but at that time it would have been impossible for me to logistically do the training due to the childcare element. I would have needed a very available and willing husband and family.

I don't know if that's changed now? Perhaps it doesn't matter if the issue is disastrous retention of staff rather than amount of trainees.

I think the idea of different levels of practitioners is a good one. Again this is just my experience and opinion but often what women (and birth partners) who are having non complicated labours want is reassurance, a calming presence and support. I think the being left alone for long periods of time causes anxiety even if there's nothing actually for a midwife to do other than be supportive at that point.

I guess that's what doulas are so maybe making that into some sort of role on delivery wards that slots in between the fully trained midwife and your mum/husband/best friend?

Bitter, yes, and heard too many times "a midwife can always tell the position of the baby" - when lived experience, mine and others indicates they can't
I've never heard anyone say a midwife can always tell? I had a load of different midwives during pregnancy because mine was on mat leave herself. Two in a row thought my baby was breech, so I had a scan to check (she wasn't). At my next appointment yet another midwife said "oh is there any chance baby could be breech?" 🙄