The nation’s future is in our hands, literally. Yet I fear the maternity system is collapsing...

Mothers forced to delay labour because of understaffing. Worrying numbers of medics on antidepressants. In a whistle-blowing new book, a devoted NHS midwife warns...

FEARFUL that the lives of mothers and babies are being put at risk by uncaring managers, a despairing NHS midwife has written an explosive book about her 15 years spent on maternity wards. Here, in the final part of our serialisation, she details how the system is buckling under the strain and reveals how staff dare not take sick leave – because otherwise they will be sacked…

THE ward is crazy today. I’m in charge of three women all giving birth at the same time, and I don’t know how I’m going to keep all the plates spinning. There are 44 mothers in the unit – not to mention the babies – and just six midwives to look after them, so it’s not only me who is going flat out. We all are.

By the time I get in the car to drive home I’m exhausted – just like most days. Except that this isn’t any old day. It’s my first shift back after four months off with work-related stress and depression – and it’s as if I’ve never been away.

Don’t get me wrong, it’s wonderful to be back among my much-loved colleagues, the families and all the babies again. It’s always an absolute privilege to be present at the beginning of a new life, and I never lose sight of that.

The best part of my job without doubt is the high of seeing a mother’s face when she first sets eyes on her child – that euphoric moment when they meet each other for the first time after nine months of such intense closeness. It brings tears to my eyes, and I never tire of it.

But I’d been promised a ‘phased return’ to work by the hospital’s management, and this has been the complete opposite. It isn’t just throwing me in at the deep end – this is like being towed out to sea and dumped in the middle of the ocean. Perhaps tomorrow will be better, I tell myself. But it isn’t.

‘Are you all right? Do you need anything?’ I hastily call to one new mother as I rush from pillar to post.

‘I’m fine. Don’t worry about me,’ she replies. She smiles, clearly besotted with her newborn. Thankfully she has lots of help from her partner and mother, but that doesn’t stop me feeling guilty that I’m not looking after her properly.

There is no time for a nice, relaxed conversation. No chance to change her bed linen, admire her baby or show her how to do her first feed. And, sadly, that’s how things are for midwives in 2020.

It’s not just the aftercare that we’re unable to provide. In the months since I’ve been back at work I’ve noticed some worrying new developments creeping in – things that wouldn’t have happened even a year ago.

One of these is the highly unsatisfactory practice of delaying induced labour by 24 or even 48 hours when we’re understaffed.

At our hospital we carry out about four inductions a day, usually for clinical reasons such as diabetes, or if the mother-to-be has gone two weeks beyond her due date.

We usually start the women on slow-release hormones for 24 hours before breaking their waters and allowing labour to begin. But these days it is possible that the ward will have to close during those 24 hours because of under-staffing. This not only means the woman can’t go home, but she can’t start her labour either. We have to stop everything we’re doing for these poor women until the unit opens again, usually 12 hours later. So they remain on our noisy, busy ward, having contractions, getting no sleep and becoming more exhausted by the hour. It’s an awful situation for the mother and the baby. It used to be a rarity, but in the past year it’s become a regular occurrence.

Understandably, people get very upset but there’s nothing I can do to change things. It’s stressful for everyone – especially for families who are watching those they love in pain, when everyone just wants the baby out as quickly and as safely as possible. After all, isn’t that what we’re supposed to be there for?

I’D REALLY struggled with the idea of going off sick in the first place. It’s not something you do lightly at the hospital where I work, because there is a big chance that if you’re away too often, you will lose your job.

In the autumn of 2018, just before I was signed off with stress, I’d been suffering with a cold that left me feeling like hell warmed up. There is a strict sickness protocol

at our hospital trust. If you take more than two days off within six months, you are summoned for a ‘capability meeting’ with your line manager and HR staff to assess whether you are actually capable of working any longer.

In other words, if you are properly ill, then your job is at risk. As a result, staff are terrified of taking time off sick. I’d had two days off in the August of that year with a chest infection, so if I went off sick now, I would potentially face the sack. I dragged myself out of bed, threw on my uniform and drove to work.

Halfway through that morning, while I was in the middle of delivering a baby, I felt my nose begin to stream. ‘Alison,’ I whispered to my student midwife, ‘will you please wipe my nose? I don’t want this baby to be covered in germs the moment she arrives in this world.’

It was farcical, really, watching my colleague rushing off to the bathroom for some loo roll so that she could do the honours. Not exactly part of her job description.

And anyway, we shouldn’t be breathing our bugs over new mothers and tiny babies, some of whom aren’t in the best of health.

We all understand that the sickness protocol is designed to stop people from taking unnecessary days off. But it prevents them taking necessary days off, too. We’re working in a hospital, for goodness sake, where sickness, bugs and infections are rife.

It’s only natural that we will occasionally fall ill. And being punished for that undoubtedly contributes to the stress epidemic engulfing our hospital wards. I am convinced there would be less depression if people weren’t so worried about taking one or two days off sick for genuine reasons.

All of us on our unit know highly qualified midwives and nurses who have been ‘let go’ after these ‘capability meetings’. If NHS managers could only accept that staff sometimes get ill, then perhaps they might hold on to them for longer – and we wouldn’t be in the mess we are.

AFTER a few weeks back, I was getting into the swing of things again. I really do believe that despite all the challenges, being a NHS midwife is the best job in the world, and nothing will change my mind about that.

I was astounded, however, that at no point did anybody from the management team sit me down and ask me how it was going, and whether I was coping. Quite the reverse, in fact. Six weeks or so after my return, I was handed a form to sign by one of the shift co-ordinators.

‘What is it?’ I asked. ‘A return-to-work form – a boxticking exercise,’ she replied.

‘It just says you’ve had a full debrief, the workload is at a safe level and you feel comfortable and happy. And that you commit to not taking any more sick days for the next three months.’

It was almost laughable. No acknowledgment of the stress that had driven me out of the ward for four months.

No friendly chat. Just a threat to send me to a ‘capability meeting’ if I had one more day off sick in the next three months. I hesitated before I signed it.

But then I thought back to the joyous births I had been involved with earlier in the day, including that of a couple who, after years of trying, had finally become a family.

So instead I smiled. ‘Give me the pen,’ I said.

After my recovery last year I gradually started to tell people the reason I’d been off sick, and that I was taking antidepressants.

What shocked me was the number of people who replied that they were too.

One doctor I work with told me recently: ‘If I pick five doctor friends at random from this hospital, at least three of them will be on antidepressants.’

What does that say about the way the NHS treats its staff?

Something is very wrong when we are all on chemical moodenhancers just to get us through the day.

The funding crisis is clearly having a dire impact on the standard of medical care in Britain.

So here is a suggestion. We could start by cutting in half the number of managers, and investing the money instead in healthcare professionals.

I know that sounds simplistic but the future of the nation is in the hands of Britain’s midwives – quite literally.

It’s your wife, daughter, partner or sister we are helping. No more corners must be cut.

The mothers of tomorrow must have the same devoted care as we’ve always given – for everybody’s sake.

© The Secret Midwife and Katy Weitz, 2020

The Secret Midwife: Life,

Death And The Truth About Birth, is published by John Blake on February 6, priced £16.99. Offer price £11.99 until March 8. To pre-order, go to mailshop.co.uk or call 01603 648155. Free delivery on all orders – no minimum spend.

Take more than two days off in six months and you face getting the axe