Shortly before Christmas, 30-year-old Stacey became a mother. Speaking to me less than a month later, she sounds remarkably bright and chipper for a sleep-deprived first-time mum. But the birth experience she describes was more “no room at the inn” than festive miracle.
Like an alarming – and increasing – number of new parents, Stacey and her burgeoning family found themselves at the sharp end of the NHS maternity crisis. Left labouring alone on the assessment ward for hours, she wasn’t provided with a midwife or any pain relief until just five minutes before her son entered the world.
Earlier this month, research by the Care Quality Commission (CQC) revealed nearly 40 per cent of women did not receive help from a member of staff when they need it during labour and birth.
The number of women saying they were “always” able to get a member of staff to help them during labour and birth had dropped from 72 per cent in 2019 to 63 per cent in 2022, described by the health watchdog as a “concerning decline” in maternity services. Adding to that worrying picture, birthing expert Samantha Gadsden recently told i she increasingly hears from women who have given birth in hospital without a midwife present.
This was exactly what Stacey feared would happen to her. “My husband spent the majority of the later part of my labour in the hallway trying to find help, which meant I was completely by myself.
“I felt like I was dying, and I was basically having to try and hold my son in. I could feel he was coming out and I started to panic about what would happen if I pushed my baby out while there was nobody there to help us,” she recalls.
Stacey had been 4cm dilated and in active labour when she and her husband arrived at the hospital to be assessed around 3pm. Her labour progressed quickly and by 6pm, having not been checked on since they arrived, Stacey’s husband started going out to look for help.
“I was in a lot of pain, I hadn’t even had paracetamol at that point, but there were no midwives available to help. He went out four times to find someone and, in the end, he refused to leave the labour ward reception until someone came to check on me,” she says.
By the time she was checked and taken through to the delivery suite, Stacey was fully dilated and was finally attended by a student midwife whose shift started at 7pm. After five minutes on gas and air, Stacey’s son was born at 7.05pm. “The student midwife was phenomenal, absolutely amazing, but they were so busy that the minute I gave birth she then had to get over to help somebody else,” she says.
With minimal time for clean-up and no one available to do her stitches, Stacey says she was then left for three hours sitting in her afterbirth – although, she adds, “I didn’t actually mind so much because we weren’t rushed like I know some people are. It meant we were able to just sit and enjoy that time together as a new family.
“I really felt for the midwives more than anything, as they were so mortified by the level of care I received, but there just weren’t enough of them on shift to cover all the labouring women,” Stacey says.
“It’s awful and really sad this is happening. I was lucky to have a brilliant midwife towards the end, and I cannot fault the staff as they were brilliant. There just weren’t enough of them. I think the majority of people in the job want to do the best they can, but they’re just so strained that it isn’t possible.”
Another new mother tells me, “[staff] had to ask my mum to help them as they were so many midwives down”. She too describes the panic of being left alone for much of her labour and again while she was bleeding after birth. “It’s an absolutely terrifying time to give birth. I always wanted another baby, but I’m scared in this current climate,” she says.
This isn’t a new crisis, but one that’s been steadily growing in recent years. In October 2021, the Royal College of Midwives (RCM) warned of an “exodus” of midwives, with 57 per cent of RCM members saying they would leave the NHS in the next year. For staff who had either already left or were considering leaving, the two key concerns flagged were inadequate staffing levels and an inability to provide safe care to patients.
Mother-of-one Zoe Ayre, who shares her parenting journey on Instagram as @therespectfulmum, gave birth to her daughter in September 2021, and says the staffing crisis was already evident then.
Having originally planned a home birth, Zoe was admitted to an antenatal ward with bleeding in early labour, and her husband was sent home until things progressed. Left alone on a ward with other women, each with just a curtain pulled round them, she recalls hearing the woman in the next bed screaming. “She was clearly in the throes of labour, and clearly on her own,” she recalls.
Later, Zoe was the one screaming out, conscious that all the other women on the ward could hear her. “There were definitely a few times when I really screamed out and shouted for help, because there was nobody coming to check on me, there was nobody there really,” she says. “I don’t criticise the midwives at all, they were stretched so thin and doing the absolute best they could in the circumstances, but there just weren’t enough of them.”
After five or six hours on the antenatal ward, Zoe was moved to a labour ward, where her husband was allowed to stay with her for the remainder of their daughter’s birth. But that experience of labouring alone had a profound impact on her. “Looking back, there were things that happened later in my labour which were objectively much more traumatic than being on my own – like having a haemorrhage straight after my baby was born – but none of it felt as bad mentally as being on my own for those hours,” she says.
“I struggled a lot with postnatal anxiety and intrusive thoughts about my baby being harmed, and it was that situation that I think had the biggest impact emotionally and mentally.”
Indeed, such experiences are, “a huge risk factor in the development of subsequent birth trauma”, according to Dr Rebecca Moore, a perinatal psychiatrist and co-founder of the Make Birth Better campaign.
“At Make Birth Better we are hearing of women feeling fearful of the news reports into maternity units. We hear of some women feeling very alone in their labour, left alone for long periods of time, or told by [midwives] that they are short-staffed. The impact is that people can feel anxious and afraid,” she tells me.
In practical terms, Dr Moore adds, the Make Birth Better team is hearing increasing stories of people choosing to freebirth, feeling they need a doula to advocate for them, or asking for a caesarean to try to control the risks. “I also know several women who have moved back to their home country as they felt they could not trust the NHS to safely care for them,” she says.
“While staff on units across the UK are working incredibly hard, there are all too many shifts that are understaffed due to people leaving the profession and/or feeling too burnt out or unwell to come to work. This is frankly dangerous, as the recent CQC studies highlight, and the Government needs to commit to increasing funding to maternity immediately.”