"Maternity Assessment Unit practice on admissions..."

About: Liverpool Womens Hospital

I find it be an unsafe practice for the triage midwife to make their decisions over the phone on when pregnant women in labour could come to the hospital . If they are going to make decisions based on phone conversations, then at least they should trust what patients say to them about how long contractions are lasting and how often and not dismiss it as being ''anxious and worried because its first pregnancy''. My wife was 41 weeks pregnant (first pregnancy). Waters broke at 6 am and I phone the maternity assessment unit and was told to come in at 10am. Contractions started and were lasting about 30 seconds so phoned again and was told by the triage midwife to come at 12 midday as its first pregnancy and it takes a long time to get to the stage of established labour (contractions lasting 60-90 seconds as the triage midwife explained). They gave advice on warm bath/paracetamol. All that was fine. Contractions got stronger and were lasting now 1 minutes 10 seconds and happening every 2 minutes so phoned again three time between 7:30 and 9:15 am and spoke to the same triage midwife explaining what was happening but they said there is no need to come to hospital before 12 o'clock and the only thing that could be done in hospital is giving paracetamol. They said that my wife couldn't have epidural yet as she is not in established labour yet (despite telling them about contractions lasting over 60 seconds). They advised that I try and comfort my wife and that they understand that I am anxious. I asked if I could bring my wife in and if they examine her and find everything OK we go back home but the answer was that this was unnecessary. At 9:45am, my wife could not bear the pain anymore so we came to the maternity assessment unit and triage midwife that I had been speaking to said '' I see that you came in before planned''. My wife was taken in, examined, and found to be fully dilated. It was too late for epidural which we have no objection to. My wife went through the pain of labour the baby was born at 12:15pm and the doctor used vacuum as heart rate was dropping. To be fair to the triage midwife, after they examined my wife they were nice and professional and everybody during labour was professional and we felt we were in safe hands. However, if I had followed the advice of the triage midwife and waited till 12 o'clock before coming to hospital, it would have been very late and risky for the baby. I understand that its unusual for first time pregnancy to progress quickly but it happened in our case and we had updated the maternity assessment unit on how contractions are getting more frequent and lasting longer but this was not acknowledged and was dismissed as being anxious and worried. What is also strange is that I have spoken to the same triage midwife throughout so you can't blame this on communication problems between staff.

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Response from Liverpool Womens Hospital

I am very sorry and concerned to hear of your experience and the information you were provided when you contacted the Maternity Assessment Unit. I would like to assure you that I will discuss your concerns with all staff in the Maternity Assessment Unit to highlight the importance of good communication. If you would like to meet and discuss your concerns in more detail , this can be arranged by the Patient Experience Team on 702 4182/4416/4061. Joan Holloway Delivery Suite & Medical Assessment Unit Manager

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