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Page last updated at 23:48 GMT, Tuesday, 1 May 2007 00:48 UK

Midwives Undercover

Hayley Cutts ID card
Hayley Cutts went undercover in two hospitals
Understaffed and overstretched, that is the lot of midwives in some maternity units, a BBC Panorama investigation has discovered.

Undercover reporter, Hayley Cutts, tells of the crisis in care she found while working as a volunteer on two large maternity units in the UK.

I was beginning to feel uncomfortable about the responsibility I was being given by my third shift as an unpaid volunteer on a joint ante and post natal ward of Barnet Hospital, North London.

It included performing the patient observations, such as blood pressure, pulse and heart rate.

I told the busy midwives I was untrained and unqualified but they insisted they needed my help.

Many parents were demanding attention and needing care on the full unit with no beds but the three midwives on duty were over-stretched.

Clearly worried, the midwife in charge said: "We are chocca, we've got labouring women over here, and I've got someone in the bath and another being induced."

Another day she confided when wards are full : "We're dangerous."

Midwife filmed with secret camera
Midwives said they were stressed out by staff shortages

Three hours into this shift a midwife was taken to the delivery ward to look after a lady in labour leaving only two midwives for 23 women on our ward.

Then a new mum arrived after giving birth to be told she had no bed.

I had to juggle women around so we could squeeze her into the overcrowded and understaffed ward.

The only solution, staff devised, was moving another lady, who should have been under midwife supervision, to the unstaffed Transitional Care ward where women who do not need medical care, stay when their babies are on the neonatal ward.

I would discover later transitional care was regularly used as a dumping ground when wards were full.

The hospital was now closed to new admissions with women told to try a neighbouring hospital or stay at home.

However if a woman in labour arrives she should not be turned away, so when a lady in the late stages of labour came to the delivery ward, they sent her to our ward where she was left on a chair in the corridor.

'No control'

Midwives knew she was squirming in pain, and crying but had no bed.

For 50 minutes she waited in the corridor without being checked or examined by any staff member.

All I could offer was reassurance.

I was later given the task of trying to get her into a more private area.

Moving women around to other beds, I managed to get a space in the room for antenatal women but there was no bed so she was put on a chair in the middle of the room.

The poor woman must have been in agony.

When I finally got her a bed she seemed relieved and I was told she delivered a few hours later.

I left the ward exhausted and felt there was no control.

I had left a woman who had given birth and needed care on a ward not designed for her needs, with no staff.

I don't get a chance to look after my patients when there's no support staff on
Midwife at St Mary's Hospital, Manchester

And I had spent the last hour watching helplessly as another in obvious pain, cried and squirmed on a chair in a corridor with no medical help.

What I experienced at Barnet echoed my research across the country - midwives working against the odds, with minimum staff to cover some of the NHS's most stressful and responsible work.

Barnet's Chief Executive Averil Dongworth told us : "We aim to make sure everybody has excellent treatment. This is a very important time for a mother giving birth to a beloved child, and we want to make sure that that is a good experience.

"But obviously when the units get busy, then decisions have to be taken and staff have to make judgements at that time and to prioritise their work."

Filming undercover at St Mary's Hospital, Manchester, staff told me how stretched they were.

"Too much workload with high risk women. Too many patients not enough support staff," said one midwife.

Another told me: "I don't get a chance to look after my patients when there's no support staff on."

She added: "Cos if I'm on they think I can do both. Oh yeah !"

Foetal heart monitor
Hayley Cutts operated a foetal heart monitor untrained

Another worrying problem at St Mary's was the lack of essential equipment, especially foetal heart monitors, which are vital to check a baby's heart in the womb when there is cause for concern.

One day, I was sent on a wild goose chase to all the maternity wards to borrow a monitor - we only had one on our ward.

I was told women were waiting for them on the other wards too.

St Mary's has told us since it has acquired six new foetal heart monitors.

I was also left to monitor a baby's heart even though I was an untrained volunteer.

The hospital admitted following our investigation : "On occasions, there have been some instances when we have not met the expectations of all women and their babies within the post-natal ward environment.

"This is due to both the increased activity and complexity of medical and obstetric conditions that women have, combined with the provision of transitional neonatal care."

It also said that a volunteer operating a foetal heart monitor was "totally outside operational guidelines".

As well as my experience undercover Panorama spoke to scores of mothers who felt their care in NHS maternity units across the UK was substandard.

There is clearly a crisis and it needs sorting out soon.

Panorama: Midwives Undercover will be broadcast on BBC One, Thursday 2000 BST.

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Update: Midwives Undercover



SEE ALSO
Midwives Undercover: Transcript
25 May 07 |  Panorama
Baby unit 'must improve' safety
04 May 07 |  Health
Maternity care failings debated
02 May 07 |  Panorama
Q&A: Maternity plans
03 Apr 07 |  Health
Big shake-up for maternity care
06 Feb 07 |  Health

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