A critical watchdog report has found maternity services at James Cook University Hospital and the Friarage Hospital "require improvement" as understaffing and a poor environment left mothers and their babies "at risk".
The Care Quality Commission (CQC) rated maternity services at the two hospitals, run by the South Tees Hospitals NHS Trust, following an inspection in August.
Ineffective governance, environments that were "not fit for purpose", and low levels of midwifery staff were "putting people at risk."
Women in one hospital even had to give birth in a standard bath, as a maternity ward lacked an adequate birthing pool.
The Trust said that areas noted for improvement by the CQC "are already being addressed through a comprehensive action plan," and emphasised their pride in the "hard work, professionalism, and caring attitude" of their staff.
Understaffing at both hospitals led to the Friarage's maternity unit, in Northallerton, sometimes being "closed for birth", as staff were drafted in to help with staffing shortfall at James Cook.
Equipment and environmental issues concerned the CQC. At James Cook Hospital, in Middlesbrough, inspectors noted a lack of a birthing pool in the delivery suite and midwifery unit, meaning mothers in childbirth had to use a standard bath.
A spokesperson for the health watchdog said: "This was unsafe and was putting people at risk due to the design of the room and the bath. Once this was highlighted to the trust, they stopped immediately."
Following this inspection, maternity services at The James Cook University Hospital have been rated as "requires improvement" overall, and for being safe and well-led.
Maternity services at the Friarage Hospital were rated requires improvement overall and for being well-led. It was rated good for being safe.
However, both hospitals and the trust remain rated as good overall, and areas of "outstanding practice" were praised by the CQC, including the service’s transparency and accountability, and the special support it provides for birth parents and foster carers if a baby is placed into the care of the local authority.
Staff were also commended for the way they managed safety, infection prevention, safeguarding and care records.
Action to improve the service is currently ongoing and includes recruitment into the maternity services in the Trust's hospitals, and improvements to the building and environment at James Cook, including plans to install a new birthing pool.
A spokesperson for the hospitals said: "The trust is continuing to seek investment to improve the environment in maternity services."
Carolyn Jenkinson, CQC's deputy director of secondary and specialist care, said: “We found leaders were generally visible and approachable for staff, as well as women, people using the service and their babies. However, they didn’t always understand and manage the priorities both maternity services faced in a timely way.
“At the Friarage Hospital, the maternity unit was sometimes closed for births as staff were required to work at The James Cook University Hospital instead, due to low staffing levels. This made it difficult for people to plan a birth there.
“We found areas of concern at The James Cook University Hospital. For example, there was no birthing pool in the delivery suite or on the midwifery-led unit.
"Staff used a standard bath instead of a birthing pool, which was unsafe and was putting people at risk due to the design of the room and the bath. Once this was highlighted to the trust, they stopped immediately.
“Leaders were also highly responsive and engaging with other concerns we raised with them during the inspection and acted promptly to improve the standard of care they were providing.
“We will continue to monitor both services, so the trust can build on where it’s providing good care and make improvements where they’re needed.”
Dr Deepika Meneni, clinical director for the Trust’s maternity services said: “The safety of those in our care is always our top priority and every member of our maternity team is dedicated to providing the best possible care.
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"We are pleased that the reports reflect areas of outstanding practice as well as highlighting those areas where we know we need to make further improvements.
"All of the areas identified by the CQC for improvement are being addressed through a comprehensive action plan and many of these have already been completed. This includes successfully recruiting midwives to all our vacancies.
"We are proud of our team for the hard work, professionalism and caring attitude that they show each day and that is reflected in our excellent patient feedback and in how closely we work with the parents and parents-to-be who make up our local Maternity Voices Partnership."
Simon Clarke, Conservative MP for Middlesbrough South and East Cleveland, said: "Following the release of this report, it's vital that expectant mothers feel supported and safe in the care they receive.
"The CQC report highlighted both outstanding practices and areas that require improvement. It's important to focus on these findings constructively and work together with South Tees to ensure the best possible care for every mother and baby in our area.
"I am arranging to meet with the new Chief Executive, Stacey Hunter, as soon as she takes up her post on February 1st to discuss the ongoing efforts at South Tees to enhance maternity services.
"I have full faith in the dedication and expertise of the team at South Tees. I know they are committed to addressing the areas for improvement identified in the report and it's their hard work and professionalism that are key to providing the high-quality care our community deserves."
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