I’ve just a seen a headline that feels like a slap in the face. ‘Give all mums one-to-one midwife care, NHS is told’.
It’s the latest NICE guidelines for staffing levels on NHS labour wards. Women in established labour should receive one-to-one supportive care, according to NICE:
“The care provided by midwives has a lasting impact on a woman’s wellbeing, and on the health of her baby”.
No kidding. I was left abandoned on a labour ward in December last year due to staff shortages, and I’m still dealing with the after-effects.
My mum, having heard horror stories from friends’ daughters about shocking levels of care on NHS labour wards, desperately wanted me to have a private midwife when I was pregnant last year. She even offered to pay for it herself. I reassured her, “No Mum, they’ve just built this new midwife-led birthing unit at my local hospital. You should see it – it’s incredible. They’ve got birth pools, mood lighting. There’s even free aromatherapy massage.” Mum wasn’t convinced but she heard the confidence in my voice. I’d seen the place and she hadn’t.
The time came and off I went to the birthing unit. It was all ticking along nicely. I was the only woman in labour and with two midwives on duty I was receiving excellent care. That is, until the midwives received a phone call from across the corridor in the labour ward: some agency midwives hadn’t turned up for work and they were short staffed on labour ward. Managers decreed that the birthing unit had to be closed and midwives pulled from there onto the labour ward. As I was the only woman on the unit I had to be moved across too.
I’d just been scheduled to get some pain relief – a shot of pethidine – when this happened. My midwife reassured me that I’d get it as scheduled on the labour ward. I’m sure she meant it, and naively I believed her.
I was transferred across, an unexpected arrival, and after some humming and hawing about where to put me they stuck me in an out-of-the-way ward for women in early pregnancy who were in for observation. And then I was just left. I never got my pain relief. I was never checked by another midwife.
I don’t remember much about it – it’s just a fog of pain – but I laboured to fully dilated, in public, without even gas and air. It was only when a midwife heard me bearing down that staff starting moving. She’d been passing by the entrance to the ward, heard the telltale noises, and made enquiries. I’d been ready for push for some time but held back – there wasn’t even a curtain round the bed, there were men on the ward accompanying their partners, and I had no idea how dilated I was. Last time anyone had checked had been back on the birthing unit when I was in early labour.
By this point I was completely exhausted and totally out of it. I remember being whisked off to a private room, and they got the baby’s heart rate hooked up to a monitor, but there were complications – baby’s heart rate was dipping. All I remember was the room filling up with people, then sudden searing pain. I heard myself screaming, as if from a great distance.
My partner said the baby was blue when they pulled her out. By that point I didn’t care whether it was a boy or girl. I knew the baby was ok when I finally heard a cry but I’d mentally checked out of the whole situation: I was in the middle of a post-partum haemorrhage and had lost so much blood they couldn’t find a vein to get a drip in.
We were in hospital for five days on a postnatal ward. I only know the details of what happened to me because the midwife in charge that day was so concerned that she escalated my case right to the top. I was able to access postnatal services and see my notes to discuss what happened. It was all there: agency midwives not turning up, midwives noting that they were too busy with existing clients to check me, things scheduled to happen that never happened.
To this day I feel deep deep sadness about my daughter’s birth. I was robbed of an experience that should have been an empowering and beautiful thing. I’d done so much to build up my confidence; my team of midwives had given me excellent and supportive antenatal care. My worst nightmare had been that I’d find myself giving birth alone on my bathroom floor or something – it never occurred me I could feel just as alone and terrified in an NHS hospital surrounded by trained professionals.
When a midwife from my local team arrived for a postnatal home visit she sat with me in the kitchen and we had a little cry as I told her what happened. She’d heard already on the grapevine, but hearing it from me personally she too confessed that there were days when she felt unsafe, as a professional, working on the labour ward. “There just aren’t enough midwives”, she said. We talked about how, with the new birthing unit, it looked like our local NHS cared about maternity services, but without the midwives to run it, it was all just window dressing. She sighed and said, “There’s all these women having babies, but maternity just isn’t valued.”
She apologised for what happened to me, but she was the last person who should have been apologising. I would never blame midwives for my lack of care. After all, they only want what I want, which is what every mum wants – the best for mother and baby. My midwives were as horrified as I was at what happened, and shared my sense of injustice and sadness.
So NICE can issue guidelines until the cows come home. We all know mums to be should get one-to-one care. It’s what we all want. But where’s the money coming from to train up new midwives? What plans are being drawn up to fill the deficit? What’s this Government doing to signal that maternity matters? A big fat nothing as far as I can see.