Please tell us your thoughts on midwives for an upcoming meeting with the RCM

[policywonk]

MNHQ is meeting up with representatives from the Royal College of Midwives in the near future, and to help us get a sense of the issues that concern you most, we'd love it if you could post your thoughts here.

Basically, we want to know: what one thing would you say to your midwife about the care that you received (or are receiving)?

Ta x

[ListersSister]

Need midwives to have more time ante, peri and postnatally to spend with their clients. Women are rushed through appointments and don't get a chance to build relationships, which means they may worry unnecessarily or have issues that aren't picked up. Most midwives want to give good care, but at the moment there aren't enough of them to do that.

[ByThePowerOfGreyskull]

"thank you for actually listening to me and hearing my thoughts and fears"

She listened thoroughly to the thoughts I had about my first birth and did everything she could to avoid a repeat of the things I had mentioned.

Sadly she went off long term sick a few months later She was fabulous - Jackie Huggins if you are out there It is you I am talking about

[whifflegarden]

I have a lovely relationship with my mw. I wish we could have some influence on which midwife we get at the delivery.

[WilfSell]

Which midwife though, wonk? Of the many?

The community MW, lovely, wonderful, marvellous, supportive and I love her forever.

But the ones that mattered MUCH more, at crunch time? So many things...

To the fucking jobsworth who basically STOPPED my labour when I entered hospital intending a VBAC after negotiating LONG and hard to labour in the community midwifery unit and use the birthing pool (because I knew I was having another long, posterior, big-baby labour and would need not to be strapped up and monitored...) by saying 'not on my licence darling' when I asked to get in said pool, and me being in no fit state to argue, leaving me crushed and distressed and utterly lacking in confidence which ate away at me until I couldn't cope anymore. To her, I'd like to say: I blame YOU personally for that. You made the difference that sent me back to another probably unnecessary C section.

Continuity of care. Awareness of how powerful their professional culture is, when it has these massive impacts from such tiny comments and decisions. This is all I want from any changes.

[theyoungvisiter]

What I would love is a midwife who is "my midwife".

That's the biggest problem in my area. In my first pregnancy I must have seen well over 25 midwives, all told.

I had 6 antenatally. I saw 7 in labour itself. At least 10 on the postnatal ward. And 2 on my two postnatal visits.

I only saw a handful of them more than once, never saw any more than twice, and had no confidence that they had any grasp of my risk factors or wishes.

In my second labour I managed to wangle my way onto the home birth team and had a wonderful experience with a small group of midwives who SPOKE to each other. It was completely different and transformative - I felt cared for, supported, and knew where to go with any worries. Yet this kind of care is only available to low-risk women who are, arguably, those least in need of intensive support.

[craftynclothy]

We need more midwives with more time and more individual care.

I booked an Independent Midwife for my second pregnancy/birth and the difference was amazing. Long antenatal appointments where I could discuss what I wanted when I wanted (none of this "We discuss birth option at 34 weeks crap" that I had first time round). Much more time spent addressing my concerns, more support postnatally too and being able to make all my own decisions with no pressure to just go along with "hospital policy", I always felt I was making a fully informed decision.

[Lulumama]

ONE WOMAN ONE MIDWIFE

or one woman, assigned to a team of say 4 - 5 midwives, that you would meet during the pregnancy and you would definitely know someone who was delivering

try not to say unfounded , scary things to women, especially primips

classic i heard recently was 'you can't have a water birth, your baby will drown'

you cannot expect women to make informed choices if they are scared , if they are told categorically that they or their baby will die, and if the MWs own birth experiences are projected onto the woman

don't resort to advising formula top ups withing hours of breastfeeding starting if the baby is sucking a lot.

i understand fully the pressures MWs are under, but you never forget your MWs and it is better to be remembered for the right reasons!!

i have worked alongside some truly, truly wonderful midwives who have been an absolute inspiration.

[capstock]

I would love continuity of care both antenatally and in hospital but would settle for continuity of care antenatally only as this is where I felt I had least medical support.

One of my community midwives was quite old, worked part-time, and did not seem to be paying real attention to me, as she handed me notes from a previous unsuccessful pregnancy to include in my file - I was very upset about that. Generally it was hard to get midwife appointments antenatally, a few times I had to see a GP to keep up the schedule of appointments I'd been told to attend.

I have had 2 midwife-led unit water births and all of the hospital midwives were great - kind, friendly, professional - but it would have been nice to have had one in the room with us all the time, I was really surprised in my 1st labour to be basically left to get on with it until near the end, she checked in every 15 mins though once I was past 5 cm. In my 2nd labour I specified I'd be happy with a student midwife and was happy that she was able to spend more time with us.

I would have liked more support with breastfeeding when my 1st child was born, as it was a straightforward birth I spent very little time in hospital so felt a bit on my own with that side of things.

[2ChildrenPlusLA]

MW for firt birth: Why were you in a MLU when you thought you were supposed to tug the cord in a physiological 3rd stage and made me deliver on my back despite me telling you that it wasn't comfortable and I wanted to get up?

MW for second birth: Thank you for listening, and for reassuring me that my wierd birth plan was actually pretty standard in Germany.

[2ChildrenPlusLA]

Oh and MW no.2. I am overwhelmed that my birth pools was filled before my arrival and was ready and waiting. Made me relaxed the instant I arrived.

[AnalysisParalysis]

Echoing what others say above... which mw would that be?

I saw a different one every single appointment... of which there were many, having a heart condition that plays up in pg, including after the birth which was a c-section. Despite having a "dedicated, single mw" that is pretty poor imo- I saw her a grand total of twice- my booking appointment, and my 38 week appointment.

Oh, and she decided at my booking appointment to refer me to the Mental Health Specialist Midwife too... despite being completely recovered from depression for over 10 years FFS (depression which had absolutely no link to pg/childbirth/PND either)

She really didn't listen to a word I said...


The 2 midwives who have been present at the birth of my children were absolutely fantastic though (and that's not just the euphoria talking). Had a EMCS first time round which was utterly terrifying, not knowing if our baby was going to make it, and ELCS 2nd time- the mws in theatre with us each time were outstanding in the care and support they gave. (Though with first birth... that was my 4th mw during labour which in itself is utterly crap, because there's not much personal bonding going on there, is there?)

Continuity of care? What exactly do they mean by that, and when are women going to start receiving it?

[2ChildrenPlusLA]

Oh and to the Comm MW that I met at 12 weeks desperately ill with tireness, depression, sickness and heartburn. 'It is only going to get worse with backache and more severe heartburn' was not the right thing to say, and in any case you were wrong.

[porcupine11]

I had four changes of midwife during my 15-hour labour in the JR Hospital, Oxford, which wasn't ideal. They were all kind and professional though and I was never left on my own for more than 5 minutes.

The one thing I'd change about my experience was the community midwife access after the birth - when I felt I needed it most. Midwife visits are crucial in helping with breastfeeding, plus I had a million other queries saved up for her each time, but she was awful, stayed around 7 minutes each time and was always complaining about how she had no time to fit all her work in, and taking calls throughout our talks. She only softened up (out of guilt) when she failed to turn up two days in a row in the first week, and forgot to do my baby's heel prick test.

[coppertop]

Refusal of pain relief was a big issue for me too. I think a woman in labour is in a better position to judge their own pain levels than a MW.

I spent 7 hours in absolute agony during an induced labour with a back-to-back baby because the MW refused to ask for an epidural on my behalf. She insisted I was only having twinges and refused to believe otherwise until she saw my baby's head crowning. This was my 3rd baby so it wasn't as if I was a first-timer with no experience.

[cyteen]

I was extremely lucky, it seems, to have had good MW care throughout my pregnancy and birth (by which I mean largely thoughtful, compassionate, well-informed, kind etc). So what I would say is: never underestimate the emotional impact on a client of everything you do. Every decision you make to listen (or not), deal with the individual's needs (or not), provide informed advice (or not), every word that comes out of your mouth when dealing with women going through an experience that affects them so completely - it all matters.

[2ChildrenPlusLA]

Oh yes, and let her have her notes back after the birth please. Some of us like to read about what has happened. To be told we're not allowed but can make an application in writing along with a £50 cheque, when the notes are about 6 foot away is appalling.

[notcitrus]

I didn't have a problem with never seeing the same midwife twice during antenatal appts and during birth, as all 20 or so were lovely and fantastic yet practical. The fact that they didn't know when my next appt should be or where it should be (hospital or care of GP who contracted out to different GP surgery miles away for MW care, or the clinic on my road which I couldn't use because you had to be planning birth at a different hospital miles away) - that was a right pain and rather scary, especially when I was fainting at 19 weeks and didn't know what to do because I still hadn't had a booking appt. And more confusion about who should visit me after birth - turned out it was someone attached to other hospital, after MrNC made about 5 phone calls.

However like most people I know postnatal care at night was appalling - I was taken to the postnatal ward and thankfully told that my baby was about to leave special care to rejoin us. Day MW stayed late to introduce herself and tell me I would be getting my painkillers every 4 hours - nighttime staff were not in evidence except to tell us the midwives were busy if I rang the bell - it took over 24 hours to get my meds sorted out, so just as well none were needed to keep me alive... and I have no idea who these people were.

If it wasn't for the pair of cleaning staff who turned up at 3am (nurse assistants? Whatever you call people nowadays who wipe your backside and change sheets) I'd probably have full-blown PND and have had a lot more nightmares about the postnatal experience. The birth, even the bit involving my baby needing special care, couldn't have been handled better.

I've run NCT tea groups and gone to lots of local baby groups and pretty much every single person says the same - antenatal care pretty good, pernatal excellent if impersonal, postnatal shockingly bad. Like school choices, there's no point in pushing birth choices unless staff are in place to support them, and all options should be 'good enough'. And rude or dismissive staff shouldn't be dismissed just because 'they're agency' - why on earth are almost all night staff from an agency? It's not exactly unpredictable that a postnatal ward needs staff at night!

[slug]

Oh yes. Refusal of pain relief!! In my case it was because, acording to the midwife, "God intended women to bring their children into the world with suffering". Thanks. Just what an athiest needed

Also my experience, not uncommon amongst women who gave birth in my area, of being strapped to the monitors and not allowed to move because there weren't enough midwives to go around. Nor was I allowed to move. I desperatly wanted to roll onto my side and get up on my knees but I was forced onto my back and into stirrups.

These are just two of the reasons that I have only ever had one child.

[sunburntats]

Even though they must see litterally hundreds of women on a regular basis, its all new and VITALLY important to each and every one of us as individuals.

Having said that, if i could meet the midwife who was with me when i had my son, (i dont even know her name)I would like to tell her from the bottom of my heart that i could not have done it without her, she made it all alright from begining to end. She was amazing, and controlled, and calm and confident and kind and human, and just wonderful.
I think that i may have had post traumatic disorder as the birth was so horrific, i certainly put down my PND and difficulty with the 1st 3 years of my sons life down to the birth.
She is my shining light when i think about it.

[theyoungvisiter]

all the weird/bossy/rude midwives I met were on the postnatal ward. Do you think the hospital keep them specially in reserve?

And yes, the notes thing is weird. My first baby I had in hospital so I had a good nosy through the notes on the postnatal ward and very interesting they were too.

My second baby I had at home, and so the midwives took the notes off with them when they left. To this day I don't know some quite important stuff that would be useful to know for a third labour - like how long my second and third stage were, for eg.

Why is it policy to swap to postnatal notes after you're discharged from hospital I wonder? Why not keep it all in the same book?

[TaurielTest]

Antenatal MW appts - fairly good, never saw the same person twice though, so these meetings were brief and functional at a time when I needed reassurance and information.

Birth MW (MLU waterbirth) - just the one, bloody brilliant, took my birthplan seriously, picked up on my need for her to back off and let me get on with it as much as possible, can't fault her or the MLU at all. So glad to have had that choice.

Postnatal MW visit - well actually she was some kind of assistant - utterly dreadful. No idea about BF advice which I desperately needed (she told me a horror story about a baby "dying at the breast" because the mother didn't hold her breast away from the baby's nose - which was (a) clearly bollocks, and (b) not what I needed to hear in my already-neurotic baby-blues bleeding-nipples state), and she also woefully mishandled referring our DS back to hospital for jaundice (terrifying us with threats of brain damage). Complaints to the director of MW did get acted on and we saw someone subsequently who was much more qualified, knowledgeable and sane - but my suggestion more broadly would be that a first home visit, especially to women who've been discharged very soon after delivering and so haven't had support in hospital with e.g. BFing, should always be made by a fully qualified/experienced MW.

[Flame]

"thank you for shuffling my appointments to ensure I always saw YOU as you knew I had never had a constant m/w for the two previous pregnancies i wish I'd had you at the birth or at least seen you post natal "

The m/w who was with me throughout labour - you were one of the most calming people I have ever known. You knew when to listen to me knowing my own body, and when to give guidance

[ilovejonty]

Midvives should basically be kind people. If they have a tendency towards being uncaring, dismissive, rude, impatient or nasty please stay away from the profession. This is a vocation - character is so important.

I think I would almost rather have a kind, but slightly incompetent person caring for me when I feel lousy than a perfectly efficient and 100% academic one who is basically not a caring or nice person.

[IwishIwasmoreorganised]

I have been lucky I think - only seeing a team of 3 mw's antenatally during both of my pregnancies.

Unfortuntaley, just before ds2 was born, 2 of the regular team went off on long term sick (back problems and a broken arm) which meant that postnatally I saw a diffeent mw each (rushed) visit. The did the bare minimum and were generally in and out in about 5 minutes.

Een thught I had bf ds1 sucessfully, I really did feel that more support and time with the mw's postnatally with ds2 would have done my confidence and mood the wold of good (I had borderline PND later on).

The things to me that make the difference are:

Time - being made to feel that you are not an inconvenience to them because things are going well, so they really don't need to waste their time with you (antenatally and postnatally).

Objective opinions based on up to date facts and research - eg regarding risks of VBAC, not having antenatal tests, physiological 3rd stage.

Continuity of care - throughout every stage. Pregnancy and birth is a stressful period of a womans (and their families) life. Being able to get to know and trust your mw can lessen this considerably.