A cry for help: ‘I have never wanted to leave the profession more’
Another lockdown. The relentlessness of 2020 continues in 2021. But how are we still not listening? When maternity staff are shouting for help: ‘this way of working is alien to what we strive to provide’, ‘I have never wanted to leave the profession more’, ‘showing compassion from behind a mask is extremely hard.’ These are quotes from our latest research that we are launching today, in which maternity care professionals share how Covid-19 is impacting them. And it pains us to admit it. But we were right.
Because before the pandemic hit, the UK midwifery workforce already battled high levels of anxiety, depression, stress and burnout. For obstetricians, 2 in 3 stated experiencing a traumatic work-related event. So, at Make Birth Better, we feared the impact of radical changes in maternity services on a system already overstretched – with exhausted and overworked staff. This is why in April 2020 we launched #thinktraumanow. To urge NHS leaders and policy makers to think about trauma prevention and treatment in the light of Covid-19.
As part of #thinktraumanow we asked staff about the emotional impact service changes have had on them, and the support they received to manage this effectively. Our key statistics show:
93% of healthcare professionals reported changes to maternity choices due to Covid-19
49% of healthcare professionals said the only emotional support has been peer support from colleagues
A further 31% of healthcare professionals shared they have not received any emotional support at all
‘MORALLY INJURED’
Our findings clearly tell us that we were right to be worried in April 2020. All around us we see similarly worrying results, like this recent study from the Royal College of Obstetricians and Gynaecologists (RCOG) showing only a quarter of medical staff said they were offered wellbeing support by their employer. And of those who did receive support, over half felt it wasn’t adequate or satisfactory. Make Birth Better’s Lead Researcher and Clinical Lead Dr Jan Smith: “It was bad for staff before, but because of the pandemic ‘being with women’ has become conditional. Compassionate care is an integral part of the role maternity staff have, so we see many are left distressed and what’s referred to as ‘morally injured’. They struggle with feelings of shame or guilt because they are unable to care for women and their families in the way they want to.” Dr Jo Mountfield, Consultant Obstetrician and Vice President of the RCOG adds: “This relentless pressure is not sustainable. Stretched and understaffed maternity services affect the quality of care provided to mothers and babies, and restricts the choices available to women.” Staff’s emotional struggle is intensified through the backlash staff are getting from some parents. Research from the Royal College of Midwives shows ‘7 out of 10 midwives experienced abuse from pregnant women, their partners and families due to changes to attendance rules during the pandemic’. A campaign that has received a lot of media attention and rightly given a voice to parents – #butnotmaternity – has, albeit unintentionally, not always benefitted maternity staff. A midwife wrote on our Make Birth Better blog: ”A lot of staff have felt very hurt by the campaign. They are anxious because they have vulnerable families at home, or are vulnerable themselves, and it has been hard to feel like they matter in this at all.” Make Birth Better co-founder and Clinical Psychologist Dr Emma Svanberg: “We see hurt on both sides of the coin. It’s important to balance the needs of patients and staff. But we do know we can never meet the needs of women and birthing people if staff aren’t supported sufficiently.”
TIME TO ACT
So yes, it’s time to listen. And more importantly, it’s time to act. This from a specialist midwife in our report: “We should be acknowledging the impact of this trauma on our staff.” And from a health visitor: “We need managers to put systems in place to support staff in their emotional wellbeing.” Dr Jan Smith: “It’s essential staff have a safe space where they can go and they are significantly supported in their team. It’s how we prevent our carers suffering from unnecessary trauma.” We have raised our voice before and we are raising it again. We urge NHS leaders and policy makers: support our staff. Listen and act. Now.
If you work in maternity care and you can relate to this post, please go to our support for professionals page here.