Back after the bump: Mums face a challenging return to the workplace

Returning to work after maternity leave is still a hugely daunting and difficult experience for many mothers, according to new survey published today (30 November) by the NCT.

One in three women (39 per cent) said they found going back to work after having a baby ‘difficult’ or ‘very difficult’, with 31 per cent saying their relationship with their boss had deteriorated since they had become pregnant. Despite a host of legislation and HR policies aimed at successfully welcoming mothers back into the workplace, many say they’re still not receiving the support they need.

The study, which surveyed over 1,500 mothers who have recently gone back to work, also found that one in three (32 per cent) felt their promotion prospects had been reduced since having a baby, while 13 per cent said they have reduced seniority since returning to work.

Currently, employees with caring responsibilities for children aged 16 and under have the statutory right to request to work flexibly, enabling them to adjust their working pattern to suit their needs. The vast majority (88 per cent) of mothers who were surveyed for the NCT’s report wanted to work flexibly on their return to work. However, one in six (16%) of those said their request for flexible working practices had gone nowhere.

Emma, a bank office clerk, found her return to work extremely frustrating: “I told the HR department and also my line manager when I’d be coming back, but still nobody was expecting me when I returned. I’ve also seen the same happen with two other colleagues. It’s a bit disappointing really and makes you feel as if you’re not wanted.”

Renata, a shop floor supervisor, also experienced difficulties, particularly when it came to a request for flexible working:

“Before my maternity leave, I decided that when I returned to work I would work part time. I completed all the necessary paperwork and it was formally confirmed with my manager. However, a week before my return, he informed me that no part-time work was available. It was completely unprofessional; they shouldn’t have made false promises.”

To help guide both mothers and employers through a smooth return to the workplace, the NCT and the charity Working Families have published two free downloadable guides available : click here: www.nct.org.uk/returningtowork

or www.workingfamilies.org.uk.

Sarah Jackson, Chief Executive of Working Families, says: “Returning to work when you have a new baby can be very difficult for the new mother and her manager. But the good news is that problems can be avoided by good communications and good planning together. These new guides take mother and manager step by step from early pregnancy, through maternity leave and a successful return to work”

Top tips on maternity leave for mums:

– Prepare a handover plan – discuss with your boss the options for handing over responsibilities and when it is appropriate to do this
– Remember, you are entitled to 52 weeks maternity leave, regardless of length of service or the number of hours you work
– Keep a record of everything and try to get agreements in writing
– Start thinking about your return to work early on
– Anything can be flexible working – it doesn’t have to be a reduction in hours, it could be home working, compressed hours, job sharing or term time only working

Notes:

The online survey was completed by 1,541 mothers from 1 September – 31 November 2008.

The experiences of women returning to work after maternity leave in the UK – This report seeks to understand experiences of mothers returning to work after maternity leave in the UK

December 10, 2009 at 4:32 pm Leave a comment

BPA in plastic bottles

Breast Cancer UK today launches a campaign calling on the Government to take action to end the use of controversial chemical, Bisphenol-A (commonly abbreviated to BPA), in baby bottles.

This call is backed by NCT (National Childbirth Trust), UNISON, The Women’s Environmental Network, the Cancer Prevention and Education Society and CHEM Trust.

Already voluntarily withdrawn from shelves in Canada and the USA, polycarbonate baby bottle made with BPA are still available in the UK, despite our view being that clear and compelling scientific evidence in lab experiments have linked even low level exposure to increased risk of breast cancer and other chronic conditions.

In the first survey of its type ever conducted, just under four in of five (79%) of the public either strongly agree (50%) or agree (29%) ‘that it is important that the UK Government acts in a precautionary way when it comes to protecting babies and very young children from BPA’.

Women feel even more strongly, those agreeing or strongly agreeing rises to just under 17 in 20 (84%).  While 61% of the public think the UK Government should ‘act to end the use of BPA in baby bottles’ 61% and only 10% think the Government ‘should follow the current FSA guidelines and leave things as they are’.

The No More BPA campaign is being launched just a day after an expected announcement on BPA, due on the 30th of November 2009, from the US Food and Drug Administration, that have similar regulatory authority on food contact products and public health as do the UK Food Standards Agency.

Baby bottle manufacturers, anticipating the Canadian ban as well as expected regulatory action in the US, have already withdrawn baby bottles made with BPA from shelves.

The plastic recycling number 7 is sometimes imprinted on polycarbonate plastics, but as the number 7 code is used as the catchall for ‘other plastics’, even this limited labelling is very unclear.

December 10, 2009 at 4:29 pm Leave a comment

Doulas – a help for mums

Commenting on BMJ.com, a doctor today says that the presence of doulas during labour may alter the doctor-patient dynamic and can compromise communication and therefore patient care.

Furthermore, the need for doulas implies a failing of medical and midwifery services and also the support provided by family and friends, says Dr Abhijoy Chakladar who was working at Worthing Hospital in West Sussex when he first encountered a doula.

Background

There are two types of doula – birth and postnatal – and some cover both areas. A birth doula is there to offer physical and emotional support to you (and your partner) during labour and for your birth. They don’t do anything medical but are a continuous, reassuring presence.

Most (but not all) doulas are mothers themselves and may or may not have done additional training. Those recognised by Doula UK will have completed an approved training course and will have de-briefed and reflected on what birth means for them. A birth doula will usually cost between £200 and £600. Postnatal doulas are there to support you at home after the birth – ‘mothering the mother’ so you can mother your baby.

December 10, 2009 at 4:26 pm Leave a comment

Improvements to care for sick and premature babies in Wales

Health Minister Edwina Hart today [Monday, 7 December] accepted the recommendations of an expert group on improvements to care for sick and premature babies in Wales.

The group, led by Dr Jean Matthes, Consultant Neonatologist at Abertawe Bro Morgannwg University Health Board, has produced a plan to improve neonatal services. Priorities include introducing dedicated neonatal transport services, improved information systems, and the establishment of a Neonatal Managed Clinical Network for Wales. The network should be operational in February.

The group’s recommendations outline how the additional £2million a year of Assembly Government funding announced by the Minister for neonatal services will be spent.  Planned improvements include:

Two neonatal transport services, one in south Wales and one in north Wales. The transport services will ensure rapid and safe transport to specialist centres. The services will operate 12 hours a day in the first instance, with planned progress towards a 24-hour service in the future as staff resources are developed. The new service should be operational from spring next year.

Specialist Neonatal services concentrated in three centres in South Wales – Swansea, Cardiff and Newport – and one in North Wales, yet to be determined.

Recruitment to begin for additional Neonatal Consultants and Neonatal Nurses at each centre to deliver the new service.

A single Neonatal Database enabling the standardised collection of data across Wales.

Mrs Hart said: “I want to thank Dr Matthes and her team for the report on how we can deliver improvements to care for the most vulnerable babies.

“The implementation of their recommendations will improve clinical safety, and ensure that neonatal intensive care services are sustainable. More babies will be treated closer to their homes, with appropriate and safe transfer to specialist services where required.

“These proposals will facilitate progress towards the delivery of the All Wales Neonatal Standards that I launched in December last year. My aim is to deliver safe, sustainable services for the benefit of babies requiring specialist care and their families. .”

Dr Jean Matthes, Chair of the Expert Group, said: “I am absolutely delighted with the development of the neonatal transport services, database and network.  This will significantly help to improve the services for newborn babies and their families throughout the whole of Wales.”

Dr Huw Jenkins, Consultant Paediatrician at University Hospital of Wales, Cardiff, added: “This is a very welcome announcement and I am pleased that the hard work of the clinicians and others involved in developing the neonatal standards and service models is coming to fruition.”

December 10, 2009 at 4:24 pm Leave a comment

Home birth figures remain static across UK

Across the UK in 2008, 21, 211 (2.7%) of all births (787,032) took place at home, compared with 20,548 (2.68%) in 2007. This shows no rise in the home birth rate.

In England 18,933 women (2.8%) had a home birth, from 665,779 births.

Wales has the highest proportion of women having home births, 1,314 (3.7%) from 35,256 births.

In Scotland, 881 women (1.5%) had a home birth, from 60,366 births. And in Northern Ireland, 83 women (0.3%) had home births from 25,631 births.

Local administrative areas with highest and lowest home birth rates include:-

HIGHEST

LOWEST

England South Hamms – 13.6% Alnwick 0.0%
Scotland East Lothian – 5.0% Eilean Siar – 0.4%
Wales Bridgend – 9.5% Merthyr Tydfil – 1.3%

New data provided by the Office of National Statistics, The General Register Office for Scotland and the Northern Ireland Statistics and Research Agency. Statistics analysed by BirthChoiceUK – available at www.BirthChoiceUK.com/HomeBirthRates.htm

NCT members have contacted us to share their experiences of home birth. Please see below for some case studies.

Case Studies:

Rosie Evans, Rugby: “After giving birth to a stillborn girl, followed by a miscarriage, we were very anxious for the birthing experience to be special. We chose to have a home birth because I knew that in a hospital environment I would not feel able to birth, because for birth you need relaxation and for relaxation I need privacy and control.

The home birth was very positive. Everyone who meets our daughter comments how calm and contented she is. I have no doubt that this, my effective contractions and short labour were all down to the fact that she was born in water and at home.”

Helen O’Donnel, Worcester: Helen gave birth in a water bath at home with her mother, husband and two community midwives present. It was a very positive experience.

Charlene Lucas, Twickenham: “I chose to have a home birth and informed my midwife (at the GP surgery) at 20 weeks. She was supportive, but said she could not guarantee me a home birth. Someone would bring round my home birth kit at 37 weeks, bit I would only find out whether someone could attend my birth at home when I went into labour, otherwise I would need to go into hospital.

As it turned out, I was recommended to go into hospital as the baby was breech and the birth went well. However, it was not my first choice and had I been able to proceed with the home birth I would not have known where I would labour until the day it happened and had no idea who will be attending which is far from ideal!”

Suzanne Borrell, Brighton and Hove: “I attempted a home birth in August 2005 but ended up in an emergency c section situation. Midwives were very positive but on the day the midwife who was attending me left at 11pm after a brief visit ‘saying – I’m off home to get some sleep and I suggest you do the same’. Although it was early on in my labour I was in a lot of pain as my baby was posterior. I really could have used her support as well gas and air as the pain became almost unbearable as the hours passed.

I had a birthing pool but was nervous about using it without a midwife present. Next morning a lovely midwife then came with gas and air but I was by then exhausted by the pain. I was taken by ambulance at 5pm to Royal Sussex as labour was not progressing and had a c section at 11pm.

After having a very positive second birth in a birthing pool, I now know that the outcome would have been different if I had received more care earlier on as much of the pain came through stress and fear.”

Full list of statistics can be viewed at http://www.BirthChoiceUK.com/HomeBirthRates.htm

December 10, 2009 at 4:21 pm 1 comment

Senior midwives report falling budgets despite rocketing birthrates

Despite the rapidly rising birthrate* well over a third (40%) of Heads of Midwifery (HOMs) say they have not had any budget increases in the past year. Worryingly, nearly a fifth (17.8%) report that their budget has been cut, and almost a third (30%) report that they have been asked to reduce their budgets. Just 42% report an increase in their budget, a fall from 47% last year.

The results – from a survey of HOMs across the UK by the Royal College of Midwives (RCM) are released on the final day (Friday, 27th November 2009) of the RCM’s annual conference in Manchester.

When asked about their staffing levels over two thirds (67%) of HOMs also reported that they do not have enough midwives to cope with the workload in their unit.  Well over two-thirds (72%) said they needed more midwives to bring their midwifery staffing levels up to an acceptable level. Over 90% of HOMs cite rising birthrates and the increasing complexity of births as the key reasons why their units are struggling to cope with the workload.

Despite recent and welcome increases in the numbers of midwives**, and plans to recruit more, the figures show that the increase is not keeping pace with the birthrate. There still remains a significant midwife shortage. The RCM still believes that the Government’s target of 3,400 more midwives will not be enough – if the birthrate continues to rise – to delver a high quality service. For this to become a reality the RCM estimates that over 5000 more midwives is the target that the Government should be aiming for.***

Thepicture however is not all bleak. Following a freedom of information request the RCM found that spending on maternity services is up on average by 7% across the UK. This is above the average NHS spending increase of 4%. But, this is a service playing catch-up, and that has seen historically low investment compared to other parts of the NHS.

Regionally there are significant variations in general vacancy rates. London (12.6%), the East of England (12%) and the South east (10.9%) all have exceptionally high levels. This is compared to the average vacancy rate for the UK of 6.5%, up from 5.4% last year, and this compares badly with an acceptable level of vacancies of around 3%.

A number of other regions have lower but still worrying levels of vacancies with South Central England (7%), the West Midlands (5.7%) and East Midlands (5%) all running well above acceptable levels. The RCM would want to see concerted action to chip away at these morale sapping levels of vacancies, and are hopeful that Maternity Matters, the Government’s blueprint for maternity services, will achieve this.

HOMs also report that they are struggling to recruit midwives, so even when they have the funding they are struggling to improve their staffing levels. Almost half (48%) say that recruitment and retention of midwives is quite a problem or a major problem. The number of HOMs who see recruitment and retention of midwives as no problem has fallen from almost 60% 2 years ago to just 25% this year.

Stress and heavy workloads top the table of reasons why HOMs say they are struggling to recruit and retain midwives.  A third of HOMs (33%) report that stress is a major issue, and nearly a third (30%) say heavy workloads are having an effect on recruitment and retention.

Cathy Warwick, general secretary of the Royal College of Midwives, said: “There is no doubting the Government’s commitment in word and deed to maternity services. The direction of their policy is good, more money going into maternity services and midwife numbers are increasing.

“However, on the ground midwives are having to work ever harder and longer to maintain a high quality service for women and babies.  I have to ask myself how long they can keep doing this, and it is obvious that there is still an awful lot of ground to cover.

“The RCM remains sceptical as to whether the planned increase in the number of midwives will match or even catch up with, the ever increasing birthrate. It is also an issue as to whether all the resources allocated to maternity services will reach the front line, given the financial pressure that the NHS is facing to save money.”

Notes:

The survey of Heads of Midwifery received 76 responses from a questionnaire sent to 203 HOMs across the UK, a 37.4% response rate. It was conducted by the RCM in July 2009. It was conducted to gather information to support the RCM’s contribution along with other unions, to the NHS Pay Review Body.

The full report can be found on the RCM’s website at http://www.rcm.org.uk/college/employment-relations/pay/ – ‘RCM Evidence to the NHS Pay Review Body 2009’.

*The birthrate has risen by 18.6% since 2001. See table below.

**The Government have pledged to increase the number of midwives by a total of 3,400 (whole time equivalent, equating to 4000 more as a headcount figure0) by 21012. They have recruited an additional 1000 (headcount) so far.  For midwife numbers since 2001, see table below.

***The number of midwives needed is calculated using a tool called Birthrate Plus. This takes into account the level of activity on a unit, including the number, type and complexity of births.  Birthrate Plus would suggest that the current birthrate requires 24,937 whole time equivalent midwives whereas there are currently just 19,639. This leaves a shortage of 5,298 whole time equivalent midwives.

The number of Headcount and WTE Midwives

Year 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008

Headcount

22,841

22,799

22,572

23,075

23,249

23,941

24,844

24,808

24,469

25,093

25,664

Whole Time Equivalent

18,166

17,876

17,662

18,048

18,119

18,444

18,854

18,949

18

The rising birthrate in the UK

2001 2002 2003 2004 2005 2006 2007 2008 Percentage Increase (2008/2001 x 100)
England & Wales 594,634 596,122 621,469 639,721 645,835 669,601 690,013 708,711 19.2
Scotland 52,527 51,270 52,432 53,957 54,386 55,690 57,781 60,041 14.3
N. Ireland 21,962 21,385 21,648 22,318 22,328 23,272 24,451 25,000[1] 13.8
Total 669,123 668,777 695,549 715,996 722,549 748,563 772,245 793,752 18.6
Number of Midwives (England) 23,075 23,249 23,941 24,844 24,808 24,469 25,093 25

December 10, 2009 at 4:18 pm Leave a comment

Midwives comment on Conservative maternity plans

Commenting on the Conservative maternity plans announced today (Thursday, 26th November 2009) at the Royal College of Midwives (RCM) conference, Cathy Warwick, RCM, general secretary, said:

“In some respects the Conservative plans  reflect a general consensus on the actions we need to take if we are to provide world class maternity services. The commitment to more midwives is positive and significant, as is the promise of more locally based services, but of course both will need to be funded.

“The focus on better antenatal and postnatal care is a promising step. These are the parts of the services to pregnant women that are often lacking and suffer when financial problems bite. However, I would like to see what the Conservatives mean by ‘providers’ of these services. Are they referring to a greater role for the private sector? The RCM has serious concerns about the risk that privatisation of maternity care will lead to the fragmentation of care for women.

“I would want to see more detail on the commitment on funding for maternity services. At the very, very least we would want to see funding matching the ever increasing demands on the service.

It is now generally accepted that the method we have of paying for maternity services does not support implementation of policy. The RCM would like to see a review of the funding structure to incentivise normal births and which recognises those services that can demonstrate high levels of maternal satisfaction.

“The Conservatives are putting forward a number of interesting proposals, but good words and good intent are one thing, and real and positive action is another. We want promises made to become promises delivered and the improvements we have seen so far in maternity services continuing.”

December 10, 2009 at 4:16 pm Leave a comment

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