Childbirth 'lonely and frightening' for thousands of women

Chronic shortages of midwives and the "medicalisation" of childbirth are leaving women terrified, alone and in pain during labour, according to a survey published today.

Chronic shortages of midwives and the "medicalisation" of childbirth are leaving women terrified, alone and in pain during labour, according to a survey published today.

The survey of more than 3,000 new mothers found that many felt antenatal classes left them unprepared and that childbirth and its aftermath was dominated by a lack of good-quality care.

Women were left alone during labour, without a midwife or doctor present, for an average of one hour and 21 minutes, with some facing up to two hours without medical supervision.

Two-thirds of the mothers said they had been strapped to electronic monitors "continuously", despite NHS guidelines recommending that the 80 per cent of women deemed to be low risk should only be placed on the equipment intermittently.

Many were not allowed to move around and were left lying in bed, waiting up to an hour for pain-relieving epidurals and without being told what was happening to them.

Only 4 per cent of women had the same midwife during labour who had cared for them during pregnancy. Just 5 per cent had experienced an entirely natural birth, with one in five undergoing a Caesarean. Furthermore, 25 per cent said they were not told what was happening during labour, and half felt they received sub-standard nursing care after the birth.

Elena Dalrymple, editor of motherandbabymagazine.com, which carried out the survey, said: "Although midwives try their hardest to provide mothers-to-be with the quality of care they should have in the delivery room, the fact is that staff shortages make it almost impossible for them to do so."

Chronic shortages of midwives across the country but particularly in London and the South-east have meant that many women do not have continuity of support from antenatal care to delivery of their baby.

According to figures from the Nursing and Midwifery Council, there are now 8,000 fewer midwives in the UK than 10 years ago. The Royal College of Midwives, which is due to publish its latest audit of vacancies next week, says that 10,000 more qualified staff are needed to plug the gaps.

Belinda Phipps, chief executive of the National Childbirth Trust, said: "The problem is that maternity is managed in acute NHS trusts, and they are geared up for treating sick people, rather than healthy women in labour. We need enough midwives to ensure that women get one-to-one, continuous care throughout their labour."

Scottish women were the most satisfied with their care, perhaps because that country has the highest ratio of midwives to mothers.

Eileen Reilly, a consultant obstetrician at Inverclyde Royal Hospital, said that many doctors and midwives felt the need to make medical interventions in childbirth, even when it may not be necessary, because of the fear of being sued.

"There is sometimes a culture of fear surrounding litigation, which means that obstetricians intervene when it may not be necessary," she said. "People want guarantees that nothing will go wrong. [But] intervention can breed intervention and then the whole process is medicalised." She added: "Sometimes information, communicated badly, can inspire fear in patients. I have had women requesting Caesareans for their first pregnancy because they are so scared about giving birth." While the trend is towards midwife-led birth units situated away from acute hospitals, these have led to problems. Safety rules governing the running of these units mean that they cannot give women pain-relieving medication such as epidurals. This means that women who attend the units and experience problems may face a drive of hundreds of miles, in labour, to a hospital that can then treat them.

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