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

And @Grammarnut

The best thing that the NHS could do is rethink induction - it uses this as a blanket intervention when women go overdue or they want the baby out, but it would be much more sensible to consider whether it is useful alongside scanning for baby's position, as in other countries. It is pointless putting a women with a malpositioned baby through an induction without thinking about how likely it is to be successful and a waste of resources. It's painful and often leads to more interventions.

💐 for your husband and your loss - that is a shite state of affairs.

It is scary what can happen.

Obviously I can only speak from my own experience and those of friends at the time. Most of my friends had natural home births/some had water births. This was back in the early 1980s and it was just part of the culture I was living in for it to be this way.

I was young, though, which is often more straightforward and therefore less complicated. I had my first baby age 19, and it was a long, bust straightforward labour ( 24 hours) with one really great and experienced midwife; my second baby age 27 was 8 hours and very intense, but still straightforward, though baby had cord around his neck - which mid-wife had to cut before he was delivered.

The third I was 28 - straightforward, except I bled throughout Labour, and ended up in the hospital. Even though the Labour was straightforward and I didn't feel I wanted or needed drugs or even gas and air( during any of those births )the whole experinece of being in hospital was a radically different, and very negative, experience for all of the sorts of reasons people are reporting here, compared to being at home ( staff attitudes, threats of interventions, feeling out of control and infantilised, like people did not care about me)

I felt angry towards my GP for quite some time after that- because it was she that pressured me into going into hospital when I Ihad intend and planned to be at home, and it had ruined the experience for me. I'm also convinced my son caught an infection in the hospital( which I suspect has compromised his immune system for life) as he developed this horrible little pustules all over his body after a couple of days.

I think you could have more compassion for the dreadful, heartbreaking stories that women are telling on this thread.

Just going back to the question I asked yesterday is whether part of this is dislike or lack of respect for (pregnant) women.

Has anyone themselves, or know of someone who has been in hospitial for a totally different reason experienced anything like what seems to be about dehumanising pregnant women?

As I mentioned I have seen really terrible treatment of older patients, who are often treated as a nuisance even though the reason they are in hospital are the symptons that nurses find a nuisance. As well as not helping patients with a bed pan etc., and then "punishing" them by making them lie in wet sheets.

I'm not trying to derail the thread to talk about other hospitial horrors but just trying to gauge whether it is that women giving birth are treated with less respect and care. Or that the way the NHS works it is just a production line and they really cant be bothered with the idea that part of the production line has rights.?

It's not news. It's stating the bleeding obvious in a formalised format.

It's fuck all new.

It's difficult to say. As you note, I have also seen/ heard of it with elderly patients, but perhaps not with the same degree of scolding/ blaming as is reserved for pregnant women/ women with gynae problems.

Difficult to know as I'm sure my personal experiences aren't representative of the whole population iyswim.

Although I didn't suffer a traumatic event during the birth of my DD it's the every day neglect and lack of care that horrifies me...

I've never felt so utterly alone and scared as I did after the birth of my dd during Covid.
Lying in bed encrusted in blood and fluids Not able to have a shower as my partner wasn't allowed and I couldn't carry my baby to the shower...midwife laughed at me when I asked if she could keep an eye on my dd.
In horrendous pain but no one answering thr call bell then given paracetamol.
Being made to feel a nuisance for asking for pain relief before an external examination after the last one was excruciatingly painful.
Had 1 health visitor visit then left to it with not a clue what I was doing.
And all the stories from friends..
DS in ICU and unable to see him as no one would wheel her to the ward after c section
Going to the toilet in labour and passing out and no one noticing after saying she couldn't be in labour
Stuck in horrendously loud,hot hospital wards after birth with nobody to help them.

Why do we put up with this in this country ? In other countries women are given time to heal and rest after birth,it's considered a sacred time.

I’ve had multiple unpleasant experiences with male gynaecologists causing pain during various procedures and then telling me off for squirming or squealing. I’ve also received bad advice from them that seems to be more worried about any potential male partner’s 'concerns' rather than my comfort.

It’s never happening again; I’ve sworn to myself that I will never let a male doctor treat me in that condescending and callous manner again. The women of Mumsnet are helping me channel my middle-aged anger.

💐 to all the great women posting here for their consciousness raising.

Thanks a bunch. I was told 1.2-1.5L by the consultant himself. I had a water birth and a deep second degree tear plus retained placenta removal with only gas and air so yes it was quite a lot thanks. This was confirmed in the post event discussion of the notes that I requested. I was so weak I couldn't lift my child in her car seat until she was about 6 weeks old, but yes I'm sure you know best.

I know plenty about how the NHS works and having read the guidelines after the event I genuinely think there were grounds for them giving me a transfusion.

And to add to that the guidelines also say you should go to the toilet within 6 hours of giving birth and they forgot, so it was more like 8 hours. PPH guidelines for haemorrhage over 1L advise a catheter to observe urine output, obviously that wasn't considered either.

I don't know best and I am sympathetic. I did not mean to be unsympathetic, either. Sorry.

Apology accepted.
Unfortunately in my experience women minimise their bad experiences rather than embellish because 'the baby is healthy' and you don't want to freak out anyone you know who is pregnant.

I suspect that it is a wider issue than just women who are pregnant and/or giving birth. I imagine that many hospitals and hospital departments feel like they are continually in fire-fighting mode. I'm not sure if this is something particular to public services - but I've also experienced it in some schools during staff meetings first thing in the morning; it can feel like a battle cry - once more into the breach and the headteacher sounds almost panicked.

Hospitals are such big employers, and many people go into nursing who may not temperamentally be suited to it. I also think some people, even in nursing, have very poor people skills and little aptitude for the profession.

My husband has been admitted into A&E on a few occasions over the last couple of years ( with sudden onset seizures) - and to be honest - the quality of nursing, and even the doctors, is hit and miss. You certainly know it when you get 'proper nurse' or doctor because so many are just not that good at all.

I've started requesting that a woman examines me when I have to go for gynae issues or treatments.

I had two horrible births in the nhs for different reasons - I did get a blood transfusion but I lost over 3 litres so lucky me 😁 When my dh went for the snip it was wall to wall cups of tea and pain relief. I got sneered at and offered paracetamol after a c section. The nice midwives were in the birthing bit and the horrific ones were in postnatal. The vet treats my pets with a 100% more compassion and empathy than midwives treat women on postnatal wards, I don’t know how they sleep at night. So sorry for everyone’s experiences

I could (should?) write a book on bad practice in childbirt but I will just pop few semi light hearted anecdotes.

Setting: ICU, me on paracetamol drip.
Doctor enters and shouts: Since when we give paracetamol to patients HERE???
Nurse: she is c section patient.
Docror: Oh, ok. (Walks away)

Cluesless registrar: your iron levels are dropping. We cannot let you go home.
Me: Can I get some iron tablets to get it up?
CR: Yes, we will give you some when you go home.
Me: And how will I get iron up to go home?
CR (in lost voice): I don't know. Maybe you needed more then two units (around 1l) of blood when you lost 3l. I just don't know.

Nurse assessing if I have preeclempsia: do you have headache?
Me: I am on dihydrocodeine, I cannot feel myself.
Nurse: great, so we can cross this.

Situation: me on operating table as I need c section according to my notes.
Another registrar who barelly passed uni: are you sure you don't want to try forceps?
Me: no, just get in with a fucking section already.
Registrar (in queens voice): starting cathegory 2 c section on maternal request.
I had uterine rupture.

GP calling me for 6 weeks checkup: congratulations, how did birth go?
Me: umm think they sent history from hospital, I went to ICU.
GP: oh really? How was it?

Healthworker at ICU changeing my bloody sheet: I wish I was as slim as you! How you do it?
Me: losing 3l of blood in an hour helps.

Another health worker: oh you tried to do dreadlocks? They look funny on white women.
Me (touching back of my hair): think blood was pouring down the tilted table into my hair.

I didn’t know requesting a female gynae was possible so I’ve never tried doing it because I’ve always assumed that I’d get stuck on the waiting list for even longer for daring to be fussy. I’m going to see what I can do for upcoming appointments.

Sadly, in 30 years, I’ve only ever come across 2 female gynaes at local hospitals - family planning is where all the female doctors seem to be here. Gynaecology, in my personal experience, has been a ridiculously male profession here and I hate it because the male doctors treat my genitalia and my uterus as if they’re not actually connected to my nervous system and therefore capable of actually feeling pain.

Plus, like previous posters, I’ve had it with the 'take 2 paracetamol before you attend for an outpatient procedure' bollix. Why do doctors get away with treating female patients as if we don’t feel physical pain in the same way they do?!

Nowadays, it feels like a large percentage of NHS staff see patients as a nuisance, and women particularly so because there’s more to 'go wrong' with our bodies. I know the NHS is overstretched but women avoiding treatment because of previous bad experiences isn’t helping anyone in the long run.

My husband was recently admitted for 'observation' after falling, the A&E dr said it would be a good idea as his Parkinson's meds routine had just been changed.
No obs happened, I had to complain that his schedule was being ignored (timing is very important in Parkinson's) Worst of all, I went to see him and found he had been moved to the geriatric ward (he's 59) and he was lying naked on the bed, soaked in urine, in full view of the entire ward. I was told that nurses were too busy doing the drugs round to cover him or draw the curtain. He massively deteriorated whilst there and still has nightmares. I definitely felt that the nurses ( but not Dr's or auxiliaries) saw him as a nuisance and assumed that he was unable to communicate or think for himself (Not so)
I would have died without medical help with my 2nd child- but like others, I was left coverd in blood from knee to chest for 2 days, and had to beg for my baby to be given to me to feed as I could not get up.

A couple of articles in the Times today

Louise Thompson: Giving birth ruined my health — for life

https://www.thetimes.co.uk/article/5a55ad4e-83cb-4051-b9bb-3ebecd7de04b?shareToken=20ddcd0a55b762d9598e60423d05a299

NHS must end medieval maternity practices

https://www.thetimes.co.uk/article/d9ad4cd0-b929-4791-a931-871c3fdbdb26?shareToken=60fca4fe9c346fa5a2ffeec7e0a4ccd2

I don't do that beforehand. If it is a man, on the day I turn up, then I request internal exams etc be done by a woman. They do always try to get your consent before examinations. But when it comes to surgery when you are under anaesthetic then it is not really an option.

For my recent procedure, which was to be done under general anaesthetic, the hospital had changed their practice - and rather than putting you under before wheeling you into theatre, I had to walk in to the theatre myself - to find myself surrounded by lights, equipment, and lots of people, including lots of men all dressed in scrubs and wearing masks. It was a very scary and intimidating scenario, to be honest.

I'm not trying to derail the thread to talk about other hospitial horrors but just trying to gauge whether it is that women giving birth are treated with less respect and care. Or that the way the NHS works it is just a production line and they really cant be bothered with the idea that part of the production line has rights.?

In a way, the above stories do not surprise me because I think that chaos, indifference and even cruelty are now systemic.

I'm personally acquainted (not in a professional capacity) with a geriatric case that encompasses indifference, deliberate ignoring of red flag symptoms, incompetence, sadism and possibly deliberate hastening towards death. From the same hospital I've heard tales of horrible treatment of other age groups too.

There is the Martha Mills case at Guys - the salient feature seemed to be less senior staff being reluctant to countermand the opinion of a consultant despite very obvious sepsis flags.

One friend told me that in their experience, the higher up the staff, the less humane.

By contrast my mother was treated with great compassion at a teaching hospital but I hear enough to know this is not universal.

So I'm not surprised that maternity care is full of horror stories but what does shock me is that female staff are frequently guilty of what can only be described as abusive behaviour towards other women.

Heartbreaking read. From that article:

“I don’t want to bash the NHS because it has also saved my life.”

It’s remarkable. Even with the errors she suffered at the hands of the NHS this is still the mindset. Can’t bash the NHS . The NHS mistreated her awfully and it only had to save her life because it put her in a position where her life had to be saved. The country has a sort of collective Stockholm Syndrome about the NHS I reckon.

I'm not trying to derail the thread to talk about other hospitial horrors but just trying to gauge whether it is that women giving birth are treated with less respect and care. Or that the way the NHS works it is just a production line and they really cant be bothered with the idea that part of the production line has rights.?

I think there is poor care throughout the NHS, and it's often the luck of the draw whether you get good care or awful care. However, I do think maternity is particularly bad - it's only in maternity that they will outright deny you pain relief for severe pain*, and it's only in maternity that they will refuse to warn you of the risks of things going wrong. It's only in maternity that they promote anti-scientific treatments like hypnotherapy or aromatherapy.

*with the probably exception of hysteroscopy.