What were/are your expectations of the care you receive from midwives antenatally? Help me let them know please!(14 Posts)
Hi there, I am a long standing antenatal teacher and am giving a talk to brand new student midwives to try to help them understand what women expect from them and also to share some experiences women have had with them - both good and bad. It would really help if you could share some experiences and they will be shared with the very people who can do things differently in the future! Thanks in advance - confidentiality will of course be assured.
1. Don't assume that if women have had babies before then they'll remember everything about being pregnant.
2. Don't leave women completely on their own in the delivery suite, or ignore them while you chat to a trainee paramedic (was on my own without DH for most of DS's labour and it was incredibly lonely stuck on the floor of the cold delivery room by myself with a tank of Entonox not knowing really what was going on).
continuity of care is important - a mum-to-be seeing a different midwife each time doesn't instill confidence as you have to go back over the same issues over and over again.
Shut the door when you have a consultation with a m2b - and read your notes. Leaving the door ajar when there's another mum in the waiting room then saying "oh, you're the mum with the down's baby" -no but that explains why the other lady's crying in the waiting room doesn't it?
Don't be surprised if m2bs are generous - I had a student midwife ask if she could take blood and I said yes. Her jaw hit the floor - are you sure?? - you're not going to learn if you don't get to practice are you, and you're better off practising on a skinny minnie with prominent veins. The girl was stunned.
Oh, and whilst you're training you may come across m2b from your university of study - academics, librarians, catering staff etc do have babies. I work in a uni and it was obvious the student midwife (from the same uni) hadn't considered that she might meet a staff member and it floored her. On her first day on community midwife placement as well. we both had the option for her to leave the consultation if we wanted to.
As a terrified first time mum I would like my midwife to be very assuring, calming and appear confident and self assured with what she is doing. Don't presume that all women know about everything to do with birth and pregnancy - some of us literally know nothing. I am a teacher and our advice is to always treat every student as the individual they are - however many students we have. And if it's possible I would love for them to make the process seem 'special'. I am aware that they must have tonnes of patients and will be over worked underpaid and stressed beyond measure - but at the same time - getting pregnant is such a special and unique experience and it would be lovely if you could make us feel special - I know they see it everyday - but we haven't! So if they could 'fake' a little bit of enthusiasm for our situation it'd be lovely. As opposed to being very conveyor belt like or not interested.
Want to add my midwife is lovely!! Very matronly and a tad scary - but I really get the sense she knows what she is doing and will take no nonsense!
Please listen to the mum-to-be!! When I saw my midwife early on in my pregnancy I warned her I usually have high-normal blood pressure and white coat syndrome, which has been investigated in the past, and that my blood pressure is even higher when measured in a medical setting.
When she found my blood pressure was raised, she started talking (in a not very calming way) about how I had to go to hospital immediately, how I was likely to have a stroke, and how I was harming my baby. Not very helpful and it really upset me (cue floods of tears), especially as I had taken the time to explain to her beforehand my personal situation (I'm well aware of the risks of high blood pressure, especially during pregnancy, and monitor it at home as a result of my history). Everyone is unique and won't always conform to the ideal (<120/80 in this case). I think communication is really important!
At 34 weeks I went to the hospital as my blood pressure was higher than usual for me (identified as a result of me checking it at home) and one of the midwives gave me labetalol. When I asked what sort of blood pressure medication it was (i.e. ACE inhibitor, beta-blocker etc.), she said "one of the good ones". That's not what I meant (before giving drugs to someone it might be useful to ask the doctor what it is). Also, no-one discussed it with me beforehand, I wasn't told about potential side effects, no one checked if I'd had anything to eat recently (it was about 4am at this point and it's supposed to be taken with food). Again, I think talking to the mum-to-be and telling them what is happening is so important! I was accused of refusing care because I was asking questions about my treatment - that wasn't the case - it just meant I wanted to know more about what I was putting in my body and how it might affect my baby.
If an m2b complains of throwing up during the night during the 3rd trimester, don't dismiss it out of hand as a tummy bug (stand-in midwife)
In some things you will know better than the doctors. Wear your authority with confidence and grace. (My usual midwife, who overrode the dr and admitted me. DS was born by emcs at 7 that night...)
Re-reading this thread it's all coming across as a bit negative, so I just wanted to share a positive one. My midwife for my first DC was absolutely amazing. I'd been in on-off labour for four days (very painful contractions anything from 10 to 40 minutes apart for 96 hours) so by the time I was getting them five minutes apart I was knackered. And when it came to pushing after another 13 hours I just had nothing left. But the MW was so supportive and so encouraging and tried so many positions for me to labour in that she convinced me we were in it together. She was with me for 14 hours (so must have been well into the next shift) and I don't think left me for more than 10 minutes at a time. What finally worked, position-wise, was me on my side with one foot hooked over her neck while she lay on her side in the opposite direction. She helped me like that for an hour and a half until DD was born. She was awesome.
And two days later she got the biggest Thorntons chocoholic hamper I could get off the website.
My named CMW has been excellent. She is enthusiastic, listens to me, explains stuff properly but is never patronising (i.e. asks me what I know about stuff first so she's pitching it at my level). She writes notes which accurately say what we've discussed but doesn't spend the majority of appointment on paperwork.
Unfortunately a lot of my appointments have not been with my named CMW and the stand-ins have mixed. One in particular quite upset me. She took calls while I was there & didn't apologise; asked questions about things other HCPs had written in my notes aggressively (hospital MWs had booked me in for an iron test I didn't need & she spoke to me as if I'd done this just to annoy her), didn't give me any chance to ask questions or tell her how I was, didn't tell me what the results of my urine or BP tests were, & started filling in someone else's paperwork before I'd left & didn't say bye. Oh & didn't give me my MATB1 form.
If I could have had my named CMW for every appointment I'd be universally happy with my care but I appreciate this is impossible with annual leave, night shifts etc.
I've seen loads of students during this pregnancy too. One was probably very new as she didn't say a word other than hello but the others have been pretty good. Chatty, enthusiastic, got on with the tasks they were allotted by the qualified MW but also checked what they were doing was right. I think it's tough as a student to put the patient at ease by appearing confident whilst also making sure they get the reassurance they need that they are doing things correctly but the students I've seen have got that balance right.
A word about unusual pregnancies! During my pregnancy with a donor egg baby, I had this handled brilliantly by my named MW (congratulations! This makes it even more special that you're pregnant but actually apart from a few extra checks it's exactly the same as any other pregnancy;) and terribly by my HV (asked the donor's ethnic origin so she could write the baby's 'true nationality' on the forms, wrote doner baby on everything so I had to ask for replacement pages for the red book as DS should choose who he tells, not have it emblazoned on the things the school and other folk may look at in years to come). In other words, be informed of the legal status of donor babies and talk to the mum2be about how she'd like it handled, and we'll love you forever.
I've only managed to see the mw who I have the mobile number of/who is on my notes once. She was lovely then and I'd really like to be able to see her all the time but have so far (18 weeks) seen and spoken to a different person on every occasion.
Other than that, most are good, but as this is my first time it would be nice if they offered more information rather than waiting for me to ask for it; I don't know what I'm supposed to be asking!! I agree about making it sound like they're actually interested in you and your baby too; the first mw I saw pretty much just wanted me out the door asap.
Oh and if somebody is worried and leaves you a voicemail it's probably best to ring them back asap rather than have them sat worrying that they are miscarrying/something is wrong for hours for no need. (This was last Thursday and I still haven't heard anything so gave up and went to the gp).
My MW is lovely. I've seen here throughout my pregnancy and she's only been late a couple if times, when she's had a student with her which is understandable. She remembered me straight away and used my nickname from the first appointment- no reminder necessary. I feel she knows me and I'm confident in her ability as a midwife. She hasn't just given me a load of leaflets or just got me to fill in a load of paperwork. I guess a lot of it comes with experience but a smile and an understanding ear can go a long way.
Seeing the same MW throughout care would be nice. But thats not really in the hands of single MWs so I dont blame them.
The main thing I would say is that if there are complications with the pregnancy, dont sugar coat them. When I had placenta previa at 20 weeks yes there was a very good chance it would move. And it did.
But that didnt stop me googling and worrying for 12 weeks thinking I might have to have a caesarian and not having a clue what that would involve.
If the MW had taken a few minutes to explain the outcome either way it would have saved a lot of worrying.
Not technically antenatal, but after delivery dont assume that every woman wants to sit for two hours having skin to skin in a room on their own.
I was cold and wanted a bath.
My midwife with dc1 was wonderful and looking back its because she listened to me, made eye-contact, was engaging and explained without being patronising. She was also confident which led to me being confident that I was in good hands.
My mw for dc2 was awful. I feel that she was inattentive, didn't listen to what I was saying, left no time for questions in consultations and seemed permanently distracted. She didn't make eye contact and spoke through me rather than to me. Unsurprisingly I have requested another mw for this pregnancy.
I am not particularly bothered by seeing different midwives throughout the pregnancy, for me the attitude of the one who is with me there and then is the most important.
I am considering retraining as a midwife as I think that overall they do a massively important job and have the potential to make a HUGE impact on a family. I think that many people in most jobs forget that, as it becomes mundane, but with midwifery I think it might be even more important to remember what a potential you have to make an amazing contribution To someone.
My CMW is absolutely wonderful. I'm on my third pregnancy in 5 years and have come to know her and her 'style' quite well during that time and I'd like to share some of the things she does that make me feel confident and listened to as a pregnant woman.
- We know you are very busy - don't show it. She always appears to have time to exchange pleasantries and for me to ask questions even though I know she's pushed for time. She never, ever makes me feel rushed but is always able to end the appointment within it's allotted time.
- She remembers things about me from one appointment to the next. She always looks back over the notes when I arrive so I suppose some of that jogs her memory but she makes me feel special and unique.
- She compliments something baby-related about me every appointment e.g. lovely active baby, nice shaped bump, ability to labour well, that sort of thing. Makes me feel I'm doing pregnancy well.
- Listens making eye contact, takes me seriously.
- She shares little things about herself, how long she was in labour for, stories about when her children were babies. Nothing too personal but enough to make me feel she's a real person and has been in my position herself.
- When the babies are born and she comes out to visit at home she always says how beautiful they are, even if they're not really......(although mine both were and of course this one will be too!!)
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