Birth Truama: Poor maternity tolerated as normal, inquiry says

[IwantToRetire]

An inquiry into traumatic childbirths has called for an overhaul of the UK's maternity and postnatal care after finding poor care is "all-too-frequently tolerated as normal".

The Birth Trauma Inquiry heard harrowing evidence from more than 1,300 women - some said they were left in blood-soaked sheets while others said their children had suffered life-changing injuries due to medical negligence.

Women complained they were not listened to when they felt something was wrong, were mocked or shouted at and denied basic needs such as pain relief.

A new maternity commissioner who would report directly to the prime minister is a key recommendation in the inquiry's report, along with ensuring safe levels of staffing.

Health Secretary Victoria Atkins said she was determined to improve the quality and consistency of care for women.

NHS England chief executive Amanda Pritchard said the experiences outlined in the report "are simply not good enough".

It is estimated that 30,000 women a year, in the UK alone, have suffered negative experiences during the delivery of their babies. One-in-20 develop post-traumatic stress disorder (PTSD).

Article continues at https://www.bbc.co.uk/news/articles/c4n1jv7xxpwo

Also published today:

Fact Check: Our analysis finds one in nine maternity services ‘double downgraded’ since 2022
https://www.channel4.com/news/factcheck/factcheck-our-analysis-finds-one-in-nine-maternity-services-double-downgraded-since-2022

Can only find a link for the actual report at https://www.theo-clarke.org.uk/news/theo-clarke-mps-birth-trauma-report-launched (The APPG doesn't seem to have a web page ... ?)

More awful news which of course MN were discussing ages ago. So sad for all the women and children affected. Unforgivable.

I've found some of the reporting around this today quite upsetting. Brings back feelings around the v difficult birth of DS. But it also lays bare how much women's pain and suffering is minimised and dismissed.
I really hope this brings about some meaningful changes but I am not optimistic.

Women are just treated as disposable. If the U.K government wants to increase birthrates, it should ensure that England's maternity wards drastically improve upon this -

https://www.bbc.co.uk/news/health-67238868

67% of maternity wards unsafe. Fucking awful.

Mumsnet has been discussing this for years! My sister had a horrific experience 26 years ago!

Too little too late and not much hope that things will change but at least more people are aware of what is happening now.

This doesn’t surprise me. I have a needlessly traumatic first birth where I was left in agony without any pain relief, or medical checks or even a bed, to birth a back to back baby. When I posted on MN that I was traumatised by the lack or care and zero pain relief I was told this was normal and I should quit moaning as I didn’t due and had a healthy baby. If men had kids they would never be told such piss poor care was acceptable or normal!

My thoughts are with all the women (and children) who have suffered a traumatic birth.

Have not read the report, but just cant get my head around the reports of how some staff behaved. Being short staffed is one thing. But actual hostility from staff and worse is hard to understand.

Another case of tell us something we don’t know.

Sadly I can remember giving birth in 2006 and thinking ‘Jesus Christ I’m being treated like a child/animal, one day this will be recognised as abusive behaviour that’s been overlooked’.

My DS is 18 next month and it’s still the same/worse. 😡

I feel for you. I had a miscarriage at 12 weeks and was rushed to hospital bleeding. I woke to find a doctor dragging my baby out of me. I thought he was going to rip off my clitoris, to be honest, but I was completely out of it. When I cried out the nurse just said 'he's trying to help you'. I knew that, and that I could have died, simply bled to death or had septicaemia (had begun to bleed day before),but a little compassion would have helped me a lot. Later, nurses all very, very kind. This was the 80s btw and I needed a blood transfusion (which means I can never give blood). I had two children successfully, one either side of this miscarriage, and have acquired step-children as well, but the memory is still there, and the waking in the dark in a room away from the ward, with a nurse watching me - truly scary.

I read recently that 1bn is spent paying out maternity claims. 3bn is the entire maternity budget.

The fundamental issue is that a large proportion of the UK population buys into the propaganda that the NHS is a wonderful institution that is sacrosanct and cannot be criticised, and everyone should be grateful for it. You see it on other health threads too, not just maternity. Waiting 6 months for your cancer op? You should be grateful! Got seen in A and E within 24 hours? Why are you going there with that problem, you’re clogging it up for the real emergencies. Your care was poor and has left you with lifelong disability and trauma? Report to PALS but it sounds like they did the best they could [shrug].

This attitude pervades the NHS itself. There’s no doubt there’s a significant proportion of NHS staff are good, caring and in despair at how hard it is to provide the care they want to provide. But there are also jaded and downright awful staff who think asking for some semblance of decent care is an affront, including midwives. “You should be grateful.” “Stop moaning.” “Do you think I have time to do that?”

There was a thread a few months back about how the UK’s Maternal Mortality Rate (MMR) has now risen in the UK to around 11. I pointed out that in Australia it’s 5.8 and for indigenous women, a group of women systematically discriminated against since the formation of modern Australia, it’s 9.4. A pregnant woman is more likely to die in the UK than an Australian indigenous woman in a rural community thousands of kilometres from a major centre. Inevitably there were posters who refused to acknowledge this was because of the poor standards of the NHS. It was because of Covid, or something else, different mix of patients, as if Covid affected Aussies differently 🙄 anything to detract from the reality that it’s the poor standards of the NHS that explains this discrepancy.

Too many people think the NHS is good. There may be occasions of exemplary care, or even “above expectations” but as a whole, it’s the health system of a second world country, not a first world country. It’s a failed health system, not a failing health system that can be rescued, and in any failed governmental system it’s inevitable that women will suffer the most.

Until there is an honest acknowledgement about the state of the NHS as a whole there won’t be any improvement in individual services like maternity.

Too many people think the NHS is good. There may be occasions of exemplary care, or even “above expectations” but as a whole, it’s the health system of a second world country, not a first world country.

Not saying I disagree with this, but part of the point of the report and backed up by PPs on this thread is that some staff working in maternity units seem to have a very negative view of women, or maybe its just women giving birth.

I have never heard of someone being treated for cancer being verbally abused by staff.

Although have witnessed very casual and disrespectful treatment of elderly patients, many of whom have no personal support network.

So why this very different attitude.

Not saying I disagree with this, but part of the point of the report and backed up by PPs on this thread is that some staff working in maternity units seem to have a very negative view of women, or maybe its just women giving birth.

Oh I completely agree. No doubt there’s a unique component specific to women, or women giving birth. But I think the toxicity of the NHS brings out the worst in people. I have worked in maternity services in different health systems around the world and that negative view of women is most prevalent in the NHS. It’s an environment that breeds complacency, to brush things under the carpet, to pretend incidents are a “one off”, to avoid criticism of its own, to not protect those with concerns who want to come forward, to gaslight patients into thinking their care was “adequate”. It just lurches from one scandal to another.

My work includes speaking to women involved in maternity claims against NHS trusts. I would never have considered giving birth in an NHS hospital despite myself being an NHS employee. That was 15 years ago, and I would feel even more strongly about it now.

Be interested to see those figures.

Aside from the terrible human cost amd the morality of it, providing supportive and good quality care to mothers and babies is cost effective in the long term, for the NHS and society as a whole.

Sometimes I feel like woman hatred underlies some of the shoddiness of maternity care. I'm pretty sure it did in my own experience.

I had one abysmal experience and one superlative, both NHS hospitals, different areas. The NHS is capable of the best and the worst!

https://news.sky.com/story/amp/woman-gets-575-000-payout-after-rushed-childbirth-left-her-with-stoma-and-ptsd-13131740

@ArabellaScott it was just from an article so unfortunately there’s no kind of breakdown or further detail.

You notice how staff standards are variable when there is a change of shift and a new nurse or other hospital staff member appears whose attitude and conduct is completely different.

I went into the local women's hospital for a routine procedure in February - I should have been out after a few hours - but was given a morphine over-dose resulting in worrying consequences, and so was told I'd have to stay in over-night. There was little sympathy or care from a few members of staff, who clearly thought. I was just a nuisance still being there, just as their shift was about to end.

I was moved to another ward with another group of staff -who seemed mostly to spend their time laughing and joking and chatting with each other - oblivious to one young woman with early pregnancy vomiting, who was kneeling on the floor retching and moaning. They just ignored her entirely. She spoke no English. A total lack of care.

I ended up discharging myself after being spoken to in a really brusque and hostile way by one member of staff who had just come on shift. I didn't feel safe there at all - and it was the last place i wanted to be.

I had my first two children at home - and the birth experiences were really positive - no damage, no drugs, no tearing......relaxed at home with a known, positive and caring mid-wife. The third child was supposed to have been born at home too - but during Labour I made the mistake of ringing my GP. -and got the GP who doesn't believe in home births - who cautioned i should be taken to hospital ( in the middle of the night in an ambulance to a hospital 30 miles away). As soon as i got into the hospital i felt the whole experienece slip away from me and my own control and timing. I was on a production line, being spoken about, rather than being spoken to.

One male doctcor came in and said to the midwife ( who i agree - many don't seem to like the women, or their job)" If she doesn't deliver in 30 minutes put her on a drip". I started to push before I was ready to push - as a result of that instruction and the whole experinece was transformed from the relaxed experineces i'd had at home during the previous two births - to one which was tense and anxious and in which i didn't feel safe.

I discharged myself from there too.....and shiffled out with baby, feeling alienated and like death - wearing my husband's trainers.

My work involves clinical negligence claims (many for birth) & so I am biased, in that I only see the worst of things.

However, the sheer lack of care astounds me. I review medical records where there can be 10-20 individual breaches of duty, by different clinicians, in a single labour & delivery. The NHS will still defend the claim for years (racking up £100s of thousands in legal fees) even when it is clear as day what's happened.

I think this idea that the litigation budget is so huge because one poor overstretched midwife has made a human mistake is wrong. It's due to systemic failure & cover up culture. truly horrendous.

Any big corporate entity can result in facelessness and lack of human connection, and in that the NHS is no different. The staff themselves must just feel like cogs in a huge machine too; and i do think there can be a culture of laziness, resentment, and entitlement in many large public service institutions -not just the NHS.

I'd ideally like to see maternity care going back closer to the community in small mid-wife led teams in maternity homes - not even further away from home in a big, anonymous hospital, in which the dominant mood is one of emergency and de-personalisation( although i appreciate that pregnancy and birth now bring with them new sets of difficulties and issues due to a variety of social/cultural factors) Doctors, and hopsital midwives, are trained to view childbirth as a potential emergency situation, rather than as a natural event - thus ramping up the medical mood surrounding it.

Thank God this is now being discussed openly thanks to the report. I heard a woman on R4 yesterday afternoon saying that when she was in labour, midwives told her to “cover up, because builders were coming in to the room to do some work”. This appalling treatment of women at the most vulnerable moment of their lives is mild compared with some of the other accounts in the report.

After one of my DCs was born I was left covered in blood over my lower half for many hours. A midwife who came to check on me pulled a face of disgust when she saw /smelled the dry blood, and forced me to have a shower on my own ( in a bath that had blood stains from other women on it), which was terrible judgement on her part as I passed out and had to pull the emergency cord. Not forgetting ringing the bell during the night to have my baby passed to me for feeding, and waiting ages for someone to come. I was made to feel like a nuisance, but how are newly delivered women supposed to climb back into bed while holding a crying newborn? It’s impossible to do this safely, never mind with a perineum covered in stitches.

This is just “normal stuff” compared with what some women are made to endure. So sorry to hear of some of your experiences at the hands of maternity services. 🌹for all of you.

I agree about attitudes to people in the NHS often being negative. My late DH said one should always turn up well-dressed and articulate and treatment was better. His comments had a sad corollary when he had a massive cardiac arrest in January. He was in his painting clothes (thin, old trousers and a grotty jumper, because we had were about to paint the basement floor). I was similarly dressed when I summoned an ambulance (arrived within 4 minutes) and DH was resuscitated. I was as asked about meds and said he had something beginning with 'm' prescribed for indigestion and this was noted. I was hardly thinking but put myself into 'middle-class' clothing, knowing DH would hate me turning up at hospital in painting clothes. Long story (very long, 18 days of Hell) short we did not feel that my DH was treated with entire respect by the doctors (nurses etc all wonderful) until the family arrived (three hours' journey for SS, DS, DD but BiL nearer) and began to talk about my DH, a writer and painter. Someone googled him, and attitudes changed remarkably. Except for one doctor who phoned me the next day and began our conversation with 'your husband is on methadone'. I had explained he had a prescribed indigestion medication but because we were in Blackpool it was assumed this man, with grotty clothes and long hair and a beard was a druggy. I was furious and said so, reading the name of the actual medication over the phone. But I and my family are articulate and well-off, and were at the hospital most of the time because we had time and transport. Another patient might have been treated for what he was not, with assumptions the partner was ignorant of medication. My DH did not recover, but he did get the best treatment in the country (DD's uncle and cousin are both doctors, so everything done and said was run past them). Would he have, in some places, dressed like a down-and-out with hippy hair (no hippy, and strongly anti-drugs having worked with young people who were addicts), somehow I think he might have received less favourable treatment in some hospitals in some places in the UK.

Thanks, I found relevant references in the article! The figures are taken from the NHS' Annual Report for 2021/22.

https://www.patientclaimline.com/uncategorized/what-does-the-nhs-annual-report-say-about-maternity-negligence/

'In 2021 – 2022, the NHS spent £13.3 billion on negligence claims, and maternity claims made up 60% of this figure.'

Source: NHS Annual Report

• In 2021/2022 there were 1,243 obstetrics claims, accounting for 12% of all clinical negligence claims by volume – this places maternity related claims among the top 3 specialties by volume. This was an increase from 1,157 in 2018/2019.
• In 2021/2022, obstetrics claims accounted for 62% of all clinical claims by value received in the year, this highlights the underlying impact of the financial costs of paternity indemnity payments, alongside the impact of harm on the patients, families and healthcare staff.

According to the NHS Annual Report, one of the new strategic aims for 2022-2025 is to collaborate to improve maternity outcomes. The report states “Bringing together key parties to determine what further improvements can be made within our areas of expertise to support the government’s maternity safety ambition.”

NHS Annual Report Findings 2022-2023

• In the period, the NHS found that in this period obstetrics claims accounted for 13% of all claims made, a 1% increase on the previous year.
• There were 13,511 new clinical negligence claims made during this period
• In the period 2022-2023, the NHS spent £7 million on negligence claims, a £6 million decrease from the previous period, however this can be attributed to His Majesty’s Treasury (HMT) discount rates which has had the effect of significantly reducing the value of claims.

https://www.birthtraumaassociation.org/

I wonder whether the changes to training has contributed to poor midwifery services. My friend who is now in her 50s trained first as a paediatric nurse when she was 17 then after working for 10 years specialised in neonates for another 5 before training to become midwife and that was the normal route into midwifery at that time. Therefore she had an enormous amount of clinical experience which she said she needed in midwifery because the unexpected was the norm and if she hadn’t had her nursing background it would have scared her to death. She has since become a Health visitor and she says it shows in their performance, skills and knowledge now Midwives and health visitors don’t have formal nursing training