Just wondered what we all that about todays news?
The jist of it is as follows:




More than 40% of 103 trusts that responded to a survey by the Tories said they had shut their doors or diverted women to other sites.






Out of 103 trusts 42% had to close their units or divert women to another site at least once in 2007 because of capacity problems.

One in 10 said they had shut their doors more than 10 times.

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Personally, (and this is really putting my views out there, so dont want to be shot down in flames or anything!)
I think 'normal' low risk women with no indicating risk factors really shouldnt be given the option of giving birth in an obstetric run high risk unit. The choices given should be home birth or birthing centre. If the birthing centres are situated close to the hospital (as our should be by 2010) the women have the security blanket of knowing they can transfer in quickly if and when the need arises. If the birthing centre is not situated as close by, then they need to understand the stastics and reasons surrounding 'getting the white bus up the road'. And to be told that if the need arose they would be given priority and it would happen very quickly. I think the point should be reiterated that the reason for transferral into a high risk unit is not usual and the majority of women starting out at a birthing centre finish up there as well!

As I say, just my own opinion and im sure many will disagree. But the situation with materntiy services in this country cannot be allowed to continue. Our own unit (3000 births a year) was shut at the weekend, and the knock on effect even until today is amazing. I get inwardly annoyed when you have rooms being taken up by 'normal' low risk women who should be elsewhere, and the real emergencies cannot be admitted and end up diverting to places sometime as far away as London (60-70 miles). I am not uncaring, I am not unproffesional in my practice and i do give these women the same care as i give anyone else, but as i say inwardly i do sometimes wonder why they are there!

And as for the units coping when there are no 'supernumary' students in to help out, well, dont even get me started on that!!
x

I have to agree completely.

I saw the news this morning and am continually astonished that something is not done about this. What is more important than ensuring the safety and lives of pregnant women and their unborn child?

It beggars belief that this is allowed to continue, I wonder whether anything will be done, as this must have been detrimental to many high or low risk women. Surely speaking on a practical level the financial repercussions of these far too common incidents are rising? How come it seems acceptable to pay out millions on litigation and not improving the service?

I wholeheartedly agree that something must be done and done now. The never ending coverage by the media is doing nothing, other institutions are doing nothing, we at the very bottom of the pecking order can do nothing. I am very concerned and becoming increasingly frustrated at the governments apparent inability to take immediate action. These rants even are pointless.

It is terrifying to contemplate where it will all end.

Supernumary? Best keep those opinions to myself too!

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Olly,

I see exactly what you are saying. Its a cultural change BACK to having babies at home where in my view, on the whole all low risk babies should be born - as long as there is a unit close by and not an hours drive, even with a blue light.

Obstetric units should be for high risk cases and emergencies. Its the cultural shift back again from where we started, back to the home. The fear that has been instilled in women that if they dont have thier baby in a hospital its not safe, has finally back fired. It was only a matter of time. There is no money to staff and support this fear and its time for a change.

Its a lottery, a high risk woman can turn up for care at an obs unit and its shut, because its full of low risk women who are petrified of 'what might be'.

The work that should be done is giving these women the confidence in themselves, in normal birth and in homebirth midwives back.

I have delieverd many women in hospital where they could have easily had the babies at home and many have said after, I wish Id done that at home, so its still in the collective consciousness.... they just need to feel safe and taking away their units makes them scared, so there is alot of soft skills work that we have to do as a profession to make these women feel safe with thier bodies, the birthing process and us.

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StudentMidwife.NET Founder

"You're braver than you believe. Stronger than you seem. And smarter than you think."
Christopher Robin in Pooh's Grand Adventure

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TallPoppy, so much better put than I!

That's what I meant!

How to do this though? Especially with doctor's influences.

'Birth centre? Why? Oh, she'll be too far away, what if something happens?, these places need to be shut down, they're dangerous' (consultant obstetricians words)

It was the 'what if?' that meant I had my two children in hospital completely unnecessarily.

What about midwives attitudes too? Many have lost faith in women's abilities andthe system.

After a year, I am in two minds as to whether some can really do it? How much does this environment really affect the birthing process? Is the whole reason they come to hospital enough to suppress the oxytocin levels? Iwant women to labour naturally but what do they want?

After all they decide to come to a hosptial even if they are low risk, just to be on the safe side? So is this decision; often made at booking, setting the women up for failure from the start?

Maybe it is, All these questions!

Primiparous women being able to labour and birth their babies at home or birthing centre fascinates me, what are the statistical success rates of this I wonder. It is common to hear comments such as 'primip, she's off to theatre, it's written all over her' How many do manage to have their babies with no intervention? particularly in a CLU.

I wonder also if their abilities are even more severely affected by the hospital environment thna multiparous women?

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Its the Midwives and Medical Men battle again. Its always been there, since women were paying Drs rather than bartering with lay midwives to attend their births at home. Even if the lay midwife did have an apothecary box full of natures remedies and tinctures and the Drs prescribed things such as scribing versues of the bible onto your own gums as a remedy for toothache............Call me sceptical but the next step was going to be to pay to have your baby in a safe place approved by the Dr.... and this is where we still are years and years later.

I agree that Drs/Consultants/SHO's etc do a brilliant job, and many I have worked with are very supportive of normal birth. My first delivery was one contraction away from forceps, but the Dr stood by and let us give her the chance to do it herself, it was me and my shaking hands locking eyes with her and both determined she could do it. We were watched by a room full waiting to pounce..... a paed, a Dr, 2 midwives and me and my newly qualified 'mentor for the day'. But she did it. They were all primed and ready to go but gave us the space to do it, all it needed was my soft words, my confidence in her and her determination and that look that I will never forget in her eyes, she was petrified, 17 yr old primip, alone.... she said after 'we did it together' but I shook my head 'You did it yourself'. How many women are robbed of that feeling???

I know that some Drs dont practice this way and are keen to have women labour in lithotomy strapped to a CTG 'just in case'. Its our job as advocates for these women to care for them with what they need - not what they might need.

I agree about the white coat syndrome about how the oxytocin levels drop, Ive seen it time and again on the ward. Yet never at a homebirth. We are guests in thier home, they are patients in ours. Not clients to care for, to advocate for, but patients who may get sick, so we treat them as such.

Its down to us as the next generation to do our bit, to keep our determination to make a difference. So many midwives start out like this and then get dissillusioned, I bet there are a few reading this rolling their eyes. But how will anything change if we dont try and try together? while the Govt is re-shaping maternity services into yet another set of sandcastles, temporary castles waiting for the next 'wave' of change to come along and sweep them down ready to be reshuffled again - we as a profession at grass roots - on the wards - are bitching and moaning about one another, about colleagues on community 'they think they are busy? huh etc' and all that other negative stuff that divides us as a profesison - while the govt are shifting sand again and while we are back biting at oneanother because of fear of change, stress and general malaise with the whole thing - women are still giving birth.

Its them we train to care for, its them we need to empower, the one constant we have had in the whole of midwifery history, throughout the battles of midwives and medical men, is the women.

As students we often feel disempowered, afraid to have a voice yet its us that spend alot of time with the women, talking, listening, laughing, reassuring. As we look up at the towering sandcastles of change, as we hear ourselves being moaned about or looked through like we dont exist, remember this, we are the next generation and we can make a difference, as we have the listening ear and the open eyes of women, and its the women who in time with the confidence we work so hard to enstill in them will be the ones that help us make that difference.

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StudentMidwife.NET Founder

"You're braver than you believe. Stronger than you seem. And smarter than you think."
Christopher Robin in Pooh's Grand Adventure

Fancy yourself as a bit of a writer? Want to contribute midwifery or SM2B articles to SMNET? If so, PM me with your thoughts/articles

Sometimes it delivery units are closed because the post natal wards are full. So they are inable to send women down to the ward after delivery. This has a knock on effect and the unit has no option but to divert even for a short time.

This happened while I was on placement a few times. Sometimes delivery suite was full, and sometimes it was because the post natal ward was full, thus stopping ladies being transferred down.

The other problem then is, that ladies who have come on for induction, of an elective section are also held up. It is a viscious (sp?) circle.

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Midwifemissy x

Student Midwife 2007
Student uni rep
Educational Resources Manager

PAB Support Worker

http://news.bbc.co.uk/1/hi/health/7304811.stm

This is the link for the report. TallPoppy beat me to the posting.

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