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What makes a good midwife?

(51 Posts)
Crazycupcake Thu 27-Jun-13 13:20:49

Based on your experiences (good and not so good), what skills and personal qualities do you think midwives should have? You have the chance to influence the training of future midwives by sharing your thoughts. I work at Bournemouth Uni and want to hear about mums' and mums-to-be, experiences/thoughts about midwives. N.B. Please don't post any info that would identify individual midwives. Thanks

Pootles2010 Thu 27-Jun-13 13:23:28

Oh gosh, tbh I'm not sure if its something that can be trained?! I had two brilliant, amazing midwives, who were just lovely, very kind and understanding, but also capable and filled me with confidence.

Also had one extremely scatty, perfect nice but quite useless one, who was forever forgetting things. I can't see how any training could fix that?!

MorningHasBroken Thu 27-Jun-13 13:49:55

Briefly checking notes before an appointment!
ds was diagnosed with serious congenital heart problems at our 20wk scan. I used to hate bowling up to the midwife appointments to a breezy 'so it's all going well then?' and having to go through the whole sorry story and plans yet again. This happened every time. A quick glance at the notes before I walked in the room would have saved me a lot of heartache and them a lot of embarrassment.

purpleaura Thu 27-Jun-13 13:58:59

I think kindness, skill and experience are top of my list. And understanding is so crucial too... I guess MW are so used to dealing with mums-to-be that perhaps sometimes they forget what its like being a 1st time mum... its all new to us! At my booking appt, I got really frightened by the MW reeling off the list of potential birth complications due to my (slightly) raised BMI. I was also asked to choose where I wanted to give birth and decide whether or not I wanted the injection to speed up delivery of the placenta. I was completely phased by it all and felt completely overwhelmed. Being only 12 weeks pregnant, I hadn't even thought about the birth yet. So I guess my main ask would be understanding and empathy.

embaker112 Thu 27-Jun-13 14:11:45

In my experience so far, it seems that the better midwives are not necessarily the more experienced, but the ones who give you the time of day to listen and not make you feel silly (especially if it's your first baby and you have no idea what you're doing!)

HumptyDumptyBumpty Thu 27-Jun-13 14:18:39

Kindness for sure, and empathy. And remembering to tell you everything (mine didn't tell me to have a full bladder for scan - luckily I am a keen obssessive MNer, so I know, but she probably ought to have mentioned...
Also, everything embaker said.

newmumsuchfun Thu 27-Jun-13 14:19:09

i had 5 during my labour and they were all amazing purely because they were friendly, sweet and reassuring. They all seemed as though they genuinely cared about me and chatted to me on a personal level so i felt they were friends.

syl1985 Thu 27-Jun-13 14:22:27

That's a difficult question.
I think the answer is different for everyone. Pregnancy, birth it's such a special time in your life.

Everyone will have special needs and being nice/kind is different for everyone.

Then there're people you just feel more comfortable with for no reason what so ever. It's just the way you feel with them. Yet someone else can feel totally uncomfortable with the same midwife.

Apart from that any midwife needs to be fully trained and know how to react on the moments that action is needed.

TravelHappy Thu 27-Jun-13 14:24:21

Another first-time-mum-to-be here. I think it is good that at my surgery we see the same midwife every appointment. The only thing is that she can't seem to explain what is the process from each appointment forward. I see a consultant as well as the midwife and each time I'm sightly surprised by what the appointment is about when I turn up. Also, no one seems to be able to answer me on when we have the discusison about labour and birth - "the consultant will talk to you about it" and "the midwife will discuss this with you". The obligation should be on both the consultant and midwife to work together and if training on "how to liaise with the hospital on consultant lead care" doesn't exist then it should. In terms of personal qualities - not being judgemental, listening skills and efficiency are vital. I can't fault my midwife on these attributes.

ExhaustedMamasita Thu 27-Jun-13 14:30:36

As a first time Mother-to-be, I’ve noticed huge differences between good and bad Midwives. The good ones are gentle, spend time talking you through what’s to come, explain answers in detail and make you feel at ease with friendly chit chat. The bad ones are unprepared, blunt, presumptuous and treat you like you’re a nuisance. This is without doubt one of the most amazing/ overwhelming/ frightening experiences of most women’s lives – lack of sensitivity to an individual’s needs can turn something so happy into distress. After waiting literally two and half hours yet feeling completely and utterly beside myself with excitement at the prospects of having my first baby, the Midwife at my booking appointment interrupted me during a question I had to tell me she was hungry, so could I get a move on. I had another Midwife answer her mobile phone in the middle of an appointment and have a fully-fledged conversation with what sounded like a friend. On the other hand, I had a Midwife who took her time to answer each one of my questions and made me feel like I was on on cloud 9 by the end of it. It’s the good ones that help make the experience magical.

ReallyTired Thu 27-Jun-13 14:43:27

Most the midwives have had have been wonderful. It is nice to have continutity of care so that women can build up a relationship with a particular person.

With DD I had the same midwife for two ante natal care appointments, homebirth and postnatal care (all on the NHS).

With Ds I had a change of midwife for antenatal care as I moved area. The second midwife was quite aggressive that I had had tests at different times and made it clear that she thought my ante natal care was quite inadequate. My lovely GP did point out to her that there are plenty of happy healthy babies in Reading so their ante natal care can't be that bad.
As ds was born on new years eve, I had a different midwife every time for postnatal care. All these women were lovely but I would have liked some consistancy.

Prehaps we need to look at systems so that midwives aren't over stretched and can deliver the best care that they can.

newmumsuchfun Thu 27-Jun-13 15:26:54

the midwife i had along the way of my pregnancy i didn't like because she was 'blunt' and 'dismissive' of my worries - but i think that was just her personality. for example i asked if there was less of a chance of miscarriage the further along i was (almost in tears) and she laughed as if i was stupid and abruptly announced that babies could die at any stage.
HOWEVER - considering how overstretched they are - the ones i had during my labour were sensational. They had a way of making me feel special even though i was probably one of at least 5 women they were looking after.

WallaceWindsock Thu 27-Jun-13 15:35:33

My memory of DC2s labour is blighted by the mw I had. She was training another mw and was far too brisk and unsympathetic. Internals done badly, going in and out like she was in a race. Bloody awful. Reducing me to tears over the fact that contractions had stopped again even though I'd got to 5cms, was in agony and had explained I didn't get regular contractions with my first birth. She made out it was my fault they werent regular, made me cry and sent me home and was then shocked when DP had to rush me in a few hours later still with irregular contractions but a baby hanging out of me. Stupid woman still tried to say I wasn't in established labour but then I started to push and she had to concede she was wrong. We left 7hrs after the birth just to get away from her. Horrid.

WallaceWindsock Thu 27-Jun-13 15:43:00

I think she just made me feel like I was being a drip. DP asked her to leave the room at one point and asked to see the mw in charge. She was lovely and sympathised with now exhausting and awful I felt considering I kept coming in with labour which was established only for it to stop again.

With DD I had lovely mws. Laughed with me, told me I could do it, boosted my confidence, held my hand and got me through it. In the pushing stage with DS the mw took the gas and air off me forcibly, told me I wasn't even trying and sneered at the pushes. I presume this was an attempt to make me get angry and push more but it just made me want to cry. Luckily DP was there cheering me on and I got through it but I still feel angry that the birth of my son was tainted by the care I received.

PumpkinPie2013 Thu 27-Jun-13 15:58:33

I'm only 18 weeks with my first so no experience post birth but so far the midwives I have seen have been absolutely fantastic!

I see the same one for all antenatal appointments (have seen her colleague once as my mw was on holiday but she was equally good) so get consistency.

They've been brilliant when I've had concerns/questions and seen me for an extra appointment due to early onset PGP. They referred me quickly to an antenatal doctor to get a Physio appointment sorted and it's all been done very efficiently.

I saw a mw at 14, 15 and 16 weeks due to the above and each time they've listened for and found the heartbeat for me as well as dealing with the PGP issue which made it all much easier to deal with as I felt relaxed and like I had something positive at the appointments. The antenatal doctor was also very good and she is seeing me again after my 20 week scan to review the PGP.

I think midwives need to be understanding and caring and take time to reassure mums at an exciting but sometimes rather nervous time!

Having said that, I know in some areas they are very overstretched and this must make it very hard to deliver the best care so more midwives should be provided where needed.

BraveLilBear Thu 27-Jun-13 15:59:47

Great question OP, and one I think can have a real impact on women in their care - particularly first-time mums who come into this experience 'blind'.

I've seen 3 midwives so far, one was amazing - kind, caring, upbeat, asked questions and listened to the answers, I wish I could see her every time! She didn't patronise me or make me feel small in anyway. The one I've seen most is a lot older and has clearly been round the block! She is kindly enough, but has a telly-offy air that borders on patronising at times - I'm 33, not 15! Tho she did go the extra mile for me to help with a certain issue.

The third one was terrible. Literally ticked the boxes and that was it. Didn't communicate what she as doing or what she found - I have no idea if baby is engaged or not as she didn't write anything in my notes, for example. I mustered the coverage to raise my concerns about internal examinations and she looked at me like I was a stupid little girl and basically said 'it's tough - there's no other way round it, get over it'.

I've yet to go through labour yet, and it worries me that so much of the labour experience will be decided upon the personality of the midwife.

I think it is also a very good idea to treat every woman with the same sensitivity they would accord to someone who has been through a traumatic sexual/intimate experience. Just because a midwife sees things every day and is very matter-of-fact about internals etc doesn't mean that it's the same for all of their patients.

In a busy, fast-paced environment, I can see how it would be easy to forget that, but it can make a huge amount of difference to both psychological and physical outcomes.

sparkle101 Thu 27-Jun-13 17:12:57

Through the antenatal care I would appreciate seeing the same midwife rather than bring shared between the two, it is easier to have continuity and not have to repeat the same facts at different appointments. That being said I only want the nice one who listened to my quite frankly ridiculous crying about getting the house ready and booked in an extra appointment to check I was okay. She also joined up quite a few dots in my notes to identify I had gestational diabetes. She takes time and has loads of patience and genuinely seems interested.

In hospital giving birth with dd the best midwife was the first one I can't across, I was petrified and really upset with my contractions, she found me a bed and took time to calm me down even though I really wasn't that far gone. She explained everything and showed dh what to do when I had a contraction.

Later on when I was moved to active birthing area she popped into see me as she was on her way home, she'd only popped into see I was okay, whilst she was there they had to break my waters, she stayed with me and held my hand whilst they did so, whilst dh had something important to do outside!!!!

Shylepite Thu 27-Jun-13 17:59:26

Some great points so far! All I can add really is that if they are busy or having a bad day being a bit snippy with the women in their care will have a really bad impact on them and they will always remember it! It may just be another day at work for them but for the people on the receiving end it is probably the most vulnerable they have ever been and the care they receive can mean the difference between a wonderful happy experience and a scary traumatic one.

Hope2014 Thu 27-Jun-13 18:20:01

Bad points so far:
- Answering the phone repeatedly whilst I sat there like a lemon in my booking appointment so I was hearing about other ladies' issues -has made me worry that someone could be there when I phone (confidentiality issue).
- Being a bit one-sided in her description of the combined test (against it) - a good MW should give a balanced view.
- Putting the wrong dates in my notes.
- Not booking the scan (I had to call up at 11 weeks and chase).
- Telling me I could try cranberry extract to prevent UTI and probiotic drinks to prevent probs after antibiotics but telling me to google both of these because she wasn't sure if you can actually take them in pregnancy.

Good points:
- Coping well with a crying woman on the phone
- Always answering the phone (a good and bad thing it seems!)

What I would like is a MW who knows the latest recommendations (rather than telling me to google) and can empathise that this is my first and I'm scared/excited/terrified/excited all at the same time. Oh and not assuming that I know why I would choose hospital or home or in fact that I know ANYTHING grin) (I know NOTHING!)

RJM17 Thu 27-Jun-13 18:43:22

I am a first time mum but during this pregnancy I have been at the hospital a few times seeing a midwife and the only one that I found bad was when they thought I didn't have enough fluid around the baby and as we were walking down the corridor to see the doctor she just casually said "you do know of this is right then there is nothing we can do and baby won't survive" thankfully she had gotten it wrong anyway but just think she could have been more tactful in giving me the news. Was also told about the issue in the waiting room in front of lots if other people by the same midwife.
Yet all the others I have seen have been fantastic and really caring! I think a calm nature is massively important as them being calm tends to calm me as well xx

glendatheveryexcitedwitch Thu 27-Jun-13 19:22:13

I'm doing my midwifery training (1st yr) and I'm really heartened to see the things you all think make a good midwife are things I think I have and also believe make good midwives.

I work on a maternity unit and over the years have met some amazing midwives who I aspire to be like as well as (unfortunately) some very rude, panicky midwives.

After having 3 children and being classed as high risk due to my bmi I want to be a midwife who offers unbiased information so women know they can make better choices and not be herded into what is best for drs. I hope to be approachable and be an advocate for women giving them the best possible experience even when it doesn't go to plan by keeping them informed and empowering them!!

Being a midwife is a privilege!!!

carlyvita Thu 27-Jun-13 21:25:59

I saw more than 10 different midwives with my first, some bossy, some patronising, some kind, one AWESOME, one so rude we had to ask her to leave, one stinking of fags(!), one nice but nervous, many more I won't remember.

I had a good midwife for my second, she was my advocate and companion throughout pregnancy, labour and the post natal period.

A good midwife helps to distribute and ensure access to balanced, unbiased materials that help a woman to make her own choices.

A good midwife will always be at the end of a telephone or email to support her clients.

A good midwife treats a woman as her equal, not her patient.

A good midwife knows her clients so well that she has no need to rifle through notes for information, ask when DD is, or your DOB.

A good midwife works one-to-one with the family to ensure continuity of care and trust to fully develop.

I feel so blessed to have had this wonderful care from such an experienced midwife and it saddens and angers me that this "gold standard" of Independent Midwifery care will be made illegal in the UK come Autumn.

ohmeohmyforgotlogin Thu 27-Jun-13 21:31:36

- are aware of their own assumptions and prejudices and leave them at the door
- respect women's bodies and understand that birth is a natural process that our bodies are made for. They need to be the guardians of safety and not intervene unnecessarily
- they should research and question what they are taught eg due dates, effects of ultrasound, rupturing of membranes. What do they do it? Is it for the benefit of the hospital system of the baby?
- don't assume partners ae ineffective. Help them to support the partner
- recognise that it may be another day at the office for yo but this is a once in a lifetime event for this family. This baby will only be born once, respect that space.

I could go oand on and on. Thanks for asking

CitizenOscar Thu 27-Jun-13 21:41:11

I'm getting towards the end of my second pregnancy and I split my experiences into 3 very distinct phases:

1) antenatal - no midwife has left any lasting impression, good or bad. Never seen the same one twice.

2) during labour, my midwife was brilliant. Very empathetic and seemed to intuit what I wanted (eg found me a floor mat & birthing ball) and encouraged me to keep going. Made sensible & timely suggestions but left me feeling like I had choices (eg about breaking waters) and let me & DH get on with it when we didn't need her.

She was quite a new midwife, too, but I don't think I'll ever forget her.

3) postnatal - saw A LOT of midwives as was there for a while. Bad ones lied on my notes and said they'd explained things that they hadn't. Other problems were down to being over stretched (promising to help me with something but not coming back).

Good ones took their time. Most memorable were a male midwife who sat with me in the middle of the night and helped me try different positions for breastfeeding, and found me a pump to make the blood transfusion quicker (no one else had thought to do that); and an older midwife who sat with me for ages explaining signs the baby needed winding and different ways to do it. Realising they had knowledge and experience that they could share with a new first time mum, and doing it with kindness and clarity.

MummyOfSunbeam Thu 27-Jun-13 21:47:15

Warmth and supportiveness. My labour midwife had neither - all briskness and impatience if I whimpered (back to back labour and very long, five days).

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