to wonder if anyone actually cares about choices in pregnancyand birth and the state of maternity services in the UK?

[TeggieCampbeggBlegg]

Do women want to have continuity of care?

Do women care about who looks after them in labour? Do women want to be cared for by the same midwife (or midwives) before, during snd after, birth?

Do women want to be offered choice or just be told what to do?

[Flisspaps]

I wanted continuity of care, cared who looked after me during and after birth and wanted a choice.

The problem is, it only becomes an issue once you're 'in the system' so to speak, and maternity services are only used for such a short time by each woman that often, by the time you realise that these things really do matter, it's too late and you've already given birth!

[Tubegirl]

Yes and no personally. I would have liked the same midwife throughout, I think thats so helpful with being able to trust your healthcare prof and feel able to contact them to ask questions. Also I suffered with ante natal depression during my first pregnancy- I never saw the same hc prof twice and had to explain things over and over. I was able to do that but imagine had my depression been worse I may have ceased to engage. In terms of the choices, I've little experience of this. I have two dc. The first pregnancy was complicated so I was told to have hospital birth and so it led to the second being hospital birth. Those were decisions made by profs with no input from me. In my case that was right and I ddn't have any strong feelings on it other than wanting baby to be born safely. I do understand however that the method of birth is more impirtant to others and in my view where there is no good reason to deny choice then there should be choice.

[emsyj]

I was very lucky to have the same midwife throughout my second pregnancy, and she also delivered my baby. I think it did make a difference. It is not a service that is widely available though.

[cory]

I did care about labour- but not necessarily for continuity in care; it isn't the most important thing for every woman. I was just as reassured by seeing a new person as long as they were pleasant and intelligent and had read my notes.

Tbh the first midwife who saw me in labour was a grumpy cow: I was delighted when her shift came to an end. Being cared for by her in the name of continuity would have been a nightmare. Rather half a dozen new pleasant faces, than the same unpleasant one. But if you could stipulate that you could have continuity of care with the most charming midwife in the practice, then I'd be all for it

I think these threads sometimes tend to assume that all women who care about their labour experience want the same thing.

[JollyYellowGiant]

I'm not bothered about continuity at all. I just wanted someone in the room who knew what they were talking about.

This time I'm fed up of my community midwife already wouldn't want her at the birth.

[TeggieCampbeggBlegg]

Very true cory.

I've heard it argued that what matters most is kindness, no matter who from.

But you can't research kindness and write a policy on being nice.

[TeggieCampbeggBlegg]

But....

Do you want to be given the choice?

[shellshock7]

I have one DS and am v early days PG again and have thought abt this...I really am not bothered abt continuity of care for antenatal appts and post birth, but my MW stayed for the whole of my labour (the hospital part!) way after her shift had finished and that was so important to my state of mind, which was in a bad way tbh . So much so the first thing I'm going to do is ask if she is on shift, she made that much of a difference to me

[tomatoplantproject]

Had the same community midwife all the way trough which was helpful - didn't have to keep going over the same ground with her. Didn't care about hospital - I was booked into the midwife led centre but went straight to the labour ward when meconium in waters, and had a lovely midwife who was v supportive. However dd was breech and it was only picked up by dr when I was 5cm. I would have given up rather a lot to have had a midwife suspect a breech earlier so it wasn't such a shock.

[bigkidsdidit]

my last birth was in a big London hospital adn I didn't see the same midwife twice, not throughout all my appts, and I had three during the birth. I didn't mind at all.

However, I had an easy pg, a supportive DH, and no issues such as alcohol / drugs / domestic violence etc, nothing I might want to discuss in confidence. Saying something difficult to ten different people might be very hard.

[shellshock7]

And jolly I agree actually, the thought of the community midwives delivering my baby gives me the shivers

[cory]

"Do you want to be given the choice?"

Depends on what the choice would look like. If it was "do you want the same midwife throughout" (but not know who she was), then I would probably say no, just in case she wasn't very nice. And they're not going to let you take a look at your midwife and then let you decide, are they; that would be unmanageable.

[cory]

I would be happy for other women to be given this service if they care about it, but I would also want to know how the choice would affect other services which I might care more about. If it costs more money, then what else would have to give?

[HoldMeCloserTonyDanza]

I agree very much with cory.

Prior to DDs birth I thought I cared about continuity of care, and I was supposed to be getting it as a part of the midwife scheme I was on. As it happened, I went into labour in the middle of the night on a national holiday and my midwife wasn't available. I had a hospital midwife I'd never seen before. And she was amazing. Within a couple of minutes of meeting her I was reassured, comforted, and felt like I'd known her all my life.

That's a skill. And it's a really important one. I don't care who delivers this baby, as long as they are as good at putting a strange patient at ease. And most midwives are.

I also agree that it's only a minority of people who research different labour choices. The majority of people don't, and there's nothing wrong with that.

Having given birth abroad I think the NHS does a really great job of providing a host of different, free options to women. It could certainly do better but women here are very, very lucky and have far more options than in some other first world countries. I am really glad to be living here for this pregnancy.

[TeggieCampbeggBlegg]

I suppose I mean the coice of what sort of care pathway;

Continuity

Same community mw but different one for birth

Dr appointments, clinics etc, with or without mw input.

I'm just pondering really. (with a sore head from all those walls i've been beating)

[Meglet]

I'd settle for decent post natal care, especially for post CS mums.

[TeggieCampbeggBlegg]

Yes. Postnatal care is crap minimal.

[GoatBongosAnonymous]

If I had not had continuity of care in having the same community midwife throughout, I and my baby might not be here today. Unlike the gp who did not know me at all, she spotted that I did not look right as she knew how I was usually.

I'm afraid I can't comment on continuity into labour as I never got there.

[purrpurr]

I'd like the choice. I've chosen a maternity unit very near to my home, but ALL the community midwives are based at a hospital in the nearest town. They have NO idea about the unit I've chosen and get extremely snotty with me every time I ask a question. The unit itself is known for being clean and modern, the opposite of where they work. I really feel like they believe I'm Up Myself because I chose the unit. It's frustrating and upsetting. I feel like I'm preparing for labour in the dark. None of the midwives know ANYTHING about the facilities or procedures of the unit. I haven't even been able to find out about antenatal classes or anything.

It's distressing. I would have chosen anything but this.

[FryOneFatManic]

I saw a variety of midwives through both pregnancies and births, but they were all nice and reassuring so as Cory is saying, it's the attitude, rather than seeing the same one which is important to me.

[TeggieCampbeggBlegg]

When i am in charge of the world and while i am overhauling the midwife education system, attitude will be top of the list of requirements.

[NotYouNaanBread]

I was a bit annoyed never to see the same midwife twice for my antenatal appointments because I had to explain the background to an aspect of my health every single time & get all the sympathy etc etc when all I wanted was to hear the heartbeat & leave.

Couldn't have cared less during labour.

[Caitycat]

Had a great community midwife and would probably have asked for her if given a choice. But chose a smaller town hospital rather than the manic city hospital she was based at. It was the best decision I could have made, the midwives who delivered dd were perfect in every way, experienced, competent and caring. I would have been wrong to choose my less experienced community midwife over them and am glad I didn't get the choice. Might be different if I hadn't had such a good experience though!

[ENormaSnob]

I am a midwife and also 37 weeks pregnant with dc4.

I think continuity is overrated for both patient and hcp.

I don't care who looks after me in labour as long as they are knowledgable, competent and kind. Listening and explaining are vital for a delivery suite mw imo.

Postnatal care is shit as there are no where near enough staff per number of patients, there is a massive increase in the workload of said staff, an awful lot of very high risk mums and babies mean that staff are stretched to capacit and beyond.