Disturbing findings in a report released in January – that half of women surveyed experienced a ‘red flag event’ during labour, such as a lack of one-to-one care – came as no surprise to me. After suffering the effects of overstretched midwifery staff on two separate occasions during the last six years, the results are depressingly familiar.
The report, Support Overdue: Women’s experiences of maternity services 2017, produced by the NCT and the WI, confirms that little has changed since their initial study in 2013. Across the UK it exposes “broad, systemic failings…rather than a ‘postcode lottery’.”
Following a textbook pregnancy in 2011, I went into labour over the Easter weekend.
My contractions were strong but erratic, so I waited until my waters broke before travelling 30 minutes to an Essex hospital. I’d been advised at an antenatal appointment to avoid a closer London unit with a worryingly high maternal death rate.
In the early hours, a tired junior midwife misjudged the irregular contractions, failed to examine me and sent me home. Unbeknown to her, I was in established labour so when my partner and I arrived back at 4am, I was 8cm dilated and delirious. Human error is inevitable, but suddenly I felt vulnerable. Now the midwife was complaining she hadn’t had a drink of water for hours.
Then my baby became stuck. They explained that his heart rate was dropping during contractions and the doctor who was needed to perform an episiotomy was held up in an urgent case in theatre.
After pushing for six hours she finally rushed in and barked, “You’re doing it all wrong”, compounding the fear in the room up until his birth at midday. Minutes later, a rep from a private marketing company bulldozed in to take my personal details, while a midwife tried to activate the pay television by my bed.
The next morning, after another rep had offered to sell me photos of my baby, the ward sister urged us to return home, even though my son hadn’t latched onto the breast once, nor taken much formula. I was in intense pain, but off I shuffled. They later apologised.
Three different community midwives flew in and out over the next fortnight. I felt like a zombie. After eight weeks they finally scanned me as I was still bleeding, and found pieces of retained placenta. They operated the next morning.
Some midwives are on long-term sickness due to horrendous pressure that has caused them to burn out
“Your story makes me go cold, look at the hairs on my arms standing up”, was the health visitor’s reaction to my account.
“Staff shortages is an ongoing issue,” explains Sasha*, a senior midwife based in the east of England. “Some midwives are on long-term sickness due to horrendous pressure that has caused them to burn out. We do not get breaks during our 13-hour shifts because there simply isn’t enough of us to cover each other. Women cannot be left on their own during established labour, especially those on the high-risk ward where I work. So we go without. Sometimes without even a drink.
“I have had so many UTIs last year, I’ve been referred to urology and I honestly think my job has played a huge part in that. There is always a joke on the ward as to whose urine looks more like orange juice at the end of a shift – nice, hey?”
Support Overdue describes the postnatal budget providing “Cinderella care”.
“This government isn’t interested in public health,” says Anna*, who has been an NHS health visitor for 30 years. “I’ve just bumped into a midwife who said, ‘I’m absolutely exhausted, not well enough to work, but there isn’t anyone else to do the postnatal visits.’ The sickness policy for midwives is quite punitive now, so you get very unwell people visiting vulnerable newborn babies. And the labour ward becomes a cattle market. There’s a horrendous lack of humanity.”
For my 2-year-old’s arrival in late 2014, I chose to give birth in the since-revamped London birth centre. After a safe, happy delivery, I was whisked straight to theatre to remove the placenta – this felt like a blessing in disguise. No one could now throw us out early and the nurse monitoring my recovery happened to be a breastfeeding expert.
I was also grateful to receive stitches in a theatre environment rather than from a harried doctor as before, who forgot to administer further anaesthetic. On the postnatal ward it was chaos, with healthcare assistants buckling under demand. The staff were incredible, but confronted with an impossible situation.
Anna fears that the current privatisation of maternity care is a slippery slope.
“I will get to retire on a full pension at 55, due to the physical and emotional toll of the job, but now people will have to work until they’re 67. With Trump doing what he’s doing, I can see us ending up with no midwives in the UK. It’s all obstetric nurses in America. At this rate, we too will be making money out of birth.”
*Names have been changed to protect identities.
*Names have been changed to protect identities.