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Student Midwives at Birth - pros and cons(91 Posts)
Just amending my birth plan, and wondering what are the pros and cons of allowing student midwives into the labour room?
Anyone got any experiences to share?
With dd1 a student mw did my post natal obs, v useful as the mw explained loads to the student in my hearing which I doubt I would have been told otherwise. With dd2 a student was with me in the assessment room before I was admitted. I was on a monitor, moaning softly to myself as thhe contractions were pretty intense. I was asked if the student could do a VE but I said no as she had just stood there looking uncomfortable since I arrived. Wasn't a problem.
I'm not sure if I saw any student midwives for birth of either of mine but would say it may prevent the experience of just being left to it with your DP and no-one else (which I definitely experienced) I'd say someone with some experience is often better than no-one, and resources are very stretched in many maternity units.
If it's your first baby be aware that things are much less ideal than you'll probably be expecting - especially on post-natal ward. My advice there would def be to go home ASAP !
The student midwife at the home birth of DS was the only one in the room (including 2 trained midwives and both paramedics who were only there as midwives weren't sure they would make it through the traffic!) who had ever been to a home birth, and she was the one with the car apparently
In terms of painful internals I would rank hcp:
Consultant (most painful)
Student midwife (least painful)
I had quite a difficult second birth , shoulder dystocia(sp? Sorry) then rushed to theatre for a retained placenta. During the bieth itself there was an extra person to hold my hand during the delivery stage. I also really liked having the extra person to talk to in theatre. It's hard to explain really but I think having the extra person around was invaluable for my whole experience. Similar to lalalala because I was never left alone, also she asked questions that the Midwife didn't ask and helped me keep my mind off other things.
I had student midwife with my ds2 birth. I used to just automatically write on all the birth plans "no male drs, no students" but one of the midwife spoke to me about it and explained that allowing students can actually be a good thing as you get extra care, more people paying attention to you etc so I changed my mind and thought why not!
I had no problems during the birth with the student midwife being there, and don't remember having internals twice or anything so pretty sure I didn't? I got to hospital at quite advanced stage of labour though, so didn't have many internal with that birth anyway - maybe only 1?
The actual delivery was done by the student so she must have been a fairly qualified one? I ended up with 3 midwifes there are he was born at shift changing time so the previous one stayed, then the next one coming onto shift, and the student - so i had loads of people looking after me and it was a great experience, they were all lovely. I wouldn't have a problem with student midwife being there in future, but wasn't asked about in for my ds3
I had a lovely student midwife at DD2's birth. She held my hand, brought me toast and made me feel very looked after.
I had a student midwife in for my first delivery. I'd stated I didn't want one in the birth plan, which the midwife looked at and then gave all sorts of reasons I should. TBH at that point I didn't have the energy to argue so she stayed.
I'm glad she did, as she was the one who came in and checked me, noticed the mess everywhere after I'd done one great involuntary push, and thus examined me, only to find a foot. This was about 10 minutes after I was told his head was engaged by the main midwife. I went on to have a footling breech birth (don't get me started on how no-one believed me when I repeatedly said he was breech).
Glad she was there as she raised the alarm.
Brave - I find internals agony. Most people don't, but I do. My first labour was full of pointless 'we'll just see how you are getting on. Oh, no progress in 2 hours' internals that destroyed my already fragile confidence (I'd had a very long latent stage and hadn't slept for two nights, so I was unusually pliant). I am very much against internals 'by the clock'. They should be for a medical reason - like the mother feeling an urge to push but it seeming early, or simply a desire by the mother to know what's happening. The idea that it needs to be regularly checked to see how someone is progressing just comes from the fact that midwives are too stretched to spend enough time with women to judge progress in any of the other myriad ways available. And since many women dilate irregularly, the fact that you are 5cm doesn't mean you are 5 hours away from delivery (or 10 hours, depending on whether you go with the 0.5cm an hour or 1cm an hour model). It just means that,right this minute, you are 5cm. You could still have given birth 30 minutes later. My birth plan for no.2 said no internals unless it was believed mine or my baby's health was at risk or I asked for one. <rant over>
All three if mine delivered by students, and with a sister as a midwife I'm fully supportive if people needing to learn.
I found that I got twice the attention, and the students were a lot better at the niceties than the over worked midwives who didn't have time for the sundries (cups of tea etc).
Thanks Amanda, that's useful to know. I feel like a bit of a hypocrite saying outright no as I work with students and totally appreciate how much they need to learn
I think the whole internals thing is very difficult to judge. At this stage (30 weeks) all the experience I have to go on (in labour, have obviously had internals before and hated them) is what I've seen on the likes of OBEM, which seems to perpetually have some poor woman writhing/screaming in agony with someone 'doing something' to them!
i had a student who.had followed.me through from my booking appt to birth. She was marvellous - asked me if I could.let her know if.she.could come to my appts (and came to the ones I agreed 2). Was with me all through my induction and I felt like I had an advocate on my side - stuck up for me.when I was begging for pain relief etc. She was an RN already, doing an 18month midwifery course, so it probably helped that she already had experience and wasn't scared to.stand up for me. My birth was horrific, but she was one of the very few.positives of the process.
Brave - You are totally able to say that if that's what you want. Observing can still be very valuable to students. Also, bear in mind that you can refuse routine internals. They actually serve far less purpose than is often made out.
Having read all of the comments here, I think I might be willing to let a student midwife observe, but would feel very uncomfortable with any hands-on
in action as this is my first child and tbh I feel incredibly stressed about anyone getting their hands on me at all, let alone someone who I may not have full confidence in their knoweldge or ability.
Whilst in hospital at the start of my pregnancy, I was cared for by a student nurse (who had three weeks left before she qualified) and was also subjected to a random consultant plus 12 students on rounds. I was also seen by a number of student nurses in the follow up care, and I didn't mind despite having had surgery on my undercarriage.
However, I fear that being completely naked and exposed, and possibly emotionally stressed and frightened, will leave me feeling much much more vulnerable and for that reason I wouldn't want half the world getting their hands on me.
If I get to a DC2, then my thoughts may well be different.
I know this isn't what you asked re prons and cons but imagine the benefits you are also providing midwife one day she could be the one to deliver your grandchild just a little extra worth thinking about
I had a fairly senior student midwife with me - I was her 30th labour and she has to attend 40 before she qualifies. She was totally brilliant and worked out how to explain things in a way I could cope with through the gas and air. There was a qualified midwife as well, throughout. I was off my face, but I got what I wanted and they worked really well as a team. I couldn't fault them.
With dd1 the student nurse was awful, told me if I didn't have some experimental drug I would be like a woman they had the other day who nearly died. Neither her or the midwife noticed that the continuous fetal monitor was not printing out nor attached properly (MILLIE luckily did). Both left me alone for large amounts of time. Lucky for me the senior consultant was passing as I needed an EMCS.
Next time round I said no students without supervision. Student and midwife were very good at keeping me and grieving DH (MIL had recently passed he had PTSD and fear of hospitals, blood etc) calm during another EMCS. So having her there as an extra person was useful.
I've no experience of giving birth yet, but I think I'd be quite happy to have a student midwife present. There was a student at my last two antenatal appointments, and whilst she made a few mistakes when measuring me, taking blood, etc, the supervising midwife was there to ensure those were rectified.
What was good about her being there was how at one appointment I was feeling very hormonal and kept bursting into tears over very little, she and the supervising midwife were able to get some gentle banter going together that made me laugh and feel much better. The three of us ended up having a good girly chat about the things that were bothering me which is what I needed. I think if I'd just had the one midwife for that appointment it might've felt a bit more awkward and intense IYSWIM.
Actually thinking about it the post birth one was with a student health visitor.
There was one there during my delivery. It was quite a difficult one: I'd had a prolonged latent phase then dilated very quickly, was denied an epidural, then contractions slowed so I had syntocin and eventually ventouse. I didn't mind her being there, every other fucker in the hospital turned up at some point so the more the merrier. She just watched. It was probably quite instructive for her because when i first got to the delivery room and discovered there would be neither epidural nor further diamorphine, I was extremely angry and shouty. Then they sent in the 60 year old, experienced, battleaxe midwife (I mean that as a compliment) who basically told me to pull myself together and work with her- and that was just what I needed. Very useful for a trainee to see someone who's really in a bad way and the techniques that can be used to take control of the situation. While my birth was far from ideal, I think the delivery itself was able management of a difficult situation that was a fait accompli by the time I arrived on the delivery suite.
I would have another again, even though my preference is definitely for one of the older midwives who's been through the wars. Mummy figure I guess! Wouldn't allow vaginal examinations though- I find those very difficult and although students need to learn to do them, my labour is too important for me to consent to something that will cause me unnecessary distress. No problem with a student watching a VE, conducting an antenatal or postnatal appointment whilst supervised or checking stitches though. Indeed, I allowed the first two and would have done the third if any student midwife had shown any interest in my fanjo after birth.
Oh mind you, a student took my blood at a community mw appointment and it bloody hurt as she was so inexperienced, and I was really pissed off!
I LOVED having a student at both of my births. As has been saud above, she was available to talk to me and be there for me all the time. It was an amazing experience.
I found the student stayed with you when the mw left the room so less 'abanded' tine
I had a bad experience with a consultant wandering into the room with my first labour. Had someone or other with him, didn't speak to me, just started talking to the medical staff. I may have yelled at him to introduce himself.
Second time my birth plan said:
- student midwives were fine. Either at home (planned home birth) or on transfer if that was necessary (it wasn't). They are working directly with the midwife caring for you and I didn't mind that at all;
- medical students, generally no. I was fine with one if they were going to stay in the room for a significant portion of time - e.g. if they were shadowing the registrar/consultant and an assisted delivery was needed. I was not ok with groups of medical students on ward rounds or anyone who was only going to be in the room a minute or two.
I was fine with students at any ante natal appointments. Indeed, one did my homebirth booking. I would not have allowed internals by a student in any circumstances - basically I find them unusually painful and only planned to allow them in circumstances where me or the baby was thought to be at risk anyway, so I don't think they'd have messed about doing two.
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