New mums to be strapped to monitors at Warrington Hospital's maternity ward

Warrington Guardian: New mums to be strapped to monitors at Warrington Hospital's maternity ward New mums to be strapped to monitors at Warrington Hospital's maternity ward

PANICKED parents-to-be are calling for answers from Warrington Hospital after being told women in labour will have to be constantly strapped to monitors and water births are highly unlikely for the next six weeks.

Heavily pregnant women were left in shock after being told the news via a statement from the head of midwifery during antenatal classes on Monday night.

After £450,000 was spent on refurbishing the maternity ward and providing birth pools, many are now questioning why this decision has been made.

A 38-year-old Great Sankey mum, who is expecting her first child in April and did not want to be named, said she feels disappointed and upset over the news and is now considering looking at other hospitals.

She added: “It’s clear from the urgency it’s a knee-jerk reaction and nobody has been able to explain why this decision has been made.

“This is all happening at the last minute for us, so goodness knows what’s happened to women going to hospital this week. I feel confused and scared to be in this position and frightened over what they are not telling us.”

Water births are opted for by many mums-to-be as the water acts as a form of pain relief and concerns have been raised over mums being strapped to devices measuring contractions and the baby’s heart rate as it will make it difficult for them to move around.

A hospital spokesman said water births would still be available but would not be possible if monitoring equipment was being used and it would have to be discussed with their midwife.

Karen Dawber, director of nursing at Warrington and Halton Hospitals, said: “We have recently received the highest national accreditation for safety and minimising risk in our labour services and always look at ways we can do more.

“We’ve seen a small trend of lower birth weights and women presenting with some other risks such as decreased foetal movement, these can all cause higher risks for babies in the later stages of pregnancy and labour.

“We want to help minimise this and one of the steps we have taken is to offer continuous monitoring of our labouring women for a period to assess how that works for women.

“We don’t want women to be alarmed by this in any way, it’s an extra element to providing safe care.

“Our other options for low risk labour such as our birthing pools and active birth rooms will still be available but we will be offering continuous monitoring first of all.”

The news follows Warrington North MP Helen Jones’ warning she does not want to see a review of current maternity services lead to any changes which would stop babies from being born in the town.

The announcement follows the maternity, children and young people’s strategic clinical network seeking to set up a special interest group to ‘reduce variation and improve outcomes’ for maternity services across Cheshire and Merseyside.

Mrs Jones added: “I am very concerned at what is behind this move.

“As we know from past experience, reviews like these have tended to impact on the services delivered from Warrington.

“I am very clear that Warrington people will want a fully functional maternity unit so people can be born in this town.”

A spokesman for NHS England (Cheshire and Merseyside strategic clinical networks) said commissioners and providers across Cheshire and Merseyside have ‘jointly agreed’ to investigate why there are ‘variations’.

He added: “They will consider ways of reducing unacceptable variations and improving maternity services to deliver sustainable excellent quality and outcomes across the region.

“Data and evidence of best practice will be gathered and analysed to inform the decisions of clinical commissioners."

A hospital spokesman has added anyone with any questions they wish to discuss with the midwifery team at the hospital can contact them directly via 275224.

If there is no answer then a message can be left and the team will call back.

Comments (25)

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10:34am Thu 13 Mar 14

Nick Tessla says...

So they are OFFERING continuous monitoring, not imposing it and IF the patient is plugged into the mains water births are not an option - well der!

The only "knee-jerk reaction" seems to be that from Helen Jones who is desperate for her constituency to stay in labour.
So they are OFFERING continuous monitoring, not imposing it and IF the patient is plugged into the mains water births are not an option - well der! The only "knee-jerk reaction" seems to be that from Helen Jones who is desperate for her constituency to stay in labour. Nick Tessla
  • Score: 6

3:32pm Thu 13 Mar 14

Rachel Evans says...

Readers can see Warrington and Halton Hospitals' statement here:
https://www.warringt
onandhaltonhospitals
.nhs.uk/news_item.as
p?fldID=520

My concern is that the "offer of extra monitoring" translates in practise to "it's hospital policy".
Readers can see Warrington and Halton Hospitals' statement here: https://www.warringt onandhaltonhospitals .nhs.uk/news_item.as p?fldID=520 My concern is that the "offer of extra monitoring" translates in practise to "it's hospital policy". Rachel Evans
  • Score: 3

4:56pm Thu 13 Mar 14

MikeJT says...

If ladies dont want monitoring "thanks for the offer, but i decline". Staff can then do nothing about it but accept the patients wishes and instructions
If ladies dont want monitoring "thanks for the offer, but i decline". Staff can then do nothing about it but accept the patients wishes and instructions MikeJT
  • Score: 8

12:14am Fri 14 Mar 14

ajanedoe says...

Ask yourself why there is suddenly a need to do this, ask yourself how many deaths they have recently had.

this is a good thing, its optional but will save lives for the next 6 weeks i am sure.
Ask yourself why there is suddenly a need to do this, ask yourself how many deaths they have recently had. this is a good thing, its optional but will save lives for the next 6 weeks i am sure. ajanedoe
  • Score: 1

9:42pm Fri 14 Mar 14

JoPowell says...

This will not save lives. The statement "monitoring allows midwives to check the health of mum and baby throughout labour" is mendacious to say the least. There is absolutely no evidence base for continuous fetal monitoring in low risk labours. It is shown to increase rates of caesarean sections without improving outcomes for babies. It is not recommended by the NICE intrapartum guidelines. I find it hard to see how obstetricians and midwives can justify this when they have an obligation to provide evidence based care. I hope that women are being told this whilst they are being "offered" this monitoring "as a routine".
This will not save lives. The statement "monitoring allows midwives to check the health of mum and baby throughout labour" is mendacious to say the least. There is absolutely no evidence base for continuous fetal monitoring in low risk labours. It is shown to increase rates of caesarean sections without improving outcomes for babies. It is not recommended by the NICE intrapartum guidelines. I find it hard to see how obstetricians and midwives can justify this when they have an obligation to provide evidence based care. I hope that women are being told this whilst they are being "offered" this monitoring "as a routine". JoPowell
  • Score: 13

2:16am Sat 15 Mar 14

ajanedoe says...

JoPowell wrote:
This will not save lives. The statement "monitoring allows midwives to check the health of mum and baby throughout labour" is mendacious to say the least. There is absolutely no evidence base for continuous fetal monitoring in low risk labours. It is shown to increase rates of caesarean sections without improving outcomes for babies. It is not recommended by the NICE intrapartum guidelines. I find it hard to see how obstetricians and midwives can justify this when they have an obligation to provide evidence based care. I hope that women are being told this whilst they are being "offered" this monitoring "as a routine".
You are wrong.It would have saved my child's life.
[quote][p][bold]JoPowell[/bold] wrote: This will not save lives. The statement "monitoring allows midwives to check the health of mum and baby throughout labour" is mendacious to say the least. There is absolutely no evidence base for continuous fetal monitoring in low risk labours. It is shown to increase rates of caesarean sections without improving outcomes for babies. It is not recommended by the NICE intrapartum guidelines. I find it hard to see how obstetricians and midwives can justify this when they have an obligation to provide evidence based care. I hope that women are being told this whilst they are being "offered" this monitoring "as a routine".[/p][/quote]You are wrong.It would have saved my child's life. ajanedoe
  • Score: 7

11:11am Sat 15 Mar 14

Galaxy90 says...

Personally i think its brilliant to have monitoring. I was pregnant in 2012 and at 27 weeks "low risk" i went to the hospital with decreased movement to be turned away by the antenatal dep, without having my blood pressure or anything checked they just stuck a doppler on my stomach and sent me home. 2day later i was back still with decreased movement and it was only when i refused to go until they checked everything that it was established that sadly my baby had passed. If i would have had this monitoring when i first went in then maybe there would have been something done for my little one. that year there were several losses seen from pregnancies which is unusual so i can see why there would be increased monitoring.I was pregnant again just last week i was turned away from AnE with severe bleeding, went back a couple of days later still bleeding and i was having a miscarriage. I understand some mothers to be may not want this but trust me its better to be over cautious than turned away and have to deal with the awful grief of dealing with the loss of a baby.
Personally i think its brilliant to have monitoring. I was pregnant in 2012 and at 27 weeks "low risk" i went to the hospital with decreased movement to be turned away by the antenatal dep, without having my blood pressure or anything checked they just stuck a doppler on my stomach and sent me home. 2day later i was back still with decreased movement and it was only when i refused to go until they checked everything that it was established that sadly my baby had passed. If i would have had this monitoring when i first went in then maybe there would have been something done for my little one. that year there were several losses seen from pregnancies which is unusual so i can see why there would be increased monitoring.I was pregnant again just last week i was turned away from AnE with severe bleeding, went back a couple of days later still bleeding and i was having a miscarriage. I understand some mothers to be may not want this but trust me its better to be over cautious than turned away and have to deal with the awful grief of dealing with the loss of a baby. Galaxy90
  • Score: 11

1:37pm Sat 15 Mar 14

ajanedoe says...

Galaxy90, thank you for sharing and I am so very sorry for your loss. Nothing can fill that void when you loose a child, especially due to incompetence of people who should be there with knowledge & experience for you to trust. I feel your pain and I believe that this 'temp' procedure needs to become a permanent option for expectant mothers.

This is all too common an experience at Warrington General as I am now finding out. JoPowell obviously works for the NHS trust and they are currently trying to cover up a high mortality rate it seems. They should be doing through checks before allowing any woman who goes to admissions to be sent home. The fact this has already happened the year you lost your child and it is still happening shows why they have now had to put in emergency measures.

I believe the Warrington Guardian is missing the bigger story here, they need to start asking how may babies have sadly been lost at Warrington General since 2010 and why this measure has now been put into place.
Galaxy90, thank you for sharing and I am so very sorry for your loss. Nothing can fill that void when you loose a child, especially due to incompetence of people who should be there with knowledge & experience for you to trust. I feel your pain and I believe that this 'temp' procedure needs to become a permanent option for expectant mothers. This is all too common an experience at Warrington General as I am now finding out. JoPowell obviously works for the NHS trust and they are currently trying to cover up a high mortality rate it seems. They should be doing through checks before allowing any woman who goes to admissions to be sent home. The fact this has already happened the year you lost your child and it is still happening shows why they have now had to put in emergency measures. I believe the Warrington Guardian is missing the bigger story here, they need to start asking how may babies have sadly been lost at Warrington General since 2010 and why this measure has now been put into place. ajanedoe
  • Score: 4

2:20pm Sat 15 Mar 14

Soph4496 says...

How very coincidental that this policy of monitoring has now been brought in to practice....and so suddenly! I know exactly why this has been brought in. Think people need to be asking questions about this hospitals maternity Department and their rates of stillborn babies. I speak from very recent and tragic experience and believe me this will NOT be hushed up.
How very coincidental that this policy of monitoring has now been brought in to practice....and so suddenly! I know exactly why this has been brought in. Think people need to be asking questions about this hospitals maternity Department and their rates of stillborn babies. I speak from very recent and tragic experience and believe me this will NOT be hushed up. Soph4496
  • Score: 6

2:37pm Sat 15 Mar 14

Galaxy90 says...

Soph4496, ajanedoe seems like weve all had very similar experiences over the last few years. Hopefully no one else will have to endure.
Soph4496, ajanedoe seems like weve all had very similar experiences over the last few years. Hopefully no one else will have to endure. Galaxy90
  • Score: 5

4:00pm Sat 15 Mar 14

Soph4496 says...

Its a pity we cannot reach other mums in the same circumstances who have had stillbirths recently. If anyone knows how to or has ideas please let me know.
Its a pity we cannot reach other mums in the same circumstances who have had stillbirths recently. If anyone knows how to or has ideas please let me know. Soph4496
  • Score: 3

9:29pm Sat 15 Mar 14

JoPowell says...

I have no connection with Warrington NHS trust and no knowledge of what particular circumstances have led to them deciding to implement this policy. I am really sorry to hear about people's sad losses. I was however pointing out that there has never been a scientific study which shows fetal monitoring reduces risk of stillbirth or neonatal deaths. They are extremely unreliable in picking up babies who are in distress. They do however lead to an increase in caesarean sections which are more dangerous for both mothers and babies.
I have no connection with Warrington NHS trust and no knowledge of what particular circumstances have led to them deciding to implement this policy. I am really sorry to hear about people's sad losses. I was however pointing out that there has never been a scientific study which shows fetal monitoring reduces risk of stillbirth or neonatal deaths. They are extremely unreliable in picking up babies who are in distress. They do however lead to an increase in caesarean sections which are more dangerous for both mothers and babies. JoPowell
  • Score: 1

9:46pm Sat 15 Mar 14

Soph4496 says...

Perhaps the study says this Jo....but I wish to God a monitor was used in this instance, it may have made all the difference.
Perhaps the study says this Jo....but I wish to God a monitor was used in this instance, it may have made all the difference. Soph4496
  • Score: 2

11:44pm Sat 15 Mar 14

Soph4496 says...

The thing is that when you enter hospital you put your trust in the Midwives and expect to receive the highest care. By failing to use all the medical tools at their disposal they are failing in their duty of care and putting lives at risk. I welcome the new policy even though it has come at a terrible price for our family. So whether or not monitoring studies show jack..a mother has the right to a fighting chance for her baby to survive. Both legally and morally.
The thing is that when you enter hospital you put your trust in the Midwives and expect to receive the highest care. By failing to use all the medical tools at their disposal they are failing in their duty of care and putting lives at risk. I welcome the new policy even though it has come at a terrible price for our family. So whether or not monitoring studies show jack..a mother has the right to a fighting chance for her baby to survive. Both legally and morally. Soph4496
  • Score: 6

1:25pm Mon 17 Mar 14

NJones453 says...

No one is saying monitoring shouldn't be used. The point Jo is trying to make is that truly low risk women in normal labour should not be continuously monitored or prevented from using pools. High risk ladies i.e. pre term, reduces feral movements, small babies and the list goes on for miles, should be monitored continuously in labour and will have been for many years. To make the point again NICE guidelines and all midwifery and obstetric guidelines state low risk labours should have intermittent fetal monitoring. Also this is all to do with labour, not antenatal admissions or high risk antenatal ladies.
No one is saying monitoring shouldn't be used. The point Jo is trying to make is that truly low risk women in normal labour should not be continuously monitored or prevented from using pools. High risk ladies i.e. pre term, reduces feral movements, small babies and the list goes on for miles, should be monitored continuously in labour and will have been for many years. To make the point again NICE guidelines and all midwifery and obstetric guidelines state low risk labours should have intermittent fetal monitoring. Also this is all to do with labour, not antenatal admissions or high risk antenatal ladies. NJones453
  • Score: 2

1:36pm Mon 17 Mar 14

Soph4496 says...

Obviously the point i am trying to make is the new policy has only been brought in re monitoring as a knee jerk response to what has occurred lately in the maternity department. It is not just coincidence. If anyone wishes to have a waterbirth without monitoring or is low risk and does not want monitoring that is their right. What I am stating is that monitoring was NOT used in our case and the result was tragic. The guidelines were not followed and obviously complaints are being made against the department and need investigating. As we have been told they are.
Obviously the point i am trying to make is the new policy has only been brought in re monitoring as a knee jerk response to what has occurred lately in the maternity department. It is not just coincidence. If anyone wishes to have a waterbirth without monitoring or is low risk and does not want monitoring that is their right. What I am stating is that monitoring was NOT used in our case and the result was tragic. The guidelines were not followed and obviously complaints are being made against the department and need investigating. As we have been told they are. Soph4496
  • Score: 1

7:18pm Mon 17 Mar 14

laura12349 says...

Surely extra safety measures can only be a good thing. As an expectant mother due to give birth in the next 4 weeks, and classed as low risk, I can honestly say I'm happy that extra precautions are being taken. Just because you're low risk doesn't mean you wont encounter problems, at least by being "strapped" to a monitor you will know straight away.
Surely extra safety measures can only be a good thing. As an expectant mother due to give birth in the next 4 weeks, and classed as low risk, I can honestly say I'm happy that extra precautions are being taken. Just because you're low risk doesn't mean you wont encounter problems, at least by being "strapped" to a monitor you will know straight away. laura12349
  • Score: 4

7:32pm Mon 17 Mar 14

Soph4496 says...

Well said Laura. We are only sad that it has taken a tragedy like ours and others to implement this monitoring to "low risk"
Well said Laura. We are only sad that it has taken a tragedy like ours and others to implement this monitoring to "low risk" Soph4496
  • Score: 5

7:47pm Mon 17 Mar 14

NJones453 says...

I understand the concerns mothers to be have but these come from lack of understanding in obstetrics. Just because you are continuously monitored does not protect you from bad outcomes this is a misconception. And deeming it an 'extra' safety precaution is just wrong, read up on NICE guidelines for electronic fetal monitoring and then present your argument, all of this is easily accessible to the general public
I understand the concerns mothers to be have but these come from lack of understanding in obstetrics. Just because you are continuously monitored does not protect you from bad outcomes this is a misconception. And deeming it an 'extra' safety precaution is just wrong, read up on NICE guidelines for electronic fetal monitoring and then present your argument, all of this is easily accessible to the general public NJones453
  • Score: 2

7:51pm Mon 17 Mar 14

Soph4496 says...

Well obviously something has gone wrong with the guidelines then as this policy has now been brought in. Does this not tell you something?..
Well obviously something has gone wrong with the guidelines then as this policy has now been brought in. Does this not tell you something?.. Soph4496
  • Score: 2

8:13pm Mon 17 Mar 14

NJones453 says...

This has been brought in to lower insurance premiums for the hospital paid to CNST. Simple as that, NHS and Money
This has been brought in to lower insurance premiums for the hospital paid to CNST. Simple as that, NHS and Money NJones453
  • Score: -2

8:53pm Mon 17 Mar 14

dking54568 says...

There is no evidence to support that all women require electronic fetal monitoring. Evidence has shown that this type of monitoring should only be used for women with high risk pregnancies, such as those with small babies. Evidence shows that electronic fetal monitoring can actually cause problems (higher rate of interventions and caesarean sections). See the link below:

http://www.nice.org.
uk/nicemedia/live/11
837/36280/36280.pdf

It is very sad that Warrington have "sold" this intervention as a positive move to pregnant women. Skilled midwives should be able to identify any concerns with intermittent auscultation which has been shown to be the best form of monitoring for low risk women. Therefore this would make me question what confidence management at Warrington hospital have regarding the skills of their staff?!
A woman should not be going into labour with an "un-diagnosed" small baby, antenatal care should identify this before the woman goes into labour. It could be suggested that midwives at Warrington may require better training/skills in identifying small babies if this appears to be a trend....Electronic fetal monitoring will not improve or prevent this.
There is no evidence to support that all women require electronic fetal monitoring. Evidence has shown that this type of monitoring should only be used for women with high risk pregnancies, such as those with small babies. Evidence shows that electronic fetal monitoring can actually cause problems (higher rate of interventions and caesarean sections). See the link below: http://www.nice.org. uk/nicemedia/live/11 837/36280/36280.pdf It is very sad that Warrington have "sold" this intervention as a positive move to pregnant women. Skilled midwives should be able to identify any concerns with intermittent auscultation which has been shown to be the best form of monitoring for low risk women. Therefore this would make me question what confidence management at Warrington hospital have regarding the skills of their staff?! A woman should not be going into labour with an "un-diagnosed" small baby, antenatal care should identify this before the woman goes into labour. It could be suggested that midwives at Warrington may require better training/skills in identifying small babies if this appears to be a trend....Electronic fetal monitoring will not improve or prevent this. dking54568
  • Score: -2

9:20pm Mon 17 Mar 14

Soph4496 says...

So njones you obviously do not know what has happened recently in the maternity dept? Unfortunately I do. Legal issues restrict me but I can assure you that insurance reasons? Maybe a part of it due to liability but most definitely not the main reason for it. Also DKing yes you are correct in that training is needed not just for small babies I am afraid. Strange that the new monitoring policy has just been brought in, sorry rushed in. Also i would be interested to know if any of the other nhs trusts have rushed it in either. May i ask both of you a question.? If you were in labour yourselves and you felt something was wrong would you be happy not to be offered monitoring? Would you want every medical tool at your disposal? Or would you just prefer to be left alone or maybe be sent home without proper investigation.? I can assure you both you would wish for ALL measures to be taken to safeguard your baby. Try asking someone who has lost a baby due to medical negligence.
So njones you obviously do not know what has happened recently in the maternity dept? Unfortunately I do. Legal issues restrict me but I can assure you that insurance reasons? Maybe a part of it due to liability but most definitely not the main reason for it. Also DKing yes you are correct in that training is needed not just for small babies I am afraid. Strange that the new monitoring policy has just been brought in, sorry rushed in. Also i would be interested to know if any of the other nhs trusts have rushed it in either. May i ask both of you a question.? If you were in labour yourselves and you felt something was wrong would you be happy not to be offered monitoring? Would you want every medical tool at your disposal? Or would you just prefer to be left alone or maybe be sent home without proper investigation.? I can assure you both you would wish for ALL measures to be taken to safeguard your baby. Try asking someone who has lost a baby due to medical negligence. Soph4496
  • Score: 5

8:16pm Tue 18 Mar 14

Hola kitty says...

First of all please let me say how sorry I am for the losses suffered by those that have commented. I know that words are not enough for what you have gone through. I think that monitoring is a good idea, but also I think that the midwives need to listen to mums to be. I had my second daughter at Warrington last year. From the moment I arrived they wanted to get rid of me and made me feel like I was pretending to be in labour. They were desperate to send me home and refused to examine me. Apparently I appeared too calm for someone in labour. I cried so they relented and let me go on the induction ward to calm down and then they would send me back home! I had her within the hour on the Induction Ward. My concern is that they are too keen to send women home without proper checks. I was lucky that this was a straightforward labour, but I know this isn't the case with everyone :-(
First of all please let me say how sorry I am for the losses suffered by those that have commented. I know that words are not enough for what you have gone through. I think that monitoring is a good idea, but also I think that the midwives need to listen to mums to be. I had my second daughter at Warrington last year. From the moment I arrived they wanted to get rid of me and made me feel like I was pretending to be in labour. They were desperate to send me home and refused to examine me. Apparently I appeared too calm for someone in labour. I cried so they relented and let me go on the induction ward to calm down and then they would send me back home! I had her within the hour on the Induction Ward. My concern is that they are too keen to send women home without proper checks. I was lucky that this was a straightforward labour, but I know this isn't the case with everyone :-( Hola kitty
  • Score: 3

12:27pm Wed 19 Mar 14

Soph4496 says...

Absolutely Hola kitty. We were not so lucky. A bad decision led to tragedy and also to a policy change. You will all be hearing the full story as soon as we are legally able to publish it.
Absolutely Hola kitty. We were not so lucky. A bad decision led to tragedy and also to a policy change. You will all be hearing the full story as soon as we are legally able to publish it. Soph4496
  • Score: 0

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