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

https://www.gov.uk/government/news/health-secretary-announces-new-womens-health-priorities-for-2024

One of my nieces (nursing background including ICU and battlefield medicine) had to go to Australia to train appropriately in midwifery.

She'll probably stay there as well given the state of the profession in the UK.

This. 100% this.

Why did the doctor want to speed up labour? Was the baby in distress? Just asking. Seems a bit weird, or are babies now meant to be born to a schedule?

are babies now meant to be born to a schedule?

Yes. In my experience, the consultant wanted to get away in plenty of time for his golf game the next day. So I was induced and when that didn't go fast enough, C section. He was quite open about this.

Yes, just random......because, i assume, he couldn't be bothered with the slow/unpredictable progression of dilation. He never once addressed me, only the midwife.

The btl comments on the DM treatment of this story show the sort of woman-hatred that is possibly part of the problem in the first place.

https://www.dailymail.co.uk/news/article-13414459/Traumatised-mothers-experiences-childbirth-damning-report.html#comments-13414459

So sorry to hear of this......just this year. This must still be very raw.

We keep being told that the only imporant thing is a "live baby" - like the child is the finished product off the production line. The woman, her experience, the importance of the quality of that experience in the early months of the baby's life, and even with her ability to bond with the child - are considered irrelevant.

I don't think midwives are even trained in how to handle a natural birth; they are trained in machine watching and medical interventions. The woman is spoken to like a naughty, inconvenient child. They have time schedules and no time for being responsive to the woman and her process. You can hear screams coming from other rooms. Emergency alarms go off, and staff rush to theatre for emergency caesarians .The whole process is the opposite of how it should be.

And then, when you've had the baby, trying to get help for birth-related injuries becomes the next hurdle and can remain an issue for years afterwards if not for the rest of your life...

I'm sorry it's so many of us.

The btl comments on the DM treatment of this story show the sort of woman-hatred that is possibly part of the problem in the first place.

Yes, some of those comments are absurd.

Developing PTSD from a hospital setting, in part aggravated by the treatment from the clinical staff, should not be acceptable. Emergencies happen but, how staff react to them and keep communicating to the patient, can make a substantial difference.

I've had plenty of counselling after my hospital experience.

Cleaned myself up with baby's wet wipes after I fainted on the way to the shower and they put me back in bed then never brought me the bed bath I asked for. Lost over a liter of blood but the consultant said 'you're a barn door case' so stop worrying, here's some iron tablets. (I have since read the RCOG guidelines and I believe there were grounds for me having the blood transfusion I asked for). Spent hours with a heart rate of 150 and their notes were querying a PE. I thought I had hypovolemic shock, weirdly the heart rate started improving when they finally remembered to put up some fluids.
I am from a clinical background and just felt completely helpless, noone cared about my quite rational questions, they just suggested I was thick.

@RebelliousCow

See, I have a totally different view of this. If I had another child (have two), I want to limit my experience of midwives as much as humanly possible due to hideous experiences.

Whilst I was in (induced) labour with my first, my midwife boasted of having travelled around birthing babies in exotic locations far away from hospitals, including in the Amazon like she was some kind of super midwife - didn't make her a nicer or more caring human being, and she missed an issue that would have killed me and/or brain damaged my baby if I hadn't insisted on being put in front of a consultant (who promptly did a section on my stuck, large, back to back baby). The same woman came back to berate me, a woman who had been awake for 3 days in labour and had lost a lot of blood on the operating table, for not knowing how to breastfeed my baby immediately in the recovery room.

I had a section with my second, which was dreamy, but I had to change community midwife twice as they kept trying to persuade me to have a natural birth again. (Anaesthetist who had had four natural births watched my son being pulled out during the section and said "wow, he is a whopper, what a fabulous decision"). In hospital, no one helped me with my food tray and I split my stitches trying to go out to get food and was then berated for doing too much . The dressing was then stuck down really hard, so that I effectively had to have my scar waxed off at my 10 day check postpartum. My "nice" community midwife commented whilst removing my Caesarian dressing "i didn't think you had a good pain threshold like this, as you chose to have a section". I mean, wtf.

I think the NhS has a cult of midwife. Those of us who do NCT classes are then further indoctrinated in natural birth at all costs.

Yes, some women birth more easily than others. Those women who birth more easily should have the home/midwife led births that they want. We should promote calm birthing as the optimum experience.

But the NHS is not spending a fortune on litigation because it is stopping people having magical home births or making people have unnecessary medical interventions who would have had really easy deliveries without any medical assistance. It's because it ineffectively triages women and encourages virtually everyone to try for a natural birth at all costs and fails to intervene until too late.

The answer is not more MLUs.

💐 to all who have had awful birth experiences.

I agree, it's part of the attitude towards women's pain and women's experiences that they are natural, therefore not bad, therefore we should just suck it up.

Some of those conments about PTSD are disgusting and so ignorant. 'Your baby didn't even die' dear God what a low bar to have! 😪

I have PTSD from an unexpected birth at 26 weeks with baby's subsequent fight for life and intensive care hell. Those comments were like a kick in the guts after all these years.

After having a brilliant midwife and jr Dr look after me in labour, I was left without food on the post natal ward and told 'you've missed dinner' despite having had nothing to eat for about 16 hours. They got a trainee to take my cannula out unsupervised and it bled everywhere (I had to apply pressure and give myself first aid). My husband / mum weren't even allowed in to say goodbye after all the trauma (you've missed visiting hours) and I was left to cry my eyes out alone.

So depressing that this has been going on for decades. It's just not a priority for the NHS - the safety of women and babies at the bottom of the heap - as usual.

I have told this story before but with ds2 I was admitted with a suspected clot, the consultant came in at midnight on a Saturday opened the curtains and his opening words were 'in view of your professions I thought I should come in myself' , my dh is a solictor and in all my pregnancies this was written in large red letters on my notes. I asked him if he would have been there if I worked at the biscuit factory, at least he had the gall to reply that he wouldn't be .
When I finally gave birth I was told repeatedly that I wouldn't be walking around if I was that in labour and to take a couple of paracetemol. Eventually I marched up to the desk and told them in my most authoritative voice that they may have delivered hundreds of babies and I had only had one but I was definitely about to have number 2 (surprising because I never make a fuss about anything) they reluctantly agreed to examine me and I was 8 cm dilated and my baby was distressed, I was rushed to theatre for an emergency forceps delivery. Something primal had driven me up to that desk, they wouldn't even let me call my dh as he could only 'come in once labour was established' , he nearly missed the whole thing.

The overriding theme of that report is the lack of care by staff and their dismissive treatment of women.

to every woman who has suffered a bad experience. It shouldn't be like this.

The NHS is not like US health care, where the patient gets to ask for particular treatments and the insurer decides whether they get them. If the consultant did not think you needed a transfusion, then you didn't, because if you did you'd have had it. The NHS is a health care system geared to providing needed health care, not pick and mix of the patient's choice. I have had some hairy situations in hospitals but never been denied life-saving treatment which I needed (and which I did not have to ask for).
NB How do you know you lost over a litre of blood? Did someone say so? What looks like a litre on the floor (if you saw this) is more like a couple of ounces, liquids are deceptive.

Blood loss is recorded in one's notes.

Also, Grammarnut, on a thread where women are sharing birth trauma, perhaps you could exercise some compassion.

No, you can't demand a particular treatment but there are way too many instances (in my private life, let alone professional - Im ex NHS ) of drugs being prescribed regardless of contraindications, wrong doses given, warning signs not being heeded, oxygen being 'given' but not turned on at the wall etc.

I don't blame the staff, they are frazzled and overworked, but it's entirely possible that someone who would have had a blood transfusion or fluids had they been in another country just didn't get it when they were supposed to.

Just seen your edit - Jesus Christ have some empathy!

I think some hospitals are like this and over-medicalise, but the two hospital scandals of last year involved midwives who avoided medical intervention until the last minute or too late because they believed in natural childbirth and blindly insisted on going that route rather than doing what was needed to produce a live baby and a live mother - sadly, sometimes they got neither. Death in childbirth was common in the UK up till the 50s, as were traumatic birth injuries. Much though I hate the medicalization of childbirth there is no merit in letting a woman labour to exhaustion in pursuit of a natural birth. There is a way between over-medicalizaton and letting nature take its (sometimes destructive) course.

@Grammarnut

The NHS is obsessed with the supposed cost of everything, so it's often not about clinical best practice as to whether you get something or not. Understandable, but very short sighted - the woman who didn't get a transfusion might have had months of difficulty breastfeeding or developed PTSD or PND, the women who are forced into a natural birth at all costs whose babies require life long care or who suffer pelvic damage - in the short term, certain things are cheaper, but in the long term doing things properly first time often wins out, you just don't see it in individual budgets.

Sorry. I have empathy. And my late DH lost 75% of his sight in his left eye to glaucoma because of the covid lockdowns, which I cannot forgive, so unnecessary. Only kicking up a fuss saved any of that sight, so that he was operated on this time last year. Consultant said his sight would last him - it did.

@Grammarnut

I absolutely agree with you about the fact that demonising medicalisation is hugely unhelpful and has damaged a lot of babies and mothers.