A former midwife told how she quit the NHS due to ‘overwhelming’ pressure which left her fearing an imminent clinical accident.
Piroska Cavell, 55, from Whitstable, Kent, left in 2019 after working in the health service for a decade.
She is one of many who have quit the profession due to a ‘harmful working culture’ – including excessive workloads and bullying from colleagues, fuelling a staffing shortage in NHS hospitals.
Ms Cavell told Radio 4’s Today programme: ‘It got to the point where I was seeing my registration flashing before my eyes every day. I was literally waiting for something to happen – a negative situation due to circumstances beyond my control.
Former midwife Piroska Cavell left the NHS after a decade of service due to the overwhelming pressure, and now runs a private wellness centre
A parliamentary report this week revealed the crisis at the heart of the NHS maternity system
‘Staffing is one of the main areas of pressure because you cannot be in two areas at once.
‘You’d find yourself one of three midwives where you’ve got to look after the labour ward, the antenatal ward, or the triage. Maternity is like A&E, you never know what’s coming and it’s continually coming in.
‘Sometimes it’s overwhelming. There are nights where it’s not quite so overwhelming, but they are very rare.
‘Obviously, everyone wants you to be in there with them, and you want to be with them. It’s not great when you’ve got to leave someone to go and look after someone else, but we don’t have the resources to enable more one-to-one care.
‘There’s a lot of talk about it, but it never actually happens.’
She added dealing with many different patients at the same time is extremely difficult and may lead to errors being made.
‘Very often you find yourself in a situation where you are looking after someone who is going through a normal delivery, and everything is great, and in the next room you’re looking after someone who is going through the process of losing their baby,’ she said. ‘You’re one person. You’ve got to remember what energy to take into each room.’
Ms Cavell said she still loves the job of midwifery but could not be tempted to return to the NHS.
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‘It takes a lot to leave midwifery because it’s a very privileged profession,’ she said. ‘I still dream about delivering babies, but I don’t think anything could tempt me back in. They need to look at recruitment, to make it more attractive.’
Birte Harlev-Lam, from the Royal College of Midwifery, said the health services loses ‘quite a significant number’ of students during their training, mainly due to financial pressures.
‘We also see midwives who find themselves in a position where they just cannot continue to do the job they love,’ she said. ‘We have to stop the leaking bucket, stop midwives from leaving, and think what can we do to make them feel safe at work so they can deliver the care they have trained to do.’
It comes after the UK’s first parliamentary inquiry into birth trauma this week found there is ‘shockingly poor quality’ in maternity services, claiming good care is ‘the exception rather than the rule’.
It heard evidence from more than 1,300 women, including new mothers who’d been left to lie in blood covered sheets for hours and even berated by midwives for having soiled themselves.
A report revealed a culture of bullying and the ‘devastating impact’ of poor staffing, few resources, low-quality care and poor communication.
One former midwife told the inquiry that she left the NHS in 2022 after 15 years because of ‘accumulated vicarious trauma and moral injury’.
She described working in a particularly hierarchical maternity unit where one consultant obstetrician behaved aggressively towards staff and treated the women in his care inappropriately.
In one instance, during repair of a second-degree perineal tear, she said the woman ‘was leaping up the bed and groaning in agony due to his stitching. I asked him to stop and provide more pain relief; he shouted at me in front of the woman and told me that ‘women do not have nerves in their vagina’.’
She also described an ‘extraordinary incident’ when the same doctor ‘dragged another outspoken midwife by her hair along an antenatal clinic corridor.’
In her final NHS shift, she described caring for a mother whose baby was stillborn before being called to an emergency forceps birth in which ‘the woman was screaming with fear and panic in her eyes, the obstetrician was useless in her communication and didn’t gain consent for the episiotomy or the forceps.’ The result was ‘another unnecessarily traumatised mother and father starting parenthood.’
Gill Walton, chief executive of the Royal College of Midwives, said: ‘Sadly, not all birth experiences are positive and poor experiences can have a devastating impact on woman and should be taken very seriously as a threat to maternal mental and physical health and infant wellbeing.
‘The women who shared their experiences with the inquiry must be commended for doing so and we owe it to them to learn and improve from the failings that happened in their care.
‘Undoubtedly staffing shortages drastically impact the safety and quality of care that midwives can and so want to deliver.
‘Our own members tell us they are struggling to give women the time and quality of care they need and deserve.
‘Also, with the rise in more complex pregnancies, having the right skill mix of staff on shift is key.
‘Access to appropriate training has also been highlighted in this report and when there aren’t enough midwives, crucial training is often postponed and this impacts how prepared staff can be for not only emergency situations, but how improvements in day-to-day maternity care can be achieved.’
Donna Ockenden, who is chairing an inquiry into maternity care failings in Nottingham, told the Parliamentary inquiry that NHS staff waste too much time dealing with red tape.
She said: ‘Leaders across maternity services report continuous requests for information from multiple bodies responsible for ‘oversight’ of maternity care in the UK.
‘Frequently the requests are duplicated or only very slightly different showing that there is ineffective coordination between these multiple bodies.
‘This is not efficient and wastes time. The system of maternity service oversight must be streamlined & this made more effective.’
The Department of Health and Social Care said there were 23,631 full time equivalent midwives working in NHS Trusts and other core organisations in England in February this year, an increase of 4,184 (21.5 per cent) compared to the same month in 2010.
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