NHS - induction delayed for 5 days, what can I do?

[pimlicopubber]

I was scheduled for a medically indicated induction last Wednesday, but so far, they said they are busy every day and don't have a bed for me!
I have several issues that point towards induction being the best course of action.

From anyone knowledgeable, what are my options here? Can I ask to be moved to another hospital? I always speak to a different midwife and they always say that they will really try to find space next day but are otherwise dismissive.

I understand the midwives are doing their very best and individually can't do anything, but surely this is not an acceptable state of events, speaking to my friends from abroad, it is absolutely unheard of to wait for more than a day and someone must be held responsible for the state of things when it comes maternity care?

When I had my youngest I was scheduled to be induced on the Friday morning. I got a phone call 20 minutes before I was due to go in to hospital stating they had no beds and to wait until they called me. I was called at 6pm and told to come up but never actually got induced until the Tuesday due to emergencies. I received a pessary to try and start my contractions on the Saturday but had to stay in hospital however a friend of mine received a pessary and was able to go home for 24 hours to see what effect it had. Not sure if they can transfer your care to a different hospital but you can ask. Do you have a consultant you can contact rather than the midwife? They may be able to do a bit more for you.

I would put in a call to your consultant tbh. I’m assuming you have one? When I was pregnant with (higher risk due to type) twins I found I was often fobbed off by midwives / computer says no staff. I’d call his secretary and magically they’d find me a spot.

Unfortunately I don't have any contact apart from the email if my midwife team and the triage center.

I'm really worried about no one taking responsibility for this.

Unfortunately I already have a negative birth experience with the NHS, my previous baby was "born before arrival" (unplanned home birth without medical assistance) because the triage line kept telling me to stay at home when I called and wait for contractions to ramp up, but when they ranked up it was too late to go anywhere. Later on I found that they wrote in my notes I was recommended to come in and they wrote it AFTER the baby was already born ... Since the calls to triage are not recorded there was no way to provide what happened.

Unfortunately I don't have a way to contact to consultant, all the bookings go through the admin or midwives but I don't have a named midwife :-/

Should I call triage and ask to be reviewed by a consultant?

What are the reasons for the induction? The NHS induce a great many women for non-urgent reasons so it all depends on why they think you should be induced.

Are you past 40 weeks? How far past? Make sure to discuss the risks to the baby as each day passes. Ask each midwife you speak to- what is the risk to my baby? What will the risk be tomorrow or the day after? Ask to speak to a doctor and have the same conversations with them. Make them spell it out to you. Keep note of what each one says.

Baby being very consistently in the 99+ (99.8) percentile plus GD. They told me they can do a sweep and send me home, but due to previous "born before arrival" baby where I didn't make it to the hospital in time, I feel this could be really unsafe.

Baby already measured 4.4 kg at the last scan, aware the measurements have a margin of error, but risk of shoulder dystocia jumps up for weights over 4.5+.

Not surprised many women prefer to schedule a c section in this situation rather than risk going through the birth process AND then have emergency c-section anyway.

Far more women are being induced now than were five years ago (large babies, women over 41 weeks, more women are having more scans so picking up smaller babies) and unfortunately staffing hasn’t changed to meet the additional demand. When women are induced they are typically on labour ward needing one to one care for longer than women who spontaneously labour. This is a massive system issue which many people have raised concerns about but Trusts have been slow to react because the birth rate itself isn’t going up. Please believe me that this is frustrating for midwives too as they are the public face of a system which they usually have little control over.

In your position, if you have concerns for your or your baby’s wellbeing I would present to triage and ask to speak to the obstetric consultant on duty for the weekend, and it is after all an obstetric decision to induce rather than a midwifery one. They will be able to explain better to you the risks of the delays. What they will not be able to do is magic up a midwife to provide one to one care if there isn’t one. If it wasn’t a bank holiday weekend I’d ask to speak to a senior manager but they won’t be there today.

Once you baby is here write to the Head of Midwifery outlining your concerns, the more people that do this the more leverage they have with the Trust boards to increase their headcount.

and yes you can absolutely ask they they contact other hospitals to see if they have capacity to take you, we do this regularly.

I would, I think it’s important that your concerns are listened too and documented rather than kicked down the road for someone else to deal with. It is rubbish but you need to advocate for yourself and have someone take responsibility.

I would take this as a sign that it's not that urgent, you are being constantly triaged in comparison to others and coming in low priority.

The fact that you had such a quick and efficient labour with your first (I did too!) is amazing and had you planned a home birth you probably would have felt very differently about the experience. The issue of course is not being listened to (ad infinitum).

If you decide to go with the induction make sure they go easy, very slowly up the induction scale, because you labour quickly it could easily go too far and cause uterine hyper stimulation. Make sure they know you have a history of precipitous labour.

Op I would call triage again and remind them there’s a reason they wanted to induce you and tell them how many days past time you are now.

I understand they are up against it and having space to induce and monitor is an issue right now however being in the hospital being monitored once induction has started is still safer than not being there.

good luck op

These days it isn’t safe to assume the decision is well planned or thought through. OP has seen various people.

Thank you, as you say, this is the wrong assumption to make, especially given the maternity mortality numbers in the UK which are not great.

I went into the hospital for an assessment, saw my consultant who was there by chance and who was surprised to see me 4 days after my planned induction date...

She advised to come in for CTG monitoring until they can admit me, but otherwise nothing they can do as they are clogged up.

I at least emailed PALS to have a paper trail and will call them Tuesday morning if nothing happens by then. Of course the doctors and midwife can't do anything individually, and they are doing their best, but the situation with maternity that has to mostly focus on emergency care should not be seen as acceptable.

Would you prefer to have a c section at this point than wait for an induction?

Frm what I've been reading OP, the earlier induction times that are happening across the NHS and in other countries are partly to mitigate (whatever you think of that!) the fact that there is a clear chance that this can happen - as well as other delays.

So it could be that somewhere else you'd be seen quicker but would have gotten a later induction date.

If your team aren't worried it's probably that you have quite a bit of leeway in there as they are super on top of inductions from what I've seen. I would try not to stress although they do lay it on so thick about reasons why induction is needed that I get it's more easily said than done.
Your body will be that bit more ready when you go in too, which makes it more likely to succeed!