Of course maternity care in the UK is falling apart — I went into labour in a ward covered in cockroaches

If there is, truly, a two-tier system in this country then it is right here in women's health, writes Victoria Richards

‘We already know that due to thoughtless planning, lack of space – and basic lack of care – those of us who have miscarried are forced to sit in the same room as those bearing happy grins and clutching print-outs of their pregnancy scans’ (Getty/iStock)

When I went into labour with my daughter in 2012, the first place I was told to go was to triage. Triage, as it turned out, was in a drafty bit of Whipps Cross University Hospital, in East London, close to the carpark – it was February and freezing. I was already a few centimetres dilated. As I hauled myself uncomfortably on to a bed, I happened to glance at the floor and saw it was abuzz with cockroaches.

I would have recoiled if I wasn’t distracted by having a baby, but I didn’t have time to feel disgusted. It was only a year later, when I read that our hospital had been branded “dirty and unsafe” by the Care Quality Commission (CQC) and was ordered to make urgent changes, that I began to think again about the insects. Cockroaches and visible dirt shouldn’t be part of any woman’s “birth experience”, but they were part of mine.

Baroness Valerie Amos, who is leading the investigation into maternity care in England and who will publish her final report with recommendations in the spring, is clearly on the same page. She said “nothing prepared” her for “the scale of unacceptable care that women and families have received, and continue to receive, the tragic consequences for their babies, and the impact on their mental, physical and emotional wellbeing”. She said change was “necessary and urgent” and doesn’t understand why it has been so slow, adding: “Why are we in England still struggling to provide safe, reliable maternity and neonatal care everywhere in the country?”

I’ll tell you why: because women’s health has been (and continues to be) consistently undermined and deprioritised in the system, as well as devalued and belittled – and it’s been this way for decades. Medical misogyny and gaslighting is alive and kicking, both in the patronising language used in healthcare (from “geriatric mothers” to “lazy uteruses”) and in medication (with women told passing out due to period pain is “normal for women”). A survey three years ago found hundreds of women forced to endure “barbaric” and “inhumane” pain while undergoing hysteroscopy tests after being denied pain relief options and because anaesthetists were not available.

Then, there are the everyday, dismissive assumptions, often made by male doctors, that “women have been giving birth for thousands of years”. The implication, whether it’s said aloud or not, is: “What’s all the fuss about?” If there is, truly, a “two-tier system” in this country – as is so often trotted out – then it is right here in women's health.

Ask any woman who’s given birth in a public hospital in England in the past decade and you won’t find any “well, blow me down” reactions of shock and surprise in reaction to the initial findings of Amos’ report. We recognise all too well that we are not being listened to and not being given the right information to make informed choices about our care – not to mention the shocking, prevalent and insidious discrimination against women of colour, working-class women, younger parents and women with mental health problems.

We already know that due to thoughtless planning, lack of space – and basic lack of care – those of us who have miscarried are forced to sit in the same room as those bearing happy grins and clutching print-outs of their pregnancy scans. It’s not surprising to us to hear that women who have lost babies are placed on wards with newborns, or that our worries about reduced foetal movement are disregarded (one consultant openly sighed and tutted when I went to hospital with a concern and wondered out loud “why” I had come at all). It’s not a shock to hear that women are left feeling “blamed and guilty”. We’re all too used to that.

There are countless anecdotes I could tell you that have led to the many women I know feeling traumatised and responsible for situations that were completely out of their control. I’ve had my own: the doctor who sent me home from the urgent care centre with a disparaging wave of his hand, telling me dismissively that my little girl had “croup” after I’d brought her in and making me feel like an overprotective mother; even recommending the old wives’ tale of turning the shower on to help her breathe – it turned out to be pneumonia. Her left lung collapsed overnight.

Or, the nurse on the children’s ward who hadn’t learned empathy yet and who made my daughter, just nine months old, scream with pain when she tried (and repeatedly failed) to find a vein to insert a cannula – and didn’t think to stop, say sorry and ask if we were OK, but just kept gripping her tighter and tighter and sticking that needle deeper and deeper into her skin.

Any one of these horrifying moments is too frequent – and the fact that they’re happening all the time creates an uncomfortable dissonance when we think about a system I still rate as one of the best things about Britain – an NHS which has been consistently and woefully underfunded for years, stripped of resources and dignity and blamed for the mistakes which most often come as a result of systemic and piecemeal destruction and neglect.

Because there are wonderful and life-affirming moments, too: I will never forget the incredible midwives who delivered my two children safely – I was so grateful that I made them a mix tape. Or, the nurses who saw me through the endless bleak nights of my daughter’s multiple hospital admissions, who made me cups of tea in the “parents’ room”. The retired nurse working past her “end date” because they were so understaffed, who helped my little girl carry round an oxygen canister twice her height; the team who rallied around my friend when she (unthinkably) lost a child; my schoolfriend who worked gruelling, 30-hour shifts in A&E during the pandemic, her PPE mask leaving deep bruises around her nose and eyes.

The staff at NICU who supported so many brave and brilliant women I know who happened to have difficult, traumatic births, who needed medical intervention, who saved the lives of our babies who couldn’t breathe. Yes, this is a damning report and something has to change – for their sakes, just as much as ours.