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!

@NotRainingToday

Honestly if I had my time again I would not have entered midwifery. Now it’s hard to leave as I am qualified and experienced in nothing else.

Most of my colleagues are on antidepressants. I know one attempted suicide prior to leaving for good. It’s a dark place right now. The bullying culture is awful along with the working conditions issues. At the very least she should check out the Facebook group and really know what she is signing up for.

It’s awful to say that as we need new midwives but as a parent I would beg my child to do anything else than NHS.

[quote Madwife123]@NotRainingToday

Honestly if I had my time again I would not have entered midwifery. Now it’s hard to leave as I am qualified and experienced in nothing else.

Most of my colleagues are on antidepressants. I know one attempted suicide prior to leaving for good. It’s a dark place right now. The bullying culture is awful along with the working conditions issues. At the very least she should check out the Facebook group and really know what she is signing up for.

It’s awful to say that as we need new midwives but as a parent I would beg my child to do anything else than NHS.[/quote]
I could substitute ‘teaching’ for midwifery and your post would be exactly true for us, too. It’s really awful.

I wouldn’t want my kids to teach or work for the NHS as they currently stand.

@Howshouldibehave We could probably substitute it for government funded to be fair. The Torys have a lot to answer for!

@Madwife123 I read 'The Secret Midwife' before becoming pregnant and it's heartbreaking to read the pressure you're all under. It's isn't why I'm so adverse to asking my midwife anything other than during appointments as I don't want to take up any of her time in the meantime. Hoping for a homebirth due to the horror stories I've read online and also whoever comes can have a cuppa and eat while I'm labouring but at the same time I'm worried the staffing issues in March will mean I'm denied a homebirth.

The Nhs can train staff they just seem incapable of keeping them. It's so exasperating to see good staff leave because of stress bullying and constantly unstaffed. It's not rocket science. I despair at it ever being sorted out.

I would love to retrain as a midwife, and seriously looked into it before going back to work after mat leave.

However, working for free, as a mature student, didn't appeal to me. Yes, there is student loan (I already have one of these from BSc), but it wouldn't be enough to pay childcare costs, let alone any other bills. My partner is out the door at 5.30 am and not home before 6pm so logistically I wouldn't have been able to commit to shifts. Let alone do bank work to top up my income.
That was the first hurdle.

Then, as I already have a BSc in Biological Studies, I thought I could transfer some modules, but that wasn't possible. So, another obstacle, although not massive.

The other, disheartening (to me) bit was that due to a certain percent of your grade being academically/practically based means that people who are super smart could still pass but have no idea about bedside manner etc and vice versa! Plus, only 40% for a pass, that is worrying!

Also, no option to study in a part time basis, that would take 6 years.

It's a shame because having been in adult care services in a past life, I know I would make a dam good midwife!!

@cushioncovers

The Nhs can train staff they just seem incapable of keeping them. It's so exasperating to see good staff leave because of stress bullying and constantly unstaffed. It's not rocket science. I despair at it ever being sorted out.

I think there are issues with providing adequate mentors to newly qualified midwives. I read a masters dissertation on this subject and the author found that the more experienced colleagues lacked the passion to be a mentor, they saw it as a chore and a pain in the ass. Mostly due to having too many other responsibilities. The less experienced, obviously, lacked the knowledge but had the passion. Meaning that newly qualified lacked any type of support and guidance and quite often became demotivated very early on.

I will do that @madwife123, I'm going to ask for a birth debrief first as it's all very hazy although wasn't an awful experience compared with may you read on here, I just have some doubts about what was/wasn't done with me. Even after the crash cord was pulled and I was rushed down to delivery I was swiftly returned to antenatal for reasons unclear without even an examination and was standing arguing about needing something more than two paracetamol and a shower less than an hour later, being made to feel like I was just being silly... my waters went and finally someone examined me to find I was 6cm and baby born less than an hour later with loads of people in the room, distressed baby and forceps ready out of the wrapper. But for whatever reason they seemed desperate to 'contain' me on antenatal overnight rather than keeping me down in delivery when I first got taken down, so consequently disturbing the other ladies in my bay twice that night apart from anything else. That can't have been just down to one or two midwives deciding that randomly on the night, I'm sure.

It must be particularly difficult as a group of staff as you'd be naturally caring in nature to be attracted to a health role and therefore everything that's going on within the sector must be that bit harder to shoulder, as a result of that caring nature.

Thank you OP and other PP for sharing your experiences.

I think it gives me more confidence to keep firmly raising issues (and escalating) if I am not being seen/examined - I used to work in the health service so I will do this in a respectful way (as I know often the person sent to examine me will have had little control over what is going on in terms of beds/patients and general conditions). I am no expert so I wouldn’t demand a particular treatment - but proper listening and examination is a minimum + consulting a senior if there is uncertainty. I’m sure midwives want to be able to provide this - but unless higher management hear about it, things won’t improve.

When I was in nhs I almost cried when I was confronted by some annoyed (understandably) relatives about a patient because they wanted more info - they kept asking but no one had responded. I was already >1hr late for finishing that day (happened regularly, unpaid), I did not know the patient and it was already outside my working schedule.

[quote Madwife123]@sleepinglionsroar The issue isn’t training new midwives. We are training new midwives but did you know to gain 1 midwife in the NHS we have to train 30? As so many leave just after qualifying and existing midwives leave faster than we can train them.

Denying epidurals is linked to the anaesthetist shortage. They are often too busy in A&E, theatre or ICU to come and do it so it’s our jobs to put women off having one. Say it’s fine you can do it. Deny them their choices. I’ve even before been told to ‘pretend’ I’ve called them and hope the patient births before wondering where they are. Again NOT acceptable and not the way we want to be working. It’s time for change![/quote]
When I had little one the hospital I gave birth in, a specialist hospital, had to 'close' to new admissions, diverting people elsewhere. This lasted 48 hours. I was induced and so glad they took me in when they did as I was not comfortable in my nearest hospital.

@8dpwoah ‘Containing’ you on antenatal ward is staffing. Once you are in labour ward you need 1-1 care. If there are no staff available to care for you we try and keep women off labour ward. Sometimes this means not examining a clearly labouring woman as once you have ‘evidence’ they are in labour you have to move them to labour ward.

@sleepinglionsroar

The government should allow people to train for free as their second degree too ( is midwifery still a sponsored first degree ?) I think many people after having children would be interested in a career change to become a midwife once their children are older.

And maybe midwifery should be more realistic instead, why do they not advise things like how bloody painful an induction is 😬 and let you have an epidural when you ask for one. Rant over 😂

This isn’t the issue. I’m a midwifery lecturer, I could fill places on the course 10x over. However there’s a limited number of places as we can only send so many to practice at a time. Recruiting isn’t the issue, it’s retaining qualified staff which is the issue. Long shifts, continuity of carer meaning more on calls, less autonomy, dire staffing levels and a blame culture are the issues.

This is really sad.
I’ve had two births and all of the midwives without exception (probably around 10 in total) have been amazing throughout. I was listened too and never denied pain relief or felt unsafe.
After the second birth the midwife explained while chatting there was so many leaving due to the way they work changing and she was considering the same. Such a shame as she was brilliant!

I would have loved to have retrained but sadly the lack of funding for mature students plus the work life balance once qualified mean it’s not possible for me.

Meaning that newly qualified lacked any type of support and guidance and quite often became demotivated very early on

^^this is so accurate.

I left because HCA’s were doing more and more of my job.
They need to change the job rather than just train more people who will leave or go abroad.

I am a NHS nurse and could not be more terrified to give birth simply because I am so afraid I won't be cared for properly or left alone. I work in paeds so regularly see my midwifery colleagues stretched to the brink (and beyond). I look after the babes who have suffered injuries from traumatic births and the odd medical mismanagement so I just can't get it out of my head. My heart goes out to my colleagues as we have similar issues and I know how truly bad things are, and I'm just so sad and scared for myself and can't enjoy my pregnancy :( will gladly support in any way I can but it's so hard to not to feel skeptical and hopeless.

@AliceS1994

I agree that it’s hard not to feel hopeless. I feel hopeless and whilst I am campaigning for change I’m also looking for my exit. I am no longer the midwife I wanted to be and used to be as the system has broken me like it did my colleagues before me.

Horrendous. Pretty much every member of NHS staff I know feels the same as you OP, including my dh (hospital consultant). There aren’t enough of any staffing group, and working with out of date equipment, and not enough equipment (it’s not just staff they are short of), just grinds you down in the end. Dh says repeatedly that he feels like he’s working in the third world.

Threads like these are a terrifying insight into what's happening in the NHS and to the downfall that is immanent. It really is just a matter of when, not if at this point, isn't it?

I gave birth in Denmark and it was a stark comparison to what I hear going on in the UK. They have a similar model(continuity of care), I believe, to what they are trying to push for here...but the difference is, DK only has 5 million people...so it actually works.

I had one midwife assigned to me at booking in and had her right up until my homebirth. I met with two others just incase i happened to go into labour when my midwife was on holiday or Ill. I also had the same midwifery student the entire time. It was an all-round lovely experience. I think giving birth here would tip me over the edge! It all seems so manic and chaotic.

I hope to God you are all listened to as a collective voice. Things cannot go on the way they are, OP. Much love to you all, and thank you for all that you do.

@MissyB1 I can see why your DH feels like that. I’ve often felt the same and yes you are correct it’s not just staff. We are constantly fighting over equipment. Having to say sorry you can’t labour in the pool as we only have 1 waterproof monitor and someone else is using it etc. It’s dire!

@MadameOvary81 The Denmark system is amazing! However yes they have less people. More importantly Denmark spend a higher percentage of GDP on healthcare than the U.K.

Denmark spend a highlighter percentage of their GDP on healthcare*
Yes so do a lot of Countries, that’s one of the main problems, we don’t seem to value or prioritise healthcare anywhere near as much as we should be doing in the UK.
And the state of our nations health is not great, I think that was exposed by the pandemic. I suspect a lot more preventative medicine and tackling poverty / poor living conditions / poor diets might help. Not policies that would be popular with Tory ministers or voters I suspect. Look at bloody Sunak reducing tax on booze! How is that supposed to help? Get everyone drunk so they don’t notice how shit everything is?!

I’m dreading going into hospital to have my baby now in December, my care up until now has been great

[quote Madwife123]@8dpwoah ‘Containing’ you on antenatal ward is staffing. Once you are in labour ward you need 1-1 care. If there are no staff available to care for you we try and keep women off labour ward. Sometimes this means not examining a clearly labouring woman as once you have ‘evidence’ they are in labour you have to move them to labour ward.[/quote]
I did wonder if it might be to do with that (the amount of staff that I ended up having looking after me was pretty big but I guess it was only for an hour while I did the last bit!) and I guess the suggestion of a dose of pethidine would have probably seen me quietly through til shift change had I not been at 6 and counting when they did the pre-jab examination.

As I say I don't blame anyone and the more I think about it the more it was quite a good way to give birth but when distress keeps getting mentioned you do wonder 'what if?' and I'm glad I felt able to argue my point about pain relief when I needed to, I'm sure lots of women wouldn't have felt able to and quietly struggled away in the shower and chomping down the paracetamol. I wasn't allowed the gas and air on antenatal either...glad my waters went really as that sealed the deal!

That's interesting @CovidCorvid

Are the students given psychometric tests at all to see if they will cope with shift work/huge pressure? The retainment odds are so bad but the candidates are there. I wonder if universities should start to look at personality traits as well as grades, but perhaps they already do?

I also think it would be worth considering a midwifery assistant apprenticeship that can be converted if desired. Give a reality for those considering midwifery, add support to the workload of midwives, doesn't cost much.

Such a shame. I've had 3 babies and with 2 I had tremendous care. I don't think there's many, but where I live there is a maternity centre that can also be used for post birth respite. I spent a week there after my third (although I gave birth at the main hospital), I didn't want to leave. Midwives in plain clothes and bring hot chocolates around at 10pm. Mealtimes enjoyed around a central oak table.
I'm just sorry that not everyone has that service.

@PutYourBackIntoit

That's interesting *@CovidCorvid*

Are the students given psychometric tests at all to see if they will cope with shift work/huge pressure? The retainment odds are so bad but the candidates are there. I wonder if universities should start to look at personality traits as well as grades, but perhaps they already do?

I also think it would be worth considering a midwifery assistant apprenticeship that can be converted if desired. Give a reality for those considering midwifery, add support to the workload of midwives, doesn't cost much.

Such a shame. I've had 3 babies and with 2 I had tremendous care. I don't think there's many, but where I live there is a maternity centre that can also be used for post birth respite. I spent a week there after my third (although I gave birth at the main hospital), I didn't want to leave. Midwives in plain clothes and bring hot chocolates around at 10pm. Mealtimes enjoyed around a central oak table.
I'm just sorry that not everyone has that service.

Not pyschometric testing but values based recruitment with a big emphasis on telling people on open days, interviews, etc that the course is full on, hard work, pressured.

There are already midwifery support workers on a band 4 who are supposed to be able to do more than a hcsw. However unlike nursing assistants they’re not on the register. So any work they do still comes under the supervision and pin of a registered midwife….even if that midwife isn’t there. 🤷‍♀️ So you could argue it’s just a way of increasing the midwives workload and stress. Hospitals can use MSWs instead of midwives to make up staffing but the fewer and fewer midwives have to double check what the msw has done as they’re ultimately responsible.