Ockendon review - the end of the cult of "natural" births?

[Frenchie8690]

Shocking findings from the report out today. Hopefully this will mark a sea change in how women are cared for during pregnancy
www.theguardian.com/society/2022/mar/30/baby-deaths-inquiry-shrewsbury-nhs-trust-condemned-for-repeated-failures?CMP=Share_AndroidApp_Other

I was fully given the risks of c sections. Basically heart attack and that the baby could have allergies. These risks were not put in any context but I had done my own research. The risks of vaginsl birth were not mentioned once. As a first time mum of a certain age, my research showed me that I had a significant risk of a bad tear with associated incontinence issues. This was never discussed with me. Surely women deserve an attempt to convey these risk profiles to them? Isn't that the basic we deserve? For my second birth I was sent for a group session discussing the risks of vbac vs a second c section. This session was excellently done proving it is possible to give women the info we need to decide.

@Franca123, not to mention the terrible NHS physio provision if you do get bad birth injuries. I was so lucky we were able to go private.

Indeed. Medium to long term outcomes are not mentioned. I know from my mother that it's common for older women to have urinary incontinence. What is the cause of this? I feared it was labour. But there was no opportunity to discuss those fears. No information was given to me. I was treated like a child essentially and put on the conveyor belt. When I spoke up and challenged, I was talked to in a way that I have never before or since been spoken to. It's not acceptable. We deserve better.

In my grandmother's case it was definitely labour that caused that and many more issues - but then she did have catastrophic injuries. I've always wondered if any of that (easy vs difficult labour, tearing) runs in families.

What I find almost as shocking is that it took many years for anyone to raise the alarm bells!!
Surely people working in this unit ,local coroner ,funeral directors,people working around the hospital WHY WAS IT MISSED FOR SO LONG ,absolutely unbelievable!

@Clockstooforward

What I find almost as shocking is that it took many years for anyone to raise the alarm bells!! Surely people working in this unit ,local coroner ,funeral directors,people working around the hospital WHY WAS IT MISSED FOR SO LONG ,absolutely unbelievable!

We lodged a complaint and received a dismissive letter in return, basically blaming confusion for our memory of DSs birth. Other families got the same response. PALS didn’t want to know that the trust was failing so badly.

Even after I had my EP and they discovered that my bladder was displaced during the crash CS, I was dismissed as a hysterical troublemaker. I cannot stress how bad the service was at every level of gynaecology. We were “lucky”

@Clockstooforward I was talking to my husband about it last night. I think it's a number of factors:

• they were actually singled out for praise in 2002 by the Commons Health Select Commit for their low number of C Sections (11% vs 20% national average) - the wrong things were clearly being emphasized over birth safety; limits on C Section numbers in the NHS were only dropped this year!
• 200 babies dead is a horrific number, but I'm not sure how much it would have raised their mortality numbers in stats over 20 years
• I have no idea if non-lethal injuries to mothers and babies are being counted; I very much doubt much attention is paid to maternal injuries and I'd be surprised if they are part of any targets
• sounds like any investigations into individual cases were cover ups

Somehow it sounds even worse if you think of all this.

@Lissiel0u I'm so sorry. I think so many are still in denial about this. I heard a Professor of Midwifery who sits on a government/ parliamentary advisory panel on Radio 4 last night trying to blame it all on understaffing. The interviewer, Evan Davis, was pushing back but she wasn't having any of it.

Basically the medical profession needs to shut up and listen to female patients.

Women generally are patronised and treated like they know nothing. It’s well recorded GP’s are more likely to take a male patient seriously and refer onwards etc.

I had serious, life threatening complications. Hours of m/w dismissing my pain as “first time mum”, and telling me to take some paracetamol, go for a walk, it’ll help. I couldn’t bloody move the pain was so bad, i was 1cm dilated, not contracting. I sat on a chair for 18 hours not moving as the pain was horrific.

Was two very young medics came to see me raised the alarm. I remember them stood examining the foetal trace, telling me to hold on, then the room being full and seemingly every senior doc in the hospital turning up. I can only thank god it was 9 am on a weekday and they were already in the building. A weekend or out of hours might have had a different ending.

If someone had actually listened to me, or looked at me, and thought hmm, serious constant focal pain, early labour, no contractions, worse on movement, they may have figured it out.

I’m no medic but could have told them it wasn’t labour pain. Even as a first time mum. But no one would listen.

@Lissiel0u….how awful for you .I would be so ashamed if I had any links with that unit. Absolutely shocking and I still cannot understand how it went on for so long @EarlGreywithLemon…I hear what you are saying but considering some MW can go through their whole career without dealing with a maternal or baby death ,I would have thought these statistics are really high . I might be wrong though.

[quote EarlGreywithLemon]@Lissiel0u I'm so sorry. I think so many are still in denial about this. I heard a Professor of Midwifery who sits on a government/ parliamentary advisory panel on Radio 4 last night trying to blame it all on understaffing. The interviewer, Evan Davis, was pushing back but she wasn't having any of it.[/quote]
Understaffing wasn’t the problem, although I’m not surprised that some are trying to pass it off as such. On the night DS was born, just after I passed out, DH found four MWs chatting at the desk. They told him to stop being so dramatic, it was only luck that a passing cons decided to look in.

Sorry, I’ve found the whole report v distressing. A friend of my sisters was a JW and died after haemorrhaging. It was reported that her religion forbade a transfusion but the hospital had stacks of her blood and a cycling machine which the MWs didn’t know how to use.

I’m so bloody angry.

@Clockstooforward I really hope you're right. It would be frightening to think otherwise. It would mean also that someone saw high mortality stats and didn't think they were important!

@Lissiel0u I'm so so sorry! I wasn't even in any way part of it and it still makes me angry. I can't even begin to think how you're feeling. I also feel, somehow, it's not being given quite the attention it deserves. Even on mumsnet I was expecting lots of discussion- there was some, but I thought surprisingly little.

@EarlGreywithLemon I feel the same. I left MN a long time ago and came back for this. But there’s surprisingly little coverage.

@Lissiel0u…I am so desperately sorry for you and your dear friend…absolutely bloody shocking and was obviously so avoidable 💐

@SalsaLove

I read on here several years ago a woman who wrote that it’s a woman’s duty to have a natural childbirth without pain medication. She likened it to men going to war. Apparently childbirth is our battlefield. I remember thinking how barbaric she sounded.

What a stupid analogy, who are we meant to be fighting- ourselves, or the baby?

@sqirrelfriends how about:
“ A large number of women want to avoid pain. Some just don't fancy the pain [of childbirth]. More women should be prepared to withstand pain. Pain in labour is a purposeful, useful thing, which has quite a number of benefits, such as preparing a mother for the responsibility of nurturing a newborn baby."

This is admittedly from 2009, but it comes from a senior midwife and associate professor in midwifery at Nottingham University.
amp.theguardian.com/lifeandstyle/2009/jul/12/pregnancy-pain-natural-birth-yoga

That's such backwards way of thinking. The whole point of progress is to make things easier and better for those who come after us, not to drag our heels and insist everyone has to suffer since that's how it's always been.

just listened to woman's hour on this.
the interview with the minister was

so much avoidable pain and grief

I think people are missing the point here. It isn't about 'natural' vaginal births verus c section births its about recognising when something isn't right and acting on it.

This is what happened again and again at that Trust, not that mothers wanted c sections and were denied.

They were mistakes in care. Failure to listen to mothers. Failure to act on clear signs the baby was in distress. Failure of the most basic kind like not reading the CTGs accurately.

This wasn't about natural births being unsafe, it was about natural births or abnormal signs in pregnancy, not being acted upon.

Please don't make this an argument on natural versus c sections. Both forms of childbirth are safe.

Negligence is just that. A failure to make good professional decisions and judgements.

Its about training, equipment, high staffing ratios, good training, good doctors and good midwives.

I'm 34 weeks pregnant and being pushed towards various interventions incl possibly a c-section which I don't think are supported by evidence in my case. It's out of an abundence of caution (based on poor studies) and just doesn't suit me personally - how I cope with things, my preferences, etc.

It feels like 'the voice of the mother' just doesn't matter. That was a theme at this Trust, but it's a theme in a lot of other places too though perhaps in a different way.

I think another theme is the 'informed choice' thing. Unless you push for info, do your own research, and ask lots of questions, there basically isn't any informed choice. So many places don't seem to volunteer any info at all, or only very selective info that suits their agenda. PPs have mentioned being told all the risks of c-sections but none of the risks of vaginal birth. At my hospital it is the opposite. And good luck breaking risk vs benefit of pretty much any kind of management of labour.

Part of it is because data is so poor and some studies contradict each other. I'm fed up reading NICE reviews that say national guidelines for various things are based on 'low quality' research. I hope this can be improved to give a better evidence base for everyone.

But mostly I think it needs to be about informing women PROPERLY, then supporting their choice. I don't want any kind of birthing ideology imposed on anyone. Give me your professional advice and the benefit of your experience, but then accept that the decision belongs to me.

IMO it's not about c-section vs vaginal, it's about having a system that supports women to the birth that is safe for them and baby, respectful of their individual needs and choices, and which bloody well listens to them.

IMO it's not about c-section vs vaginal, it's about having a system that supports women to the birth that is safe for them and baby, respectful of their individual needs and choices, and which bloody well listens to them.

absolutely

@LittleGwyneth LOL!!!! I did perineal massage religiously as was so worried about tearing. Had a 3rd degree tear. No forceps or anything. Baby was 7lb 4 so not even massive. What a waste of time!

NC for this. I used to be a midwife, am still registered actually but working as a HV. I’ve read the full report & was horrified. Some of the examples are similar to what happened in the trust I worked for. When I worked there bullying was rife. Patient notes were regularly falsified, obstetricians were horrible & unapproachable & no one was ever held to account or investigated. Increasing midwife numbers is not going to happen. It’s just not, unless there is a culture change.