With the first draft done, I have decided to try and do a blog or two again, but in this instance it is something that I decided to leave for a year before I wrote it.
It is intended as an observation nothing more.
One year ago today at the time of writing we (well more exactly my wife) had our second child.
Much as had been the case with the first one there were a few complications that led to her being hospitalised a week or so before the birth, although she was sent home and then had to go back in again a few days later. This was due to lack of beds.
When she had our first son three years before this, Derriford Hospital had been running two maternity wards plus the birthing suite, by the time we went in for the second one of the wards had been closed down, so everyone in the final stages of a pregnancy was being squeezed into one ward.
At the time no.2 was born the demand for the ward was horrendous. Mothers to be were coming in, giving birth and going home again, within hours, just to try and keep as many beds free as possible. This meant that the longer term patients, the ones with standard pregnancy issues – high blood pressure etc – got the beds. I'm sure in a lot of cases this worked out for the best.
But the closing of one ward was not the end of the issue, as the number of midwives was cut back to. Where once it had been one midwife per bay, it was then two per ward, which meant that they were spread out over about four or five wards, not forgetting the smaller rooms as well.
I trotted in dutifully to visit my wife in the mid afternoon of the 18th April, fully expecting her to be bored out of her mind in bed. She was not due for a few more days and when I had spoken to her earlier she had seemed in that 'I want it out of me!' mode.
When I got there I discovered that things had changed. The baby had decided it was time, her waters had broken and labour was under way. She was lying in bed, sheets soaking wet with contractions coming nice and regularly. She noted they were painful. And having missed out on the whole birth experience first time around due to an emergency caesarian we joked that this was what it was all about.
I stayed with her for most of the afternoon, but caught unprepared I had to go home to get the other son from nursery, sort him out and get him to my parents for the night. He was unsettled enough with his mum being in and out of hospital, that I thought it was better for him for me to see him and tell him what was happening.
I was gone for about two and a half hours.
When I returned things had changed. Sort of. My wife was in the same bed. It was still wet. She was in the same clothes she had been wearing when her waters broke. Due to the heat in the hospital it was beginning to stink. Not just smell but stink. A small like salt and blood, all going stale.
And she was in pain.
With each contraction she was screaming. But it seemed wrong. There was an animal edge to her cries. It is easy to be objective, say she was in labour, one of the most painful things a human can experience, certainly nothing a man can know about – the nearest we can come is kidney stones apparently – but it did not feel right. That little bit of instinct was telling me it was wrong.
She told me that she had pressed the button for a nurse and had been told they would inform the midwife.
And then that the midwife had been informed and would be there as soon as she was able.
And then as the pain got worse, the button was pressed again. The alarm would sound, the light would flash and then it was turned off from the main desk and no one would come. Or a nurse would come in and tell her she was in labour, the pain was normal, that the midwife was dealing with a much more serious case and would be there when she could.
Time passed. Pain got worse.
She was screaming by now, blood curdling screeches with every contraction, and we were being told the same thing over and over, when the nurses could be bothered to answer.
And it was not just me any more. People in the other beds, women in labour were pressing their buttons, telling the nurse that there was something wrong with the lady in the corner, and they were told the same thing.
Around this time the bed opposite became empty and another mum to be was wheeled in.
With each contraction she screamed. It did not sound right.
So we had two women in the ward, both in a lot of pain, both screaming, and both getting the same words from the nurses.
At this point the second midwife came in. She told us that the nurses were getting a bit fraught with the constant bell ringing and could we refrain from pressing the buttons please. The woman opposite swore at her, told her that she had had two kids already and what was going on felt wrong compared to the previous two. The midwife nodded, but said there was nothing she could do as both the woman and my wife were patients under the other midwife. She said she would inform her, but there really were more important cases to be dealt with and left.
A few minutes later the other midwife came in. She looked tired, and had a stern look on her face. She started laying down the law. That she was dealing with bad case that needed attention more than ours, or indeed the lady opposite. That she would be there when she could, that the women were in labour. Pain was part of it and could everybody please stop pressing their buttons because it was stressing the nurses out.
She was just emphasising how she was dealing with something more important when my wife screamed again, and she heard it for the first time. Immediately her face changed and she acknowledged at once that there was something wrong, that suddenly we were a priority. It was about then that the woman in the opposite bed screamed and the midwife conceded that both cases were more important than what she was working on and contacted the birthing suite.
There were no free suites, only the emergency one held on standbys for real emergencies. She told them she had two, and by some incredible act of humanity and magnanimity the woman in the bed opposite said that she had not been in pain as long as my wife, and she did not think she sounded as bad.
So we were taken to the birthing suite.
Once there things were brilliant. Perhaps because things were one on one, well five on one really. A midwife, a nurse, a doctor, and an assistant who floated from room to room (and me) all for my wife. Despite a few requests from my wife for pain relief they held off until they had done their tests – the medication could interfere with the outcome. There was a lot of screaming that diminished as she learned how to use the gas and air. I noticed everything, my favourite (not at the time though) being when the nurses pretended that the blood pressure machine was broken. I presume they did that so they did not let either of us panic because it was so high. I saw the reading though and kept my trap shut.
They kept promising the epidural, but only when the doctor finished her examination, to try and ascertain what was wrong. In order to do this she had to have my wife breathing and pushing and everything that comes with that. But it was then that they realised that the cervix was not retracting properly, each contraction was trying to push the baby out, only to meet with solid resistance and find there was nowhere to go.
This was the cause of the pain.
The doctor played with the cervix and after a lot of pain and instrumentation use, then hands – (It made me think of sliding doors, jammed with her trying to unjam them) – and my wife asked again when she would be getting her pain relief, at which point the doctor grinned, and told her it was a bit late for that, one more push and the baby would be out.
And he was.
One year ago he was born, and although this might not sound like it this is a massive thank you to the midwives and staff at Derriford Hospital in Plymouth. All of them.
They are forced to work under near impossible conditions facing cuts and setbacks that are made by men in suits, sitting in offices who believe it is better to cut maternity wards and staff than it is to cut wages of the over abundance of administrative posts. So when a midwife is expected to cover multiple bays with as many as twelve beds in each bay it is hardly surprising that when something urgent happens at one end, she can't immediately check on those at the other; where stupid rules and regulations mean that midwives have to stay with their own patients and not help others.
This seems to be the state of the NHS, or at least they way it was in the Maternity region, and it seems that when it comes to trying to save money in this organisation things would go a lot better if some of the upper administration were given the push, and the medical staff were not the ones who are cut again and again.
I would like to add, that when I have known serious problems, with my mother – where a surgeon decided to operate on a Saturday rather than play a round of golf – they saved her life, dad and myself had already been given the small room speech, if there are any close family, get them here sooner rather than later; with the birth of the first son; and with the care I received from the first on the scene paramedic through to the consultants who cared for me after my big seizure were all exemplary. When it really matters they are superb, for me at least.
Just don't talk about my hernia op...