Clinic consultation

If You Don’t Like This, Go Private: What My Maternity Said About Late Scans | NHS

Alison, 38, gave birth to her son in June 2021 at a busy London hospital.

“We had exemplary care during delivery, and the midwives who attended to me during my antenatal care were also fantastic,” she recalls.

“However, I did not see a midwife in person between my nine-week admission appointment and my 30th week of pregnancy. Then I didn’t see anyone again until I was 34 weeks pregnant, and the next time I was seen was at 38 weeks, although you’re supposed to be seen weekly at this point .

During Alison’s two-week postpartum check-up, she had to have her stitches checked in a chair as no other facility was free.

“The room was so full that they had to close the birth centre; labor and delivery were complete, and I met two laboring women in the early stages of their initiation down the hall. The midwives who came to do home visits were in a rush and left me in tears every time,” she says.

All NHS staff she came into contact with throughout her maternity care were clearly overworked, Alison says, but were doing their best.

“There was just no availability on the system, no capacity.”

Jedidajah Otte. Photography: Antonio Olmos / The Observer

Alison’s experience matches mine well. When an A&E doctor calmly explained last June that I was suffering from early pregnancy malaise, I reluctantly decided to return to the London hospital where I had given birth eight years previously.

My high-risk twin pregnancy had ended in 24 weeks premature birth and tragedy – with a baby who died after a three-month battle in intensive care. Throughout my prenatal journey, crucial appointments had been canceled due to staffing issues, so no one spotted the first signs of preterm labor until it was too late to intervene.

My hopes of receiving better care this time, assuming the trust knew about my story, quickly evaporated. At nearly 15 weeks pregnant, I still hadn’t been seen by anyone, with text messages supposedly informing me of appointments that weren’t showing up.

When I asked why I had been given a date for a CT scan two weeks after the last possible date such a screening could give a diagnosis of a chromosomal abnormality, a receptionist at the clinic told me that I should go in private if I didn’t like my dates. A complaint sparked an apology from the trust’s chief executive months later for protracted problems in the booking process, as well as an apology from the deputy chief midwife for the receptionist’s “inappropriate” advice.

By then I had paid hundreds of pounds for a private scan and a private appointment with an obstetrics consultant at the hospital. I was quickly referred for specialist prenatal care on the NHS, and have received excellent care since, but plagued with the knowledge that my ability to pay had started the ball rolling.

Kerrie, 31, a solicitor from Leicestershire, is one of hundreds of women who responded to a call I made through Community, the home of content for readers on the Guardian and Observerthe website of. I wanted to know how others had experienced NHS maternity care in England over the past year, but was surprised at the number of responses from virtually every corner of the country.

Overhead view of newborn with hat in crib in hospital
The long delays in labs during pregnancy have made women worried about the health of their babies. Photo: Cavan Images/Getty

Like me, Kerrie saw no way but to shell out hundreds of pounds for private scans during her pregnancy last year as her trust only offered her appointments outside of the windows in which they could be performed.

“Each scan was beyond the normal NHS care time scale. I was unable to have an NHS ultrasound for Down syndrome because I was only offered an appointment after 14 weeks pregnant which is too late,” she says. “My only option was to go private, according to my midwife, who recommended a screening which cost £450.”

All of Kerrie’s midwifery appointments also happened later than they should have. When there were concerns about her baby’s growth in her second trimester, she waited almost two weeks for a scan which should have taken place within 72 hours.

Last summer, the Care Quality Commission’s chief hospital inspector told a parliamentary inquiry that inspections found 38 per cent of NHS maternity wards ‘required improvement for safety’ – more than in any other medical specialty. A report by the House of Commons Health and Social Services Committee on Maternity Safety in England subsequently concluded that staffing is the most essential element in delivering safe care and that progress is needed urgently regarding the continuity and personalization of care.

But in many parts of the country, the pandemic appears to have reduced NHS capacity for a well-managed long-term maternity benefit. Hollie, 30, from Staffordshire, who is expecting her second child, has discovered that the lack of continuity is precisely what is making her prenatal care problematic. “It has been minimal and insufficient, only because midwives are understaffed and overworked,” she says. “In 30 weeks of pregnancy, I met my real midwife once, but saw four other midwives who knew nothing about me, so the appointments were all a repeat of the last one. I I rarely had a chance to voice my concerns.Her local hospital stopped delivery services during the pandemic, so her nearest hospital is now over 40 minutes away.

“I’m sent all over Staffordshire on dates. I don’t drive and I have a four year old – the whole situation is very stressful. Compared to my first pregnancy, I find it incredibly difficult to get the support I need,” says Hollie.

For some women, the draconian Covid regulations in hospitals and severe staff shortages have led to highly traumatic experiences.

Rachael, 31, from Deal, Kent, is still processing the birth of her son, Ollie, in June 2021.

“I felt really disappointed,” she says, “although I’m extremely grateful that Ollie was born safely with the help of hard-working professionals.”

Her excruciating 33-hour labor was marred by disagreements between doctors and midwives, poor communication and excruciatingly long waits in hallways due to capacity issues. “I felt brutalized. I was in so much pain. I don’t want to scare off moms-to-be, but that really wasn’t OK. I feel like the lack of staff has affected my care, my communication, but also my compassion.

Gemma, 34, from Woking, Surrey, gave birth to her second child in September 2020. Although she had far less contact with healthcare staff than during her first pregnancy and was annoyed by the fact that many appointments took place over the phone, she found care to be top of mind. until birth OK.

“The birth, however, was the worst experience of my life,” she says. “Partners weren’t allowed in before active labor, so I was self-induced. Staff refused to touch me for comfort due to Covid, and due to lack of staff, I I was left alone for hours in the dark with no pain relief I was screaming for help but no one came.

Edyta, 37, a medical assistant at Rugby, had an equally ‘horrendous’ birth experience. “The maternity ward was so understaffed that it was dangerous. On my first night on the ward, a nurse came and said, “I apologize in advance in case you feel let down, but it’s just me and a medical assistant.” the levels, not the staff. “There aren’t enough of them and they’re crushed to the ground. This has deterred me from wanting another baby at the moment, but if I were to have more in the future, I would consider going abroad to give birth, where private is cheaper.

Jon Skewes, executive director of external relations at the Royal College of Midwives (RCM), said: “Countless independent reviews of maternity services have cited staff shortages as a potential risk to safety and quality of care. The MRC has been raising concerns about this for more than a decade, but successive governments have chosen not to listen. There are massive pressures on maternity services and the wider NHS due to the pandemic. This sometimes means that certain services have had to be adapted or restricted, such as fewer in-person appointments. All of these decisions were made with a heavy heart because midwives know how important this is for women.

An NHS spokesperson said: “Despite the pressures and impact that Covid has undoubtedly had on staff, the NHS remains one of the safest places in the world to give birth and services have continued to see women and their babies throughout the pandemic. In addition, the NHS has invested an additional £95million this year to increase staff numbers, training and leadership.