Live webchat with shadow health secretary Andrew Lansley, Tues 24 Feb, 12-12.45pm

[GeraldineMumsnet]

We're welcoming Andrew Lansley as our webchat guest on Tues 24 Feb. He's interested in Mumsnetters' take on the Tories' research about women in labour being turned away from maternity units. Please join us if you can, or post questions in advance if you can't make it on the day.

Many of you have raised the issue of home births so let's start with that.

SnowlightMcKenzie, you raised an important question about the right of women to give birth at home. One of my key aims for the NHS is to make it more centred on the needs of patients by making sure that the service is geared towards actually listening to their wishes. That means that women should be able to choose a home birth if they want it, and should know that they will be properly supported in giving birth at
home. It does mean support for midwives too. In the Netherlands, where one third of all births take place at home, there are three levels of support:

1. Maternity Care Assistants
2. Kraamszorg workers who support mothers at home
3. A consultant-led maternity unit within 30 minutes.

I think BigTeuchLittleTeuch touched on this when she shared her story. In that situation what was needed was for someone to actually take the time to listen to the mother. It is about empowering mothers with the right information and resources to make a choice about what's the best option for them and their baby. One way of doing this is to encourage more community-based midwifery teams who can provide continuity of care
for mothers, and support home births.

Actually, if only the trust management had the level of expertise to run a supermarket.

Part of the issue is that trusts are multi million pound businesses, being run by people who are not professional, well qualified and experienced managers.

Quattrocento, you asked if I was aware of the practice of women being taken into maternity units but not being assigned delivery rooms. First let me say how sorry I am to hear about your experience; it sounds
very distressing. Sadly, yours isn't the only story that I've heard about women being denied privacy and dignity in childbirth. I feel really strongly about this. Privacy and dignity should be basic rights for any mother. We have promised to provide new mothers with privacy and dignity during and after childbirth, by guaranteeing every women who wants one a single room in hospital. This pledge will be delivered as
part of our plans to provide 45,000 more single rooms in the NHS.

Another questions: it is one thing maternity units being closed, but there is also the issue of Midwife Led Birthing Units being closed more than half of the time. These facilities have mopped up considerable financial resources, yet seem hardly used in some cases because of pressures on staffing. Most mothers are denied access to them and instead forced to labour flat on their backs in public wards instead for most of the time, which is an undignified as it gets. Question: are you planning to collect data on how frequently these units close??

Andrew, what do you think of a return to the domino system, where a community midwife was responsible for a woman throughout her birth and return hom, no matter where that birth took place. For instance when I was born, my mother called the midwife team, someone met her at the hospital, stayed with her throughout, settled her onto the ward, and then met her when she came home - so total care. I understand that there is a team in London working in this way to the great delight of their patients

Do single rooms include postnatal room as well? Just wondering how the hospital where I work will achieve this as we're on the 3rd floor, take up the whole of the 3rd floor and can't extend. Will we have to move to a new building? The expense will be huge!

On breastfeeding, which many of you raised, the discussions that went back and forth on were really interesting. There are clearly different views; I do believe that 'breast is best' for babies (although I know that isn't your favourite phrase Bluemary3000!) but it seems to me that the most important thing for government to do is empower women with the freedom and information to make the best choice. I think nannying and lecturing mothers about this is likely to be counter-productive. Providing information,
examples, positive peer support and supportive role models will all help
mums to make the decision that's best for them and their baby. Specifically, I do think that Government should be working with
employers and businesses to tackle any stigma that surrounds breastfeeding. We have to encourage them to support mothers in their choice.

Hi, about home births and the Netherlands experience. In the Netherlands, one of the reasons they have a high number of home births is that the compulsory medical insurance system in the Netherlands (their equivalent to the NHS) does not cover the full cost of having a baby in hospital unless this is necessary for medical reasons. So, can you reassure us, that the Conservatives won't move to a system whereby we have to pay any money to give birth in hospital if we want to (i.e. if there is no medical reason)?

the NHS Next Stage Review-the Darzi Review has recommended many changes to NHS manangement and the role and involvement of clinical staff.to boost staff input,staff influence at policies and procedures level. concerns about PCT and foundation trust ability to achieve these aims have been raised by commons health select committee

will PCT and trusts be compelled to accept the NHS Next Stage Review-the Darzi Review recommendations

Accommodation is short, but what women need is a midwife of their own in labour. If the Conservatives made this a manifesto pledge I think almost every woman of child bearing age would vote for them!

And more (sorry Andrew, this is turning into a tsunami of BoffinMum anxiety to communicate).

On MumsNet we spend a lot of time late at night collectively diagnosing serious conditions such as retained placenta and puerperal infection as total amateurs because women do not receive sufficient postnatal visits, have trouble accessing out of hours services, and get fobbed off by NHS Direct with long call back times. We should not have to do this.

Question: will the Tories be able to bring back daily postnatal visits for new mothers and ensure they have access to medical professionals with proper experience of childbirth, rather than GPs who don't know them and who do not have enough current topical knowledge?

In response to wasuup3000, I agree, that the NHS is suffering from 'review fatigue'. The issues now are less about analysis and more about delivering (forgive the pun!). We have known for five years that the birth rate is rising. The number of midwives has simply not increased in line with this. We have to encourage midwifery training and those who wish to return to work. By giving more autonomy to midwifery teams - like the famous Albany Practice in South East London -we can give midwives more encouragement and stimulate recruitment.

Stimulate recruitment?

THERE ARE MIDWIVES STACKING SHELVES IN TESCOS WHO ARE DESPERATE FOR JOBS

With my 4th child I drove myself to hospital after my waters broke 4 days early. I was then made to wait 24 hours until advised by a nurse on the ward that I could say I wanted my baby induced after 24 hours that they would have to do so. So I asked and was induced obviously worrying about your baby for over 24 hours after your waters have gone is not ideal.

I told them my labours were quick and I was induced. During may stay on the ward pregnant mothers had been sent back up as they were not enough into their labours to be on the delivery suite.

I knew my labour was progressing and that I was due to give birth soon and wanted some gas and air. My midwife did not believe me insisted on moving me to an empty ward and examined me. After which I was bundled quickly to the delivery suite and gave birth within 2 minutes off arriving there.

Mothers are just treated like cattle and it is not good enough.

Yes - Maiakins - I do understand. Closed wards in some maternity units are also part of the problem. Closing units to mothers is the tip of the iceberg. As I just said in response to 'wasuup3000', we need to recruit more midwives. But we also need to ensure that the hospitals are given the right 'tariff'(i.e. the payment they get for providing services) to support maternity. The money they are paid should accurately reflect the costs and the level of standards we need.

SKSS is right. the midwives are there but the jobs are not. Only London has recruitment problems.

Example of MN 'collective diagnosis' thread for someone 11 days post natal who should have better access to a skilled midwife

Did you see Stripysocks posting further up that as a newly qualified midwife she couldn't get a job (along with others). Just like Health Visitors, it isn't people, it's posts the NHS is lacking. Unlike clinical scientists which the UK produces about 50% of it's requirements each year out of training - leaving a massive shortfall which is unaddressed by politicians as unexciting

He should know this as I wrote to him some months ago about the fact that there is no shortage of midwives in the UK, but a lack of funding to employ midwives.

Anyway I'm off to work for a shift on the labour ward, where if the last few weeks are anything to go by I will probably be looking after 3 labouring women.

Thanks Bizibee, there are some things I wish to highlight. One is our intention to introduce universal and more intensive health-visiting in the first weeks after birth, helping to get every family on the right track. This would help with everything from breastfeeding to family health and relationships - not least, working with father and the family to establish how a newly expanded family works.

BoffinMum, we have worked with independent midwives to tackle this problem. Independent practitioners should have access to indemnity insurance, but there is a major cost involved.

Graduate employment NHS. newly qualified highly trained healthcare graduates cannot find training posts eg Medicine,nursing, Allied health professionals. MTAS was a well documented disaster, and health care graduates are unemployed.graduate entry level posts are over subscribed

this is a real waste of talent for graduates who have pursued vocational training and want to work for NHS

StripeyKinckersSpottySocks, Yes I do mean postnatal as well, although choice should mean a single room for those mothers who want it - not everyone does. I know some units are constrained physically, but we have to look at how to accommodate expansion and higher standards, for example, by developing midwife-led units alongside an obstetric service.

Can I change tack here a little bit since I had the experience of actually being admitted to hospital while in labour with my first but due to fact that I had been diagnosed with IUGR and was 6 weeks early there was a requirement for a special care bed.

While in labour I was told that there was none free in my local health authority area or indeed in the Midlands where I live and they were contacting Glasgow and London hospitals for me. In the end the neighbouring health authority took ds in to special care as an emergency and I was left traumitised at having to be moved in an ambulance with a blue flashing light in my latter stages of labour and almost giving birth on the ring road of a large local town.

My question surround the lack of communication by NHS give to mothers and how this could be imporved and what initatives would the conservative party put in place to ensure that other mothers and babies are not put in such a traumatic and bewildering situation while in labour?