Albany Midwives lose contract with Kings - this affects all pregnant women!

[HollyBunda]

Here is a link to the Guardian article about our protest on Saturday. Please share it around and sign the petition.

I was blessed to recieve the care of two wonderful Albany midwives this year and it is shocking what Kings is doing to them.
It's a witch hunt, and once again women and babies are losing out.

Please take some time to help if you can.
This effects all women giving birth in the UK. No matter where you choose to give birth, continuity of care which the Albany offered, is the single most important factor in helping a woman feel confidant and secure during her birth.

Guardian article

www.guardian.co.uk/society/2009/dec/07/albany-midwives-kings-college-hospital

petition

www.gopetition.co.uk/online/32641.html

And if you aren't familiar withe the excellent work the Albany do, check out their website.
There model of care is revered around the world. All women deserve it!

So as mums you need to stand up and be counted. Mums net is a very big organisation. Please stand together and shout very loudly at the people that matter. The government is all about maternal choice (Maternity Matters) and Safety. Parents have the power.

A Midwife

Amen Canugess.

BUMP.

please take some time from your day to sign the petition! Get involved. Change maternity care now.

Press Release - 7th December 2009

SAFETY OF DISADVANTAGED WOMEN AND BABIES IS THREATENED BY KING?S CLOSURE OF THE ALBANY MIDWIFERY PRACTICE

King?s College Hospital has abruptly severed its contract with the Albany Midwifery Practice with no prior consultation with women ? and without proper provision in place to replace the service ? leaving expectant and new mothers in the lurch and anxious about receiving appropriate care.

The Albany Midwifery Practice has been shown to offer the Gold Standard of care to around 200 women in Peckham each year. It provides an outstanding service which enables women to be cared for by a midwife they know. Women who use this service are enabled to make their own decisions about the place to birth. It is unacceptable to withdraw such a safe and much needed service from the poorest women in society.

The Albany Midwives? care has provided women-centred care for women from deeply disadvantaged backgrounds for twelve years. Peckham ranks as the fourteenth most deprived district of 354 districts in England.

The statistics speak for themselves:
Albany Midwifery Practice
Caesarean section rate 14.4%
King?s College Hospital 24.1%

Breastfeeding rates
Albany- 80% at 28 days
Kings- 35% at 7 days (UK 2005)

Perinatal Mortality
Albany- 4.9 per 1000 (1997-2007)
Kings- 7.9 per 1000(England and Wales 2006)
11.4 per 1000 (Southwark 2003-2005)

The Practice offers women a chance to have care from a midwife they know and to have their full attention throughout labour. Between 40% and 50% of these women choose to have their babies at home.

'I feel blessed and truly privileged to have had the Albany midwives care for me during my pregnancy. They are an amazing group who go out of their way to treat their women (and our families) with the care and consideration we deserve during our pregnancies. I know for a fact that I wouldn't have had the confidence to resist an instrumental delivery if I had not been so well informed and supported during my pregnancy and labour. I also know that I wouldn't be the confident mother I am today if I had not met the Albany midwives. They have made a profound impact on my life and if I am blessed with a further pregnancy I wouldn't hesitate in trusting them again with my care.' (Serra)

The Association for Improvements in the Maternity Services is concerned that these women may well find themselves in hospital where one-to-one care in labour is not offered. The Health Care Commission Report showed that over a third of women in King?s were left alone in labour or shortly after birth and were frightened. Already the UK maternal death statistics show that women in these disadvantaged groups are more than six times more likely to die in childbirth. All these deaths took place in hospital.

In order to justify the suspension of the service King?s College Hospital appears to be trying to make the case that the service is unsafe. They have looked at a selected number of Albany cases admitted to their Special Care Baby Unit and asked the Centre for Maternal and Child Enquiries (CMACE) to investigate.

We understand, however, that they have not examined the deaths of babies that have occurred in the King?s unit nor the babies from there who were also admitted to the Special Care Baby Unit. Nor do we have what AIMS believes is crucial data ? comparative rates of mental illness after childbirth, where we believe the Albany is likely to have far better results.

This action mirrors the attempt, in 1985, by obstetricians at The London Hospital to strike off Wendy Savage, a consultant obstetrician, who provided the kind of care that women wanted and who also had a far lower caesarean section rate than her colleagues.

'The suspension of one of the Albany Midwives and cessation of their practice reminds me of my own suspension in 1985. The same intolerance to alternative ways of providing maternity care, despite comparable outcomes for the babies and lower Caesarean section rates, the same technique of selecting cases with adverse outcomes without looking at the overall care, and the same refusal to look at what the women themselves want. I hope that King?s will listen to those who consider this suspension an outrage and reinstate the midwife and the service immediately.?
Wendy Savage MBBCh MSc HonDSc FRCOG

King's has claimed that it has suspended the service because it has the safety of the mothers and babies at heart. The Albany Midwifery Practice has long been acknowledged as a centre of excellence, yet King's management is unwilling to provide this standard of care for more women, and instead is trying to remove it so that women have no choice but to accept medicalised care.

The reality is that King?s College Hospital?s action in withdrawing the Albany Contract has put women and babies at increased risk.

AIMS demands that King?s College Hospital releases the CMACE Report and the comparable statistics for its own consultant unit so that data from both services can be examined objectively.

Contact: Beverley Beech, Email: [email protected]
Phone: 020-8390-9534

www.savethealbany.org.uk
AlbanyMums on Facebook
www.gopetition.co.uk/online/32641.html

From the Guardian article:

"But King's says babies delivered by Albany midwives had higher rates of hypoxic ischaemic encephalopathy ? brain damage caused by lack of oxygen and lack of blood flow to the brain ? than those delivered by midwives it employs directly over the last two and a half years."

Is this completely untrue, then?

You'd need to see all the statistics properly evaluated first, wouldn't you? It does sound from the Guardian article that it might be a bit of a knee-jerk reaction from one death; otoh it is possible that this death was genuinely due to malpractice; impossible to know from just reading the article. I'd want to know how much higher the brain damage rates were, how many births we're talking about, and if there are any other differences.

I'd also want to see what criteria were used to select which women got to use the Albany MW service

The Albany has a catchment area AND a waiting list, but they do take on desperate women who have had terrible care before if they can.
You also have to remember that the catchment area is a highly deprived area and they may be dealing with women who don't speak english, have little education or resources.
Some women who don't or don't know how to take care of themselves properly, let alone a baby.
They do the very best they can for these women under a lot of pressure form KIngs.

My midwife was involved in the case they are quoting, I find it impossible to believe that there was genuine malpractice on her part, I really do.
She was competent, caring, supportive, and most of all completely informative. She spent hours and hours with me, and even though I had had two pregnancies/births previous, one of our meetings was the 'birth talk'. It took two hours and she completely explained everything that happens during labour and answered any questions or concerns I might have.
I was truly impressed with that meeting alone.

I had 'care' from Kings midwives in 2005 and their level of attention was shocking.
I was forgotten by them and made to feel like a nuisence when I was in labour.
My care using Albany midwives is what every women deserves.

Then again, I did not have midwife led unit care because my hospital realised I might be at risk- I was monitored regularly on one of the big machines - this was how they detected that ds's heartrate was going right down- otherwise they wouldn't have known- ds is still alive- unlike this poor woman's baby. Which to me is more important than whether I was made to feel a nuisance or not. Not even the nicest of midwives or the most comfortable labour could have compensated me if they had failed to spot that ds was in serious trouble.

There isn't enough information to go on in this case. I'd want to see those brain damage statistics first, fully analysed with all possible other risk factors accounted for, and also all the other statistics pertaining to infant death or injury and maternal death and injury. Agree that King's need to be more open. But won't necessarily sign the petition until I know that they are wrong.

"serious shortcomings in terms of non-compliance with trust policies and risk management procedures" seems a good enough reason to suspend their contract to me

I suppose the way I'm looking at it is, if I'd been in that woman's position (encouraged to have water birth, only monitored with hand held device, failure to spot change in heartrate), then I might well have had a wonderful experience with a caring and supportive midwife, but ds would almost certainly be dead.

As it is, I had a very hospitalised labour, which certainly did have some inconveniences (first midwife was a cow, but fortunately came off her shift quickly)- but time rolls on, 9 years later it is more important to have a healthy thriving boy than to remember a midwife fondly.

Noone is questioning the rights of women to have as natural a birth as they can, but it does seem possible at least that in some of these cases, the desire for a natural birth did over-ride other considerations- and I'm very glad that didn't happen to me.

The ideal solution would be if Kings and the Albany midwives could have come to some sort of agreement as to how safety procedures were to be implemented/monitored in cases where there might be cause for concern.

Ok, I've been wondering whether to post on this thread or not. But have decided to do so as I believe that this is very sad news.

I was on the waiting list for an Albany birth as I was keen on a home birth and kings has a number of community group practices which is why they have such a high home birth rate overall. Due to the waiting list I ended up with the equally brilliant Oakwood midwives.

Sadly, my son died from brain damage caused by to a lack of oxygen during labour that went undetected during his labour during a very swift home birth ( with complications of a shoulder dystocia and possible GBS).

However, I truly do not believe, having had an inquest into his death and spoken extensively to birth the obstetricians at kings, that the outcome would have been any different had been in hospital as I was very low risk and no sign of distress were indicated by ds. I do know that I had the most brilliant care, with two midwives with me throughout the process, monitoring his heartbeat after every push in my relatively long second stage of labour.

Now indications may have been apparent had I been strapped to a monitor at all times, however no one would have suggested that, even if I was in hospital, as there was no obvious reason for me to be.

Of course there are, and will always be the "What if?" questions. But I actually feel that we were in many ways privileged to have a week with our son and believe that this was entirely due to the high quality midwifery that relieved my son from a very bad shoulder dystocia as quickly as they did.

Now, this is not the Albany practice as I have said, but one who work on a very similar model for the same hospital and offer the same quality of care.
I would be devastated if our tragic outcome resulted in the unnecessary over medicalisation of other womens births, which in itself has its own possible complications.

This time round I will be having an elective c-section. However I am under the care of the same brilliant team of midwives.

Obviously we do not all know all of the facts over the termination of the contract between the albany and kings, but I do think that it is a very sad turn of events.

Dear All,

I am very sad by this news. I am a Kings midwife, working in hospital. It is true to say that women are very often not getting one to one care, or continuity in hospital. All the community teams at Kings offer a higher level of continuity than the hospital, and if I was having another baby, I would definitely opt for community care. I would probably book for a homebirth, and then at least, if I was tired and needed transferring, I would have the same midwifes following me into hospital.

yangymac : I am sorry to hear your story, and actually, we do routinely test cord ph at birth, in the hospital. This can give an indication of any lack of oxygen. We do not normally test for blood sugar at birth, and unless there is a medical indication, this is not always helpful. I am sorry to hear that your baby's blood sugar was "dangerously low". I hope this issue was resolved. Routine early testing blood sugar is actually contraindicated. What we should do, in every case, and wherever possible is to initiate early breastfeeding. This alone would help to stabilise blood sugar, and provide the babies with the vital nutrients they need following birth.

As for the Albany team, I will wait to read the statistics, and any reports published to make any comment. I have worked with these midwives, and found them to be giving an excellent service to women in their care. I hope and pray that this does not spell the end of woman-centred midwifery care, or give license to obstetric-led care for all women. Women should be listened to and respected and all care should be centred around them. From my experience at Kings, I know that the Albany and other group practices have succeeded in achieving this goal. Perhaps the focus should be the risk management criteria, and having a higher level of scrutiny on cases of concern rather than to throw away a model of care which has been much loved by women for over a decade. This is no victory.

WE are in total sympathy with your plight in the United Kingdom.
Thousands of Australian mums and dads with children (the most powerful force - who frighten politicians)and midwives - (the invisible ones who do not DO anything to labouring women they mostly work with them using masterly inactivity) have just been through the wringer (as in clothes wringer). We have just with astounding energy gone through the tough process of re-educating some of our influential politicians who have been conned into believing the distortion of statistics and manipulation of their minds by erstwhile pretenders to the throne of midwifery.

I am a midwife of 5O years and will remain one until I die. I have a Masters in Bioethics taken up because of observation of unethical and dangerous practices in hospitals which caused distress to those who respect the ability of womens' bodies to birth. I was a Senior Lecturer and co-ordinator of the Midwifery Course at RMIT University in Melbourne Victoria Australia. Midwifery students were placed with home birth midwives.

I am a successful campaigner, mother of 4 I birthed on my back pushing up against gravity as our men of science dictated, grandmother of 7 (induction free except first one had gel and ruptured membranes in 1995 because his other grandmother had to come back from Perth to Melbourne for business reasons grr. permanent tremor probably from the resulting cone head outcome of aggressive induction of birth.

Currently we are suffering from a push by pompous patriarchal patronising obstetricians who are at the head of the AMA and RANZCOG. The Medical Journal of Australia has just published research. the editorial and synopsis is unprofessional. The research method would fail most advanced research student. This provocative attempt to smear home birth practices in South Australia will be used by the media to assist the attack on professional registered midwives. Most of our midwives have matured professionally and practically. Midwives and (pregnant) women have raced ahead in research methodology unlike our erstwhile pretenders who are out of date and out of touch with how credible research is done.

Wow Bevmid, I wish we had a few more midwives like you who would speak out about what's happening, aa a journalist I wrote and am now involved in the campaign to Save the Albany - and had a helluva time getting the message acroos.

Have blogged about the process - in the first article which gave some of the highly dubious statistics in the report used to terminate the contract with Albany. Blog is hereYou will have to flip the thread to read from the beginning.

It turns out that King's is actually in breach of the law by terminating the contract WITHOUT patient consultation. Even if they used the notion of "patient safety" - suspension would have been enough while they got to the bottom of it.

So the campaign is by no means over, in fact it is just beginning. And there is going to be a big March on March 7th - appropriately from the Imperial War Museum. Can't you send over some Oz Mids to join us.