Yet another maternity scandal in the NHS

[MoltenLasagne]

Today there are reports on the outcome of the review into yet another NHS maternity scandal, this time at Shrewsbury and Telford hospitals.

The themes are horribly reminiscent of previous scandals - women not listened to, warning signs missed, c sections refused when they should have been the course of action. Then to add insult to gravest of injuries, mothers blamed for staff failings, intentional cover ups and bereaved parents having to fight for the truth.

This feels to me very much like a feminist issue. Also, hearing from friends who have had babies this year how much they have felt abandoned both during labour and by health visitors once home, I'm worried we have yet another scandal brewing.

These are truly shocking reports. This has been going on for longer in different places. The NHS appears to have been more worried about pronouns than training and recruiting staff . From the report on woman’s hour it sounded as though women were demanding Caesarian sections on a whim and being refused even in cases where they might be necessary.. 40 plus years ago I was not happy about the use of forceps but realised they were necessary to save my daughter.

I'm not at all surprised by any of this tragic mess. Everyone knows there aren't enough resources and our figures are a disgrace for a rich, medically advanced nation.

I had a planned C section partly because I didn't trust the midwives to find a doctor in a timely fashion and it was August-worst time to have anything done in a hospital anyway as consultants are away and junior doctors are fresh in (women were giving birth in foyers turned into delivery rooms). I think they take planned surgeri more seriously than vaginal birth-you can't be left to have a c section on your own.

How dare they blame mothers for the deaths of their babies The absolute monsters.

Also, hearing from friends who have had babies this year how much they have felt abandoned both during labour and by health visitors once home, I'm worried we have yet another scandal brewing.

I think you are right. There is already evidence that this is happening, it' being reported in the media and it is sickening that nobody is listening. My own DD had a very problematic pregnancy and birth. She had to sit in A&E, 3 times, during the second trimester, whilst bleeding heavily, then go for scans, all on her own. Luckily the pregnancy continued. But then a major issue was not spotted during any of the 10 scans she had throughout pregnancy, which resulted in a crash CSection. Luckily baby is here and all is well. DD and SIL are traumatised. I cannot believe this negligence of women is still going on in 2020. I don't Covid can excuse the incompetence.

Shrewsbury was always known as having high rates of vaginal breech birth when the rest of the country had moved to CS so perhaps not terribly surprising (nothing wrong with vaginal breech birth if chosen by the mother, risk assessed and well planned but not as an only option )

I think monitoring maternity services by their CS rates is contributing to a culture not of ‘normal birth’ but of ‘anything but CS’ and not recognising that non CS births can be and often are more dangerous and traumatic than a CS.

I wanted a normal birth but I had in my own birth plan that if I wanted a CS at any point then I wanted one without quibbling. I was happy to have a vaginal birth I accepted forceps etc might even be necessary in some situations but I didn’t want the long dragged out labour, try everything, push fetal distress as far as possible and then do forceps. That is what is dangerous.

Birth isn’t a place for ideologies among professionals in a government funded health service. It’s a place for as safe as possible care for mothers and babies and listening to what women want as individuals.

I'm sorry to hear about your DD's experience Lizzie. What a scary start to motherhood.

A friend of mine also had an emergency c section, this after being left to labour on her own for hours because they said she wasn't far enough along. Suddenly they were bringing her husband in as they were rushing her to theatre.

Another friend had a normal birth experience but had awful experience of her baby getting sick after with no HV visits. They'd been told to try to guess at baby's weight to monitor if he was improving which lead to doctors in the hospital struggling to know treatment options because of lack of records.

I've also heard anecdotal evidence that birth injuries are increasing because of this policy of leaving mothers on their own. It sounds like a very scary time to be pregnant and makes me wonder what lessons we'll be saying need to be learnt next.

lPl
,z

yep, you get what you measure. if you measure for low rates of c-sections then that is what you'll get, regardless of the effects on mothers and babies

the news reports on this have been harrowing

and yes, it is a feminist issue. dealing with medical professionals while pregnant shocked the life out of me. i've never had a problem making my wishes known, and yet all of a sudden it felt like no one could hear me

Reading between the lines, and from listening to Jeremy Hunt yesterday, I am guessing that there was one or more very senior person in the department who had a bee in their bonnet (s) about avoiding CS at any cost.
This is increasingly rare these days because of evidence based practice and the green top guidelines. It is easier for junior staff not to be compelled to pander to unsafe foibles, but I can see how it could happen.

Yes, of course this is absolutely a feminist issue.

I saw this in the news and was thoroughly saddened and depressed by it. My thoughts with the mothers who've lost babies, and the women who have died.

At root, the problem is how women are seen and treated - that they are not respected, not listened to and not cared for, despite various drives to try and do that because everyone knows it massively improves outcomes for mothers, babies and families. Of course this leads to PND, PTSD, etc.

It's shocking how bad some maternity provision is. I would go so far as to call it actively harmful and abusive. (I've also experienced excellent woman-centred care, so I know that it's possible and does exist in some trusts.)

From the sound of it, Covid precautions led to some absolutely inhuman situations.

yep, you get what you measure. if you measure for low rates of c-sections then that is what you'll get, regardless of the effects on mothers and babies

Yes, what they should measure is outcomes not processes. In the case of S&T, the outcomes were dead babies, but they were too busy boasting about their low c-section rate for anyone to notice.

So much wrong with what was happening at S&T - failure of midwives to escalate to obstetricians, failure to warn mothers of risk in transferring from MLU to hospital, inability to read CTG trace correctly, misuse of oxytocin, altering medical notes after the event, blaming women for their babies' deaths...I could go on. Absolutely disgraceful. In any other situation where there were this many deaths, people would do something about it but apparently in maternity no one cares.

And none of it picked up by the regulator who are, frankly, worse than useless.

I heard the dad of baby kate on radio 5 live this morning. His wife and he and one other family had fought to get this to Jeremy Hunt. They collected 23 family’s evidence and presented it and he opened the enquiry.... within weeks it was over 600 cases and ended up in thousands.
I’m not a very emotional person but as he spoke about what happened to his wife and daughter in the hours and days after her birth I felt physically sick and I welled up.
I despair at governments (of all sides) at times and their insistence arbitrarily measures that encourage all the wrong behaviors but that said, the behaviour of a couple of the midwifes was shocking. And when he described having to phone round Birmingham hospitals trying to find out which one had his daughter it was just unbearable.

The sister of a friend's partner died this year after giving birth.

She endured an insanely long labour (iirc around 40 hours) and was denied a CS. She died a day later.

I was astonished when I heard about it. I don't know how much of this is because Covid has fucked everything, but it's frankly an absolute scandal that maternal mortality is happening at all in a country with supposedly advanced healthcare.

The stories from this enquiry have been shameful. Sadly too many women (including myself) have dismal stories of poor quality care, bullying of women and downright dangerous practice. Maternity care has proved time after time to be inadequately funded and too often staffed by poorly trained staff lacking in understanding and empathy. It's a tragedy and must be awful for all the well trained caring staff to see scandal after scandal being reported.

Not strictly on this heartbreaking story...

Generally though I think that the Conservative government have deliberately starved the NHS of funds leading to understaffing and inadequate ongoing training. The idea being to run down the NHS so they can say it is not fit for purpose/those who can pay give up and go private. Although private options for maternity care are limited the NHS as a whole has been seriously underfunded which impacts on all areas.

Not so long ago any mother having a Caesarean section would be in hospital for 5-7 days being looked after and supported. After a normal birth in hospital a mum would be in for 2-3 days and could elect to stay in a midwife led unit to rest and recover for up to a week if she chose to.

Community midwives used to visit daily for the first week, and at least three times in the second week, more if required. Then at least once usually to sign off in the third week. Midwives could continue to visit mums up to 28 days after the birth of a baby if they felt that a mum and/or baby needed it.

We need more midwives who have more time to spend with women and more care assistants to support midwives.

Best practice is impossible in a situation of constant crisis.

With enough midwives we could have a caseload system for those midwives who want to practice that way. Mothers and midwives both benefit from such a system where a relationship can be established during pregnancy and care can be tailored to women’s particular needs and circumstances.

That is horrific.
Even the person I worked with who was an awful bully to the staff was kind to the mums.

I read about this in The Times today. Well done to those brave, tenacious parents who didn't put up with being blamed for their own babies' deaths and collated evidence. I see the people running the show in both cases failed upwards into consultant type roles. Sick.

This is awful. The NHS treats women appallingly and has done for years. Particularly young mothers.

I was left for far too long with my first (over 2 days) when I was young. It took my mum marching to hospital and demanding they listened to me for them to realise baby was in severe distress, I was in theatre 5 mins later. Whilst in theatre I told them the anaesthetic wasn’t working and I was screaming because I could feel everything, they called me a baby. I kicked the surgeon. I ended up in intensive care and baby.

Even all these years later I desperately wish I’d complained.

They don’t listen. Funnily enough with all of my subsequent babies, when I was older, I was treated with far more respect.

It’s not just about funds. It’s about staff - well paid ones - who don’t care and who close ranks. The NHS is such a sacred cow. Parts of it are rotten to the core but no one dare criticise it. I worked there and saw for myself: the bullying, the cliques (often based on nationality) and the doctors who thought they were god .

@RoyalCorgi

yep, you get what you measure. if you measure for low rates of c-sections then that is what you'll get, regardless of the effects on mothers and babies

Yes, what they should measure is outcomes not processes. In the case of S&T, the outcomes were dead babies, but they were too busy boasting about their low c-section rate for anyone to notice.

So much wrong with what was happening at S&T - failure of midwives to escalate to obstetricians, failure to warn mothers of risk in transferring from MLU to hospital, inability to read CTG trace correctly, misuse of oxytocin, altering medical notes after the event, blaming women for their babies' deaths...I could go on. Absolutely disgraceful. In any other situation where there were this many deaths, people would do something about it but apparently in maternity no one cares.

And none of it picked up by the regulator who are, frankly, worse than useless.

So depressing. And upsetting.

And when they look at outcomes, I wish they'd look further in. Look at the lifelong issues women are left with because they had risky "natural births". Trauma, injuries, incontinence, PTSD, PND, etc.

But they never do. We're not encouraged to raise birth injury issues afterwards, just expected to shut up and get on with it and 'aren't you happy you got a baby out of it all, be grateful and stop complaining'.

The interview on R4 Today this morning with the woman whose poorly baby died in her arms at home was harrowing. I was crying for her when I pulled into the car park at work. The losses these families have experienced are heartbreaking. 😞 As someone said upthread, their tenacity in pursuing this is humbling.

At root, the problem is how women are seen and treated - that they are not respected, not listened to and not cared for, despite various drives to try and do that because everyone knows it massively improves outcomes for mothers, babies and families. Of course this leads to PND, PTSD, etc.

I completely agree with this. Of all the experiences I've had with medical care maternity was the only one where I was completely ignored and told that I was just not feeling what I said I was. I was told off like a school child for coming in, shouted at for not lying still enough for the CTG, told that I didn't need to push, that 'you'll know when you do and you'll realise then how silly you're being now' and left to labour alone in a triage ward (without the curtains even drawn) for two hours until DH finally convinced someone to examine me and they finally realised that DS was near crowning and rushed me to a labour room, he was born 20 minutes later. I think it's probably why I tore so badly, and it really scares me looking back because it was classified as a high risk pregnancy, I was told that I had to be monitored throughout and so wasn't eligible for a water birth, and then in practice was left completely alone until that last 20 minutes (and if I'd listened to them I'd still have been at home then).

Eight months later I had to have (minor, but under GA) exploratory surgery for suspected cancer and the contrast in how I was spoken to, treated, attitudes to pain killers, etc. really brought home that it wasn't the hospital or the NHS, it was specifically maternity services that had the attitude that you don't need to listen to the patient. Absolutely I think it's a feminist issue.

It's horrific. I don't have children so it's not like it's just something mum's find horrific. Yet again it's women not being listened to. I heard a mum of a baby who died talking on radio 4 this morning. I was sobbing listening to it. I was also fucking furious. Yet it keeps happening.

Plussize - I think we must have listened to the same interview.

Friends of mine who work in the NHS in other areas were shocked at how they were treated as a labouring mother. And they were probably treated a lot better than average being medics and therefore more knowledgeable. My latest friends who have had awful treatment during Covid are all a lot younger and working class which I'm certain will have exacerbated bad treatment.

Its just stories I hear time and again, even from women who are fortunate enough to be assertive and have comparatively easy labours. It makes me feel angry, scared and hopeless. What on earth can we do?