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Are we at risk with maternity services?

The ongoing proposed closure of birth centres around the country is an outcry, from both health professionals and communities. We have become aware that areas such as Dover, the East. and Coastal regions and parts of Derbyshire have fallen victim to the postcode lottery of health services provision whilst in Cambridge progress continues for a world first class maternity services, mainly through campaign and donations and the public’s charitable help. I wonder if this is a sign and times to come for this gesture to be rolled out nationally.

Pregnancy specifically is a very critical and tender phase for mother and the child as well as fathers. Repercussion of ignoring the health during this critical phase can be seen in mother as well as child in the form of various disorders, some being irreversible ones and even perinatal mortality.

Like many other issues going on, I have chosen to raise this issue with friends and colleagues who have or are going to experience pregnancy and childbirth at some point. Certainly, for first timers it is overwhelming, well at least I was. Amazingly, despite living in the same region we all seem to have experienced very different services. Other than the feeling of joy about our pregnancy; I commend the midwife, all the other health professionals that were involved and the maternity services provided. The end result: A healthy newborn, overjoyed parents and enough education to deal with the next one. It was comforting to know I would be getting my weekly visits from the midwife and never needed to worry.  Not many have the same experience, and what I had concluded from all the chatting was, fear for another pregnancy and birth process, looking to go private and some wanting a different birth experience in a hospital not local to them. These feelings have been brought on as a result of shortage of staff; lack of time to share valuable information and basic education, particularly first time mothers; understaffed hospitals with poor services. In one case, she had had a caesarean (not out of choice) when the baby was born, she was left to it, a remembrance of the many times she buzzed, with no response.

courtesy of Treetops Photgrapgy

Learning from hospital incidents is important for patient safety; at the same time ensuring expectant mothers are given a choice about their birthing options, as long as health professional deem it safe. There are a number of initiatives that seek to reduce incidents, that impact on patient safety in which case lessons should be learnt. I have come to learn that hospitals in relatively poor areas have a population with more social health problems therefore increasing the perinatal mortality rate to 30% within the UK. Research shows that, two thirds of the mortality rate results directly from differences in medical and health care. So this could mean neonatal death and unnecessary complications can be prevented by improving medical and health care in failing areas.

The perinatal mortality rate is indicative of perinatal and neonatal care, as well as living standards, maternal health, medical intervention and care. There is an awareness of the risk factors through research and lessons learnt from hospital incidents. A combination of factors seem to increase the risk of poor maternal health, “Patient UK” 2009 quotes that maternal health; social class; age of mother( below 20 or over 40); region of maternal residence and marital status (where still babies  born outside marriage) are all possible risk factors.

To choose between campaigning for better services for the NHS with the help of public donations or privatising maternal services, I am certain I will be lifting that placard high enough and marching the streets. In some cases I must say it is either sheer luck or a consistently good service or maybe bad timing and a continuous lack of standards. If all women are to have one-to-one midwifery care through labour, and in some cases, urgent assistance from other members of the maternity care team such as obstetricians, anaesthetists and neonatologists. Then a review in funding maternity services and resources needs to be considered. Pregnancy and childbirth should be safer for mother and baby, should not be determined by region, ethnicity, health condition or even social factors, at least not in the UK. Strengthening partnership working has been the order of the day for some time; hence all these factors presented should be addressed. It is imperative that there should be systems and funding in place for people to do their jobs effectively.

If there is a chance that routine visits from the midwife are to be affected due to staff shortages or merely not enough trained community midwifes, then why not educate first time mothers and fathers to make them aware of the most vital issues to watch out for.

This will definitely not just affect mothers and new borns’, but we may find ourselves at the bottom of the Europe league tables in terms of providing and sustaining good standards of maternal services. People talk about accessing better health and care; accessing is the easy part, its’ the fully funded, equipped and resourceful services that need to be available.


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