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 quite agree but many many midwives do not provide clarity of information informed by evidence based research. They provide their personal opinions which too often are misinformed.

Women have not helped the maternity services by sucking up the bitter sweet pill that they are free and they should be grateful. I was given more conflicting information by midwives than I care to relate and had too often to correct inaccurate notes.

@Madwife123 I made that exact distinction (elective v emergency) in my previous post. I am sorry you did not read it properly. I rest my case.

Anyway I'm off to the airport now. To the land where maternity care and health care is delivered so much better for less. France. Where there is a continental insurance system in place rather than the NHS.

@RobinPenguins I think evidence shows it improves outcomes for women (physically and mentally) so is the ideal. However it seems they’re trying to implement it without actually having enough staff so it’s pointless and causing more problems.

I really feel for the women having to give birth in these conditions. Proper staffing and adequate work conditions for midwives and maternity staff underpin women receiving decent care. I dread to think how many women will be having traumatic experiences, informed consent not properly obtained and choices taken away. I hope someone listens soon.

The years of austerity by the conservative government cannot be corrected by the measly 3% increase in NHS funding paraded for 2020/21. I hate the conservative ideology. I want to live under a democratic socialist system, I want big government, I want nationalisation, I want collectivism not individualism.
I accept this costs money. I work in finance. Base erosion and profit shifting is suffocating tax revenues.
Separate entity accounting needs to end and worldwide unitary taxation take it's place.
Everything we know about economic theory has gone out the window. Quantitative easing has not lead to inflationary rises. The world will always buy our debt because we will never default. The government needs to SPEND for social services to recover.

So we actively need to hire more midwives to share the load. Would love to know the last time this country built a hospital and didn’t just close them (tories and Labour have both closed hospitals/ reduced beds)

From a personal point of view - I had a good experience with the continuity model as I had 1 midwife for all antenatal appts - I didn’t have to repeat my medical history, why I was on meds etc…. Until the midwife left… since then I have found it hard to get an appt (probably due to staffing issues).

I liked it, but is it worth it if it is causing midwives to leave? - No (at least not for me). Most important for me is that all antenatal appts had same midwife and all postnatal had the same. I’m not massively worried about Labour as it is variable and might not happen due to chance (eg multiple women seen by same midwife going into Labour on same night).

Could I understand if they had the continuity model for specific women who have trauma, complex social situations, phobias - yes, if the women and midwives find it beneficial.

@RosesAndHellebores You stated “ELCS’s performed after exhausting labours”. A Caesarean section performed in labour is not an elective. I’m not quite sure why you feel the need to be repeatedly rude when I am repeatedly agreeing that maternity care in the U.K. is substandard.

@player212 Me too. I worry every day about the care women are currently receiving.

@OnlyFoolsnMothers There are trained midwives not currently working in healthcare that we could attract back into the profession if we improved working conditions. There are bank staff that would take on contracts if they could have family friendly hours. There are private midwives that have been legislated out of practice that could return. It’s disgusting what the government are doing to the NHS.

@Namenic The ‘old’ system provided continuity for antenatal and postnatal care and there has always been schemes of continuity for those with safeguarding and mental health issues etc. (Although there is often issues with a very strict eligibility criteria). However the new system means we have to have labour continuity as well and that actually means less continuity in the other areas due to the lack of staffing. Implementing now has made things worse!

@Namenic
Glad to hear you had a good experience with continuity.
As previous midwives on here have said we just do not have enough of us to role this out, plus many of us will need training on complex areas of each others area of expertise.
The community midwife might not have experience looking after a lady with severe pre eclampsia on a concoction of drugs during labour or a lady who has had a massive PPH with an arterial line insitu. Likewise I would need retraining in community work making referrals/social care meetings/referrals.
Continuity would work really well ante and postnatally and as you said ladies who are vulnerable with MH and social care issues. These are the ladies who would benefit most from continuity. Unfortunately you would then have a two tier system so could be seen as unfair by some.
The govt want this to be put in place it will save them money no doubt about it. We have been told we have to use our own cars and for those of us who car share with our partners we have been told to buy or lease a car!! If only it was so easy. Yes we would get mileage allowance but imo does not allow for wear and tear and mileage on my car.
Staff retention is dire. It's easy to fill the courses it's keeping the junior midwives that's the problem as the pressure is intense. Midwives of my age group 59 are either taking flexi retirement so less shifts being worked or retiring.
We try our very best we really do but nobody seems to be listening to us and unfortunately this is where we are now, crisis point

I apologise, I typed ELCS meaning emergency. That was incorrect.

@Thedogscollar

That’s a real bug bear of mine! I have to use my own car. This means I have to have a car at work and can’t use public transport or car share etc. Yet I am charged for parking when I have no choice but to bring a car. I am required to have business insurance to use my own car. I have to pay that myself also. My car is so full of equipment for use in community that it’s barely usable as a family car yet I bear all the expense of running the car for the purpose of work.

My mileage allowance is paid based on google maps distances between homes. It doesn’t take in account sometimes the shortest route isn’t the quickest and on a tight schedule you need to go the quickest route. So it doesn’t anywhere near cover costs.

That’s without the fact I’ve had to buy my own equipment also. We were not provided with a syphg and stethoscope for example yet have to do postnatal BP checks. Managers answer - go and collect the one from the community centre before the visit and return it after. Like we have time for that! So I like everyone else bought my own.

I also have to use my own phone in community as well. We can claim call allowance but manager encourages everyone to have unlimited calls on their plan. Except they don’t cover the cost of that. I won’t use my own phone as I’ve had a bad experience in the past where a patient had my personal number due to this and I was hounded when off sick. So I bought myself a cheaply work phone, plus a calls contract for it. That’s my cost as I ‘chose’ to have a separate phone. Some days I wonder if I add up all the costs of doing my job and deduct them from my salary am I even making minimum wage.

That’s really shocking dogscollar. It should be rolled back if it is causing these issues. It’s going to be a lot easier to retain the midwives now rather than try and get them back when they have left. I hadn’t considered the 2-tier issue.

OP - from a personal sanity point of view look on jobs boards to see what is out there as an alternative. Having my escape route planned helped me stay another 3 years in nhs - before the right job opportunity came up. You sound like an excellent midwife and it would be a shame for nhs to lose you, but we can’t always change the system and you have to do what’s right for you.

@Madwife123
Completely agree about the car. When our students qualified last year the HOM just said if you want a job with us you have to have your own car, one student didn't and she said oh now you are being paid you can lease one or buy one Why should we be taking on a debt to do the job they want us to do

Honestly it's a joke. Re buying/ using your own phone that is ridiculous as you say the opportunity for misuse is right there if ladies have your personal number.
Don't know the answer to it all tbh the union at national level is worse than useless that's why I left the RCM years ago. As far as I'm concerned it is not good value for money and as for the NMC don't get me started on them.

No doubt we will keep going but something has to give somewhere. If we can't staff our units which we can't then community teams at this present time are a no go. If this govt want this level of service they will need to plough millions into it for to pay for retraining and equipment.
We will need a laptop, phone, weighing scales stethoscope and sphyg oh and a car.
They have no clue the mammoth task they are asking of the service. They want to provide a champagne service with a lemonade budget. It's just not feasible.

Yep the RCM are next to useless but at least their membership is optional. The NMC on the other hand are diabolical. Just what exactly do they do to ‘earn’ the registration fees that we all pay them? I mean £120 a year from every nurse and midwife is a huge amount of money and yet I can’t see any improvement they make at all.

Another issue is that as continuity teams are being rolled out then students are starting to be expected to train within a continuity team and I’m not sure it works for them. Not when they don’t have cars, have kids and childcare issues but no wage to pay for decent childcare.

In order to get their numbers they’re expected to be on call 4 or 5 nights a week…..fair enough if the woman they’re following gives birth the first night then they might not have to be on call for the next few nights but if not then they are. The argument being that they’ll only get called out once….but I think the people who say that don’t realise how shit being on call is. Some students might be ok with it, but for others it’s enough to tip them over the edge and the attrition rate for students isn’t great as it is. I’ve got a number of third year students who say they’re not planning on working as midwives when they qualify.

Totally agree with* @blairresignationjam*, it's only system change that is the real answer to this problem. Maybe these dire conditions will raise the consciousness of my fellow midwives, the majority I work with are quite reactionary and seem to have failed to join the dots between current conditions and 11 years of Tory austerity.

@Madwife123
I just completed an interview with Think Britain organised through the NMC when I answered one of their emails asking for midwives/nurses opinions re the work they do and how they "represent" us!!!
Needless to say I let the person asking the questions know exactly what I thought of the NMC. To think they regulate our fitness to practice, it's ironic.

As much as I feel this is such an important issue (and something that as a therapist in the NHS I can relate to), I hope that it doesn’t cause women who are on this forum looking for support, additional anxiety and fear approaching their birth. It can be such a stressful time anyway and with concerns over birthing a baby, covid and now staffing being thrown left right and centre, it can be a very overwhelming place.
Just wanted to raise that 💐

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.
This happens to teachers too, who are also leaving in droves. Unfortunately the government has a habit of overworking certain public sector employees in this way because they don’t want to invest the funds to resolve it. They probably don’t even have enough funds to resolve it, which is why they’re ignoring the situation.

@AllSinging

As much as I feel this is such an important issue (and something that as a therapist in the NHS I can relate to), I hope that it doesn’t cause women who are on this forum looking for support, additional anxiety and fear approaching their birth. It can be such a stressful time anyway and with concerns over birthing a baby, covid and now staffing being thrown left right and centre, it can be a very overwhelming place. Just wanted to raise that 💐

@AllSinging I am aware of that and this is a huge part of the reason midwives have carried on for so long. But the time has come where we have to speak up to get change or we would be doing women a bigger disservice.

@Marelle

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. This happens to teachers too, who are also leaving in droves. Unfortunately the government has a habit of overworking certain public sector employees in this way because they don’t want to invest the funds to resolve it. They probably don’t even have enough funds to resolve it, which is why they’re ignoring the situation.

I'm a teacher too and it's shit but honestly, nowhere near the shitshow of midwifery. We're not doing 13 hour shifts dealing with life, death and all the blood and guts in-between

@AllSinging

As much as I feel this is such an important issue (and something that as a therapist in the NHS I can relate to), I hope that it doesn’t cause women who are on this forum looking for support, additional anxiety and fear approaching their birth. It can be such a stressful time anyway and with concerns over birthing a baby, covid and now staffing being thrown left right and centre, it can be a very overwhelming place. Just wanted to raise that 💐

We really really do not want to cause any anxiety or fear and the women must always come first, however we owe them a duty of candour to let them know the state of midwifery in the UK today. Hopefully by doing this we can achieve improvements in the service and pass this onto the very women that at the moment are receiving a frankly second rate service.

@AllSinging

As much as I feel this is such an important issue (and something that as a therapist in the NHS I can relate to), I hope that it doesn’t cause women who are on this forum looking for support, additional anxiety and fear approaching their birth. It can be such a stressful time anyway and with concerns over birthing a baby, covid and now staffing being thrown left right and centre, it can be a very overwhelming place. Just wanted to raise that 💐

At 36 weeks pregnant I'm reading this thread with interest. It's been very obvious to me throughout my care that there are issues with staffing levels (my first midwife retired, my second has been off long term sick, appointments rearranged due to cancelled clinics, etc) but despite all of this whoever I've seen has always made time for me on the day. I trust that my baby will be delivered safely, but I know this will only be as a result of a midwife / midwives going over and above. Thank you for all you do to care for us through these difficult times.

I would love to retrain as a midwife but perhaps that's misguided right now!