‘Don’t be too kind’: Maternity staff used offensive terms to refer to patients
The Controversial Acronym
Don t be too kind – A recent revelation has exposed a pattern of dismissive language among maternity staff at Nottingham University Hospitals NHS Trust (NUH). Midwife notes, once a tool for clear communication, were found to contain cryptic abbreviations. One such trio—“FOH”—was scrawled beside patient names on a whiteboard, not as a medical reference but as an acronym for a derogatory phrase. The initials stood for “F” (a swear word), “O” (for “OFF”), and “H” (meaning “HOME”), reflecting a desire to send pregnant women back to their homes with minimal support. This shorthand, uncovered in a 2018 resignation letter now shared with BBC Panorama, highlights a culture of indifference within the unit.
The letter, penned by a senior midwife, also detailed other examples of harsh attitudes. A colleague was quoted as advising: “Don’t be too kind, she’ll keep coming back.” This sentiment echoed the dismissive approach seen in the FOH acronym, suggesting that some staff viewed expectant mothers as burdens rather than patients in need of care. Such remarks have raised serious concerns about the emotional tone of maternity services in the region.
The Ongoing Maternity Inquiry
NUH is currently under scrutiny as part of the largest maternity inquiry in NHS history. The investigation, led by senior midwife Donna Ockenden, examines care provided to approximately 2,500 families between 2012 and 2025. It investigates stillbirths, neonatal deaths, maternal fatalities, and cases of injury to both mothers and newborns. Panorama has obtained previously unseen documents and interviewed 10 former midwives, offering a deeper look into the unit’s operational challenges over the past decade.
Ockenden, who oversees the inquiry, described the trust’s mindset as one of complacency. “Nottingham thought that there was a Nottingham way, that they were some kind of superior NHS trust compared to others,” she told the BBC. The current chief executive, Anthony May, has acknowledged the need for accountability, stating: “We need to take accountability as an organisation.” However, the systemic issues identified in the 2018 letter suggest that the culture of care may have been deeply ingrained before his tenure.
Staff Experiences and Work Conditions
Former employees describe a workplace environment marked by stress and a lack of empathy. One midwife recalled a patient who called the hospital in labor, only to be told she didn’t require admission. By the time she arrived, her baby had died, and her mother’s perineum and vaginal wall had collapsed due to prolonged labor. “She now has a stoma bag,” the midwife said, emphasizing the consequences of delayed intervention.
“Who writes that in a caring profession?” Sarah Hawkins, a mother whose daughter Harriet was stillborn in 2016, questioned after learning about the FOH remarks. She had voiced concerns to ward managers over six days, only to be met with dismissiveness. “That’s quite upsetting for me to hear,” she said, referring to the acronym. “The last phone call I made to a ward manager, she might as well have just said that to me.”
Midwives also spoke of chronic understaffing, which compounded the pressure on frontline staff. A community midwife noted that managers often claimed staffing levels were adequate, yet the reality was far more challenging. “You have to be resilient, and to be resilient you have to lower your compassion,” she explained. This sentiment underscores the emotional toll of working in a system where support was scarce.
Another midwife recounted being told to return to the labor ward after personally experiencing a late miscarriage. “There was a lack of empathy, interest and care,” she said, highlighting the disconnect between staff and patients. A fourth described the unit as a “frightening place to work,” where chaotic shifts and rushed procedures led to errors. Meanwhile, a fifth midwife recalled being the sole person on duty capable of analyzing babies’ heart rates using a monitoring machine. “I remember running in and out of people’s rooms, fearing a,” she began, her words cut off by the weight of the situation.
The toxic culture, as described by former staff, has persisted for years. One midwife shared an anecdote about a junior colleague who was promised support for a “complicated woman” but was left unassisted during a critical moment. “But [she] was ignored when she buzzed [for help],” the midwife said. “The co-ordinator and her cronies were busy shopping for handbags online.” These accounts paint a picture of a maternity unit where efficiency sometimes overshadowed compassion.
While the FOH acronym and other remarks are evidence of poor attitudes, the inquiry also highlights systemic failures. The emphasis on keeping women at home for as long as possible appears to be a recurring theme in many of the tragic outcomes. This approach, though intended to reduce hospital stays, may have contributed to preventable complications. The trust’s response to these allegations has focused on accountability, but the question remains: how much has changed since the 2018 letter was written?
As the inquiry prepares to publish its findings on 24 June, the stories of affected families and former staff serve as a reminder of the human cost of institutional neglect. Sarah Hawkins, whose daughter’s death was linked to ignored concerns, continues to advocate for better care. Her experience, combined with the accounts of midwives who witnessed similar attitudes, underscores the urgency of addressing the culture within NUH. The challenge now is to transform these revelations into lasting improvements for maternity services across the NHS.
