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Saturday, April 20, 2024
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HomeNewsCall the Midwife (if you can find one these days) 

Call the Midwife (if you can find one these days) 

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THE bumper Sunday supplement arrived this weekend, listing all the exciting TV programmes to be seen over the next two weeks of merriment.  

It came as no surprise that the highlight of Christmas Night is to be that old regular, Call the Midwife, which has figured as a Christmas special since it was first broadcast in 2012.  

Originally based on the memoirs of Jennifer Worth, who worked with the Community of St John The Divine in East London in the 1950s and 1960s, the stories have ranged far beyond her original writings.  

In my view, the brand is far past its sell-by date. We all know what the story will be – complex domestic situations among the deprived East Enders, with much fatuous BBC virtue-signalling over equality and diversity, while the saintly midwives go beyond their remit to solve all the problems, ending with a new baby and a happy mum.  

There will be a bit of religion from the nuns (but not enough to cause offence), mince pies, turkey, sherry and general goodwill. The mad old nun will make a few pithy comments, and of course it will snow (as it does every Christmas in London).  

But I have my own story to tell. As a medical student in East London (1967-1973) I was required to spend a two-month period in the winter of 1972 learning basic obstetrics and gynaecology. Although this was about a decade after the setting of Call the Midwife, not that much had changed. 

The first month was spent at my alma mater, now renamed The Royal London Hospital. It always puzzled me that one of the maternity wards was named the Marie Celeste. Why would you name such a ward after an abandoned vessel? The work there was mainly observational rather than hands-on. But I did get to go out with a district midwife on two occasions, but in her Morris Minor rather than by bike.  

The first visit was a false alarm. However, the second was in the middle of the night, and yes, it did start to snow quite heavily and visibility was very reduced. The address was in one of the complex tenement buildings and it took us ages to find it in the dark and snow.  

Finally, after shining a torch on many doors which all looked the same, we located it and were welcomed in. The mother, who already had several children, was in an advanced stage of labour and the delivery was quick and successful. Smiles and tea all round. It was very exciting.  

The second month was spent in the maternity unit of the Chelmsford and Essex Hospital (now downgraded to a health centre) and was much more hands-on. Since there were no midwifery students, the midwives, generally older ladies, were more than happy to let us get on with it under their tutelage.  

During the month I delivered a total of 44 babies. The final one was on my last night on duty, and the midwife, busy in another room but within easy reach, allowed me to fly solo with just an auxiliary assisting. It was all uncomplicated, and I delivered a bouncing boy (none of this ‘gender assigned at birth’ nonsense). The whole experience was exhilarating and life-enhancing.  

After it was all over, the grateful parents announced that they were going to name him after me – the only occasion this happened. So if you are aged 50, were born in Chelmsford and are named Thomas, then you owe me one.  

I checked this out on a doctor’s website, and sadly this sort of experience has virtually disappeared. Today’s medical students never get near a baby. Apparently the training of midwives takes priority, so delivering a baby is now something which most modern doctors will never experience unless they specialise.  

I think this is sad, because they will miss out on a very rich experience. Doctors are often involved in the end of life; what a shame that so few are now involved in its beginning.  

 I am not suggesting that things never went wrong in my day, or that there were not some tragedies, but despite all the modernisation and new techniques, things have changed for the worse over the years – as the statistics show.  

Most recent was the report into maternity services in East Kent, but this comes on the back of the reports on Shrewsbury and Telford, and Morecambe Bay. Each reported the same issues of avoidable birth injuries with neonatal and maternal deaths related to poor practice, bad staff relationships and staff shortages.  

The reasons for this are multifactorial, but the Royal College of Midwives has reported that the number of midwives has been dropping month by month since July last year, a figure of 331 in November 2021 alone. Last spring, the minister for maternity services confirmed that NHS England was just under 2,000 midwives short, and figures have become worse since then. 

NHS Resolution is the body which handles litigation, and its 2021-2022 annual report states that there were 1,243 obstetrics claims reported in 2021/2022, accounting for 12 per cent of all clinical negligence claims by volume. This places maternity-related claims among the top three specialities by volume, alongside emergency medicine and orthopaedic surgery.  

However, obstetric claims accounted for 62 per cent of all clinical claims by financial value. Of the £13.3billion annual cost of harm, maternity claims accounted for 60 per cent of these. The costs of supporting a brain-damaged baby for the rest of its life are staggering.  

A member of my family is in the third trimester of her second pregnancy, and her sister works as a lawyer in medical negligence (defence). She knows the score with regard to poor obstetric practice, since she has to regularly deal with the negligence issues. So she wants to try to stay with her sister during labour to make sure that it is handled properly and that any warning signs are acted upon. What has the NHS come to?  

So if you are able to stay awake long enough to watch the midwife programme on Christmas Night, don’t be taken in by the warm fuzzy Christmas glow. The real world today is much more troubling. 

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Dr Tom Goodfellow
Dr Tom Goodfellow
Tom Goodfellow is a retired NHS consultant radiologist who had a specialist interest in paediatrics and cancer diagnosis.

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