Our maternity services: what needs to change?

maternity services

During the course of my 4 pregnancies, I have seen a lot of the local maternity services – from the midwife led unit to the high dependency wards and neonatal unit. I have been scanned, monitored and given medication and surgery by  midwives, health care assistants, surgeons and anaesthetists. 

I have experienced some incredible care, and some not so incredible. 

There are things about our maternity services that are absolutely spot on. My midwife was a godsend – she sat, she listened, she understood. She pushed for my care to be the way I wanted it to be, even when things went wrong. She cared before, during and after the birth. She became my friend. The neonatal team who cared for my babies were second to none. They made us feel an important part of the care team when we felt like outsiders. They were so kind, so gentle and so warm with our children. They supported them, and us, until we were ready to start our life as a new family. The anaesthetist in charge of the epidural for my last birth talked me down from a panic, kept me calm when I realised my husband was going to miss the birth, and rejoiced with me when a healthy baby girl came into the world.

But, sadly, there are some areas of our maternity care that need improvements. So what changes would people like to see?

Partners being able to stay in hospital. I was so worried about being left in hospital on my own with a newborn baby. I ended up having a home birth so it didn’t matter in the end but it’s a horrible thought. A Slice of my Life….Wales.

Following on from that:

For dads to be treated like they matter too. All too often the focus is just on the mum. I understand why, but dads are often an after thought even though they too go through a life changing process and have questions etc. For instance, why are dads just allowed to be around during visiting hours when it’s his wife and newborn? The Dadventurer

Consistency of care and more regular check ups feature highly on the wish list:

I would like to see the same appointments and checks for everyone regardless of whether it is first baby or tenth baby, I found with number 3, 4 and 5 they were very much ‘Oh you’ve done this all before’ however each pregnancy is so different that it doesn’t matter if I’ve done it before. Mum of Five Staying Sane

More scans. I had fortnightly scans with my twins and it made me realise how I was really left to it with my son. My friend is pregnant and she was scanned at 12 & 18 weeks and that’s it. That’s a long time for things to change so I personally think another later scan would be a brilliant change. Twinderelmo

Consistency! I feel like I never saw the same doctor or midwife twice throughout pregnancy and the birth itself. If I had of had consistency maybe they wouldn’t have missed problems and I might have felt less uneasy. Hi Baby Blog

More regular care and checks for ladies considered ‘high risk’ or those under consultant care. Due to the lack of midwives in our area, I don’t feel I saw my midwife enough despite being consultant led. The Hart of the Munchkin Patch

To be given a midwife that you see every time whilst pregnant and beyond. I never saw the same one and therefore didn’t have a relationship or someone I could open up to. Dear Bear and Beany

I would like to see nationwide introduction of Midwife caseloading, so you have one midwife throughout your ante natal care and that midwife is on call for you when you go into labour. In tricky birth situations having a midwife you know and trust can *literally* (and I don’t use that word lightly) be life saving. When I gave birth to my daughter her shoulder got stuck and my midwife got very short and stern with me, commanding me to change positions and to push, she then had to get very ‘hands on’ with me and there was no time to prepare me, ask permission or check I was OK. Because I knew her back to front and inside out, trusted her and knew how much she cared for me, was against ‘purple pushing’ and *for* informed consent, I knew that she was only acting as she was because it was a real emergency. This meant I immediately did as she asked and worked with her to get my baby out which saved her life. Yes, I may have acted the same way with a midwife I didn’t know, but I may not have, or I may have been too scared to push like I needed to and I would DEFINITELY have felt traumatised and violated by what became a very scary and hands on birth. Live Oxfordshire

To centralise pre-natal care to one site. In our NHS trust I ended up having to go to 3 hospitals. I completely understand why I can only give birth in one, but why did I need to go to a different town for an ultrasound when my local hospital had the facilities to do it? Was really difficult because I didn’t drive and I had bad sciatica so getting on and off buses wasn’t an option. Luckily R’s work was flexible so he drove me and when he couldn’t his mum was available. The Diary of an Unexpected Mother

More support for mums who’ve had problems first time around. I only found out at 39 weeks i should have been offered the c section choice earlier in my pregnancy due to complications I had with James. Mummy to my Little Cheeky Monkey

I’d like to see more communication between different teams. I’m under consultant care and a diabetic team and end up having to answer the same questions at every appointment because they don’t seem to link up with each other. In the last two weeks I’ve had four appointments in two hospitals miles apart because the teams aren’t even based in the same place. Each time, the consultant has said the diabetic team will put a plan in place, while the diabetic team say they’ll wait and see what plan the consultant decides on. I’ll have given birth before anyone settles on an answer! Baby Holiday

Support for feeding is a really big issue, and one that many people feel strongly about, whether you choose to breastfeed or bottle feed. Giving birth doesn’t mean you naturally know how to feed this new life, or to provide them with their everyday care.

I would like to see more support for mums who are bottle feeding . As I wasn’t breastfeeding I found that I wasn’t supported at all with feeding. Beauties and the Bibs

I would like to see more support with breastfeeding, especially if we are struggling and wanting support. I did not get enough support and it really influenced and impacted my role as a mother and ruined a precious opportunity for me. Days in Bed

I feel as though I wasn’t given enough information as to what labour would be like, and I was pushed to go to MLU (Midwife Led Unit) with my first, even though there was no special care baby unit there, or any doctors to perform certain tasks that are sometimes needed during labour – the nearest is 45 minutes away. I wasn’t given enough information about medication, and was unaware of what was available. I was also not helped at all with my birth plan so didn’t know what I was doing with it. I asked how to write it, and they said: “Just put what you want.”However, with me not knowing what was available, or what format the birth plan needed to be, I found myself feeling a little clueless. I also had no idea how to care for baby, in terms of how much they need to feed, how to change them etc. My birth ended up going wrong, and I had to go to the hospital 45 minutes away, and skip the local MLU all together! And I had an epidural (good job I didn’t go to the place I was pushed to go to!) Chasing Esme

Screening for Strep B is something I feel really strongly about too – I think it should be offered as a routine test. It’s so quick and so simple, but could save lives. Another routine check that we should see being offered for all newborns is a tongue tie check – it could save so many breastfeeding journeys. 

Screening for strep B. I had it with both of my little babe’s but luckily I knew. So many mum’s don’t know they’re carrying the infection which can be fatal for their tiny baby’s life (ps it’s not something you can catch, it’s an infection present in your genetics). I feel really strongly that every mum should be screened or given the option even if it means us paying the small fee. First Tooth

I feel that all babies should be checked for tongue tie at birth. It is a two second check and had they checked my baby it would have saved me two weeks of hell with a baby who hit dangerous levels due to weight loss. The Adultier Adult

Birth plans can be a really useful tool during your labour, but what happens when things go wrong? I really needed to sit down with someone after my crash section, to talk through what had happened and why. At the time, it all happened so fast, and I didn’t really understand why the decisions were made.

Would be great if they explained what had happened during your birth especially for things like a crash section (why they had to etc.) I didn’t find out till 4 years later and only because I was pregnant and they thought the same things would happen again. Not my year off

A time to go through your birth plan and really be listened to about your wishes. My first birth was an awful experience as I felt so ignored, hence opting for a home birth second time. The Mini Me’s and Me

We all know that midwife units and hospitals are critically understaffed, but this can have such an impact on maternity care.

More midwives and staff, I went in on the Saturday morning at 8am to be induced. I couldn’t head upstairs to delivery until the Sunday evening as there was no spare midwives upstairs to help. So I was held off given the drip longer than I should have in my opinion and ended up having an emergency c-section 14 days overdue on the Monday afternoon. Rachel Bustin

I think instead of centres closing down more should be opening. It can be so difficult for people who don’t have centres locally, especially if they don’t drive. This sort of service should be easily accessible for everyone. Mama Mummy Mum

Most parents just want their babies close to them after the birth, but all too often they are swaddled up in a crib out of your reach. I found it really difficult after my C sections to be able to get out of bed and get to my baby, and didn’t feel I could keep ringing the bell to ask for them to be passed to me.

More bedside cribs and allowing mums to co sleep. Kids, Kicks and Cloth

More advice about how to co sleep safely so new parents don’t feel they have to lie to their health visitors, education rather than judgement. Chilling with Lucas

Postnatal care is as important as the care provided during pregnancy and labour, but all too often we can feel as though we are sent home to ‘get on with it’.

Proper postnatal care – popping round for 10 minutes to see if ‘you’re doing well’ isn’t enough. How can a midwife or HV see if a new mother is managing and doing well with a ten minute visit? Rock & Roll Pussycat

For those tragic times when things go wrong. For those who have lost babies, there needs to much better care all round. They need help, support and advice, as well as understanding staff.

Somewhere different for mums who have stillborns to go. My sister went in to labour at 20 weeks and gave birth to her baby who didn’t survive. She was then transferred to a ward that was full of new mums smiling and their babies crying, whilst she had to lay there silent and crying with her dead baby in her arms. Adventures of a Yorkshire Mum

Somewhere private to sit and wait should things go wrong. After a miscarriage I had to sit crying for 2 hours with all the other patients and pregnant ladies awaiting to see a consultant and for blood tests. Emmys Mummy

I would like to see more support and help for those who miscarry. We lost our first at 8 weeks and apart from the scan to confirm loss and being told to contact the birth centre if I didn’t get a negative test after 2 weeks there was nothing. I don’t mean therapy or anything but just some sort of support, maternity check in, more info and education about it, I was so stressed about getting pregnant again it would have been nice to have had a bot mote early on support in that sense. Two Hearts One Roof

The most important thing to remember is that this is YOUR body, YOUR pregnancy, YOUR birth and YOUR baby. YOU can make the decisions, and the healthcare staff should be there to support that. 

As with ALL healthcare: a removal of the idea of healthcare providers “letting you” or “allowing you” to do certain things. A change in the language to make it clear to everyone that you have a choice in every situation and it’s our job (as health care professionals) to advise and support, not to instruct. 2 boys 1 mum

More information available about our rights, not many people know that you are entitled to the birth you want, you can always opt for a homebirth and they have a duty of care towards you. The Mummy Adventure

What experiences have you had with the NHS maternity services? I would love to hear your thoughts – positive and negative – and how you would like to see things change in the future.

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19 Comments

  1. May 13, 2016 / 1:24 pm

    There is a lot to be considered and plenty of Hingis that can be worked on. Having good maternity services is really important as it really does impact on the infant and relationships. Thanks for an eye opening post. Angela from Daysinbed
    Angela from Daysinbed recently posted…Birthday Party PreparationsMy Profile

  2. May 13, 2016 / 1:32 pm

    I would have lovin’ dad to be able to stay in the hospital with me on the first night. Lots of changes seems familiar to changes that need to be made in Ireland. Great post. Let’s hope something changes…

  3. Paula Forrester (worrisome_mommy)
    May 13, 2016 / 2:48 pm

    I agree with so many of the points raised in this post. Two that are particularly close to my heart would be the idea of a post-labour debriefing, if you will, and the chance for Dad’s to stay overnight, especially that first terrifying night.

    When we had our little girl in February of last year, it concluded with a VERY scary emergency c-section under local antithetic due to little-ones heartbeat dropping significantly everything time I had a contraction, and the doctor failing to take a successful blood test from the top of her head whilst back-to-back, and still very much inside a first-time mommy who they had taken the gas-n-air from, in order to to get her to focus at. As you can imagine it wasn’t very successful, the doctor shouted at me and treated me like I was an imbecile before informing me that the baby had to come out immediately. Cue lots of frantic running around, legal documents shoved in my face and much panicking from everybody involved. I awoke 45 minutes later, at 3am, to find my husband at my bedside holding our beautiful daughter, by 5am I was wheeled up to the delivery suite and my husband, who doesn’t drive and lives almost an hour away was told to leave and that he could return at 9am when all the other Dad’s arrived. Leaving a rather sleepy, drowsy and very much in pain, me to look after our tiny newborn. Not once during my 4 day stay in hospital, did anyone come to me and explain why I was suddenly rushed into theatre, or what was actually causing my daughter so much distress. I found out almost two weeks later, from my husband who was obviously as shocked as myself about the entire thing, and wasn’t in the right frame of mind to be relaying information, that it was in fact due to the cord being wrapped around her throat.

    Sorry to have highjacked your comments but bascially my point is that telling my husband to leave at 5am, with no easy way of getting home, only to return four hours later after a traumatic night of events and also not coming to use and explaining what the hell had happened the next day is beyond ridiculous. My whole birth experience, and post-natal frame of mind would have been greatly improved if only we had been given more information and more immediate after-care, not just for me but hubby too.

    • kate
      May 13, 2016 / 4:45 pm

      A post labour debriefing was so valuable for me, and helped me to understand that what happened wasn’t my fault – I couldn’t have done anything differently. New mum guilt and birth trauma area huge factors in PND, and I think this needs to be recognised and planned for.
      Your labour sounds very similar to my first – I also had a crash C section under general anaesthetic and she was very poorly. I felt unsupported and completely out of the loop – and my husband also had to leave fairly soon after the birth.
      Sorry you had a bad experience. It’s stories like mine and yours that prompted me to write this post – things do need to change.

  4. May 13, 2016 / 3:00 pm

    Absolutely fantastic post and so important too. These are the issues that women and families using the services would like to see improvements on. I agree with them all- especially continuity of care and making birth family centred. xxx
    ghostwritermummy recently posted…#HG: A Pregnancy Unlike Any OtherMy Profile

  5. May 13, 2016 / 8:55 pm

    Brilliant post and I would encourage every woman who would like to make a difference to search out their local maternity services liaison committee (mslc) all areas have them and they are run by service users, our local one has been very powerful and many good things have happened within our local hospital because of the powers that be listening to the voices of the mums xxx

  6. May 14, 2016 / 5:19 am

    I had a similar experience to worrisome-mummy above the first time round. I recently found out that I’m expecting baby #2 during the middle of a possible move to America. We decided not to move to California because I insisted I wanted the baby at home in the UK and part of that reason was that it’s so expensive to give birth in America. After reading this, I’m kind of curious to know how different the experience is over there, especially as they don’t have midwives that you see pre-pregnancy.
    I spoke to blogger Amy Antoinette about how she felt about it having given birth in both the UK & the US and she said she was going to write a post about it soon so I’ll be keeping my eyes peeled for that as if love to know how different it really is. I’ve heard from people who have been in hospital in America for things other than giving birth that it’s more like staying in a hotel!
    Wishing all you future mummies a happy and uncomplicated pregnancy & birth xxx

  7. Margaret Gallagher
    May 14, 2016 / 11:01 am

    Really does have a major impact ion the family as a whole
    Always comes down to money or lack off and overstretched services

  8. May 14, 2016 / 1:31 pm

    Great post! Have you tweeted it to the NHS? They could learn a lot from this!

    For my part I feel that all babies should be checked for tongue tie at birth. It is a two second check and had they checked my baby it would have saved me two weeks of hell with a baby who hit dangerpus levels due to weightloss.

    • kate
      May 14, 2016 / 2:48 pm

      I will tweet it now – thank you for reading!

      I think a tongue tie check is another thing that should definitely be routinely offered. Would you mind if I added it to the post?

  9. May 14, 2016 / 5:53 pm

    It is so interesting reading this, it’s almost a lottery depending on where you live as to what kind of care you get. For my first baby in London I had different midwives at each check, but now I’m in Slough I’ve had the same midwife throughout which is good, but I totally agree we should have the same amount of checkups as with the first baby. I do feel I’ve been left to it the second time round. I was also lucky to have my husband stay with me overnight when Tyler was born, I can’t believe some dads are sent home, that is awful! There definitely needs to be more consistency across the country in the NHS xx

  10. May 14, 2016 / 6:09 pm

    I would have liked to see the same midwife and health visitor rather than a different one at each appointment! I understand they’re short staffed, but it would be better to arrange appointments with the same member of staff where possible.

  11. May 16, 2016 / 2:04 pm

    I think that hospitals really need to have some type of breastfeeding support. I was basically told after my first son was born “when hes hungry he will eat”. I had no idea what I was doing! Then the lactation consultant came to see me hours before I was discharged, when all I could think about was going home. There should be more support for new moms that want to breastfeed. Great post!

  12. May 17, 2016 / 8:03 am

    I actually had a great experience with my midwife and time in the delivery suite. We got given a family room and my husband got to stay the night too. I know some people have some shocking experiences though.

  13. May 17, 2016 / 8:14 am

    There is a lot that can be changed. I didn’t feel in control of my birth at all. Breastfeeding support was also non existent. Brilliant post to highlight what has to be changed.
    Mellissa Williams recently posted…Technology And Wi-Fi AccessMy Profile

  14. May 22, 2016 / 7:46 am

    Fantastic post. It’s good to know that others are having the same ideas as me about our maternity care, but so frustrating that these things need changing in the first place.
    I’m currently pregnant with my third, and blogging about the journey. There needs to be a massive change in how overweight mums to be are treated. I have been bullied, patronised and threatened. The attempts to coerce me into accepting treatment I don’t believe is necessary or acceptable are appalling. Through blogging about it, I’ve discovered that I’m not alone. Others agree that the care is shocking. I felt so lonely before, but having the support of my readers is giving me strength to keep defending myself.
    Thanks for this post.

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