To think that some NHS midwives are taking advantage of covid 19

[NinaNeedsToGo]

I actually replied with my rant below to another OP but I decided to start a new topic with my post here.

Sorry ladies but I think what we're going through regarding our antenatal care is a disgrace to put it mildly. More and more post are recently appearing on MN where women are rightly concerned that they are not seen by MWs during second trimester at all. It might be just a BP and dipstick appointment that they are missing but most of us would agree that these seemingly minor test are vital for mother and baby's health. They detect quite common problems such as pre-eclampsia or GD and are a bare minimum we receive through NHS.

I have 3 friends working in NHS hospitals (London and Midlands). From what I can hear from them, and we speak weekly, after an initial surge in covid cases at the end of March up until mid April, it's all gone pretty quiet. All planned treatments or OPs have been postponed or cancelled to create more capacity. It's gone to the point where HCW friends seem to be actually bored on their wards. For example, 24 bed capacity on my friend's ward and just 5 patients, and they have not been even nearing a full capacity at any point of this pandemic. All three of my friends work on virtual wards which basically means that they can be assigned to any ward during their shifts. And they were. Surprisingly, or rather shockingly, one of them had actually worked for a week with covid infected patients and a week later on maternity ward (sic!).

With high staffing levels (surprise surprise high for a number of patients they currently have), bank staff hours were actually ceased because of lack of demand.

I am actually pretty angry with how NHS is handling this crisis because due to the pandemic craze (not that I minimise its severity) we seem to have large swathes of population left to their own fate without vital cancer/ maternity/ diabetic etc treatments/care.

Our maternity care shouldn't be affected because midwives are not really involved in covid cases. What's more, many trusts cancelled some vital services such as GTT at 28 weeks ( I was informed that they would test me for GD from blood only), home births, 16 weeks app,and I heard of 24week apps also being cancelled. Postnatal wards are doing whatever in their power to discharge women asap so that midwives and HCW don't have to run between beds while partners are kept away. So at least in theory, midwives should have it easier or at least the same as pre covid.

It took my midwife an extra minute spent on disinfecting my chair and the desk for me when I had my booking appointment. She barely answered my questions and her responses were short and vague. I actually found that a box in my maternity notes was ticked where she didn't actually mention healthy eating to me at all during the app.

What it is then that leads to such an appalling state of care? Aren't we actually quietly allowing this state of affairs to continue by sitting quiet because in our minds all NHS staff is bravely combating covid19 which I know first hand is not true?

Rant over. Waiting for your points of view

I can only speak from my experience in Swansea to say the midwives etc. Are all doing a great job. At my 20 week scan we had to put on masks and gloves straight away, the staff looked like they had adequate Ppe on them and they did the bp and urine tests and stuff whilst i was there. I've had phone calls before my scans and for my consultant appointment to check in and ask how things are as well as break down current procedures.

Different areas have different levels of cases and numbers of people taking up beds. Thankfully the numbers appear to be going down but they're still not great.

I don't think it's fair at all to say midwives aren't going to encounter covid. Maternity nurses have died from the virus. Mothers and babies have been diagnosed with it. A very small minority of partners back in the beginning of this madness were hiding symptoms so they could go visit partner/baby infecting them and putting them and others at risk. Sadly a baby's death in our local hospital was in the news this week, the mother has corona diagnosis, for the baby it was a secondary cause.

I would rather the hospital be over cautious to protect me, themselves, other mum's and babies than risk getting ill.

Working on a covid ward and then back to a maternity ward - shocking!
It’s really not a great time to be pregnant at all! Communication has been poor for me, given the fact I’m not seeing anyone face to face apart from at scans. It’s not very reassuring, especially for a FTM like myself. I don’t mind the telephone calls if they can be done over the phone (like the booking appointment), but I don’t think vital tests and other important appointments should be cancelled.
I understand it’s a difficult time for them and the NHS, and I know some areas are struggling with covid cases and staffing more than others. For the point you made about Discharging women asap, this may be more beneficial to patients and women than convenience for midwives - the longer you’re in hospital and around others the risk of catching the virus increases.

My mum is a midwife and I know how much her team are struggling with staff absences at the moment due to people having to self isolate; either on a temporary basis I.e 14 days or in some cases much longer because of illnesses that put them in the vulnerable category. So whilst they may not directly be the most involved with covid cases, they are still affected and are having to deal with the effects it has caused. Many community midwifery teams are understaffed at the best of times so I do believe they wouldn't be restricting care if it wasn't absolutely essential.

It's a scary time but unfortunately we all have to accept that the level of care cannot possibly be the same at the moment, despite what we may hope. I am also pregnant myself so am on the receiving end of the changes.

I'm 38' weeks' with my third. Had planned a home birth since I knew I was pregnant but about six weeks ago the Trust suspended. Neighbouring Trusts have now reinstated but not mine. They keep saying it's due to staffing levels and social distancing, but how come then the other neighbouring Trusts have either kept going (even doing more home births than usual) or reinstated?

The antenatal care I was receiving also became a big cause for concern. I suffer with significant health anxiety and Trust made the decision to do a lot of my appointments over the telephone. When I questioned what the midwife could actually measure in this way, they admitted "not a lot."

There are also heavy restrictions on partners in the hospital. Whilst I fully understand why this is the case, I didn't want to risk my partner (first and last baby for him) not being present at the birth and strongly feel that I need a birthing partner to help support and be my advocate (especially with my anxiety issues).

Postnatal care is also sadly lacking with tests such as newborn hearing tests not happening. Sadly my youngest was born with major hearing problems so I know how important this test is.

We are in the fortunate position where I have some savings and we have booked an Independent Midwife (works separately to the NHS). She has been brilliant. But I am so aware not everyone is able to make this choice.

As a previous poster has stated, some mw's appear to be working on a covid ward and then back to a busy maternity ward - this also concerns me greatly. Is this perhaps the reason as to the short staffing issues?

I agree OP. My consultant was really cross that I was going 20 weeks without seeing a midwife and wouldn't be getting urine, bloods etc checked in that time. I had to inform midwife of this who got really pissed off and after loads of back and forth agreed for me to be seen.

I also flagged my baby was measuring really big on 20 week scan and should I be concerned. She told me they would only test for gestational diabetes at 36 weeks 🤔

I understand we are in pandemic and they're under pressure I really do but there is a reason these checks are in place. I could have had a midwife check me at 20 week scan as she was just sat literally doing nothing the whole time I was waiting but now I have to back into hospital to get it done.

@ChipsAreLife That's shocking re the GD test only happening at 36 weeks! Could this mean potentially a much bigger baby and all of the potential risks that can go with that?

I think to say midwives are 'taking advantage of Covid' is beyond harsh. Midwives, mothers and babies have lost their lives due to covid! They are trying to do as little face to face contact to protect you and tour baby, not to deliberately make things harder for you.
I'm glad the midwife took so long to clean the area before/after toy sat down, you have no idea who was sat there and for all you know the midwife could be terrified about catching covid and passing it on to her family. I think we all need to try and be a bit more understanding at how differently the midwives are being asked to work, that they will be seeing colleagues going off sick with the virus, speaking to patients on the phone who are panicking because they have symptoms and knowing their is nothing they can do to support them.

I agree the care currently is poor but it's certainly isn't the midwives fault . Every single midwife I have spoken to has apologises for the situation they find themselves in . They don't want to be virtual they want to support us .

I'm 33 weeks. Was told I was high risk at 20 weeks then covid -19 happened and I was called and told I wouldn't get the extra scans they booked anymore. I think this could be my trust and area but it's has done nothing but send my anxiety through the roof. As it stands currently I now won't see anyone till 36 weeks. I've been left feeling so incredibly anxious .

On the plus side when I have attended MAU due to reduced movement the care has been incredible. They know how hard it is for us.

As a PP has said it's clearly varying from place to place. I'm 37 weeks and have had all my mw appts face to face still, been seen in triage with reduced movements no problem, had additional scans no problem. Yeah my husband can't attend but he isn't the patient, I am. Home and water births have restarted recently. Only annoying thing for me is that husband can't attend with me in labour until I'm 4cm dilated and can't stay or visit me port natally.

We have a maternity covid ward at our trust as believe it or not, some mothers to be are covid positive so some nurses absolutely are working with covid patients.

As a PP has said, it's the staffing crisis that caused a lot of the changes. Most places are seeing between 30 and 50% absences because now if they or their house hold has a slight symptom that's it they're offf until a swab comes back negative. This can take 3 days. If the swab is positive for their child for example they have to stay off for 2 weeks. It's (and I hate this word) unprecedented and I genuinely believe people are doing their best.

The NHS is not using this as an excuse to do less work. The less work they do they less money they get (they get funding and pay per out patient appt/investigation etc) it's going to cripple a lot of trusts and prevent investment in the future.

I'm sorry you and some of the posters have had a less than adequate and in some cases down right poor experience. I'd recommend calling PALs to discuss, and also read up on the college of midwives or Obgyn guidelines and challenge any local policies that contradict this guidance!

Good luck x

Midwives, like everyone else who works in health care, are risking their own health to see women. They are exposed to focus because they're in a public facing role. They are under pressure because some are off work sick, some are shielding, some will have no childcare, some will be looking after vulnerable relatives.

Women don't stop having babies during a pandemic. Unlike other hospital wards which may be quiet as people are afraid to go to A&E, or because surgery has been cancelled, Midwives are still just as busy - if not MORE so covering absence as outlined above. Their case loads will be up, their remit might have changed (community midwives sent to labour ward etc) and they're having to deal with PPE shortages etc just as the rest of the health service is.

I'd suggest that rather than blame individual professionals you consider the wider blame of a government who have left maternity services under funded for years. If you're not happy with your care I suggest you complain to your local MP.

Midwives don't go into the profession not to work hard. They work their socks off. They care about women, women are at the centre of their whole philosophy. They are battling to stay afloat during a global pandemic and have the same worries, responsibilities and problems as the rest of us. It's time for kindness.

You do realise midwives have died, don’t you?

We are working to national guidance. Yes it requires mothers to take a little more responsibility and report symptoms that concern them rather than waiting for their next appointment, yes it worries me that we are not carrying out some tests and scans that were previously considered routine, but we are trying to minimise contact for the sake of mothers and babies health - not to slack off!

I’m pregnant. I walk into the hospital every day not knowing if I’m going to pick up covid, if I could be taking it home to my toddler, if I could be unknowingly passing it on to some of my more vulnerable patients. It’s hardly fun.

Covid19* not focus

It's not the midwives you see for your appointments that are setting out national and trust level guidance though is it? If the consultant has concerns about the level of appointments he needs to raise them through the correct channels, not just get you to moan at your midwife as she will be following policy. With colleagues off work, PPE taking time to put on and adding to their workload, and everything else going on no, they're not taking advantage. But yes, it is scary no doubt for expectant mothers who are not getting the level of support that you would normally get; but they are doing their best.

I agree in part with the original post but I do not feel that the midwives are to blame for the reduced care/appointments that some seem to be getting. I think as previous posters have said it’s the Government who should be blamed - the poor NHS has been underfunded for many years and a crisis like this has clearly not been planned for.

However I do share your concerns in that the lack of appointments is really concerning :( I had my booking in appointment over the phone and a 5 minute appointment to take bloods (which I was happy with). What I’m not happy with is having to chase referrals, not having blood test results discussed with me and not getting basic checks such as blood/urine/BP.

I also did not get nuchal measurements at my 12 week scan and that was rushed due to covid. I then had my 16 week appointment with the midwife which was vital as I couldn’t have the nuchal measurements so needed the bloods for downs screening. At my appointment the midwife refused to test my urine (I had brought a sample in) and after 2 attempts to get my blood (for vital tests I missed out on at my 12 week scan) and then fobbed me off on to the practice nurse (who took her time to take my blood) didn’t even give me time to ask any questions and missed off all the checklist for 16 weeks, then told me she will see me at 28 weeks!

I’m sorry I know they are putting their lives at risk and I’m really grateful but I do feel a bit let down by the care I’m receiving as a first time mum with serious anxiety around pregnancy I feel terrified!

Yet the flip side is I have been to my doctors surgery for vaccinations and for blood tests during this pandemic and the nurses have been so kind and have always had time for me and listened to my concerns (it took over an hour to get blood from me last week) the nurses in doctors surgery’s are also on the front line risking their lives - yet the care certainly with my GP has been outstanding during this pandemic so why is so different at such a vital time in a woman’s life with a midwife?!

As I say I’m not placing the blame with midwives individually I personally feel let down by our government - we now have empty hospitals and many people (not just pregnant women) are suffering as a result.

Yes, I think it's disappointing and worrying that ante natal services have suffered because of coronavirus but I certainly don't agree that midwives are using this as some kind of excuse to see us less.

We are not ill, we are pregnant! Why do some pregnant women become so selfish and entitled? It's like their pregnancy is the most important thing happening in the world right now. Dont you think It's more worrying that essential things like cancer treatments and end of life care is being affected than the fact us pregnant women aren't getting every single appointment? People are losing family members, they can't see them to say goodbye, they can't give them the funeral they probably would have wanted to! It's awful but I understand difficult decisions had to be made to keep hospital beds and ventilators free to treat this virus so we didn't end up like other countries with patients dying on the floor and in corridors. The fact our hospitals haven't been overrun and nhs nightingale hospitals haven't been needed is because of the measures put in place, not in spite of them. Maybe have a bit more perspective.

I'm a FTM, 27 weeks and only had one non-essential appointment cancelled which was at 25 weeks. When I needed an extra scan at 23 weeks, it was booked in no problem and I've seen lots of posts on here proving that triage/EPU is still operating fairly normally. If you are worried something is wrong, you can still call, they are still seeing you to check on mum and baby. The care is still there if you need it! I'm in the north east which is one of the worst hit areas of the UK and I think they are doing their very best in unprecedented circumstances. All the staff I have met have been so understanding and apologetic and they've done everything they could to put me at ease.

It beggars belief that so many people have the luxury of working from home and self isolating with family yet have no appreciation for key workers like nhs staff who are putting themselves at risk every single day! Nhs staff across the country have lost their lives because of Covid 19, this isn't some kind of pretend danger. They have family themselves at home that they have to think about too so, of course, they want to minimise their contact with people. Are we not all doing the same everyday, minimising contact with strangers?

And it's not just about protecting themselves. There are still vulnerable people in hospital so having more people coming and going brings increased risks to them. Appointments might be shorter and discharge after birth might be sooner, not because the midwives want to sit twiddling their thumbs being lazy but because they are trying to protect you and your child. The sooner you are out of the hospital, the less chance you have of catching it! Not having partners on the ward or at scans etc is disappointing but it's to protect us, our babies, other mums, other hospital patients, not just the staff!

Of course I wish that things were normal and I was getting all the usual appointments and level of care but I can see outside my own little bubble. This is a global pandemic, it's not just happening in the UK and it is completely unprecedented. We are all having to make sacrifices of some sort to keep people safe.
This is temporary, it won't last forever.
We can all feel disappointed, that's natural, but i do think we need to stop being so selfish and think about the bigger picture.

I'm concerned with the lack of antenatal care also, I've been seen face to face at 8 weeks and next time will be 28 weeks (other than scans) I don't know beyond that I don't want to know tbh!
I know it's good that telephone calls are in place rather than cancelling completely but other than talking about worries there's no physical checks that could be done which is the thing that puts my mind at rest eg BP, measurements, heartbeat. I did go up to the hospital in the end as I was concerned with a pain the Midwife's were lovely but the doctor clearly didn't want me there.
Just have to roll with it I guess!

I agree that antenatal care seems to have been dialled right down. I'm in a plus size pregnancy group - people have had growth scans cancelled, appointments missing or by phone (so no BP check etc), GTT is now just the one blood test (my midwife has given me a home monitor as I'm high risk and the single blood test is not as accurate). It also begs the question as to whether we over medicalise pregnancy normally - if it's so easy to cancel so much now!

But I think you're unreasonable to blame individual midwives. These are policies put in place by trusts, not individuals. Now that its starting to get out how quiet a lot of hospitals are, maybe these policies will start to be rolled back slowly.

Tell this to the family of the midwife who died yesterday of Covid at Birmingham women's hospital.

At my 20 week scan yesterday they didn't even bothered to weigh me, the measurements recorded were copied from my 12 week appt. Therefore my recorded weight is not correct as i am 4.5kg heavier.
It wouldn't have even realised if one of the nurses did say that my height has actually
shrank over the last 8 weeks. When we looked at the weight and bmi it was just copied from previous page. God know what else they didn't bother to do and just ticked the box.
I'm losing my trust in NHS unfortunately.

@djbebe They don’t need to weigh you at the 20 week scan. It’s irrelevant.

Why is it necessary to be weighed @DJBEBE ? Just wondering as I am 37 weeks and not been weighed since my 8w booking in appt and have been seen very regularly for a number of reasons, no one has asked about my weight at all

@DJBebe have women ever been weighed at a 20 week scan? I've never heard of it.
What difference does it make?

I gave birth 3 weeks ago and unlike the majority, had excellent care antenatally. I was consultant led and had appointments every 1-2 weeks but also saw/ spoke to the midwife as planned. My midwife was off for 3 weeks with covid at the ebd of my pregnancy but I had 2 phone appointments in that time with someone else.

I developed pre eclampsia at 36 weeks and the care on the antenatal ward was thorough (although the ward was empty - 5/18 beds filled).

Postnatal care in hospital was a different story but there was certainly no rush to discharge me - in the end I was desperate to leave after 5 nights. The midwives on PN made me feel like an inconvenience and like any request for help was too much.

In the community I’ve had 4 visits from community midwives (mainly to weigh babies) and was discharged from their care on thursday (day 21). I’ve had calls from the bf midwife at the hospital and the outreach team to discuss (and re-discuss) a feeding plan for the babies.

So it’s not all bad...in fact at times if feels like I am having too many appointments!

I don't know if I was meant to be weight or not but on notes they recorded my measurements as taken yesterday and one of the nurses said i shrank in height in comparison with my 12 week measurements. Then she looked at the weight and asked me if the previous nurse actually took the measurements at all. Why would they record incorrect data against yesterday's date?

Are you joking??

Our maternity care shouldn't be affected because midwives are not really involved in covid cases. Firstly, do you think babies born to COVID positive patients are delivered by pixies?

Secondly, what about the midwives? They have the right to feel safe at work which means it’s not just about the risk to you, but the risk to them. If they sit in a room with 20 different women a day then it absolutely rockets their odds of catching COVID.

Midwives don’t become midwives for the massive salary packets - they care deeply about mothers and their babies and are just as disappointed and concerned by the necessary changes to antenatal care as you, but the key thing is that it IS necessary change.

Don’t be an arsehole and imply all this is because midwives are being lazy.