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Archive for November 5th, 2008

Yesterday started off as an average day in our little office, out of 7 midwives there were 3 working. Within 30 minutes though things were looking rather problematic as there was a homebirth ‘niggling’ and both the on-call midwives were from our office. We spoke to our ‘mothership’, the main community midwives office, and asked them if one of them could attend if required during the day as the homebirth woman was in their area rather than ours. They declined. The problem was that us 3 all had commitments, including a full antenatal clinic, so if the on-calls were needed there was no way the clinic could be covered. Support was sought from our manager, her advise was to wait and see and then cancel the clinic if the homebirth called the midwives. We were all seething, the women don’t appreciate the machinations that go on behind the scenes and will just feel abandoned so I said that if the worse happens we should advise the women to write to the manager about it, as that’s the only way that anything will be done about the staffing levels. The other 2 midwives immediately jumped on me, ‘no we mustn’t do that, we are not allowed to tell the women to complain.’ My colleague then went on to relate how she was disciplined for advising a couple to write a letter of complaint. The reason. Well apparently if a complaint is put in writing they have to respond and be seen to take action. Well blow me down, I thought that was the whole objective of putting in a complaint, whether in writing or verbally, someone taking notice of it!

I have a multitude of issues with all this. If we complain nothing at all gets done, unless we go to occupational health and tell them we are stressed, and you really don’t want to do that as it goes on your record. Most of the time the discord we feel is due to the impact that restraints on the service have on our women and the care we can provide. The women will, obviously, grumble to us about shortcomings, but it is pointless us presenting the issues to managers, as they do nothing, so if that’s the case it is sensible to advise the women to let the managers know how they feel. Now though I’m just supposed to absorb all the discontent, knowing that the women may as well be talking to a brick wall, as I can’t suggest that if they feel strongly they should write in because no one is going to take any notice of me.

Why else am I stunned by the idiocy of the system? Once again it’s the staffing issues. Here we are in a situation where the government is promoting homebirth, where the maternity services (the midwives) are being told to increase the homebirth rate, and all this within a service which already has problems fulfilling routine commitments. Is it so difficult to perceive that increasing the number of homebirths will also require an increase in the number of midwives available and that if this doesn’t happen then other aspects of care will suffer, like antenatal clinics.

Finally, is this a ‘whistleblowing’ by proxy issue? We should be able to highlight problems within the service without censure. We can certainly do that, as long as it’s not in writing. However, give women advise on how to raise issues effectively and you are disciplined. Catch-22 methinks.

The homebirth happened. The clinic was cancelled. One happy new Mummy and baby, 12 unhappy pregnant women.

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