Independent readers say it’s no surprise that England’s maternity services are in crisis – arguing that decades of underfunding, mismanagement and a culture that fails to listen to women have created the conditions for today’s tragedies.
In response to Baroness Amos’s shocking early findings, many in our community said the issues are longstanding and well known.
Several readers pointed to systemic failures: chronic staffing shortages, exhausted midwives with inadequate training and argued that many qualified consultants are put off obstetrics because of the high risk of litigation.
Some said the NHS is no longer able to offer safe care, with one reader describing the system as “not fit for purpose anymore” and another, responding to columnist Victoria Richards’ experience of giving birth in a ward riddled with cockroaches, shared trauma so severe it pushed their family into private healthcare.
Many argued that maternity safety cannot improve without “proper funding”, sustained investment, smaller local units and a workforce treated with respect rather than blame.
So much trauma
My own personal and horrific experience giving birth at the hands of the NHS has left me with so much trauma, 11 years on, that I can't even speak about it.
It was so bad that we decided to get private healthcare from that day onwards, which put us in huge financial setbacks. We had to abandon many of our goals, but it was worth it. And our two younger children were both delivered privately — which turned out not just to be a blessing but lifesaving.
My youngest birth resulted in my being in ICU for eight days due to surgery complications and nearly dying. I dread to think what that would've looked like under the care of the NHS; I know this from nurses who also split their time 50/50 with the NHS, who told me it would've been horrific. My heart goes out to all the women who have no such choice but continue to rely on the NHS. I would go so far as to say, if we hadn’t been able to afford private healthcare, we might’ve considered moving abroad — that's how damning my feelings are about it.
Voices are silenced
Commendable comments from Baroness Amos. However, as a former midwife I can save her a lot of time in identifying the reasons for this sorry situation. Quite simply, this situation has arisen because those concerned are women — pregnant women, midwives — whose voices are silenced or lost.
Doctors are reluctant to go into obstetrics because they are aware of the huge risks of being held culpable when things go wrong. Experienced midwives leave, leaving younger, less experienced staff struggling to cope, and then they also leave the profession because of stress.
There have been radical cuts to maternity service provision for decades, making units deal with more and more women but without the necessary resources or expertise to meet demand. If this were men then there would be an outcry.
Massive investment is needed — smaller units, more encouragement to train and retain midwives, better community care during pregnancy and afterwards, and bringing back GP delivery units within hospitals. You’re welcome!
If you’re not caring for the mother, you’re not caring for the baby
Lack of funding.
The so-called focus on the baby rather than the mother, treating her as a host rather than a person.
Failure to tackle poor staff by management.
Lack of training of midwifery staff in adult health care. They are not nurses and should have to go through full nurse training before being allowed in the care of adult patients.
If you’re not caring for the mother, you’re not caring for the baby and that’s an attitude that needs to change.
Professional rivalries and lack of interest from midwives when the mother also requires consultant-led care.
The fact that most midwives bring in their own choice of midwife when they have their own children says it all about their own confidence in the system.
Catastrophic, shameful management
You wonder what a similar review of elderly care would reveal.
I don't know if this is an issue of funding and, if so, what that issue is. It is certainly an issue of catastrophic, shameful management and no additional or redirected funding can put that right. I don't think yet another national inquiry is warranted, but certainly I want to see those responsible in front of a select committee.
If you want top quality healthcare you have to fund it
“The question the investigation and the Maternity Taskforce must now answer is simple: why has change not happened?”
Probably because the staff and resources are not available to introduce the required changes. I’d question whether reviews etc. are needed to establish that. The public needs to face the fact that if you want top-quality healthcare you have to fund it properly.
The NHS is not fit for purpose anymore
That the NHS is not fit for purpose anymore is old news, and has been like that for a decade or more. If anything, it’s getting worse, as 1) home-trained nurses, doctors and surgeons go abroad for a better salary; 2) skilled nurses, doctors and surgeons from the EU don’t come anymore because of Brexit; and 3) we import nurses, doctors and surgeons from anywhere else, quite a few with dubious qualifications to say the least.
Add to that chronic mismanagement of funds, massive waste of money, endless layers of useless management and you end up with a toxic mix that costs a fortune and simply doesn’t work. Wishing it does and telling ourselves everything is fine won’t work anymore. But it’s such a huge, hot mess that no politician has the skills, vision and attributes to really turn it around. So who can, goes private, the others die in the wards, and everyone pays loads for it to get absolutely nothing in return.
Blame culture
Sixty years ago, I had two lovely stress-free births in my local cottage hospital where it was the norm to spend 10 days. The less-than-fully-qualified but bossy nurse was a nightmare, but the laughter when she left the ward united the six of us. Experienced mothers reassured the new ones. We had many failed pregnancies, stillborns and tragedies experienced by my own family and most of my friends. The fact that it was nowhere like that of our Victorian grandparents we regarded as a blessing. No one complained, sued or demanded compensation.
So I’m nonplussed that massive advances in saving ever more premature babies and the choice of requesting a less painful birth has resulted in more unhappy mothers, more blame and millions more spent on compensating them for what would have been, sixty years ago, an expected but tragic loss.
Who’d want to be a nurse or doctor under such a blame culture?
Some of the comments have been edited for this article for brevity and clarity.
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