A newborn baby’s first, silence-shattering cry is something that never leaves you. It’s a sound that rings through the corridors of Lewisham Hospital’s maternity unit, where four and a half thousand of London’s babies will be born in the next year alone.
There, mothers-to-be are placed in a relaxed environment where they are quietly cared for by committed staff. Though she conceded that giving birth is never pleasant, Sarah Atkinson, 35, of Honor Oak, described the midwifery-led unit where she gave birth as “a really nice, safe, comfortable environment designed after consultations with women who had given birth at Lewisham before.”
Alexandra Hill, 34, an ITV newsreader, gave birth to her daughter, Olivia, at Lewisham in 2011 and her son Alfie there in 2012. “I was looking into a home birth as the idea of a birth surrounded by doctors and machines scared me,” she says. “But I was also worried at the idea of not having that, if I needed it. So Lewisham was perfect, and is the most fantastic place to give birth.”
Hill refers to the fact that, on top of the home-from-home experience, an A&E department and 24 hour blood banks are just moments away, should an emergency arise. It’s the perfect scenario for most mothers.
Yet an emergency has arisen; a haemorrhage of a kind unlike any seen here before.
The neighbouring South London Healthcare Trust is in millions upon millions of pounds worth of projected debt, and the Trust’s special administrator, Matthew Kershaw, has proposed the closure of Lewisham Hospital’s busy A&E department.
Without an A&E, and without readily available blood stores, women carrying high-risk pregnancies will no longer be able to give birth at Lewisham.
At present, the hospital provides services for many mothers under the age of 16 and over the age of 40, two high-risk categories. If the closure goes ahead, their babies will have to be born in the nearest obstetrics-led units at Kings and Woolwich, which are not only miles away, but are also ‘badly overstretched’. On January 21, Harriet Harman MP wrote an open letter to Jeremy hunt, estimating: “If Lewisham maternity services close then there will be 3,235 more births at King’s to add to the existing 6,000 births. There is simply not the capacity at King’s for a 54% increase in births. It would not be fair on the mothers, the babies or the staff.”
Toyin Adeyinka, 33, from Catford, is a Domestic Violence Support Worker and mother to a 21 month old son who was born at Lewisham in 2011. She says that, as a first time mother, she felt the support she received there was essential, and that staff were wonderful on every level. The suggestion that high risk pregnancies could be moved to Kings or Woolwich enrages her: “The so called ‘nearest’ hospitals are the opposite, they are hard to get to via public transport and a cab ride would be more than double the price to Lewisham hospital. You can imagine what people are now going to be considering at what could potentially be life or death decision”.
She continues “I’ve been to meetings and I attended the last march, signed petitions and filled out the consultation. I also try to raise awareness by talking to people and by using social media. I will also be attending the upcoming march on 26 January.”
Amongst all the women interviewed, there is a feeling of unrest; unanswered what-ifs ripple through their narratives. Hill muses: “I know women who’ve started their delivery in the birthing centre and have had to move quickly onto the ward. I can’t imagine how awful it would be to have to go through that in the first place let alone add in the trauma of having to be rushed to a different hospital. I find the prospect really scary.”
Similarly, Atkinson’s voice quickens as she discusses the proposed closure of the A&E. “At present, you have the best of both worlds; you’re in a midwife-led, home from home environment, yet you know you’re moments away from a really good hospital with great facilities. It’s less reassuring if you’re no longer so close.’
She stops. “I was very lucky – my daughter and I were fine. But emergencies can arise, and although midwives are very good at spotting them, if there had to be a transfer, that could be very frightening.’ She pauses for a moment, thinking. ‘My daughter was my second baby. The labour was very fast. If I’d have had to go to Kings, she would have been born in the car.”
Student midwife Alice*, 25, agrees. “If the unit is in hospital grounds then it’s easy to transfer a haemorrhaging woman. But if Lewisham’s A&E were to close, traffic could make a transfer difficult, and the only way to rescue real emergencies would be flying them out.”
She echoes Atkinson. “We (midwives) are experts when a birth is going well, we can recognise when there’s a problem… but dealing with the problem isn’t in our sphere of care, and if the nearest consultant is miles away, that’s a bit frightening.”
A collective of Lewisham Hospital’s obstetricians have also opposed the closure, writing an open letter to Kershaw pointing out the many flaws in his proposal, particularly in relation to high-risk births. They quoted a Royal College of Obstetricians and Gynaecologists report which outlined the risks of splitting antenatal care between two hospitals. They call the resultant arrangements ‘a lottery,’ and the proposal to maintain a “low risk obstetric unit” at Lewisham: “unsustainable, unsafe, not economically feasible” and unable to “provide the quality improvement that the reorganization is supposed to deliver.”
Hill simply says that if the A&E closed, she would hesitate to recommend the birthing centre to first time mothers, “because of the worry that if something went wrong help isn’t on hand.”
Atkinson also worries about Lewisham’s status as a University Hospital without the A&E: “It’s a teaching hospital, but with no consultant-led service, what will happen? A student midwife delivered my daughter. She was wonderful. I don’t want the hospital to become second tier; no one wants that. Staff don’t want to deliver second tier care, either.”
Alice sighs. “It’s awful for women to lose the choice of where to have their babies,” she says. “It’s a loss of freedom, having to go where they might not be as comfortable and won’t be as close to home. And it’s hard for us as midwives, too, knowing that our women are being forced to go somewhere else.”
*name changed for confidentiality purposes.