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.

This is just awful. When I think how hard I used to work, the shifts when I ended up staying for 18 hours or more so I could deliver a lady who needed me. We had a lot of military families, prisoners from the local prison, women who had nobody to stay with them. We tried to be supportive and kind to the women in our care.
I remember a lovely man sharing his sandwiches with me because I wouldn't leave to have a break.
When did it all get so bad?
I have a box of cards and letters from women I cared for; I have kept them for 40 years.

Yep, that is my experience of the NHS maternity services - try to avoid c section at any cost, no listening to the mother, little kindness. I am sure it is understaffed, but there is still no excuse for treating women like this.

NC as outing, but I personally nearly died there in childbirth this year and am entirely unsurprised.

It's really sobering and distressing to read these reports (sadly, again and again) as a midwife. I absolutely agree that women are not listened to. It's exhausting to be pregnant and feel like you are fighting a battle (I felt like this in my first pregnancy, and I was a midwife at the time!

My personal opinion is that the entire system is misogynistic. I don't believe that any midwife goes into the job not caring. Everyone starts out wanting to do their best for women. What I think happens, is that midwives go into a system where they are eventually beaten down- overworked, undervalued and underpaid. In some units, those conditions lead to a toxic culture of lateral violence, which is what always happens between people at the bottom of the system. That lateral violence between midwives spills over into lateral violence against patients. It's terrible, but actually not that surprising in a system that is underfunded and set up all wrong.

The best outcomes are achieved when women are listened to, informed and in control of their care. There is so much gatekeeping, both of Caesarean section on one hand, but also of low intervention birth on the other hand. I agree with the OP who said we need fundamental reshaping of services including continuity of care schemes, which we know lead to better outcomes. We have all the data to prove that! Unfortunately it is exhausting being a caseloading midwife (it brought me to my knees while also caring for a young family so I had to step back) but I think it's one of the key elements in improving the mess we're in.

@sockywock

NC as outing, but I personally nearly died there in childbirth this year and am entirely unsurprised.

I'm so sorry to hear this socky. Clearly lessons are not being learnt fast enough.

Women like me, staying silent, saves the successive UK governments multi-millions when we don't sue.

However, after many years, we start to use our £ and voices to 'throw in' with other girls and women.

@boatyardblues

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

Yeah I was driving to the garage to drop my car. I thought I'm gonna arrive in a state! I thought she was amazingly composed. She really did a good service to her daughter to be able to tell her story.

It was just heartbreaking.

My personal negative birthing case introduced a specific positive system to our area in the UK.

I think that's a really powerful and insightful post @teezletangler, thank you for it. I've read that the evidence is strong for more continuity of care but I don't see it how could be achieved without much more money in the system (or banning midwives from taking holiday or having their own lives...)

@lady69

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 .

I agree. I gave birth in Shrewsbury in 2007. Their desire to avoid CSs was insane. I got off "lightly" with my injuries and my daughter's injuries (I can still see the scars on her face and head 13 years later).

My husband still cries when recalling the birth, he found it so traumatic. When they pulled with the forceps they pulled my whole body down the bed and he had to hold onto me and wedge his foot against the wall to keep me from being pulled onto the floor.

People who enabled the culture and practice there should be prosecuted.

Privatisation is one thing, but please God not the American system. I worked in a posh private hospital in the USA and saw more serious birth injuries there in a year than in 5 years in the UK.

@MoltenLasagne thank you. Just read the report and the overuse of oxytocin, lack of compassion (not from, in my personal case, midwives but consultants/registrars) and allowing a long labour to avoid section at any cost are all very familiar to my experience this summer. Cannot believe that lessons are still not being learned here.

I lost 3 litres of blood in a severe haemorrhage during a crash section under GA. Had several transfusions. Had an extreme fever and acute kidney injury. Was kept sedated for so long afterwards I didn't meet my DC until the next day and I was so out of it on morphine I don't even remember it. Have flashbacks of the moment I came round and PTSD. The review was ongoing then and still no learning. Wonder whether I should say something?

I didn't get the growth scans I needed thanks to Covid either. I even questioned this. My baby was 10lbs. I measured on the 99th percentile and should've received regular growth scans.

I gave birth twice in t&s hospitals, in the past 5 years. I think the women and families who have come forward and pushed for this review have a strength and a dignity that is so humbling. I knew it was rumbling when I had my son, the local papers had been covering the efforts of the families to get the inquiry heard, so it was pretty worrying knowing that I was going to be giving birth there. My care, however, was good on the whole, and at times excellent. The staff were truly wonderful, and in both cases I generally felt listened to and respected. I can only hope that my experience becomes the norm. No one should have to cope with what these families went through.

I know that some of the local mlu units have now been closed, and at telford hospital a brand new mlu has been set up right next to the consultant unit, which will make for quicker transfers. Of course none of that makes a difference unless the culture itself changes. But I deeply hope that these lessons will be learned, and quickly too.

@katmarie I did find the midwives there provided compassionate and wonderful care there, with the odd exception. But consultant decisions rule, which I think contributed to my experience.

@teezletangler

It must be very distressing for you.

In my experience, it is getting worse - am pregnant again and the younger midwives are so pushy about me trying a VBAC and keep saying things that are biased and/or not supportable with evidence (like "having had one big baby doesn't make any difference to the the second one being big" - well, no it doesn't guarantee a big baby but as there is a strong correlation, noted in all scientific papers I have read on the subject of larger babies, it's probably a good thought to factor this in to our thinking, no?! Why venture a view that is at odds with the ducking science?!). The older midwives who have had kids are SO much more supportive and pragmatic, but they are often the ones working in the community and then the younger ones are in the hospitals, so in my view this is one reason why the cycle continues.

My (young) midwives the first time around couldn't tell that the baby was stuck and would not descend and initially refused me access to a consultant to discuss when I knew some hing was wrong and I was dismissed because they thought I was in transition and just being negative about what my body was capable of. I was continuously gaslit and shamed. Once I had access to a consultant, they were immediately overruled. Then, they gave me the cold shoulder after my emergency section, didn't check on me at all, then came in to berate me for falling asleep for an hour (hadn't slept in 3 days) rather than feeding" ("you could have killed your baby"). Finally, no one told us when the meal trolley came (at 4.30!!), so I had eaten one sandwich all day and had to order a takeaway because the canteen was also closed.

It astonishes my friends from other European countries that there is so little use of data to try to inform birth choices in the NHS as standard. I mean, if in your specific situation, your chances of a non intervention led vaginal birth would actually be likely to be less than 50%, 20%, why is this information not given to women unless high risk? It would save the system money to avoid lengthy and fruitless inductions in favour of sections if this is what women want with all the information available, surely. A consultant obstetrician friend said he tried to propose writing an article about evidence based interventions/sections in the BMJ, but that no one would publish it, because the midwife lobby for natural birth is so strong in the U.K, so he has given up.

Second time around, I do have a lot more support from the older midwives at least and the system allows me a genuine choice of birth option. I seem to be treated more as someone who is capable of weighing her options. Why the hell are first time mothers assumed to be so incapable of having a sensible view on what is happening to them?

Hearing about this on Radio 2 this afternoon really made me think properly about my two emergency sections several years ago. I was pushing for about four hours following induction, and have very little memory of any of my labour with my first. My mum and husband told me afterwards that the midwife was absolutely insistent that I could do it naturally and was very reluctant to let the doctor in. My daughter ended up with scratches on her head and arms, and the doctor sprained his wrist as she had descended quite far so he pulled her back up essentially.

I hadn't ever considered that the care I received was poor but I really did have to go back over it in my mind today and wonder if my situation was actually avoidable. With my second, I was a bit more lucid and insistent because I wasn't 26 hours into a horribly painful labour, and she ended up being an emergency section before I did any pushing. Something to do with the way they were both sitting and pelvis shape or something. Not sure whether it should've been picked up, you don't really ask questions after you have a baby I guess.

@BackwardsGoing

I am so sorry this happened to you. Horrific. I cannot believe medical professionals are so dehumanised that they think this is acceptable.

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

Agreed I used to work in the NHS and found a culture of bullying, I even complained a few times about others being bullied and nothing happened or the bully would be moved up the chain and out of reach of the victim. The cliques were strong and kind of mean girls esqe. And those drs that thought they were God were always moved on up the chain to eventually make the big decisions hospital wide. The thoughts were at least they didnt have to meet patients and make things worse.
Basically the worse a person you were, the more rewarded.
I will never go back.
Although I believe the NHS is a great idea, but how do you stop the rot that leads to mums/babies dying unnecessarily.

This is shocking. I had an awful time having my son, they let me labour for days, wouldn't examine me, were so rude, then they couldn't get him out, his heart rate was dropping and had the suction cup and forceps. His heart rate was half what it would be, he was on the cusp of oxygen deprivation, so I spent a year worrying he had cerebral palsy. They also said they'd done a blood test when they hadn't, so I had to have a blood transfusion after days of severe anemia unnoticed. I was also having a mental health crisis and told someone I wanted to go without my baby or jump out of a window. Nothing was done. They discharged me in the cold dark evening while I was crying. I've had to have EMDR therapy for this and nearly had to go inpatient due to the PTSD I developed.

This is so awful. I didn't realise things were so bad.

@vaccinationstation thank you. I still think I'm not allowed to complain as I have a healthy child. I was "lucky" in comparison to so many.

@endofthelinefinally, there is one part of the American healthcare scene which if embraced would make a massive difference, and that is litigation - sue midwives, sue trusts, sue doctors, sue administrators.

Not shilly-shallying around with official inquiries, and reports, and hand wringing about "lessons learned'.

The only way to make things change is to hit everyone concerned where it really hurts.

Interestingly, the nhs spends a fortune on insurance and their legal departments. Unfortunately a fair chunk of that money goes on investigating fraud. Yet it all still goes on.

I'm feeling very nervous pregnant with my 2nd. Had my 1st at a hospital in London with brilliant care. Have since moved and now live 1 minute away from one of the scandal hit hospitals. The other nearest hospital is over an hour away.

So far the difference in care has been quite shocking to me. I have had to pop into maternity triage day care a few times and it's a total shambles. I wasn't informed about my 20 week scan and has to call them to find out it was the following day! Not sure if it's to do with COVID or the hospital but feeling very nervous about my impending labour and birth. The midwives seem very disorganized. There has been a culture of women not being believed at this particular hospital (when they're in labour, baby movements etc) and I had a very fast labour last time, 58 minutes, worried I may end up giving birth without assistance at home because they don't believe in in labour.

To be honest wish I could go private.

I have personal experience of doctors standing up and lying at an inquest. I don't know how to fix it. I am retired now and worn out.