The NCT and WI commissioned a survey in 2013 to understand women’s perception of their birth and postnatal experiences. As a result of that survey they have launched a national campaign for 2017 targetting ‘red flag events’ called ‘Support Overdue’
Red flag events are instances where levels of staff support for women is so low it is considered dangerous. The survey found that half the women surveyed (nearly 3,000) had experienced a red flag event during their birth. E.g. no one-to-one care during established labour, waiting for more than an hour to be stitched following vaginal injuries.
“The aftercare was awful, I was alone and in a lot of pain” (a quote from the survey)
Another key finding highlighted adequacies in postnatal care. E.g. 1 in 5 women unable to see a midwife postnatally as frequently as they felt necessary and for some leading to a notable delay in the diagnosis of health problems for either Mum or baby.
In a climate of policies driven by cost cutting, the results from the survey are no great surprise. E.g.
- 79% of Trusts did not meet recommended staffing levels
- 88% of women had never met the midwife that attended them for their birth
Elizabeth Duff (Senior Policy Advisor at the NCT) commenting on Woman’s Hour (Jan 2017) stated that understaffing was a significant problem and despite increases in the number of students training to be midwives their research is finding that many trusts simply “do not have the money to employ the midwives that they know they need.”
The first step for ‘Support Overdue’ is to present the survey findings to the Health Select Committee in Parliament requesting:
- Review staffing with a view to fulfilling the standard, set by the four medical and midwifery royal colleges, of a midwife-to-birth ratio of 1:28 per year;
- Take action to ensure continuity of care: NICE postnatal guidelines are robust, but seem to be implemented inconsistently across different areas. One trust in London reported it offered women three postnatal visits as standard, a neighbouring trust offered women just one – yet both reported they were delivering in line with the guidance. Poor data and recording hampers proper analysis and means it is difficult to get a comprehensive picture of care standards and service provision.
- Enable women to build and maintain a relationship with their midwife: many women give birth in locations chosen by them and known to providers months beforehand; facilitating a relationship between midwives and women in their care would help provide much valued continuity of care from the antenatal period into labour and postnatal care. NCT Press release Jan 17th 2017
What is incredible is the inability of decision makers to connect astronomical maternity litigation costs with the radical cost cutting experienced by the NHS. How many deaths and near misses (never mind the cases of PTSD) do there have to be before they ‘get it’.