#Nottingham maternity scandal

[coochiequeens]

Doctors and nurses who are not willing to listen to their patients should be replaced

BY VICTORIA SMITH

The third time I went into labour, I was determined to avoid getting told off. With both of my previous births, I had somehow managed to get things wrong. My errors the first time: going to hospital too early, then, when I returned three hours later, “leaving it so late”. The second time: ignoring assurances that I didn’t need to come in yet, then giving birth in the car park — an event I later discovered was being used in antenatal classes as an example of women “not planning ahead”.

“My previous births have been fast,” I said, when I went into labour with my third, “so I’d like to come in now.” I was speaking to the woman at the midwife-led unit that is the only option where I live. (If you need a caesarean section, you have to be transferred to next town.) “Third babies are notoriously difficult,” was her response.

What an odd thing to say to a woman already in labour. The “notoriously” suggested it wasn’t based on any actual evidence, but rather a kind of folk wisdom. It felt as though I was being warned not to tempt fate, not to assume that this baby would just pop out. I saw myself being categorised as one of those arrogant women who presumes to know her own body, only to be taught a harsh yet much-deserved lesson. “Third babies are notoriously difficult” sounded not unlike “third-time mothers shouldn’t get above themselves”.

In fact, I have never been particularly cocky about childbirth. When I was pregnant with my first child, back in the days when the Right-wing press were still obsessed with famous women being “too posh to push”, I wondered if I might be able to get an elective caesarean myself. I did not particularly care about childbirth being a wonderful experience, or about “doing it well”. I didn’t care if the Daily Mail thought I was a joke.

What I cared about was not having a child who would face the same difficulties as my brother, who was starved of oxygen at birth. This has had serious consequences for him, and for the rest of my family. Just how serious is hard to gauge. He was born traumatised; there has never been a before to compare the after with. What there has been instead is the hazy outline of an alternative life, one that runs parallel to the one he has now. It’s a life that began with the problem being identified sooner, with him being delivered quickly, perhaps by emergency caesarean. The difference between this and his actual life comes down to something small: mere moments, mere breaths.

I was born three years after my brother, in a larger hospital, where my mother was induced and monitored carefully. There is something very strange about being the sibling who had the safe birth. It feels as though I stole it. There is a constant sense of guilt, as if my life — my independence, my choices — constitutes a form of gloating. “This is what you could have had.” Everything I do feels like something owed to my brother (do it, because he can’t) but also something taken from him (you shouldn’t have done that, because he should have done it first).

Still, my family were fortunate, insofar as my brother didn’t die. Current reports on the Nottingham maternity scandal reference 1,700 cases, with an estimated 201 mothers and babies who might have survived had they received better care. What strikes me, reading them, is the enormous gulf between the cost of a disastrous birth and the trivial, opportunistic way in which childbirth is so often politicised — with mothers themselves viewed as morally, if not practically, to blame if anything goes wrong.

As a feminist who concerns herself with how the female body is demonised, my interest in debates about birthing choices is more than personal. I have read books railing against the over-medicalisation of childbirth, aligning it with a patriarchal need to appropriate female reproductive power. I have also read books protesting the fetishisation of “natural” birth, suggesting that it infantilises women, that it implies women deserve pain. To be honest, I find both arguments persuasive and dismaying. Both are right about the way in which misogyny and professional arrogance can shift the focus away from meeting the needs of women and babies. I feel a kind of rage that we are told to pick a side.

Representations of the labouring woman are so often negative: the naïve idealist, the “birthzilla“, the birth-plan obsessive, the woman who is “too posh to push”. This latter stereotype has gone hand-in-hand with a veneration of vaginal births, and stigmatisation of caesareans, that has had sometimes disastrous consequences. Midwives at the centre of the Furness General Hospital scandal were reported to have “pursued natural birth ‘at any cost’”, referring to one another as “the musketeers”; at least 11 babies and one mother died. But their approach was sanctioned by their employer: the 2006 NHS document “Pathways to Success: a self-improvement toolkit” explicitly suggested that “maternity units applying best practice to the management of pregnancy, labour and birth will achieve a [caesarean section] rate consistently below 20% and will have aspirations to reduce that rate to 15%”. Proposed benefits to this included “a sense of pride in units”.

Responses to maternity scandals now express horror that such an anti-intervention culture ever arose — responses in the same press that denigrated women such as Victoria Beckham and Kate Winslet for not giving birth vaginally. Instead, newspapers now stoke outrage over “natural” treatments during NHS births, such as burning herbs. Women have been shamed for having caesareans, but they have also been shamed for wanting births with minimum intervention — as though they are selfish and spoilt for seeking control over such an extreme situation.

In his memoir This Is Going To Hurt, former doctor Adam Kay writes disparagingly of women who arrive at the delivery suite with birth plans:

“‘Having a birth plan’ always strikes me as akin to having a ‘what I want the weather to be’ plan or a ‘winning the lottery’ plan. Two centuries of obstetricians have found no way of predicting the course of a labour, but a certain denomination of floaty-dressed mother seems to think she can manage it easily.”

Wanting to have some control over your experience of labour — which will hurt you and could kill you or your baby — is not akin to some messianic aspiration to control the weather. And in his mockery of the woman who wants whale song and aromatherapy oils, ironically, Kay deploys the same silencing techniques that might intimidate a woman out of seeking the very interventions he so prizes. What he and others do not seem to grasp is that their arrogance is a problem, regardless of which course of action they champion. It makes women feel they can’t speak, for fear of inviting hostility at their most vulnerable moments. It’s true that none of us knows our body well enough to know how we will give birth. But, looking back, I find it utterly insane, not least given my own family history, that one of my biggest worries during labour was “please don’t let anyone get cross with me”. Then again, I don’t think that fear is unrelated to the desire to remain safe.

Birth is not a joke. It is not a place for professional dick-swinging or political one-upmanship. I cannot describe — and, as I am not my mother, cannot fully understand — the shame of feeling that you “let down” your child before they drew their first breath, that they will forever suffer because of it. You watch an entire life unfolding and that feeling is there, every single day. This is the fear of the women in labour who are characterised as either idiots mesmerised by fantasy homebirths or cold-hearted posh ladies who can’t take the pain. If things go wrong, they are the ones who will bear the consequences, reflecting every day on what might have been, if they’d only done more.

When people discuss their siblings, my mind does wander to the one I don’t have, the one who was born safely. Perhaps he would have a job he loved, or one he hated, but in any case a job. Perhaps he would have a partner. Perhaps he would have children, and I would be their aunt. Perhaps we wouldn’t get on, wouldn’t even speak, but he’d have a life of his own. I know he thinks about this too. I wonder if the professionals who presided over his birth have thought about him since.

My third labour was not, by the way, “notoriously difficult”. My third son arrived into the world safe and well. No one can say why him or me, and not my brother. Mothers may long for control over birth, for which we are mocked; but we do not have it, for which we are blamed. Politics still takes precedence over our needs, and the needs of our babies.

#Traumatic births #Doctors not listening to women #There's no such thing as a birthzilla #Women aren't too posh to push #Doctors are so posh they schedule cesareans to accommodate their schedules not the mothers #Furness General Hospital Scandal #This is going to hurt #Keep Adam Kay away from women #Women wanting a say in their births are not acting like they want to control the weather #Nottingham maternity scandal #If the baby suffers during a traumatic birth it's the mother who will providing the care after they come home from the hospital

[ukrfeminism]

NHS maternity services are getting worse with two-thirds of units in England now deemed unsafe as staff and hospitals find themselves under “huge pressure”, a damning report has warned. 

Some 65 per cent of maternity services are now regarded as inadequate or require improvement for safety, up from 54 per cent last year, the Care Quality Commission (CQC) has found. Of these, 15 per cent are inadequate.

When looking at overall ratings, one in 10 maternity units are now rated inadequate, while 39 per cent are under the rating requires improvement.

The worsening picture of maternity care in England follows major scandals in Shrewsbury and Nottingham uncovered by The Independent. 

The report says the “overarching picture” is “one of a service and staff under huge pressure”. Staff cover “is often fragile, with the rotas relying on every consultant being available”.

It added: “On top of this, consultants face additional pressure from, for example, having to cover registrar rotas and extra on-call shifts to meet the needs of their service.”

One patient told the CQC: “I couldn’t move and asked someone to help me feed my baby and was told ‘you can do it yourself’ … [The midwife] also told me that she was very busy and had other patients that took priority – when I still couldn’t move.”

The report further pointed to issues with governance and lack of oversight from NHS boards, as well as delays to care and lack of one-to-one attention during labour. The report also highlighted poor communication. 

The watchdog has said a similar picture has emerged for ambulance services, with 60 per cent deemed to be inadequate or requiring improvement on safety – double last year. 

Mental healthcare was also highlighted as an area of concern with 40 per cent rated inadequate or required improvement for safety. 

Inspectors pointed to a lack of beds, meaning people can be “cared for in inappropriate environments – often in emergency departments”.

“One acute trust told us that there had been 42 mental health patients waiting for over 36 hours in the emergency department in one month alone.” the report said. 

In its wide-ranging report, the CQC warned that healthcare risks becoming a two-tier system, with society divided into those who can pay for care and those who cannot.

It said: “Getting access to services remains a fundamental problem… Along the health and care journey, people are struggling to get the care they need when they need it.”

Factors such as long waits for hospital treatment, waits to see GPs and for referrals, combined with a lack of staff, “increase the risk of a two-tier system of healthcare, with people who can’t afford to pay having to wait longer for care and risking deteriorating health”.

During a press conference watchdog officials said: “More and more people are entering that long-wait category and it's becoming harder to prioritise and deprioritise people, when as I say we are, they are seeing a number of people who, who have effectively not been sustained on electric backlogs arriving into A&E with a serious condition.” 

Research by YouGov showed that eight in 10 of those who used private healthcare last year would previously have used the NHS, while another study found 56 per cent of people had tried to use the NHS before going private.

The CQC added: “People may also be forced to make difficult financial choices. We heard from someone who receives benefits who resorted to extracting their own tooth because they were unable to find an NHS dentist.

“They then had to pay £1,200 on a credit card for private treatment, doing without household essentials until the debt was paid.”

CQC chief executive Ian Trenholm said the ongoing strike action by NHS staff – who are unhappy with pay and conditions – has contributed to backlogs.

Sally Warren, director of policy at think tank The King’s Fund, said: “This comprehensive report reveals the sad reality that the quality of care that patients need and deserve is not being met in many parts of the NHS and social care.”

A Department of Health and Social Care spokeswoman said: “We are delivering on three major recovery plans to improve access to urgent and emergency, primary and elective care, and have made progress to significantly reduce the longest waits for routine treatment, despite pressures including industrial action.

“There are record numbers of staff working in the NHS and our historic Long Term Workforce Plan will retain and recruit hundreds of thousands more staff alongside harnessing technology to reform the way we work and save staff time.”

#articles #health

[qudachuk]

Families are expected to receive an apology from the trust at a board meeting later on Monday.

[elefapt]

VIDEO! Maternity scandal: One woman’s heart-breaking story

VIDEO! Maternity scandal: One woman’s heart-breaking story

Watch video here https://www.youtube.com/watch?v=Bf5-zm1UNyA Buy some tshirts here … Video description from channel A mother whose baby died in hospital after failings in her maternity care tells her tragic story of losing her daughter, Harriet. Helen Gittos gave birth at a hospital under a different trust to the one in the Ockenden review. East Kent and Nottingham are also having their…

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#Sky News

[qudachuk]

Jack and Sarah Hawkins called for all families affected by the Nottingham maternity scandal to be included automatically in the review.

[ukrfeminism]

Babies’ lives are at risk because maternity units are still unsafe years after families raised concerns about preventable deaths resulting from poor care.

Of the 193 NHS maternity services in England, 80 are rated as “inadequate” or “requires improvement”, meaning they do not meet basic safety standards.

Parents whose babies died avoidably have said they feel guilt that other families have suffered the same fate because hospitals have not investigated incidents and improved care.

The eight hospitals that have been given the lowest, “inadequate”, rating by the Care Quality Commission (CQC) include Morecambe Bay NHS Foundation Trust. It was the subject of an inquiry by Dr Bill Kirkup, which concluded in 2015 that a “lethal mix” of failings had led to the deaths of 11 babies and one mother. The report recommended several urgent changes.

However, last year’s CQC report on Morecambe Bay showed failures in maternity care, including women who had been at risk of sepsis and had not been given antibiotics in time. There were not enough midwives to “keep women safe from avoidable harm”.

Maternity services at Nottingham University Hospitals NHS Trust are still inadequate, six years after families raised the alarm.

Harriet Hawkins was stillborn at Nottingham City Hospital in April 2016. An investigation found 13 failures in care and said her death had been “almost certainly preventable”.

At the time maternity services at the hospital were rated good, despite evidence that the trust was failing properly to investigate or report serious incidents. It was left to Harriet’s parents to highlight problems. Dr Jack Hawkins, a consultant who worked for the trust at the time, said this showed the CQC was “not fit for purpose”.

Families have called for a public inquiry into maternity care in Nottingham, where dozens of babies have died or suffered brain damage. Although a review has been ordered by NHS England, families have said it is “moving with the viscosity of treacle”.

On Wednesday 100 mothers wrote to Sajid Javid, the health secretary, to demand that he appoint Donna Ockenden to lead a review of Nottingham. The senior midwife, who led the inquiry into the maternity scandal at Shrewsbury and Telford Hospital NHS Trust, said it would be a “privilege”.

Her report on Shrewsbury said 201 babies and nine mothers had died avoidably because of “repeated failures over two decades”. It criticised external bodies, including the CQC, which had rated the trust’s maternity services as “good” in 2015. It has since been reported that in 2016 the CQC rebuffed calls for an independent inquiry into maternity care in Shrewbsury.

Ockenden’s report, published last month, said a toxic culture at the trust had not been addressed. She called for systemic change across the NHS to ensure safe maternity care for all. The police are investigating the deaths of two babies last year.

Last week a report on Sheffield Teaching Hospitals added to fears that aspects of the unsafe care identified by Ockenden may be evident across England. Hospital inspectors found that mothers were being denied adequate pain relief, food and water, with the service rated “inadequate”.

Kirkup is now investigating East Kent Maternity Trust in an inquiry involving about 200 families.

Only two NHS maternity services in England — 1 per cent of the total — are rated “outstanding” by the CQC. It said: “Over time we have strengthened and improved the way we inspect maternity services, and when we returned to [Shrewsbury] Trust in 2018 we took enforcement action to protect women using its maternity services, rated the trust inadequate and placed it into special measures.”

Case study Sarah Hawkins arrived at Nottingham City Hospital to give birth, only to be told that her baby, Harriet, was already dead (Eleanor Hayward writes).

“I was left for nine hours trying to give birth to a dead baby,” she said. “I felt like I was dying and I didn’t really care.”

Her contractions had started six days earlier, but midwives repeatedly turned her away, claiming she was not in labour. An independent review found that Harriet’s death, in April 2016, was “almost certainly preventable”.

The hospital trust initially blamed Harriet’s death on an infection, meaning that her body had to be kept as evidence for two years before it finally admitted gross negligence.

In recent months, 461 families have alleged failings in maternity care at the hospital. Harriet’s father, Dr Jack Hawkins, said that he “used to feel guilty” that her death had not led to improvements. He believes that a full investigation could have saved other lives.

“Just before Harriet was born, the CQC visited and rated Nottingham as good,” he said. “They failed in their duty to recognise problems in maternity care.

“We later found out that Nottingham were failing to investigate serious incidents before Harriet died.

“We had to fight to discover the truth about why Harriet died . . . It is not fair that it falls to bereaved families.”

Last year, the CQC apologised for failing to prosecute the trust for failures in Harriet’s care within the legal three-year time limit.

Victoria Vallance, from the CQC, said: “Maternity services at the trusts Nottingham City Hospital and Queens Medical Centre are currently rated inadequate and we have taken enforcement action requiring them to take action to make improvements.”