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"Birth trauma as a result of poor care at several stages"

About: Adult Mental Health Services / Perinatal Mental Health Team Queen Elizabeth University Hospital Glasgow / Maternity care (Wards 47, 48 & 50) Queen Elizabeth University Hospital Glasgow / Neonatal Unit

(as a service user),

In December 2021, I gave birth to my first son. I had planned a home birth, but knew that as a primiparous mother I was likely to need a hospital transfer. Because I had a history of depression and PTSD, and already had a couple of bad experiences with this hospital, I focused a lot on being informed about different interventions and maintaining a sense of calm.

My waters went early and my labour was predictably slightly chaotic, which didn't worry me but meant that I had to be in and out of Maternity Assessment for monitoring over 48 hours. On one occasion the doctors on duty were so focused on getting a clear 20 minutes worth of data for my child that they would not let me off the machine to use the toilet, and my partner had to insist. I was contracting while this was happening.

After returning home from this visit I found meconium in my waters, so we went back, and this was when things took a real turn for me.

The doctor in triage examined me and performed a sweep without my consent, something I am still struggling to make sense of because my waters had broken long before.

I consented to receiving augmentation and an epidural. The midwife on duty was excellent and very kind. Unfortunately the epidural pooled on one side, the anaesthetist took a long time to return and give me local anaesthetic, and then he seemed more preoccupied with interrogating me about why I thought it had gone wrong than relieving my pain.

I got an infection and my son began to have decels so the midwife called the obstetrician, who decided to deliver my baby by ventouse. This was very far from the kind of birth I'd wanted to have, but I consented.

It took 40 minutes for my son to be delivered in this way; I received an episiotomy and have since been told the scar is unusually long by other health workers; I lost 900ml of blood (no one ever followed up with me about this); and my baby was left with fluid on his lungs and an infection.

He went to NICU (everyone in NICU and Neonatal was wonderful, if clearly extremely overburdened).  We were reunited after 24 hours and had what I can only describe as a nightmarish experience on the maternity ward - breastfeeding was extremely challenging under the circumstances and my husband actually had to phone the ward to ask someone to help me, at which point I felt berated for not insisting enough.

Even if care had been more readily available, it's now clear to me that it wouldn't have been of a good standard (e.g. the expectation that newborns would feed *only* every 3 hours, rather than every 3 hours at minimum). After a hellish night with zero sleep, an attendant berated me for not feeding my baby (he had been latched all night but was possibly still hungry as I had no idea what I was doing).

He began to develop jaundice and required phototherapy, but no one had time to discuss his prognosis seriously with me, with the result that we wound up on a rolling 12 hour clock as he got worse and worse and my mental health deteriorated.

I eventually persuaded a paediatrician to discharge us while we waited for results; he seemed to find me challenging as he asked me questions about my professional background in social science and speculated that I had 'cabin fever' (rather than an existing mental health condition). He also rarely referred to my child as a person, continually focusing on the 'line' on the chart.

Once discharged, a midwife from the home birth team (all of whom were fantastic, incredibly supportive individuals) collected a blood sample to be couriered back to Queen Elizabeth University Hospital.

Sometime after the driver received it, it was lost. We had to be readmitted (the jaundice was only getting worse, in any case) and after I cried in front of a paediatrician (one of the few genuinely compassionate people I encountered during my stay), we were given a family room in Neonatal. From here things improved a lot, and we were eventually discharged a few days later.

I have since had EMDR therapy via Perinatal Mental Health to deal with the fallout from this experience, which affected my ability to breastfeed (requiring help from a private lactation consultant, which I could just about afford). This has been really helpful and I can say that I have processed much of what happened. However, it was really harrowing, and I know I am not the only parent who has been through an experience like this at QEUH.

While I understand the structural reasons for this standard of care, to me it is a tragedy that things are this way, and I will never forget what I went through.

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Responses

Response from Gaynor Bird, Lead Midwife, Maternity, NHSGGC 13 months ago
Gaynor Bird
Lead Midwife, Maternity,
NHSGGC
Submitted on 07/03/2023 at 10:36
Published on Care Opinion at 11:40


picture of Gaynor Bird

Dear Hazel36,

Thank you so much for taking the time to tell us about your birth experience at the Queen Elizabeth University Hospital. I am sorry to hear that your journey was so difficult and that you had treatment that you did not consent to in Maternity Assessment. We always aim to ensure that our care is person centred and that any care or decisions are carried out in partnership with women and I apologise that this did not happen.

I am glad that the midwife caring for you in labour was excellent and kind but it is sad that your birth was not as you would have wanted and that your baby needed additional care in the Neonatal unit and it is good to hear how wonderful the staff were.

It is very disheartening to hear how you did not receive the support which we would aim to provide for all women on the postnatal ward, particularly breastfeeding support and I am so sorry that this had such a negative impact on your first few days with your baby.

I am sorry that no-one took the time to discuss your baby’s jaundice with you and support you during the treatment journey and that you had such a negative experience. It is reassuring that the home birth team were incredibly supportive and that you found empathy within the neonatal team on your admission to a family room.

In order for us to learn from your journey and shape and improve our service and care as a result of this feedback, can I offer you an opportunity to meet to discuss your journey in more detail? This would be invaluable to the service to help to improve care for all women and their babies.

Kindest wishes

Gaynor

gaynor.bird@ggc.scot.nhs.uk

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Response from Gaynor Bird, Lead Midwife, Maternity, NHSGGC 13 months ago
We have made a change
Gaynor Bird
Lead Midwife, Maternity,
NHSGGC
Submitted on 29/03/2023 at 10:21
Published on Care Opinion at 10:36


picture of Gaynor Bird

Dear Hazel36,

It was lovely to meet you yesterday and thank you for your feedback. It was great to explore your journey and be able to update you with our actions following your initial post and talk to you about some of the work we have ongoing within QEUH around Person Centred Visiting, birth choices and our MNPI service. Following our meeting, our neonatal team have shared Quality Improvement work which is in progress to help with ensuring that families have information about their baby and jaundice.

Also, thanks for agreeing to participate in further work we plan to do as part of our Maternity Voices Partnership.

Best wishes

Gaynor

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