What would you do if you were pregnant and lived in Shropshire?

Didn't stay in that job long.

This is all a terrible tragedy but it reminded me of my days in commissioning emergency services. We had 2 maternal deaths in 2 years and that was a red flag causing an enquiry. At the same time I was told by my then boss, the Director Finance if you please, to limit the number of terminations I commissioned. When I protested he asked me how many I thought I needed!!!!!

No manager or accountant would tell doctors and midwives how to manage the clinical care of a patient MerylStreep. There is no excuse for a professional not to whistle blow when aware of bad clinical practice, and it sounds as though a number of staff knew but didn’t challenge the culture - they are also culpable.

If the Government had adequately funded the NHS over the last 10 years this may never have happened because more staff may have mitigated the effects of the bad culture on the unit, and there must have been local management failures if there had previously been known problems, but to place the blame entirely at the ends of local management without recognising that clinicians run clinical services, and are a decision making part of the management team is frankly ridiculous.

DaisyAnne

MerylStreep

Perhaps we can now enter into a dialogue where it’s acceptable to not treat the NHS as some holy grail.
I will point out that I mean the NHS not the majority of doctors and nurses who work within it.

I'm not sure anything so underfunded would claim to be a "holy grail". It is held together by the goodwill of the staff, which seems to be dissipating.

Absolutely, the NHS is breaking apart.

I think it is a deliberate policy.

MerylStreep

Perhaps we can now enter into a dialogue where it’s acceptable to not treat the NHS as some holy grail.
I will point out that I mean the NHS not the majority of doctors and nurses who work within it.

I'm not sure anything so underfunded would claim to be a "holy grail". It is held together by the goodwill of the staff, which seems to be dissipating.

Well, what ever the cause, something has gone as wrong as it could be.

From my point of view, nothing in my life has been more precious to me than my children.

To look at my brain damaged child every day knowing that she would have been born with a normal brain but for the incompetence of the midwife, the prevailing culture, staff shortage, neglect or whatever would utterly break me knowing what my child is suffering was inflicted upon it at birth.

My daughter in law swore she’d never birth a baby in this country based on her friends experiences with NHS maternity care in London and Greater London (this was before Shropshire made the news)

DillytheGardener

I had a dreadful and frightening experience in a Surrey Hospital many years ago, luckily we were both all right but with no thanks to the negligent staff.

In all those years, maternity services have gone from poor to worse.

Thankfully my three births in Oxfordshire in the 1980s went well. But: I attended NCT classes and the feeling was that if you didn’t have a natural birth with no painkillers you had let the side down! I was lucky and was able to do this. In my ward with my first baby, a young mum had to have an emergency caesarean. She was devastated and felt she had missed out on the real birth experience!

There was a piece in the Times the other day, on the dogma of prioritising natural births, at seemingly almost any cost.

I’m reluctant to blame midwives, but at the same time I’m aware that a fairly substantial body of them were, at one time at least, very much against what they saw as ‘interference’ from obstetricians.

I still feel that my dd suffered for this, though it wasn’t in that area. As she realised later, staff in her midwife-led unit were well aware much earlier that her first baby was ‘back to back’ and the birth was going to be difficult. But although the obstetric unit was only just downstairs, and she could have been helped a lot sooner, thus avoiding a lot of unnecessary pain and subsequent damage (to her) though the baby was fine, thank goodness.

At a meeting later, when she asked whether she couldn’t have had help sooner, they said, ‘Oh, but we thought you wanted to do it yourself.’
Which she had originally, but that was before labour proved to be so difficult.
For her two subsequent births she was well aware of the need to be a lot more vocal, if needed, but thankfully those births were much easier.

I can't imagine how awful it was for the women who lost or had brain damaged babies, plus I think 9 mothers died as well.

Casting my mind back to my first pregnancy I do think natural childbirth was held up as a holy grail that was mid eighties. I remember one midwife telling an ante natal class I went to "how you cope with impending childbirth is an indicator as to how you cope with life generally" as if we were all entering some competition/endurance test. In retrospect such a damaging blanket statement which took no account of umpteen factors that determine the eventual birth. I myself had a difficult long and protracted labour and a forceps delivery.

MaizieD I think there should be public judgement given the catastrophic outcomes of negligence from U.K. midwives have been covered up for so long, and still continue to occur.

Casdon
Who instructs the Doctors and nurses: management and accountants. In this shit show it appears they were the very worst.
The good guys knew what was happening but under threat of loosing their jobs had to keep shtum.
Every health secretary for the past 20 years has known about this hospital.

I would be scared, because apparently the culture still persists, with staff being frightened of voicing concerns or worse, still believing that they know best and not listening to the mothers in distress.
My deliveries, in Staffordshire forty plus years ago went well, but the second midwife made it clear she was the person who made the decisions: 'are you a doctor?'. At that time there was conflict over whether mothers should have epidurals and the presence of fathers in the delivery suite.
Looks as though the attitude hasn't changed.

Katie59

Rent a place in a safer area for a few years, it would be easy to rent mine out for a year or two, thankfully I’m way past all that.

As a retired midwife I threw the towel in 6 yrs ago, there were just too many “lucky breaks” due to staff shortage. (not Shropshire)

I'd be very interested id Katie59 would come back to tell it from a midwife's perspective.

There have been some very judgemental posts already; it would be good to get a professional view.

Casdon
Cases were still being reported last year 2021 !!!!!!

But this situation has happened because of the doctors and nurse (midwives) in the system MerylStreep, saying you don’t mean the majority of doctors and nurses is a cop out. What exactly do you mean?

Whilst I agree the situation is shameful & frightening my question is what part did the " targets" play in this appalling situation.
Who set the targets to limit C- sections, what were the consequences of not meeting the targets?
Was it administrators or doctors driving decisions?

Over time, in all public service areas there has been a deliberate move away from the professionals ( lawyers, doctors, teachers etc ) to administrators/ CEOs directing policy. In many cases this has caused weaknesses and deterioration in provision of services.

I am not completely exonerateing staff directly involved in patients' care whose own lives/ babies have been lost or severely damaged. But the context in which they were carrying out their professional role may have been beyond their control.

*birth units. Apologies so many typos. Dyslexia and posting is such a pain. Wish I could do voice notes as on WhatsApp!

My care, my mother in law’s care and anecdotally from friends and family (excepting birth care) has all been fantastic.

I think the issue is the body that runs midwives in the U.K. has a dogmatic view of natural birth and an unwillingness to defer or consult obstetricians when births are/become complicated. There was a huge campaign to avoid birth interventions such as caesareans and though now guidance globally proves otherwise, midwives in the NHS still dogmatically hold to it. They also stubbornly hold to the breast is best policy, even when babies are undernourished and it causes post natal depression in mother’s who feel at fault when their babies refuse to take the breast.

I think it will take that midwife body being fired and replaced with competent individuals, preferably those with midwife experience abroad in a country with a better midwife culture who will not be influenced their colleagues and obstetricians place on the board too, to overhaul the culture completely. It will take a generation to weed out the current toxic culture until those practicing now retire.

From what I’ve heard from friends children having babies, the maternity care is great until they actually come to give birth itself. It is the culture in the both units that needs the change.

Perhaps we can now enter into a dialogue where it’s acceptable to not treat the NHS as some holy grail.
I will point out that I mean the NHS not the majority of doctors and nurses who work within it.

The care I received with my first child was second to none, with my second child I watched in agony as a midwife and a doctor argued over me about what needed to happen, until the doctor shouted this baby needs to come out now. Emergency caesarian and he was thankfully ok. Looking back the midwife had been worried all night and my guess is had not acted. I was given my birth notes and asked to take them to my first community midwife appointment, a couple of days later. I hadnt had time to read them (strangely enough!) and when I asked for more time they would not give them to me or provide me with a copy. I obviously should have insisted as it was clear they didnt want me to see them but I wasnt in the state for a fight. It is why I found the fawning over sorry this is going to hurt so depressing.

Rent a place in a safer area for a few years, it would be easy to rent mine out for a year or two, thankfully I’m way past all that.

As a retired midwife I threw the towel in 6 yrs ago, there were just too many “lucky breaks” due to staff shortage. (not Shropshire)

If it’s that bad still I would go elsewhere too Whitewavemark. I’d be really surprised if nothing had already been done in reality though, because health organisations react very quickly when there are big problems like this, rather than risk more lives. As I said, the big problem for the Trust in the future will be rebuilding a service, because nobody is going to be attracted to work there now when there are recruitment issues throughout the UK - why would they?

Casdon

So awful for all the families involved, knowing your baby could have been saved must be very difficult to live with.
The Report covered the period up to 2019, so it is to be hoped and expected that a lots of changes have already taken place, and that there will be a very close implementation and monitoring system in place now to bring the service up to scratch. That will include dealing with any individuals, and the consultants and senior midwives who set the culture of the department will no doubt have been through the mill, and been dismissed/disciplined. The hardest part is rebuilding the reputation, and attracting high calibre staff to work in the unit now. If the whole department was removed as you suggest Whitewavemark I can’t see that it would ever be able to reopen because the staff just aren’t out there to recruit.

The person who looked into the issue, does not think that anything has changed. The culture is so bad that people are frightened to report any issue because they are apparently threatened with their job!,

God almighty what is the matter with people.

To be frank I would rather go anywhere than have my baby there. I would be so frightened.

I’d move temporarily to another area with family or friends and have the birth in an area with safer statistics.

My daughter in law swore she’d never birth a baby in this country based on her friends experiences with NHS maternity care in London and Greater London (this was before Shropshire made the news).

Three of her friends have sued the NHS for birth injuries to baby or mother, from midwife negligence.

My daughter in law had her baby in an Auckland hospital, with an obstetrician (no midwives) and stayed in another mother care unit for a week afterwards. No issues, they just keep older mothers in longer to keep an eye on them. She left having a positive birth experience and feeling confident in her abilities as a new mother.

I think ‘call the midwife’ and shows of that type show a very rosy view of midwifery. From what I’ve heard through dils friends, seen on another BBC documentary on Shropshire and read in the news it seems like U.K. midwives are ‘natural’ birth zealots and risk mother and child to avoid caesareans. Rather than the best birth is a birth when mother and baby are safes. The news and documentary have also uncovered a culture of midwife knows best, where they avoid consulting the resident obstetrician when births become complicated.

If I had a daughter having a baby in the U.K. I’d pay for her to have a private birth than take the risk.