Higher infant mortality in out-of -hours births

[foreverastudent]

www.bbc.co.uk/news/health-10631092

I thought that staffing and facilities were the same day and night. Considering most spontaneous labours hapen at night it's totally unacceptable that these babies are not receiving the care they should be.

I am sure that your doctors are giving you the correct advice lavita, this is more of a general aside. That private doctors might be expected to prefer expensive medical options over cheap home births with maybe a midwife in attendance rather than a harleys st doc IYSWIM

Like I say just an aside, I am sure that what they are recommending is best for you, just thought it was funny!

By definition obstetric consultants never see normal, natural, easy births. They only see the worst case scenarios. You should keep this in mind when considering their opinions.

Do I need to add that they get paid more for ELCS?

I'm not surprised.
When DD1 was born just after lunchtime I had the attention of a very experienced consultant who attempted forceps and then performed an emcs.
My second DD was born in the middle of the night with 2 registrars on hand. Registrar 1 (a "junior registrar") wanted to use forceps to deliver my baby in the labour room. She needed rotating and was very high up so forceps really were not an option. I screamed my head off because I hadn't had any drugs and told her I needed an anaesthetic first. She was trying to convince me otherwise when Reg 2 (a "senior" one - at least 5 YEARS experience) walked in, stuffed his hand up me as though I was a dairy cow and informed someone (no idea who, he didn't speak to me) that I needed to go to theatre. I only got them to stop suggesting forceps by explaining that the consultant and I had agreed that in that situation I should have a section. I dread to think what could have happened if those two had been let loose with the keillands. They were not exactly the A team.

I had an out of hours August baby first time round. And an ELCS second time round, definitely know which ones I preferred and felt safer!

forever a student, sorry but that is ridiculous. never? seriously?

many consultants have both private and public commitments. if so - then they would be delivering natural straightforward births frequently, especially in private land.

regardless, they all would have been around for plenty of natural births during their training in order to become a consultant obstetrician in the first place. that's how they learn to make the hard decisions in difficult cases, by starting on the easy stuff.

'Lord knows how many die then because consultants paid 6 figures don't want to do weekends and evenings even though they signed up to be doctors, not exactly 9-5 stuff.'

All the consultants I know do nights and weekends as required. What they don't and indeed can't do is 9-5 and then all night or all weekend as well.

It's true you don't want to be near a hospital in August though.

Doesn't suprise me at all and is reason I am going for an ELCS next time! Went in to labour early hours sunday morning. Was left on my own (well with DH) for ages until shift change at 8amish. No consultant- delivered at 4pmish with registrar I think- episiostomy and forceps oh and an oxygen starved baby. Was told in my traumatic birth debrief that the registrar should never have tried and failed to use ventouse. That alone could have saved 4mins and dd's brain.
Though DD is fine now and developing normally so her prognosis is good thank god!

The worst time to go in is near shift change, my midwife with my second got very shirty with me because i wasnt quick enough for her. She then left without putting a tag on either me or my baby, i asked for one when i left , after being made to wait around for a peadiatrician that never showed up, only to be told that i had to state i was happy the baby was mine!

my first little boy was stillborn..

Second pregnancy my consultant went home at 5pm to go on holiday. When ds2 still hadnt put in an appearance at 10pm he left his family and came back in to make sure ds2 was delivered safely

so they dont all just do 9-5 and not think about their patients after that

Daisy- well I stand to be corrected. When I was fighting for a HB one of the arguements they gave me for a hospital birth was that there would be consultants available if there was a problem.

Today I discussed this thread with my Mum (ex-midwife of 10 years). She said that you were right, consultants go home at night, leaving the registrars in charge. They can be called from home is needed, but obviously this could take some time .

More worryingly she said that the BLOOD BANKS also shut down at night and it could take 3 to 4 hours to get cross-matched blood out-of-hours .

hilee- you would think that would sound like a sensible way to traind OBs but unfortunatlely it doesn't happen like that.

In the UK, unlike the US, midwives not OBs manage the 'normal, natural' cases. OBs only get called when there is a problem so this skews their perception of 'risk' and 'normality' in childbirth. There is no requirement in their training for them to have witnessed a spontaneous, drug-free, intervention-free birth, let alone a home birth.

It might have been 10 or even 20 years ago that it was discovered that late and night time surgical operations had a less sucessful outcome and higher mortality rate than day time ones. Hence only emergency ops at night.

Don't know if it was due to the human body recovering more slowly at night or tired staff but probably the same situation occurs in obstetrics.