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 agree with the post that said this seems to be a bit of a postcode lottery in that it is up to Trusts to set their own approaches and they obviously have their own budgets. I don’t think we can be blaming midwives here
I feel desperately sorry for the people who fell pregnant after COVID and haven’t had much face-to-face contact with midwife appointments and no-one at scans with them etc and have to fight to be seen - But these are unprecedented times and ultimately I do feel that perspective is needed. Nobody could have seen this situation coming and we’ve got to get through it as best we can.
From my experience and from the vast majority of what I read on here, people are being taken care of, it just might be slightly dialled down, compared to how things usually would be. You absolutely have a right to pursue the care you feel you are entitled to but sometimes you can think there will be more appointments than there actually are. If however, you aren’t getting the core appointments then you can take control of your own care, like other posters have said, and call antenatal triage if you are worried about something or don’t feel well. GPs have also been really good at calling me back, in my experience.
I am in South Manchester and cannot fault my care. All of my appointments have remained face to face. Some appointments are more brusque but I’m ok with that because what’s important is the baby and if my test results are good then that’s all I really need to know.
I’ve been reassured that all maternity services (bar homebirths) are operating as usual but there are obviously restrictions on partners attending appointments. I can’t fault my care - I’m very grateful for the NHS care and I am receiving. I’m 40 so am getting extra scans at 32, 35 and 38 weeks which I find quite remarkable and I’m sorry to be receiving ‘better’ care than others but I’m terribly grateful for it. If I wasn’t receiving the care I felt I was due/required, such as blood pressure monitoring, I would be proactive and either push my hospital trust for it or go via the GP. As previous posters have said, PALS is available, as well as organisations such as Birthrights. Antenatal triage is open 24/7. I think care is available - the format has changed.
I don’t think we should roast the OP who is obviously having a hard time but I do think patience is required during these times and I don’t think anyone can see their experience as being objective as to what is occurring nationwide. I realise the level of care I am receiving is not occurring everywhere, but neither is the OP’s experience. I think she should take it up with her Trust.

I feel obliged as OP to clarify several points in my original post.

I am not under playing the seriousness of the pandemic. I am very much scared as many of you are. I am a key worker and pregnant and I still have to leave my house and do my job without a word of complaint. So no, I am not sitting in the bubble of my own home office.

When I said 'midwives take advantage' I mean community teams working in centres across our towns and cities as managed by their individual management teams/senior MW according to the guidance they receive (or not at all). Obviously, individual midwives have very little to say but their seniors are a different story. I did a lot of research before writing the OP and must say my findings really sparked my post. I can't add the link but if you search RCOG antenatal postnatal care covid 19, you will find a document which specifies which appointments can be omitted. And I wasn't really happy with what I found vs what I am finding discussed here by many terrified mums on MN. In fact, not many of these appointments should be routinely cancelled for all women. It clearly says, when needs arise such as under staffing, only 16 week appointment can but doesn't have to be omitted for all women and virtual/telephone app should be taken instead. BP and urine must then be collected at 20 week scan. FTMs should still receive their 25 week app and their 31 week app should be moved to week 32. What I am reading, many FTMs are not seen for 20 weeks following their booking in! So my question is quite natural. What is happening? Why are some trusts/ community centres cancelling FTF appointments and not even following with a telephone one. They clearly are not following their own guidelines. For me it's as simple as taking advantage.

For those of you who called me insensitive because MWs are also dying. So do teachers, taxi drivers, care home workers, shop assistants, office workers, stay at home mums. No one is really immune! Just because I am not a frontline NHS worker doesn't make me less at risk. I still need to perform my duties when looking after key workers children and I do not cancel. I am scared as much as them. Key workers children can be a ticking bomb. Exposed to risks at home, they can bring the disease to school/nursery offering care.

For the person who said that the pregnancy is not an illness, you need to think twice. We wouldn't need to be seen at all if that was all as simple as you think. Why to need monitoring? Can you simply get pregnant, continue as normal and poop out your baby in your own bathroom? In 25% of pregnancies, you will collectively find that women have pre-eclampsia, DG or HELLP. That's a quarter and we are not even talking about preexisting maternal medical conditions.

I am really angry with the government, but also NHS management for their handling of the crisis. In fact, antenatal and postnatal care is a preventative care. It is to prevent problems and deliver healthy babies by healthy mums. That's their role. Ante/post natal care should shield from any other wards which treat people who are ill to make sure the likelihood of the spread is minimised. Instead, this seems to be a standard procedure to send all NHS staff to work around covid for some time.

And finally, I did mention cancer/ diabetic etc patients so no I am not treating expectant women as holy cows. As in my OP I am equally concerned about them too.

If it's 'self absorbed or self indulgent' to be concerned for your antenatal care then I must be those things

There's a difference between being concerned for your ante natal care (as we all are) and being so tunnel visioned and entitled because you are pregnant that you are unable to appreciate the reasons that things are happening (or not happening)

My 3rd MC started last weekend. I rang the EPU who said their genetics dept was closed due to covid swabs, so no point bringing the products there for testing, as they'd only check it wasn't molar.

I emailed & called the IVF clinic. When I did hear back 2 days later, I was told that someone 'might' get back to me within 5 days! I explained I needed the products tested NOW, not sitting in my fridge for 5 days. Their clinic is in the same hospital where the genetic lab is, that were open, but instead said to take it to their other hospital, miles away and much farther from where I live.

I ended up twice at a different EPU (3hr round trip to walk there to avoid public transport, and no parking there as central london) to take the products there due to ongoing bleeding and passing products over a 6 day period. They saw me twice in the 1 week, within the clinic, but wouldn't scan as it wasn't deemed an emergency- although said that in 'normal times' they would have scanned me.

During this, the midwifery receptionist called to say the midwife would be calling in 2hrs for the booking in appointment and would I be at home. I explained I had started bleeding and was likely MC, but hadn't been confirmed and I still wanted to speak to the midwife. They never called though!

I realise the health service is under pressure, but maternity services are supposed to still be open and running. Its my 3rd loss, so I have experience of this now, but I too feel neglected and left. Even a phone call from either the IVF clinic, midwives or EPU might have been reassuring.

Taking advantage . Going to work to pick up COVID-19 potentially, be even more short staffed than usual, not being able to eat / drink / pee etc.
Sounds like they are living the dream for sure! The NHS and maternity services have been under pressure for a long time, this is an additional challenge

What exactly is a pandemic craze? Is it a bit like Pokemon Go or Fidget spinners?
You sound like you're just out to get at midwives, who are only following guidance from the RCM, they're not making the rules up by themselves.
If you don't like it, find yourself a private midwife.

There's a 6% chance of preeclampsia and a less than 1% chance of HELLP syndrome. I don't know and can't find out online what DG. But for there to be a collective 25% of all three in pregnancy it must be pretty serious.

I think the main issues here are some of us are being told we will receive phone consultations instead and but these are not happening, different trusts have differing rules/protocols etc and not necessarily related to areas that are badly affected by Covid. I think we all understand and appreciate that sacrifices have to be made by everyone and that all healthcare workers are working under exceptional circumstances, but the fact that we are all being told different things in different areas, and sometimes in the same areas but by different health professionals is not acceptable and is leading to very stressed and frustrated pregnant women, myself included.

For those of you who called me insensitive because MWs are also dying. So do teachers, taxi drivers, care home workers, shop assistants, office workers

Yes- but you started a thread discussing midwives, not taxi drivers. You said that midwives are taking advantage of the “pandemic craze”
It’s a deadly virus, not the Macarena.

OP I think the issue is you're not slating, calling out or singling put "teachers, taxi drivers, care home workers, shop assistants, office workers, stay at home mums"

I am lucky to be able to work from home and it's admirable you are pregnant and also a key worker putting yourself at risk, but imagine how you would feel if someone took to the internet to call you lazy or say you were taking advantage/lacking off right now?

I accept your point that pregnancy requires additional care and monitoring. I also accept that some women develop illnesses during their pregnancy requiring additional care and monitoring. But pregnant just isn't an illness! And to say it is I personally find insulting to a woman's fortitude and ability to have and carry a baby...

You're allowed to be scared and dissatisfied for your antenatal care and the health of you and your baby! That's only natural and actually prudent! Women and patients in general need to advocate for ourselves and our medical treatment but we mustn't tear down the people who genuinely are and do save lives every day

I can only speak for my area, but I've not noticed much difference really. All appointments still face to face (I've even got an extra one at 25 weeks for some unknown reason, despite this being my second pregnancy), still having the full GD test, no gloves or masks needed at scan or appointments. Only differences so far have been not doing the carbon monoxide test.

For those of you who called me insensitive because MWs are also dying

Anyone who called you ‘insensitive’ would be being very generous . Your thread title and OP are heartless, thoughtless and ignorant. There’s lots we’d like like to be able to do to help patients at my NHS trust but central government dictates against it.

But that's exactly my point. I can't say that in week 2, 5 and 7 of the pandemic I can turn my back on children and send them home because I am overwhelmed and therefore I can cancel. And we look after the education of all of them, not just the key workers' ones. Yet, some community services are taking piss, not calling the patients back, not following the results, not offering what's in the covid guidance.

My friends who are actually at the frontline of covid said they have never been really overwhelmed with patients despite working in hotspots of covid. That's because practically all non-essential, not life saving treatments have been stopped. And this is where I think it's all going badly wrong.

It's been announced by ONS this week that 50k excess deaths occurred in England and Wales alone in the first 5 weeks of the pandemic. After 5 weeks we were approaching 20k covid related deaths according to the hospital data published. That means 30 thousand people died needlessly, most likely not directly because of covid, how many because they could not access vital services, we will probably never know. That is exactly what I call the pandemic craze. Prioritising covid patients over any other resulting in a huge loss of life. You can call me nuts, I don't really care, but when my NHS friends say that they have been badly managed and many people will die because they didn't have an adequate regular care, then I can have nothing more to add.

NHS have been successfully shielded from being overwhelmed. They are less busy than usual. AE depts had 40% drop in admissions. All NHS staff, after the initial flop with testing, are now routinely tested to be able to return to work. We passed the worst time now. The government that was reluctant at first started getting their acts together and things are going better than at the beginning of the pandemics.

I still have 2 trimesters to go and my main worry is that when the pandemic is gone, NHS will be busier than ever trying to catch up with everything they postponed or simply neglected. And that will show through many instances of inadequate care.

First time mum to be here, my 16 week is over the phone as will be a number of other appointments and one has been cancelled all together. I’ve found the midwifes to be very apologetic for the situation and have answered any questions I’ve had over the phone. I would really love to have the extra reassurance of The extra Doppler tests my husband at my appointments but understand that these are strange times and i have to get on with it. It does make me wonder if they overdo the amount of Appointments in normal times however - if they can safely cut the amount of blood / urine tests now could they be saving on these in normal times too?

@QuaverQueen if you really want to help, follow the guidelines. Central government has not prevented you from treating patients. Its the interpretation of the guidelines that is going badly wrong at the cost of non covid patients. Each trust, or worse each practice interpret these as they please and as a result it's again a postcode lottery.

I don't know your specific school or set up so correct me if I am wrong but since only children of key workers and those who are vulnerable are attending school right now be a fraction of what the would otherwise be? I appreciate you still need to set out work plans and distribute them to the children who are being home schools right now, but are you honestly trying to compare that to the unprecedented hospital attendances and patient volume that hospitals are facing right now?

"My friends who are actually at the frontline of covid said they have never been really overwhelmed with patients despite working in hotspots of covid"

That's wonderful, that absolutely is. However try telling that to the thousands of newly qualified and retired doctors that have been granted emergency registration to help on help during the pandemic because everyone is so overwhelmed. Rationalise that against the floods of facebook/media stories from front line workers who, using their actual words, and telling us all how overwhelmed they are. I am somewhat media sceptic and defiantly don't believe everything I see and read on the BBC but it's just insulting to even suggest that midwives, doctors or any HCP is exaggerating how broken and overwhelmed they and the NHS are and are just using this opportunity for a doss...

@MrsRose2018 well said!

To be honest OP, the more you are replying the more I really don't understand your perspective here.

You seem very set on referring to guidelines that were obviously not written with Covid19 in mind. As PP's have mentioned, these times are unprecedented and that means we cannot surely base current care expectations on guidance set out with no consideration to a pandemic.

Hats off to you for being a key worker but you must have some understanding as to why everyone is so unhappy with your post? If you were called lazy and taking advantage of covid 19 because you were looking after less children and had to adapt your normal routine, would you be happy? I think not. The title of your post is offensive to all those midwives who are trying their hardest and putting their lives at risk on a daily basis and you must realise now that perhaps you could have worded that and some of your post a little better?

As a midwife you are very naive if you a) believe we have any say over the changes being made to antenatal care b) think we are not involved in the CoVid situation, pregnant women are not immune from CoVid you know!

@MrsRose2018 let me then enlighten you. I am a college teacher, I work with vocational subject learners. We deliver teaching online every other day. So no, my learners are not left to homeschooling. I am still responsible for them to complete their vocational studies. Also I am twice weekly called to attend either our nursery or our college open for vulnerable and key worker children. I am working 5 days a week and daily do overtime work. Apart from planning and marking+feedback, I deliver essential in class care. I believe you are trying to downplay teachers' role all of the sudden to bite back but I don't mind. I don't cry to media to say how stressed I am being exposed to all the risks. We don't even have any PPE when working with others. Our guidance is very clear. We stay open for all in need term time and during holidays. We don't cancel. We don't turn our backs on anyone. And we have truly been overwhelmed with work all those years, yet very little has been said about the stretched educational system.

Look at the facts and read between the lines. It's far worse now in health and social care than NHS. They really have been overwhelmed and not really looked after. No one is clapping for them. No one seems to care. The government will not acknowledge the disaster they have caused. NHS played its role in this disaster discharging/getting rid of untested patients into their care homes. And let's not forget that NHS called juniors and retired to shield themselves as they expected half a million covid cases very quickly. They are now by no means overwhelmed. They have more staff and volunteers than they could have bargained for. And therefore, continuing an appalling level of care now in May and into June and July when we passed the peak is incomprehensible. NHS has had a lot of internal problems that go well past the beginning of the pandemic. It's known for its postcode lottery approach. They have been very inefficient in many ways. Their care is better on the paper than in the reality. They have barely been proactive, their actions are mostly reactive. So many stories emerge every single day about inadequate level of care they provide. Their lose approach to how they treat patients depend on individual doctors and nurses really, some of whom provide great care, while others are inadequate but often get away when they did not care much for the well-being of their patients. If I was inadequate in my job role, I would have been finished as a teacher many years ago. I would have been driven out of my profession and never let back in.

@LouLouP7 it's exactly the opposite. I am talking about new covid 19 guidelines that are not adhered to.

@NinaNeedsToGo fair enough then, I stand corrected. Notice you didn't reply to my other points though

OP just look how you responded at having to justify how overworked and overwhelmed you are! Look how offended you are at having to justify what you do and what it's worth and the tole it is taking on you!

You no more need to justify what you are doing and how you are coping and how busy you are than a midwife or other HCP has to! Both my parents were teachers. In fact my mother who is 72 is STILL teaching. I wouldn't downplay a teachers role any faster than I would a midwives!

You have completely proved my point!

Are you honestly trying to tell me in the years you have been fulfilling your duties as a teacher you have never slipped. Never dropped your standard. Never once made a mistake or didn't delivery the quality of your work to the 100% best of your ability. Not just now during the pandemic but when things were "normal". If you say yes then well done because I certainly haven't. Only difference is when we make a mistake no one dies.

Yes health and social care is fucked. Everything's fucked. From the NHS to charitable organisations to refuse collections. Never have we faced something like this - at least I haven't in my lifetime.

You may not be inadequate in your role OP, but you're certainly inadequate in your ability to express even slightest bit of empathy and understanding.

@sel2223

I don't mean to be argumentative, but if you see my previous post on this thread I haven't been risk assessed as an individual and according the the RCOG own guidelines I should be having growth scans in my pregnancy. I was told by my Consultant it's a blanket no growth scans for everyone to protect the ultrasonographer from exposure. I'm on board with the telephone appointments and restrictions on partners etc but my issue if some of the changes aren't evidence based or risk assessed, vary across postcodes and I believe my antenatal care is now unsafe. In fact I know it is as I can't access the care as recommended for me previously or as set out in the RCOG own guidelines on rationing care during the pandemic. I'm being really let down. I'm a NHS doc, would be front line but currently removed slightly as I'm pregnant. I understand the behind the scenes rearrangement of services and staffing and work hard in my own department to keep everything going and the majority of staff and patients as safe as can be. I do not agree with blaming midwives or getting worked up about non-essential contacts being minimised, but this is not all that is happening everywhere. There's rationing and then there is unsafe and that line is being crossed in some cases.

Some parts of hospitals are still very busy and although numbers of very sick people are down most hospitals still have many diagnosed Covid patients,some negative and some awaiting results.
The whole system was turned upside down to accomodate the predicted wave which fortunately due to all the measures taken didn't overwhelm us.
That left some areas underutilised.
We are now putting back services and it takes time as they need to be configured differently.
And most of this does not affect maternity.
This has shared problems with reduced staffing due to sheilding,vunerable staff.They also care for pregnant women with Covid.We can take histories from mums to be about their isolation etc but not partners so you are all potential carriers.
So thing take time and you do have a phone number if you are worried.
And midwives are very,very busy at the moment,we seem to be doing more csections in our hospital and it all takes a little longer because everything between patients in all areas of the hospital have to be bleach cleaned.
Your job being stressful should give you insight into how others are managing sadly you may not mean it to but your coming through as self centered .
If you have genuine complaints then put them in writing,if you are worried about an aspect of your pregnancy that needs attention then call your midwifery team.
Sorry for all you other ladies having a stressful time but it's not over yet.

@QuaverQueen if you really want to help, follow the guidelines. Central government has not prevented you from treating patients

Where the fuck did I say I have not been treating patients? Are you being deliberately provocative?

Central government has stopped non emergency elective surgery which is hard but is going to start again soon, in the mean time we’ve been running another hospital’s trauma service.

I’m beginning to wonder if this is a thinly disguised anti teacher thread

One alleged profession attacking another.