NHS Midwife story

[Zebra 10]

This made for an interesting read:

http://www.dailymail.co.uk/health/article-1235921/Midwives-meltdown-A-NHS-worker-reveals-understaffed-maternity-wards-sinking-chaos.html

 

NHS maternity services in meltdown: A former midwife reveals how understaffed wards are sinking into chaos

 

Clutching her husband's hand and with agony and exhaustion etched on her face, a young woman struggled into a room in the maternity unit where I worked.

 

She was in the early stages of labour with her first baby, she was terrified, in excruciating pain and desperate for any crumb of support.

 

Helpless beside her, her overnight bag in his hand, her poor husband looked equally traumatised.

 

My heart went out to them. But I knew there was little I could do. With five other pregnant women to care for at the same time, all with hugely different and complex problems, I was rushed off my feet and didn't have the time to look after her properly, to allay her fears or to hear about how she wanted the birth to unfold.

 

I longed to sit with this poor young woman, calm her and remind her gently to breathe deeply through each contraction.

 

Just half an hour of my time could have made all the difference. Instead, I put on my cheeriest smile and followed hospital procedure. 'Would you like a painkiller?' I asked.

 

Ten hours later, after she had been drugged to the eyeballs to dull the pain, I heard she'd given birth.

 

Her baby was healthy, but I knew I'd let her down.

 

As I watched her being wheeled into the ward, I felt eaten up with guilt. She'd effectively been ignored from the moment she turned up until the moment she gave birth.

 

Plonked on an antenatal ward until her time came, with no one to reassure her during what was most likely the most terrifying moment of her life.

 

No woman should have to give birth in these conditions - let alone in a modern hospital with professional staff at hand.

 

Welcome to the modern NHS maternity ward. A world of shoddy practice, poor hygiene standards and a shocking disregard for patients' individual needs.

 

When I read about newly qualified midwife Theresa Naish, who hanged herself in January after a premature baby died on her shift, I couldn't help wondering if she, too, was a victim of the over-worked and under-resourced labour wards I have experienced.

 

Her father Thomas told the inquest into her death: 'Like all NHS staff, she was over-worked, doing too many hours in a department that was understaffed.'

 

Although the child had little chance of survival, poor Theresa spent weeks torturing herself that she was to blame, before killing herself.

 

I don't want to alarm people for, of course, the vast majority of babies are born healthy and safe, but I think it's time we admit what is happening in our hospitals.

 

Driven by targets and mired in red tape, our NHS maternity wards are becoming baby-producing factories where mothers' needs come very low on the agenda.

 

The quicker midwives turn out babies, the more successful everyone tells us that we are. We might as well be producing sausages. It's utter madness.

 

I started working as a midwife in Basildon in 1995. I left to work as an independent midwife in January last year because I simply could not bear to let any more women down.

Midwife and baby

 

Special job: Midwives play a vital role throughout the birth

 

During a typical 12-hour shift, I could be the sole midwife in charge of six women in the antenatal ward - some in early labour - or one of two qualified midwives running a postnatal ward with up to 32 women.

 

If I was in the delivery unit, I would assist in the births of up to three babies a shift.

 

Obviously, if there was a crisis during a woman's labour - such as a sudden need for an emergency Caesarean - there was always a surgical team on call, and there would be an anaesthetist available to administer epidurals and so on.

 

But in terms of the normal care through labour, that was all down to the midwives.

 

Although we were under huge stress even back in 1995, current cutbacks mean fewer and fewer midwives are caring for more and more women.

 

No wonder new mothers are encouraged to leave hospital just hours after giving birth.

 

When I started in the mid-Nineties, there were 35,000 midwives working in Britain. A year or two ago, that number had fallen to 25,000, more than half of whom were part-time.

 

So, how bad did it get? Take one typical day I remember a few years ago. I found myself with up to six patients to look after at once and no back-up.

 

From the moment I stepped into the admissions ward, the area was crammed with women clamouring for attention.

 

Two women were in early labour. I longed to reassure them. But my stress levels rocketed when I saw the dramas that lay ahead.

 

One young woman, expecting her second baby in three months, had arrived in an ambulance with high blood pressure.

 

She had been sent by her GP, who feared that her life and her baby's were in danger.

 

High blood pressure is often a symptom of pre-eclampsia - one of the most serious risks facing a pregnant woman and one of the most difficult to detect.

 

Terrified she was going to lose her baby, or die, or both, she was frightened. I tried to reassure her.

 

All the while, half my brain was on the screams of the two women in early labour a few doors away.

 

Did they need more pain relief? When would they need to go into the delivery suite?

 

I had to check my new patient's blood pressure every 15 minutes as well as taking blood samples to be sent for analysis to see exactly what the problem was.

 

It was a race against time because if her blood pressure carried on rising I'd have to ensure she was whisked off for emergency surgery.

 

As I ran between her bed and the two women in early labour, I barely had time to greet another patient.

Midwife and baby

 

Bonding: But staff need to teach mothers how to feed their infants and are rarely given the time

 

She was in floods of tears. Her baby was due in a month. He had stopped moving and she was convinced he was dead.

 

Strapping her up to a monitor to check the baby's heartbeat, I tried to calm her. But I didn't even have time to offer her a cup of tea before rushing to another new arrival.

 

She'd arrived in an ambulance after her waters broke while she was out shopping. The baby wasn't due for another week. Again, her unborn baby had to be urgently monitored.

 

I was frantically checking my watch to ensure I remembered my patient with high blood pressure when a young woman, hair matted with sweat and eyes wild with fear, staggered towards me.

 

'I can't take any more,' she said, gripping my hand. 'You've got to help me.' She'd been in labour for five hours and the pain was excruciating. I knew she'd be happier in a delivery room - which is more comfortable and has better specialist equipment - rather than a bed on the ward, but my heart sank. There was no room.

 

I felt sick with guilt as I led her back to her bed. She was in agony, but she'd have to wait.

 

It was an hour before she was wheeled into the labour room. And in between nursing, I had to write up notes on each patient.

 

There were days when I barely had time to go to the toilet.

 

In the 13 years since I joined the NHS, conditions have deteriorated. Starting from the moment they arrive through the hospital doors, birth plans tucked neatly in their overnight bags, women are being betrayed.

 

There is reams of evidence to prove that a woman's labour is likely to be shorter and she runs less chance of needing medical intervention if she feels calm and relaxed in the early stages. It's not rocket science.

 

Yet because midwives don't have time to sit with women in early labour for more than a few minutes at most, we are encouraged to do the next best thing.

 

We offer them strong painkilling drugs such as pethidine or diamorphine - which is a form of heroin.

 

Drugs keep the mother nice and quiet which, of course, suits staff.

 

But they also likely to make her and her unborn baby terribly sleepy.

 

Although these drugs can sometimes increase contractions, they all too often slow them down.

 

The end result at the woman will need more drugs, not fewer, and labour will take longer.

 

But, of course, we don't explain of that as we dole out our pain killers. Besides, on a busy ward, what's the alternative?

 

Once a woman is in full labour, you'd thought we'd put her needs first. But I'm embarrassed to admit that, all too often, we were not allowed to.

 

Most hospitals rigidly enforce the rule that, once in labour, a woman's canal must dilate at the rate of 1cm an hour.

 

If that isn't happening, midwives are encouraged to tell the her that her baby may be getting in distress - even if that isn't the case.

 

Terrified and exhausted by a haze of drugs, the woman agrees to anything which is offered.

 

In practice, this means we give her extra drugs to intensify the contractions and so speed the arrival of the child.

 

Her pain levels increase and she'll need an epidural injection in her spine to numb the pain around her groin.

 

It's a vicious circle. I felt terribly mean persuading women to go along with it. I knew I wasn't always acting in their best interests. But what could I do?

 

It's a joke to say women have choices over how they give birth. The truth is - thanks to the drive to cut costs and improve efficiency - births are turning into conveyer-belt productions.

 

Women dream of having a natural birth and there is often no medical reason why they can't.

 

Instead, they leave the delivery room with a healthy baby, but feeling like a failure because they have used drugs.

 

Some are on such heavy drugs they don't remember giving birth at all. It's heartbreaking.

 

I also get very angry when I hear NHS authorities extolling the virtues of breastfeeding.

 

According to the NHS website, it's the 'best start in life'. I couldn't agree more.

 

But the truth is that breastfeeding rates are plummeting in the hospitals I've worked in.

 

The reason is simple. Midwives don't have the time to spend helping mothers to feed properly.

 

And without that vital support in the early days, women give up. With three women arriving on a ward at any one time, and three ready to leave, how could I possibly sit for an hour and help a new mother?

 

It's physically impossible, particularly as we are encouraged to rush women home as soon as they are on their feet.

 

It's to save money, but it does at least reduce the risk of the new mums and their babies picking up an infection.

 

It's no news that hospitals are often dirty. By the time I left, I was almost inured to the filth around me.

 

With so many women and too little time, it was impossible to keep the wards spotless.

 

I regularly found myself wiping off blood which had been missed by the cleaners in their rush.

 

It's a huge relief to have left the NHS. As an independent midwife in Northwich, Cheshire, I am finally able to help women the way they deserve.

 

Calm, supported and not rushed, my mothers give birth in six to seven hours. In the units where I worked, the average labour was ten to 14 hours.

 

I feel guilty about the women I let down as an NHS midwife. Weak and in pain, they don't have the knowledge or strength to stand up for themselves.

 

Instead, they end up being patronised by doctors and bullied by midwives into taking drugs they don't want.

 

But what makes me most sad and angry is that those hospital staff - everyone from managers down - are taking advantage of women when they are at their most vulnerable.

 

Interview: TESSA CUNNINGHAM

[bluecanary 13]

Well, as a first time mother due to give birth in the next week or so, this cheered me up and reassured me no end - thanks.

 

Anyone like to post anything more positive to balance this?

[jellybellybean 10]

I must admit my experience in Jessops was thankfully not as bad as this. I arrived at triage around 9am and wasn't waiting long before i was examined and told i was 3cm. The midwife suggested i went home but i said i'd rather stay in hospital so i was transferred to a ward. I must admit my time on the antenatal ward wasn't great, i was in agony and had no support, my OH kept going and looking for the midwife as i was in a lot of pain and she kept saying "just a minute" eventually she came and transfered me straight down to labour ward as i was 10cm and ready to push just a few hours after arriving.

 

Once on labour ward i had a wonderful midwife who encouraged the unmedicated birth i had planned and calmly talked me through each stage. I delivered a gorgeous little girl at 12.48 that lunch time.

 

There were complications after i'd delivered, i lost a lot of blood and needed a transfusion so i spent 2 days on the high dependency unit. The staff there were amazing and were never too busy to make me some toast or just sit and have a chat, the breastfeeding support i got was great too.

 

I then moved onto Concord ward where it was evident they were understaffed, i felt i stil needed help with breastfeeding and at times i had to be very vocal to make myself heard and get the support i needed. Thankfully in the early hours one morning one of the support workers sat with me and helped me to correct DD's latch and we've been fine since.

 

I wish you luck bluecanary, my only advice to you would be not to give up or stop asking if you want something. If i was to have another child i would like a homebirth but wouldn't rule out Jessops again. I do here the Derby birthingcentre is supposed to be really lovely though.

[bluecanary 13]

Thanks jellybellybean. I'm not deluded enough to believe that everything's definitely going to be perfect by any means, but it's reassuring to hear that you were looked after for at least some of your time in Jessops!

[mosaic 10]

Hi Bluecanary, I had a much more positive experience in the Jessops. Staff were always with me when I needed them, the birth had some difficulties but they were dealt with efficiently. And after the birth a midwife stayed in the room with us for a very long time chatting about the birth and giving us lots of reassurance. I am very thankful to her as it made the hour after the birth really calm and wonderfully positive, and that feeling of calmness stayed with me for months afterwards (I know it sounds silly but it really felt like that!). I hear a lot of other women have had similar experiences, so it's not all doom and gloom.

 

I think hospitals in very large cities such as London might be very severely understaffed, but I don't think it is the case in Sheffield.

[bluecanary 13]

Thanks mosaic - it's good to hear that you had such a positive experience. I will hope for more of the same!

[Strix 11]

It's already making me nervous that when booking hospital appointments they've had difficulty finding a suitable appointment slot

 

does this mean there's going to be a peak in births around the time I'm due, and they can't create staff or facilities out of thin air!

 

The NHS templates for deciding number of 'beds' is really worrying - across all departments. How the heck are the staff supposed to cope with any of the peaks in 'demand'?

[Birth-Peace 10]

I think its incredibly, incredibly sad that a trained midwife refers to the most amazing experience of birth as "Plonked on an antenatal ward until her time came, with no one to reassure her during what was most likely the most terrifying moment of her life."

 

And what a sad thing for woman about to give birth to read.

 

Bluecanary, if you or anyone else would like to read a very positive birthing story, then please pm me and I shall send you mine x

 

I would very much like to say that I had the most amazing birth with my first child and am thoroughly looking forward to giving birth again in a couple of weeks.

 

Please don't get trapped in the birth is awful vibe people. It was the most amazing experience of my life.

[pattricia 574]

The thing is not many young women want to train as midwives now. There lies the problem.

[cuddlycats 10]

Neither of my births were 'to plan', but that wasn't anything to do with Jessops, equipment or staff. The treatment i received lived up to what i expected, and the staff were lovely. Don't let horror stories scare you-for everyone bad story there are probably 100's of good ones. Good luck

 

p.s i needed diamorphine and it was great

Edited December 15, 2009 by cuddlycats

[Birth-Peace 10]

Pattricia, I'm pleased to say that I have had the honour of teaching many, many sixth formers who wish to go onto train to be midwives.

[hodgepodge 10]

I would like to know what Zebra hoped to achieve in posting this article. She advertises and therefore represents SF Parenting group, yet this article does nothing to empower and give confidence to women about to go through the most important day of their lives.

 

Its a totaly negative view of one very disalusioned midwife.

 

There is so much you could take apart from this report, I know from experience the policy at Jessops involving progress in labour involves making "some progress" and is not strictly 1cm per hour.

 

Also it discusses the midwife delivering 3 babies in one shift.... I arrived at hospital with my second baby and delivered her 40 mins later, so 3 babies in a 12 hour shift is quite feasible.

 

No one will deny that maternity units across the country are, at times, busy and over stretched, but having had three children in sheffield I can honestly say that I never felt patronised by doctors, bullied by midwives or taken advantage of my any member of staff. I had 3 amazing experiences, each time well supported......and if I can do it then so can you!

Edited December 15, 2009 by hodgepodge