UK

‘Russian roulette’ maternity units risk lives of mothers and babies, say midwives

Rosie Taylor
Mon, 13 November 2023

Midwives said that they were given so many patients to care for they often did not have enough time to complete basic care tasks 

- JGI/TOM GRILL/TETRA IMAGES RF

The lives of mothers and babies are being put at risk in a maternity culture so toxic that it feels like a “game of Russian roulette”, midwives have warned.

A report by front-line staff has described “endemic” bullying and “dangerously low” staffing levels, which meant that women in labour were treated as if they were “on a conveyor belt”.

Maternity units “often” had less than half the number of staff needed to operate safely and unqualified students were left to look after multiple women on postnatal or labour wards.

Midwives said that they were given so many patients to care for they often did not have enough time to complete basic care tasks, such as giving women painkillers or properly sterilising equipment – putting patients at risk of infection.

The report by the #Saynotobullyinginmidwifery campaign group – a team of leading midwives and midwifery academics – featured the experiences of hundreds of midwives who are currently working in or have recently left NHS services.

Many of those who contributed had witnessed babies harmed as a result of their “unfathomable” working conditions, describing a “toxic culture” in maternity services.

One said that working in maternity units in the UK was like “playing a warped game of Russian roulette and just praying the tragedy doesn’t occur on your shift or with a person you’ve been caring for after you’ve gone off shift”.

‘Things have got so much worse’

In her foreword to the report, Mavis Kirkham, emeritus professor of midwifery at Sheffield Hallam University, said: “Twenty years ago [it was] reported how midwives were leaving midwifery because they could not give the care they wished to give. Things have got so much worse.”

She warned that “care has been squeezed out in the interests of efficiency” and that the service was “run on a conveyor belt model” which was “so inappropriate”.

The report’s authors blamed chronic staff shortages, as well as pressures on midwives from senior management to discharge mothers and babies as quickly as possible to free up beds.

It follows a call from bereaved parents for a statutory public inquiry into England’s maternity services.

The request, made by the Maternity Safety Alliance, followed a number of high-profile reports that revealed poor care and toxic cultures in maternity services at individual NHS trusts, including the Ockenden Review into Shrewsbury and Telford Hospital NHS Trust and the Kirkup Report into East Kent Maternity Services.

The latest report, published on Monday, featured similar stories from across the country.

A newly qualified midwife told how she had been left alone on her first shift to deliver the baby of a woman with multiple high-risk health problems.

The baby died hours after it was born.

‘Poor organisational culture identified’

Another described the “utter hell” of pressing the emergency bell when they noticed problems with a baby’s heart rate during labour, only for it to go unanswered.

One said that she never had enough time to care properly for women and babies so prioritised the tasks most likely to prevent harm “because at least when you hand over [to staff on the next shift] you can tell them that nobody died”.

One midwife cited in the report said that midwives working in her hospital were given 10 high-risk women and 10 babies to care for on each shift.

“That’s 37 minutes to give each individual everything they need … It’s unfathomable,” they said.

The report told how midwives who raised the alarm with senior staff about unsafe conditions were often bullied or threatened, with many leaving their jobs as a result.

Its authors said that workplace pressures meant there was an “endemic” bullying culture towards newly qualified staff in particular, with managers “colluding in, and sometimes leading, this ethos”.

A spokesman for the Royal College of Midwives said: “Poor organisational culture has been identified as a key factor in recent investigations and reports on maternity safety. We know that maternity staff who feel supported and valued provide better care and when there is a positive working culture the quality of the care improves.”

A spokesman for NHS England said: “The NHS is committed to working closely with local trusts and partners to make necessary improvements so that we provide the best possible services for women, babies and their families and it is completely unacceptable for any member of staff to feel silenced or unable to speak about issues affecting them.”

Stone Age babies received better parenting, study suggests

Sarah Knapton
Mon, 13 November 2023 

Modern-day parenting is less effective than the Stone Age equivalent

Modern parents take on much more of the childcare responsibilities themselves than their Stone Age ancestors, but this leads to less effective parenting, a new study suggests.

Anthropologists at Cambridge University studied Mbendjele BaYaka, a semi-nomadic tribe who live today in the Democratic Republic of the Congo, to find out how traditional societies care for their youngsters.

They found that children were often looked after by more than 10 members of the group, who would respond to more than half a baby’s bouts of crying.

Communal parenting allowed children to receive an average of nine hours of close contact with older members of the tribe, which gave mothers time to work and rest.

The team speculated that sharing of parenting helped to prevent abuse, while allowing children to become better parents themselves.

“For more than 95 per cent of our evolutionary history, we lived as hunter-gatherers,” said lead author Dr Nikhil Chaudhary.

“Therefore, contemporary hunter-gatherer societies [like Mbendjele BaYaka] can offer clues as to whether there are certain child-rearing systems to which infants, and their mothers, may be psychologically adapted.

“As a society, from policymakers to employers to health care services, we need to work together to ensure mothers and children receive the support and care they need to thrive.”

DR Congo study

The DR Congo study showed that, at any one time, the ratio of caregivers to children was greater than five to one, much more than in modern homes or nurseries.

And researchers speculated that children may be “evolutionarily primed” to expect exceptionally high levels of physical contact and care, as well as personal attention from several caregivers in addition to their biological parents.

The team concluded that throughout human history and prehistory, parents had never been under the pressure they are now in terms of lack of support.

“Support for mothers also has numerous benefits for children such as reducing the risk of neglect and abuse, buffering against family adversity, and improving maternal wellbeing which in turn enhances maternal care,” said child psychiatrist, Dr Annie Swanepoel, of Elysium Healthcare.

The study also found it was common for older children and adolescents to be heavily involved in caring for infants, further supporting mothers and giving these young carers valuable experience, boosting their confidence and lowering anxiety about becoming parents themselves.

The research was published in the journal Developmental Psychology.