Could it be a risk to give birth in Eastbourne?

“I have daily reminders staring back at me in my son and daughter of how I have been let down.”

These are the words of a mother who’s baby was born with a life altering heart defect that, had it been spotted during her pregnancy, could have made an inconceivable difference to her birthing experience and her young family’s life in the months afterwards.

Rebecca Coutanche, 35, Pevensey, gave birth to her son in December 2015 after receiving “very good” antenatal care at the District General Hospital (DGH) in Eastbourne, which lost its full maternity services in 2013 when health bosses decided to permanently switch full consultant led care to Hastings. This decision left a Midwifery Led Unit at the DGH and resulted in an “Inadequate” overall rating from the Care Quality Commission.

According to the Eastbourne, Hailsham and Seaford Clinical Commissioning Group (CCG), there were 1,973 births in 2012/13 at the DGH when consultant led services were still available there. However, Last year less than 300 babies were born at the DGH, some mothers chose not to give birth there, while others do not have an option due to the lack of full services in place.

Mrs Coutanche did not have a choice as her pregnancy was high risk and the services at the DGH could not meet her medical requirements. Instead her son, Charlie, was delivered prematurely via emergency C-section, at the Royal Sussex County Hospital.

“Sadly our son was in distress and as he wouldn’t stabilise, they rushed him to the Trevor Mann Unit for assessment where they found his heart defect,” said Rebecca. Following this discovery, baby Charlie was rushed by ambulance to St Thomas’s hospital in London to receive specialist care.

After eight days, the Ronald McDonald House accommodated the Coutanche family, in the mean time, leaving Rebecca without an adequate place to sleep or rest following her major surgery. “I had no opportunity to recover myself… I had nowhere to go.”

Charlie was discharged after three weeks and is now in a stable condition. Mrs. Coutanche said: “He does face surgery in the future. But our shock and upset stems from the fact his defect was missed on the scan.”

This traumatic ordeal could have been completely avoided, had the consultant led maternity and paediatric services been available at the Eastbourne DGH.

According to the Department of Health, nationally, 79% of women are within a 30-minute drive of both an obstetric unit and a midwifery-led unit, this is not the case for the mothers of Eastbourne, who are only a few miles from a Midwifery led unit, however lack the consultant led obstetric unit, which is now based over almost hour away in Hastings.

This journey is a terrifying prospect that some mothers have to face before or during their labour, when consultant led care is needed but cannot be provided by the DGH, where many women begin their labour.

The CCG confirmed that the number of babies born before arrival, travelling to the Conquest Hospital from the Eastbourne area, had increased in the year the transfer of services had taken place.

Stephen Lloyd, former MP for Eastbourne, and a campaign group member of the Save the DGH campaign, said the risk of transferring mothers to the Conquest at the last minute is “unacceptably high”.

The Save the DGH campaign aim to return the core services back to Eastbourne eventually, however this could take a long time. The decision to make the transfer of the services was defended by the fact that it was difficult to recruit enough consultants to operate both hospitals at once, and that instead it would be safer to run one site with full specialist services.

Stephen Lloyd said: “There should be some consultant access at the DGH, as this will mean many more women can again have their babies there.” Even though the DGH lacks consultants, Mr. Lloyd added that the Midwifery Led Unit is “a very good one”.

The Eastbourne Midwifery Unit (EMU) is intended to be used by women who are expected to have “low risk pregnancies”. This means that the mother will not require consultants, operations or epidurals. While this is not an option for mothers like Rebecca Coutanche it is for many others, who are refusing it due to fear of medical complications and safety.

At the EMU mothers get more one to one care due to the small volume of women that are admitted at a time. Matron of the Eastbourne Midwifery Led Unit, Marie Foreman, said: “We have more time that we can spend with them one to one, rather than a big busy postnatal ward, where there might be one midwife looking after 12 mothers and 12 babies.”

Research shows that midwife-led units are safer than hospitals for women who are experiencing a low-risk pregnancy. Professor Mark Baker, Director of NICE Centre for Clinical Practice, said: “Most women are healthy and have straightforward pregnancies and births. Over the years, evidence has emerged which shows that, for this group of women, giving birth in a midwife-led unit instead of a traditional labour ward is a safe option."

Marie Foreman, supported the statement made by NICE and said: “We need to get the message out into the community that it is a safe place to have your baby.”

However, the lack of obstetricians at the DGH mean that midwives are now the lead professionals. Marie said there is a “different kind of pressure” on the midwives since the changes to the services have been made, due to the fact that EMU only handle low risk pregnancies. Marie Foreman added: “Everyone who comes here is low risk, having said that, labour and child birth is unpredictable.”

Statistics from the Health and Social information centre show that over 60% of all deliveries are spontaneous; considering this and the unpredictable nature of childbirth, the cuts to the maternity services at the DGH could potentially put Eastbourne families at risk, and hospital staff under extreme pressure.

The services at the DGH may one day restore back to their original condition, however, this is uncertain. The return of access to obstetrician led care would reduce the stress and ultimately the risk of bringing a child into the world without emergency backup services, which could hold unthinkable consequences.