Making childbirth easier

Ali wrote:

Dimples wrote:

Ali wrote:

Dimples, generally hospitals only have one delivery unit, some will have high risk units and low risk units in the same hospital others don't, but they cannot magic up space for hoardes of women in early labour who are having no medical problems. Those women who are actively labouring and are in the process of giving birth must come first.

There are multitudes of women out there who have stayed at home, waited until the contractions are strong and regular, gone in and had perfectly normal, uncomplicated deliveries, women in fact who could have just as easily given birth at home.

Ali please stop lecturing me. I know every bit as much as you do about how hospitals work and I know very well that many are under-resourced and also that many hospitals have had their maternity services moved or withdrawn, leading to many women having to travel further to their "local" maternity unit. Many women in rural areas have to travel many miles. In Edinburgh alone, we have lost 4 maternity units since the 1980s.

I am talking about women who did as they were advised and went to hospital when they were in established labour - women who in the recent past would have been able to be admitted to the hospital and remain there without being sent away.

I accept that many women could deliver at home but if that is not their choice or is not an option for whatever reason, no woman in labour should ever be sent away from a maternity unit.

I'm not lecturing you any more than you are me Dimples.

I'm well aware that many maternity units have closed in the past couple of decades or so, too many have closed, some have become birthing units only like one that is local to me. Both of my 'local' consultant units are just a little over 20 miles away and have seen an increase in the numbers of women choosing to access them because some of the smaller units have shut. But these haven't been increased in size, they have no more beds now than they did in the 1980's and therein lies the problem.

I think there is also a problem with the definition of established labour, it isn't just when contractions are regular and strong, it is that combined with cervical dilatation of about 3cm's. Many of these women who come in complaining of strong, regular contractions aren't actually dilating, particularly those in their first labours when the cervix needs to be taken up before dilatation even starts to take place.

I know it's unfair if women want to be in hospital because they are distressed or in pain but if the staff are spending their time dealing with these women then they are not spending their time with women who really do need them. There is enough crap about midwives having to spread their time over more than one labouring woman as it is without adding even more and so reducing their time even further.

Ali wrote:So what's the answer, build more maternity units, stop closing down those still in existence and create more midwifery jobs obviously.

But the fact is Dimples that thousands of babies every year are not dying through lack of midwifery care in labour, established or otherwise, thousands every year are not being born in hospital corridors or car parks because there is no room at the inn and the fact is, if women didn't come screaming into hospital at one centimetre dilated demanding epidurals (and they do) and then complain about it when it doesn't happen then the midwifery profession could get on with the job in hand of delivering those women in most need of their care right then.

Dimples wrote:

Ali wrote:So what's the answer, build more maternity units, stop closing down those still in existence and create more midwifery jobs obviously.

But the fact is Dimples that thousands of babies every year are not dying through lack of midwifery care in labour, established or otherwise, thousands every year are not being born in hospital corridors or car parks because there is no room at the inn and the fact is, if women didn't come screaming into hospital at one centimetre dilated demanding epidurals (and they do) and then complain about it when it doesn't happen then the midwifery profession could get on with the job in hand of delivering those women in most need of their care right then.

Not everyone is looking for an epidural and not everyone comes into hospital at 1cm dilated. However, if someone has arrived in labour, they should not be sent home - particularly if they have come a long distance or are reliant on someone else for transport. In addition, no woman wants to feel as if she is on a production line when she comes to hospital to have her baby. It should be made as pleasant an experience as possible and there should be continuity of care, which becomes harder to implement if she is sent away and comes back later to a range of people who are different to those she saw when she arrived a few hours earlier.

Ali wrote:

Dimples wrote:

Ali wrote:So what's the answer, build more maternity units, stop closing down those still in existence and create more midwifery jobs obviously.

But the fact is Dimples that thousands of babies every year are not dying through lack of midwifery care in labour, established or otherwise, thousands every year are not being born in hospital corridors or car parks because there is no room at the inn and the fact is, if women didn't come screaming into hospital at one centimetre dilated demanding epidurals (and they do) and then complain about it when it doesn't happen then the midwifery profession could get on with the job in hand of delivering those women in most need of their care right then.

Not everyone is looking for an epidural and not everyone comes into hospital at 1cm dilated. However, if someone has arrived in labour, they should not be sent home - particularly if they have come a long distance or are reliant on someone else for transport. In addition, no woman wants to feel as if she is on a production line when she comes to hospital to have her baby. It should be made as pleasant an experience as possible and there should be continuity of care, which becomes harder to implement if she is sent away and comes back later to a range of people who are different to those she saw when she arrived a few hours earlier.

No, and not everyone in early labour or early established labour or with ruptured membranes gets sent home either, a lot will simply depend on how busy the unit is that day.

I was on the unit one day when there 17 women on CDS, some with pregnancy problems, some in early labour who had come in to be assessed, some labouring and two post natal in high dependancy, but with 7 delivery rooms, 4 assessment beds and 4 post natal beds, with only 7 midwives and two students on duty that is excessive and not only is it excessive it can be downright dangerous too and some people can't understand why those women who don't really need to be at the hospital are sent home.

Dimples wrote:

Ali wrote:

Dimples wrote:

Ali wrote:So what's the answer, build more maternity units, stop closing down those still in existence and create more midwifery jobs obviously.

But the fact is Dimples that thousands of babies every year are not dying through lack of midwifery care in labour, established or otherwise, thousands every year are not being born in hospital corridors or car parks because there is no room at the inn and the fact is, if women didn't come screaming into hospital at one centimetre dilated demanding epidurals (and they do) and then complain about it when it doesn't happen then the midwifery profession could get on with the job in hand of delivering those women in most need of their care right then.

Not everyone is looking for an epidural and not everyone comes into hospital at 1cm dilated. However, if someone has arrived in labour, they should not be sent home - particularly if they have come a long distance or are reliant on someone else for transport. In addition, no woman wants to feel as if she is on a production line when she comes to hospital to have her baby. It should be made as pleasant an experience as possible and there should be continuity of care, which becomes harder to implement if she is sent away and comes back later to a range of people who are different to those she saw when she arrived a few hours earlier.

No, and not everyone in early labour or early established labour or with ruptured membranes gets sent home either, a lot will simply depend on how busy the unit is that day.

I was on the unit one day when there 17 women on CDS, some with pregnancy problems, some in early labour who had come in to be assessed, some labouring and two post natal in high dependancy, but with 7 delivery rooms, 4 assessment beds and 4 post natal beds, with only 7 midwives and two students on duty that is excessive and not only is it excessive it can be downright dangerous too and some people can't understand why those women who don't really need to be at the hospital are sent home.

But you were there too.... so that must have made ALL the difference!

Ali wrote:

Dimples wrote:

Ali wrote:

No, and not everyone in early labour or early established labour or with ruptured membranes gets sent home either, a lot will simply depend on how busy the unit is that day.

I was on the unit one day when there 17 women on CDS, some with pregnancy problems, some in early labour who had come in to be assessed, some labouring and two post natal in high dependancy, but with 7 delivery rooms, 4 assessment beds and 4 post natal beds, with only 7 midwives and two students on duty that is excessive and not only is it excessive it can be downright dangerous too and some people can't understand why those women who don't really need to be at the hospital are sent home.

But you were there too.... so that must have made ALL the difference!

As a first year student left to care for the high dependency women pretty much unsupported because my mentor was too busy running around like a blue arsed fly dealing with women pitching up in early labour demanding to be assessed there and then.

Dimples wrote:

Ali wrote:

Dimples wrote:

Ali wrote:

No, and not everyone in early labour or early established labour or with ruptured membranes gets sent home either, a lot will simply depend on how busy the unit is that day.

I was on the unit one day when there 17 women on CDS, some with pregnancy problems, some in early labour who had come in to be assessed, some labouring and two post natal in high dependancy, but with 7 delivery rooms, 4 assessment beds and 4 post natal beds, with only 7 midwives and two students on duty that is excessive and not only is it excessive it can be downright dangerous too and some people can't understand why those women who don't really need to be at the hospital are sent home.

But you were there too.... so that must have made ALL the difference!

As a first year student left to care for the high dependency women pretty much unsupported because my mentor was too busy running around like a blue arsed fly dealing with women pitching up in early labour demanding to be assessed there and then.

Were you a midwifery student or nursing student?

Ali wrote:Just to add though, there were also no antenatal or postnatal beds empty on the wards (44 of them) and that is the one and only time I ever saw that unit closed in the time I was there.

Ali wrote:

Dimples wrote:

Ali wrote:

As a first year student left to care for the high dependency women pretty much unsupported because my mentor was too busy running around like a blue arsed fly dealing with women pitching up in early labour demanding to be assessed there and then.

Were you a midwifery student or nursing student?

Midwifery.

Dimples wrote:

Ali wrote:

Dimples wrote:

Ali wrote:

As a first year student left to care for the high dependency women pretty much unsupported because my mentor was too busy running around like a blue arsed fly dealing with women pitching up in early labour demanding to be assessed there and then.

Were you a midwifery student or nursing student?

Midwifery.

If you don't mind me asking, why did you not continue with it?

Ali wrote:

Dimples wrote:

Ali wrote:

Midwifery.

If you don't mind me asking, why did you not continue with it?

I'll pm you.

Dimples wrote:

Ali wrote:Just to add though, there were also no antenatal or postnatal beds empty on the wards (44 of them) and that is the one and only time I ever saw that unit closed in the time I was there.

..... which would rather confirm the absolute folly of closing down maternity units left,right and centre.