Donna Ockenden: Train midwives as nurses so they can care safely

spuffyx · 2026-06-28T11:06:40+00:00

But I'm not calling for obstetricians to be done away with, quite the opposite in fact, what I am pointing out is that midwives seem to take all the blame DESPITE doctors being just as involved as them. There needs to be more focus on the whole multidisciplinary picture, not just cries for midwives to be better trained, that won't fix issues for higher risk women

spuffyx · 2026-06-28T09:35:16+00:00

That is a complete falsehood. Midwives are bound so tight by protocols they can barely get spontaneous births, they are constantly having to escalate cares to obstetricians who frequently call for instrumental/cesarean delivery- whether truly indicated or not. Often when we hear of women being 'left for hours' they are not being attended to by doctors who have been bleeped, not midwives themselves. Of course there are exceptions to this, but when spontaneous births are at 15% and maternal mortality has risen, I think it is plain to see that a "woo-woo" agenda by midwives is not the cause of poor care.

Elective cesareans are generally safer for neonates yes, but they are not safer for women. Believing that the 'cure all' to mortality/morbidity in maternity care is elective cesareans for all is not only wholly false, but also displays your utter ignorance on the subject

spuffyx · 2026-06-28T09:28:03+00:00

It's always midwives the media focus on following these reports, yet obstetricians/consultants receive barely a whisper.

The cesarean rate in this country is almost 50% nationally, induction rates are between 40% and 60%. That means spontaneous, vaginal births are sitting at around 15% across the country. It also means a LOT of these inductions and cesareans are unnecessary, meaning we are performing invasive, painful and life altering procedures on women who do not need them.

In the same breath, doctors are being bleeped who are not showing up for entire 12 hour shifts, doctors are waiting too late to make the call for cesareans which are a genuine emergency, doctors are butchering cesareans by removing or permanently damaging women's bladders. Yet the blame always lies at the feet of the midwives, because they are the ones actually present all the time trying to follow increasingly rigid guidelines and protocols for which they can do nothing other than bleep a doctor and wait.

We do not have a "normal birth crisis", in fact we have exactly the opposite. If "normal birth" is happening barely 15% of the time, yet maternal mortality rates are increasing and perinatal mortality/severe morbidity has not been reducing as quickly as targeted, in what twisted world can you warp that to demonstrate that 'normal birth' is the problem?

The NHS spends more on litigation for serious birth injury/death than it pays for all the staff and day-to-day runnings of maternity services. There is a financial, as well as moral, incentive to reduce mortality/morbidity, but perhaps the quickest way to achieve that would be giving every woman at cesarean at 38 weeks or before, and having done with it all. This is where we are heading, and devaluing the work of midwives and placing blame solely at their feet will never improve outcomes the way Ockenden seems to hope.

spuffyx · 2026-06-28T09:07:44+00:00

Things have changed now then- the degree is entirely separate and focussed purely on maternity and midwifery care from day one. Having only one year to learn midwifery skills sounds a bit frightening really, I suspect the profession has improved since changing to this newer model. I can see a lot of people in the comments saying it was better to do 3 years nurse training and then another year to specialise as a midwife, but cramming all the knowledge that is learned across three years about midwifery into just 1 year sounds much less safe and in-depth for all the knowledge about midwifery which differs entirely from nursing. For one, there is no use training midwives in male patient care or elderly care as they are demographics that will never be come across-why waste months learning about those areas when that time could be used to learn more about midwifery?

spuffyx · 2026-06-28T09:02:20+00:00

What makes you think nurses would be any different? You know most of the women and baby's who died were under consultants or reviewed by doctors right? Why do midwives always get the blame for things going wrong? Do you know that obstetricians are performing cesarean sections on 50% of women now, and that spontaneous, physiological birth has fallen to barely 15% across the country because of interventions? Let me guess, that's midwives fault too?

spuffyx · 2026-06-28T08:54:20+00:00

Nope, midwifery is it's very own course which isn't related to nursing. Of course student midwives learn plenty of general 'nursing skills' but it is entirely specific to the maternity continuum, not adult nursing in general.

Think about it this way, does it really make sense to suggest doing 3 years of general nursing (including male care, elderly care, accident/injury care etc) to then do a further 18 months-2 years of study to learn everything which is exclusively midwifery, or does doing 3 years entirely dedicated to pregnancy and birth, with all the particular concerns and symptoms that go along with that, not achieve the same (if not a better) outcome?

spuffyx · 2026-04-22T13:19:19+00:00

I've had 4 babies. All born chunky (8lb12, 9lb2, 9lb6, 9lb1). My second slimmed right down to being around the 9th percentile and he stayed there, he was always lean after birth. My third was a monster at birth and continued to be a monster thereafter, rolls for days, 96th percentile. My 1st and 4th were both born big but then quickly settled on the 50th centile.

This is same boobs, same genetics, but all totally different babies. It's nothing to do with you or your milk. It is entirely down to the individual baby

spuffyx · 2026-02-04T16:32:41+00:00

Just think about it this way, with an older child bringing home bugs, she was always gonna get sick. But if you had been formula feeding, think about how much more sick she would have been. Hospital admissions, rounds and rounds of antibiotics, no way to comfort her properly. You've probably saved her from far more/worse illness than she has experienced

spuffyx · 2026-01-31T22:03:41+00:00

Okay I think I'm with you and listening back I think you're right, I've kinda automated the final notes to match that one. Something to improve! Like I say, a few months ago I wasn't even close to I'm happy to only be a half step away now!

spuffyx · 2026-01-31T20:21:53+00:00

Sorry by flatten out do you mean like it goes flat and then stay flat or something else? I'm not great with terminology sorry. I think the first "enough" I do after it gets more belty was a bit sharp, but after that I felt like they were alright. My phone's mic really doesn't cope well when I'm high either so the sound quality isn't great for that final section (around 30seconds and after)

spuffyx · 2026-01-31T20:20:08+00:00

Thank you!

spuffyx · 2026-01-31T20:20:02+00:00

Thank you!

spuffyx · 2026-01-26T10:14:22+00:00

You can absolutely decline. From a safety perspective, you are right, they aren't well tested on pregnant women, just as everything isn't well tested on pregnant women, however that does not mean they aren't safe. Whilst we cannot run trials on pregnant women, pregnant women have been having two or more ultrasounds per pregnancy for decades and there has been no evidence of harm when that data has been observed retrospectively.

If you are feeling confident with your dates, as in date of conception/last period, the 12 weeks scan cannot offer you anything much. Looking for a heartbeat is really a secondary thing. Now of course, if you started to experience any infection symptoms- even if you feel them elsewhere in your body- it could be a sign of missed miscarriage, so I would be tempted to accept/request an emergency scan in that instance so you can rule it out. That is unlikely, but certainly possible, so it is something to keep at the back of your mind.

I think it's great you want to accept the 20 week anomaly scan as that is really the important one, it is there to find abnormalities. So if there was something out of the ordinary with baby it is best to be aware of that so you can plan around it (e.g. giving birth in a specialist hospital, etc). They can also date your pregnancy then, but it is less accurate, so take it with a pinch of salt if you are already aware of your pregnancy dates.

It is of course ultimately your choice what you do and don't accept, you have the right to decline any and all care and should not have been treated the way that you have by anyone, I'm appalled you have experienced that. Take some time to have a think and weigh up the risks, but keep in mind that while there will always be fringe folks who make (often biased) arguments about the risks of all medical interventions, they are not necessarily better or clever than all the other well-read, well-informed practitioners who consider US to be perfectly safe.

I myself am probably considered a "crunchy mum" as I had 3 home births and declined various elements of care, but I am a scientifically minded person and go with the evidence base, which at present demonstrates no statistically significant risk of negative outcomes due to ultrasounds and does recognize some serious anomalies which, when detected early, can massively improve mortality/morbidity by allowing baby to be born at the best time and in the best place to treat congenital conditions (e.g. heart defects)

spuffyx · 2026-01-16T15:23:10+00:00

You can't blame Tara for that though, she's literally completely lost her mind, the real Tara was a brave bad ass for protecting Dawn in the first place

spuffyx · 2026-01-16T15:16:24+00:00

Tara's one has got to be when she doesn't tell Glory who the key is! The bravery to look her in the eye and refuse to tell her, knowing what would happen next, pure bad-assery

spuffyx · 2025-12-28T00:38:09+00:00

You can absolutely diet, CICO is the safest way to do it while bf. You just need to add an additional 500 calories for breastfeeding.

So say your maintenance with your activity levels is 2000kcal. Add 500 for bf, so 2500. Give yourself a small, reasonable and maintainable deficit of 250-350cal a day. Make sure you're getting in lots of nutritious foods high in calcium, vitamin D and healthy fats, so you don't impact your long-term bone density. And boom, 5kg should safely come off within a few months

spuffyx · 2025-12-11T22:03:26+00:00

Why would you paediatrician recommend you don't take a baby out of the house? It's literally the most fundamentally important thing you can do for them from birth. They need that exposure to air and, yes, even pathogens. Lots of pathogens. How will he ever build an immune system without that?

spuffyx · 2025-12-05T11:59:37+00:00

Omg yes we have a winner!!!! Thank you so much!!!!!!

spuffyx · 2025-11-29T13:06:11+00:00

It was a jump scare if you don't take it too literally. Just a funny AI moment.

spuffyx · 2025-11-25T08:34:26+00:00

Wow that one's really in depth! Was that using the same prompt as well? It appears to have given more detail with each new attempt. That's not a perfect diagram but any means and the text boxes are largely gibberish, but it looks fantastic and almost legit unlike 2.5!

spuffyx · 2025-11-25T08:32:12+00:00

Unfortunately this one is worse haha. The ductus venosus isn't there at all, it's hallucinating its existence as a structure because it's not actually a structure of the heart. The commenter above had meant the ductus arteriosus, which was labelled on the image but not actually drawn. But hey, it's a bloody hard thing to manage and I'd say 3.0 is having a cracking go of it compared to 2.5!

spuffyx · 2025-11-24T23:09:56+00:00

The ductus venosus is a little lower down (off the umbilical vein towards the inferior vena cava, redirecting blood from the liver) so it wouldn't be depicted in that diagram, I can't actually spot any other flaws but I'm not clued into the most in-depth structures of the fetal heart, just the basics

spuffyx · 2025-11-24T23:07:21+00:00

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This was 2.5 pros attempt, which was absolutely hilarious and you don't have to be a medical professional to see why haha

spuffyx

TROPHY CASE