Story Highlight
– Midwives report unsafe, exhausting shifts beyond 24 hours.
– Over 14,000 signed petition for work hour regulations.
– Sleep deprivation impacts midwives’ competence and patient safety.
– Many midwives leaving profession due to excessive pressures.
– Investigation launched to address maternity care safety issues.
Full Story
Concerns are growing among midwives in the UK regarding their working conditions, particularly the extended hours that some professionals are compelled to work. Jo*, a midwife with nearly two decades of experience, expressed that her passion for assisting women in enhancing their healthcare and rights is overshadowed by the dangers posed by excessively long shifts. On occasion, Jo finds herself working an entire day shift only to remain on call through the night, leading to grueling shifts that can extend beyond 24 hours, where providing care to mothers and their newborns becomes physically and mentally taxing.
“It’s not safe, and no other profession is expected to stay awake, give care and concentrate for that long,” Jo lamented. “So why is it that midwives, who have such a high level of responsibility, are expected to do that?” She strongly believes that these prolonged working hours jeopardise the safety of both midwives and the mothers under their care.
The growing frustration among midwives is documented in a recent petition that has garnered support from over 14,000 individuals advocating for legal limitations on working hours for midwives. Leah Hazard, a midwife and author, initiated this movement after learning of the tragic case of Jennifer Cahill, who sadly died shortly after giving birth to her daughter, Agnes Lily Wren Cahill, at home. The coroner’s report unearthed significant deficiencies in the care provided, which included the finding that the two midwives attending to her delivery had been awake for over 30 hours.
“I know what it’s like as a midwife for you to do a night shift and to be sleep deprived, but then to have been awake or even working the whole day before that, I thought, ‘Oh, this is really unconscionable’,” Hazard reflected, highlighting the impact of sleep deprivation on cognitive functioning. “Of course, that will affect people’s competence because it’s well evidenced that sleep deprivation can cause cognitive impairment similar to alcohol consumption. You don’t want anybody looking after you who’s operating with that level of impairment.”
Hazard shared her insights after posting about Jennifer’s story on social media, which elicited an overwhelming response from midwives recounting their own experiences of abnormally long shifts. This online dialogue illuminated the widespread concern regarding how prolonged hours are affecting care quality, particularly during critical moments for mothers and infants.
“Some of them were really heartbreaking, with stories of real harm coming to midwives and women,” Hazard recounted. She explained that community midwives frequently face demands to work lengthy hours, often leading to situations where they are required to respond to calls for assistance at night due to staffing shortages in hospital settings. “They’re often working all night, and then some the next day are even expected to work all day as well. This is inhumane, unsafe, completely unacceptable and starkly contrasts with other safety-critical and historically male-dominated roles, like bus and lorry driving, which have strict regulations on working hours,” she emphasised.
The petition calls for similar legal protections for midwives that would prevent them from working when fatigued. Hazard advocates for measures such as ensuring a minimum of 11 hours between shifts. She expressed hope that such changes would transform the midwifery profession, stating, “I’ve had an alarming number of stories from midwives who’ve crashed their cars on their way home from work because of excessive fatigue, who have inadvertently harmed women and babies because they’ve known they’ve been too tired to work and they’ve asked to be relieved and that’s been refused.”
The issue of excessive working hours is compelling some midwives to reconsider their careers altogether. Millie*, 33, is an example of this disillusionment. She recalled a distressing experience while working a temporary shift that extended from 1.30 am, only to be told she could not leave due to staffing shortages, resulting in her working an additional eight hours without any sleep. “That shift pushed me into one of the deepest holes I’ve ever fallen into. I remember doing another IV drip at about 6 am and just breaking down,” she shared.
Despite the harrowing circumstances, Millie feels compelled to persevere, stating, “It’s so difficult, but you just have to get on with it, because if anything happens to that labouring woman, you have to be there.” She divulged that the physical and emotional toll often leads to situations where midwives feel overwhelmed, seeking refuge in restrooms to compose themselves while desperately trying to maintain their composure.
Amidst the urgent calls for change, Gloria Walton, Chief Executive of the Royal College of Midwives, has voiced that the crux of the issue lies in the unsustainable working conditions facing many midwives. “The fundamental issue is that you cannot deliver safe maternity care with exhausted and overstretched staff. Well-rested midwives who have manageable workloads provide better, safer care,” she stated, emphasising that an effective workforce is key to ensuring the wellbeing of both staff and patients.
Recent inquiries into the state of maternity services within the NHS have drawn attention to these ongoing issues. A critical review led by Baroness Valerie Amos highlighted alarming instances of inadequate care experienced by women, which prompted calls for immediate reforms. “Changes within maternity care have been too slow,” she noted, addressing systemic issues such as a lack of understanding and support for the diverse experiences of women seeking care.
The Department of Health and Social Care has reiterated that there are legal frameworks in place intended to restrict working hours and safeguard both staff and patients. A spokesperson acknowledged that any breaches of these regulations are unacceptable, and a rapid independent investigation has been commissioned to delve deeper into the challenges faced by maternity services.
As the discourse surrounding midwifery hours continues to evolve, the petition remains a pivotal instrument in advocating for legislative changes aimed at safeguarding the health of both midwives and mothers alike. Advocates believe that such reforms could lead to a revitalised workforce that can provide the high-quality care that every expectant mother deserves.
*Names have been changed.
Our Thoughts
The situation described in the article highlights serious breaches of the Working Time Regulations 1998, which stipulate that employees should not work more than an average of 48 hours per week and must have at least 11 hours’ rest between shifts. The excessive working hours and on-call demands faced by midwives pose significant risks to both staff and patient safety.
To avoid such incidents, healthcare employers must strictly enforce these regulations, ensuring proper scheduling practices that allow adequate rest and recovery for their staff. Implementing a legal cap on working hours for midwives, as suggested in the petition, could prevent cognitive impairment linked to sleep deprivation and its associated risks in critical care situations.
Furthermore, comprehensive risk assessments and a culture that prioritizes staff wellbeing should be adopted, along with robust reporting mechanisms for unsafe working conditions. Regular training on the implications of fatigue and strategies for managing work-life balance could improve overall care quality and enhance job satisfaction among midwives, thereby reducing attrition rates and ensuring safer outcomes for patients.
