One of the comments we often hear is “Why doesn’t the NHS learn from it’s mistakes?”. A huge topic. The NHS will say it does; it listens to criticisms and it learns from investigations, inquiries and the number and type of claims it faces.
Sometimes though, it does things itself that make you wonder….
The national press reported recently that despite the damning Ockenden report on the failures in maternity care at Shrewsbury hospitals that led to avoidable deaths of babies and mothers, hospitals are still advertising for midwives with a commitment to “normal/natural births”
In it she quoted:
“This final report of the Independent Maternity Review of maternity services at the Shrewsbury and Telford Hospitals NHS Trust is about an NHS maternity service that failed. It failed to investigate, failed to learn and failed to improve, and therefore often failed to safeguard mothers and their babies at one of the most important times in their lives.”
The report found that in the hospital maternity unit, amongst other problems, there was an over-commitment to “natural births”, possibly to meet targets. This meant that Caesarean sections and other interventions were not offered when they should have been and thus babies died or were severely brain injured.
In a letter sent to hospitals in England last month, the health service’s chief midwife Jacqueline Dunkley-Bent and national clinical director for maternity Dr Matthew Jolly told all maternity services to stop using caesarean section rates as a means of performance management.
They added: ‘We are concerned by the potential for services to pursue targets that may be clinically inappropriate and unsafe in individual cases.’
The Royal College of Midwives formally abandoned its ‘normal birth’ campaign in 2017 (5 years ago!), after previously praising trusts for keeping these rates low.
There are further similar reports planned, one not far away in Nottingham.
Obstetrics still remains one of the highest risk specialist medical fields in which to work. Sadly, this leads to a circular argument. Fewer people want to go into, so there are fewer staff, so the risk becomes higher. Baby brain injury claims attract the highest level of damages if successful, often running into tens of millions of pounds. They account for a very large part of the NHS’s claims budget.
We can understand that many women DO want a “natural” birth. They want it to be a good and happy experience, but babies don’t always read the script! There is no shame and no “failure” in intervention in a birth if it is needed to result in a healthy baby and mother and no-one should ever be told or think differently.
But units still seem to be promoting this non-interventionist attitude in their adverts for midwifery staff up until early April.
Northumbria Healthcare NHS Foundation Trust’s advert read;
“Seeking a highly motivated, experienced dynamic midwife to join our team who is committed to the philosophy of normal birth. The staff member will work as part of midwifery unit teams that are staffed by passionate, normality-focused midwives”
Maidstone and Tunbridge Wells NHS Trust:
“Seeks a midwife for a midwife-led unit who is interested in the ‘promotion of normality”
“Normality is promoted in all clinical areas, and we have an above average rate of out of hospital deliveries.
“Normality?” Ask any women about their experience of birth and every one will be different. Even Princess Anne’s daughter Zara Tindall ended up giving birth on the bathroom floor to her 3rd child, son Lucas! Pregnancy and birth is no respecter of who you are or often where you are. If that baby wants out, it’s coming, ready or not. Birth isn’t QUITE like Hide and Seek, though….
To be fair, Northumbria did take down its advert and in a statement, Marion Dickson, executive director of nursing, midwifery & AHPs at Northumbria Healthcare NHS Foundation Trust, said:
“The safety of our mothers, babies and their families remains at the heart of everything we do. I would like to reassure the public that we are currently reviewing the language used across all of our digital platforms and patient information to reflect the recommendations in the recent report by Donna Ockenden.”
It’s possible that the adverts were written and posted before the Ockenden Report was published and does not now reflect the Trust’s policy. We also know that it takes time to change attitudes and approaches.
But they must surely have been aware of the imminency of the report? There must have been rumblings and rumours about what it’s findings might be? Did no-one stop and think that the wording may not prove appropriate? What’s wrong with asking for midwives committed to safe births and healthy and happy mothers and babies?
It’s not enough to “review the language used”. The policies and attitudes have to change and change quickly to avoid further tragedies. To use the time-worn cliché “Lessons must be learned” and more to the point, SEEN to be learned.
And to finish on another cliché:
“Actions speak louder than words”
We can help
You can speak to our medical negligence team for initial advice on 01522 561020 or email firstname.lastname@example.org if you have any concerns about pregnancy or birth issues.