Maternity care - spooked by BBC article

[Yazoop]

hi all,

it is still a while to go for me (13weeks) but have been a bit spooked by today’s BBC coverage about maternity care and shortage of midwives: quit over 'unsafe care' and staffing www.bbc.co.uk/news/health-67732916 Here

It prompted me to double check my current maternity unit’s CQC report and found out has recently been downgraded to “inadequate” - when I first signed up for care it was rated “good” so has fallen quite a bit!

Regarding NHS hospitals, there is only one other nearby which is also “inadequate” - others are a bit further afield (I’m in London) and don’t make sense really if I need to get there in a hurry. Feel a bit stuck / worried - and particularly anxious as I’ve tried for years to have a baby and feel this might be my last shot. So stories of increased stillbirths etc are incredibly concerning. could consider possibly shelling out for private birth but not sure if worth it, or if a suitable place nearby (and angry to have to contemplate this as a supporter of the NHS)

is anyone also concerned about this? Probably overthinking a little - my antenatal care has been fine so far and facilities seem good. Maybe I just need to be extra vigilant. But feels like more and more maternity units are under massive strain.

Maternity units are really underfunded at the min and it's awful that the staff and mothers and babies are suffering because of it.

I'm sorry this has scared you.

I think I'd be on the other side of it. If the rating has changed recently, it means there's been a recent inspection and I would hope that result would trigger a lot of reviewing of processes, staffing, training etc. It might be the very best time for care. Would you consider a birth partner or even a private support, douala, midwife?

Good luck either way.

Yeah it's bad tbh, I feel like you have to be really lucky to get good care. My midwife was really nice but almost completely useless, she never remembered anything about me, constantly cancelled appts and was literally never contactable. Every time I asked why she just said 'oh my phone's been playing up'. My friend had the same midwife 2 years later and she said the exact same thing to her. I was pretty cross about this. I understand there is a shortage and I'm incredibly supportive of the nhs but having a baby is scary and sometimes you feel really out of control.

I'm not sure going private would be a massive improvement tbh, it's only a benefit if it goes smoothly or else you'll end up in hospital anyway. I would say just be really clear and really firm with everyone you see. I'm sure it'll be absolutely fine but if you feel like you're not receiving good care then make your voice heard. Ask to be shown around the birth unit, meet the nurses and doctors. Do whatever it takes to make you feel more comfortable.

If you have the money for a private birth, I'd also consider instead hiring a very experienced doula/birth supporter so that you have someone knowledgable who will stay with you the whole time and advocate on your behalf.

I've just checked the 3 hospitals that offer maternity care in my area, 2 are inadequate and 1 requires improvement. I can see why you're worried OP. I'd go for the one with the best safety rating if there is anything in it?

Honestly, I was terrified after reading threads on here and my local maternity being downgraded to inadequate.

However I gave birth two weeks ago and the level of care was brilliant. Yes the wards were busy and there was a wait for the delivery suite (I was induced) but every member of staff was professional, friendly and I felt extremely well cared for. All my ‘buzzes’ on the ward were answered quickly and the midwives took lots of time to help me with feeding and getting up and about post emergency c section. They looked after my baby whilst I showered and made sure I understood all the medical procedures being offered throughout the whole induction / c section process and afterwards.

I really shouldn’t have worried - it really loomed over me during pregnancy and I considered going private / using a doula but it really wasn’t necessary.

The only complaint was a lengthy wait for discharge because of skeleton staff in the pharmacy, but it was Boxing Day so understandable.

Yeah to be honest, I read this today and was put off by this. Luckily if I choose I have the option to give birth abroad, I think I will decide based on my friend's experience. One had a baby last year via Cesarian and they left her to the very last minute to admit her to the procedure, she had an infection in it afterwards. Now I will have another friend giving birth any day now in a hospital that I have my hopes up for, if she has a poor experience then I might actually opt for giving birth abroad.

There is a massive staffing crisis in midwifery - this is not new but its really beginning to bite. CQC is merrily downgrading maternity units all over the place but it's not very helpful as, realistically, massive investment is needed to turn it around.

That being said, it is a good sign that you are happy with your care so far. Maternity units usually prioritise safety in labour and birth, but I can't lie to you - postnatal care is a bit grim, specially in London. Fingers crossed you get to go home quickly!

I work in the field and I think maternity services are not in a good place right now. But the vast majority of women still have safe and straightforward births and take home a healthy baby. Midwives take safety incredibly seriously.

What hospital are you considering, if you don't mind telling us?

Thanks everyone - really appreciate all your thoughts on this. I think I will make the best of it - but just really do my homework on the birthing unit etc - everyone at the hospital that I’ve dealt with so far has been lovely.

It definitely isn’t a comment on staff and more the big structural issues that seem to be prevalent in maternity care at the moment. I’m anxious in general about so much at the moment!

@Ketzele it’s North Middlesex.

Yazoop, there are some London units I would take pains to avoid. N Midd is not one of them. Best of luck.

I gave birth at Barnet Hospital in Aug. Their maternity care is very good in my view. Think they are rated good by CQC as well. Yes they are busy and sometimes logistics can be a bit messy but the staff are all very nice and show great care and empathy. I was under consultant care for gestational diabetes. They let me choose between induction and c section. I also worried about all the issues of NHS so I went for a planned c section. All went smoothly.

North midd is going to be fine. Barnet is also actually good (This is based on experience in 21/22 and 2nd half this year... )

I had some dealings with RF recently in my 2nd pregnancy and thought they were a total shit show tbh. A Dr in Barnet told me separately Royal free is so bad they are pretty much about to close it.

Re Barnet
I am fussy and couldn't really fault their prenatal care either time. Really helpful despite always being busy
On the ward day nurses were good, Night shift midwives were fucking horrible but that's potluck 🤷‍♀️

What I found is:

• when you need it generally the "system works"
• If you do have a complicated pregnancy you help them and yourself being advocating for yourself and asking questions. I pre-prepared all mine.
• for the birth itself I opted for ELCS and the midwife crisis was one of many reasons why- the uncertainty of not knowing what would happen and help would be available in labour made me feel very panicky/uneasy

Thanks all! I’ll check out Barnet’s birthing centre though it is quite far from me - and it looks like an interim assessment has recently downgraded it to “requires improvement”. Feels like so many maternity units have been downgraded, I guess staff shortages and funding must be part of that.

If you can afford it go for an independent midwife. You will get one to one care and if you don’t want a homebirth- they have arrangements with hospitals where they can be your primary carer. The situation is dire at the moment- I had my youngest 20 years ago and even then opted for homebirth as unhappy about procedures in hospital.

It worries me too OP. Maternity care is so so important for women and their babies.

In my case, I had an ectopic pregnancy which ruptured two years ago and I had emergency surgery to save my life. I have chosen the same hospital to give birth in. I could see how under pressure they were that day but they acted quickly - I was in theatre within an hour of the scan which showed the internal bleeding. I also had good care there when I had a miscarriage last year.

So far I am pleased with my care (currently 19 weeks). Both midwives I've seen are good. The obstetrician is good. So were the sonographers at my 12 week scan and all the EPU staff for the 5 and 7 week scans I had due to the previous ectopic. It's a good start and sounds like you have similarly had good initial care.

Are you going to do a tour of the maternity unit at your hospital? It may help to meet some staff in advance.

@DemelzaRobins so sorry you had to go through that, but glad you got good care and came out of it ok! I’m still fairly early on (13 weeks) but will go for a tour of the maternity unit when possible (think they encourage this a bit further down the line)

I loved my private midwife, despite my home birth not going to plan and her needing to leave me at the hospital after a transfer (baby was born via forceps and I was only allowed one person with me, so it was hubby) I believe she was the #1 reason I coped so well with the pain.

I felt empowered, not at all traumatized despite being blue lighted in an ambulance, and so well informed throughout my pregnancy and early post partum. I just needed to send her a WhatsApp message when I needed her, even at middle of the night. She was amazing.

For what it's worth, there's a hospital near me that was under investigation recently and everyone I know who birthed there during the investigation had nothing bad to say. Almost as if they were consciously trying to be better.

Completely understand your concerns. I'm having my first baby.
My hospital has a shortage of midwives , emergency surgery suspended. Consultants threatening to walk out and last year the nicu unit had to close due to no staff. They also have a lack of nicu beds. Only 2. I'm absolutely terrified of when the time comes to give birth.
I just want to to give place in an environment where I know both myself and my baby will be safe