Another day, another damning report on the state of the nation’s maternity services. According to the BBC the Care Quality Commission’s latest statistics demonstrate that more than half of England’s maternity units fail to meet basic safety standards, including a small but not insignificant number which “pose a high risk of avoidable harm”.
This latest indictment will come as no surprise to anyone who has given birth in England or been even peripherally aware of the maternity crisis that has continued unabated in recent years. For midwives like me, the CQC’s latest figures are unsurprising and deeply frustrating. We have been screaming into what feels like a wilfully ignorant void for years – pushing for change through our unions, writing books, marching on Parliament – but our desperate pleas for help appear to have gone unheeded. Like Alice in Wonderland, we regard our increasingly surreal environment with a deep sense of unease; it is “curiouser and curiouser”, but also sadder and sadder, that a service which should embody safety and nurturing has turned into a twisted, looking-glass world fraught with danger and indignity.
The government has had fair warning – not just from us, but from independent investigators and rightfully enraged parents. Most recently, in March of this year, the Ockenden review of maternity services at Shrewsbury and Telford Hospital NHS Trust exposed the horrors behind a spate of preventable maternal and neonatal deaths. While there will always be individual cases in which negligence has caused harm, the Ockenden review also highlighted endemic issues of understaffing and excessive workload. Midwives like me read the report with a distinct sense of “there but for the grace of God…”. Many of us have struggled to meet basic safety standards in the midst of a toxic, overwhelming workplace culture. We see the near misses that happen around us all the time; some of us, in fact, pray for our own trusts to be investigated so that our hospitals, too, can be placed under special measures, with all the scrutiny and subsequent support that such status brings.
Unfortunately the CQC’s recent findings demonstrate that little has changed since the Ockenden review was published. There was a brief media outcry at the time, but then the deaths of women and babies seemed somehow less newsworthy than a shambolic Conservative leadership contest, and safety took second stage to politics. About those politics: Thérèse Coffey, the new Health Secretary and Deputy Prime Minister, proudly announced her “ABCD” of priorities as “ambulances, backlogs, care, doctors and dentists”. No mention of M for maternity, even though every single one of us is born, and roughly half of the population gives birth.
Perhaps I’m being too tough on Coffey. Perhaps I should declare the true state of the skin I have in this game. Not only am I a midwife with nine years’ service, but I’m a midwife who’s currently off work due to burnout, exhaustion and complications from Covid that I acquired at work while wearing ineffective personal protective equipment. My patience – like the system in which I work – has been stretched perilously thin. Training and supporting new midwives means nothing unless experienced staff like me are retained and resourced. Our nation’s public health depends on it.