It's been in the media after yesterdays 'inadequate' CQC report went public for Leicester maternity, and lots of worry and panic about it. It's raised several red flags, so I want to break it down and give you ways of helping yourselves, if you're pregnant and due to give birth in Leicestershire.
A quick caveat that this isn't a target on UHL maternity as a whole and maternity in general is in a national crisis. I will explain further below, but changes are being made, and people are having positive experiences, but this report is public domain and important for pregnant people in Leicestershire to be aware of to enable them to make informed choices over their birth place.
So what is the report?
In February and March this year, an inspection was carried out on the three birthing places of UHL - Leicester Royal Infirmary, Leicester General Hospital and St. Mary's Birth Centre. The roundup of the reports were:
Leicester Royal Infirmary
'Maternity' rating moved from 'good' to 'require' improvement'
'Safety' rating has moved from 'requires improvement' to 'inadequate'
'Well-led' rating moved from 'good' to requires improvement'
Leicester General Hospital
'Maternity' rating moved from 'good' to 'requires improvement'
'Safety' rating has moved from 'requires improvement' to 'inadequate'
'Well-led' rating moved from 'good' to requires improvement'
St Mary's Birth Centre
'Safe' rating remains 'good'
'Well-led' rating moved down from 'good' to 'requires improvement'
Overall rating for maternity remains 'good'
To read in full - https://www.cqc.org.uk/press-release/improvements-needed-university-hospitals-leicester-nhs-trusts-maternity-services
We are well aware that there is a national maternity and midwifery crisis, so this comes as no surprise that staffing levels at LGH and LRI weren't safe. Highlighted at the moment is that due to staffing levels, have put birthers and babies at risk. Currently they're at the equivalent of 57 midwives short. The good news is that the director of midwifery of UHL have already put plans in place and started to employ more staff at both, and will continue to do so. Here's an open letter they wrote to discuss the changes they're making https://www.leicestershospitals.nhs.uk/aboutus/our-news/press-release-centre/2023/open-letter-following-latest-cqc-reports-into-leicesters-maternity-services/
Other issues that have arisen during this that the director of midwifery has become aware of are the blanket policies to maternity care and not individualised care. Meaning that birthers weren't given care or information that was personalised to them. Every individual is different and we know that blanket policies aren't helpful for the majority of people. So they are working on changing this. The other was the overwhelming rates of induction of labour (UHL has a 31.7% induction rate). Induction of labour increases the intervention rates in birth, including caesarean sections, postpartum hemorrhage, instrumental birth, 3rd & 4th degree tears etc. so induction of labour needs to be done with careful consideration, and, as above, not just under blanket policies, but through individualised care. UHL caesarean rates are also extremely high at 46.1% (national average is 34% yet World Health Organisation state no higher than a 10-15% rate caesarean should be done and higher than this doesn't improve outcomes). Caesarean is major surgery and should be treated as such, there are real risks that come along with that - it goes without saying that caesareans can absolutely be a life saving tool that we're lucky to have.
Birther Feedback
Leicestershire, Leicester and Rutland have recently opened up the Maternity & Neonatal Voices Partnership (LLR MNVP) again, and ran a survey across Leicestershire to get real birther feedback. I'm proud to be a member of the LLR MNVP and hoping we can make real positive changing working with UHL to improve maternity From survey's that have been carried out across Leicestershire carry some common themes in maternity care across those two main sites. Those are lack of informed consent, poor postnatal care (including breastfeeding support), unhappy with their birth, and pressure for intervention.
The voices of birthers need to be a priority, hearing their stories, they are valued and should be seen as a catalyst for positive change.
However, amongst some upsetting feedback, were two other very common themes which were that St Mary's Birth Centre and Home Birth Team gave excellent care. Birthers in these services were mostly very happy with their care, antenatally, during birth and postnatally.
What can you do?
Prepare in pregnancy by doing antenatal courses. My hypnobirthing courses ensure you are fully informed about as much as possible, but you know the questions to ask and how to make informed decisions if you haven't got the answers yourself. They teach you management tools, your birth rights and offer valuable education and support around birth. As well as specifically preparing you to breastfeed, if that is your chosen feeding method. Knowledge is power when it comes to birth and hypnobirthing is even more vital if you are planning on birthing in one of the main hospitals maternity wards https://www.beasbirthandboobs.co.uk/hypnobirthing
Explore home birth as an option can be incredibly empowering. The UHL home birth team continue to shine in all the care they provide and is incredibly rare that any negative feedback is given (seriously, ask around anyone who has been under their care, I challenge you to find a negative comment) https://www.leicestermaternity.nhs.uk/maternity-services/where-are-we/home-birth-team/
If home birth doesn't take your fancy, giving birth at St Mary's Birth Centre in Melton might interest you more. If you are wanting a birth with as little intervention as possible, home birth or St Mary's are the places to be https://www.leicestermaternity.nhs.uk/maternity-services/where-are-we/st-marys-birth-centre/
Even if you end up birthing at LRI or LGH, go to St Mary's for postnatal care. It is genuinely second to none. The time they take, the care they give, the information they provide is excellent. Their breastfeeding support is wonderful, so if you end up struggling with feeding, ask to be discharged to St Mary's and get some support there.
Hire a doula. There are many benefits to hiring a doula including less interventions in birth, more birth satisfaction and continuity of carer (it is common not to see the same midwife in pregnancy, and even if you do, the chances that they will be your midwife in labour is even rarer) https://doula.org.uk/research/ I will always recommend https://www.birth-hood.co.uk/doula for a doula
Why am I sharing this?
Because, as a birth worker, it is my responsibility to ensure birthers have all the information to make informed choices. Being aware that there are limitations to maternity care at the moment, and UHL are actively changing everything that they can but it is important for you to be aware of what current maternity is like in UHL now as you have choice. This way, you can make that choice.
Final Thoughts
Ultimately, antenatal preparation plays a vital role in a positive birthing experience. By staying informed, advocating for better care, and exploring all available options, you can take control of your maternity journey and work towards a safer, more satisfying birth experience in Leicester.
If you'd like to start your journey in to getting informed and protecting your birthing experience, hop on to my hypnobirthing courses to see how I can help you https://www.beasbirthandboobs.co.uk/book
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