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

"By anonymousmw Sun 13-Dec-09 23:43:09
Sometimes I am tired of the job...... and then an amazing woman will come in who has armed herself, with our support with the knowldge of pregnancy and child bith. Then, we can help to support her through this period regardless of outcome. On those days, I love my job"

It would be interesting to look at what information a woman needs to arm herself with in order, to be fully supported by her midwives ?

And whether new pregnant ladies are given access to this essential information ?

Thank you for the update onebatmother.

Am warmed they didn't speak in tones of facilitation and pathway development activities.

They will have a hard task if they are going on the campaign trail, given the curb on spending that is upon us. They might have been wiser to do this when the treasury called a free for all last decade.

Ask a woman from Papa New Guniea what breastfeeding support they receive. 99.8% of women there breastfeed and the other 0.2% get a female relative to do so on their behalf. Why are we so different here? Why do women have to be shown how to do the most natural thing in the world? Who do those women go to when they have a problem? Their elder female relatives. These are the things we need to change - making normal, pain-relief free birth and breastfeeding the norm; teaching our daughters' about natural, active birth and breastfeeding, so midwives are SUPPORTING the transition to motherhood and not expected to do it for you. We are mant to be "with woman" not "doing it for the woman". It is not the fault of this generation of mothers, it is a result of the system and values that have been instilled around childbirth and motherhood over the last century or so. This is what needs changing.

Hi Everyone

Well we met with the RCM last Friday and had a very positive discussion.

No-one talked about pathways to change or empowerment strategies . They were already keenly aware of many of the issues that had been raised on the thread - kindness, poor post-natal care, lack of breast-feeding support for example. We got the strong impression that over the coming year they are hoping to make a bit more noise, and it sounds as though post-natal care is one of the areas they wanted to focus on.

We now understand a little better how the system works, and the points in the structure where a difference can be made. We're going to keep up the dialogue and hope that we can lend them some heft when needed in the coming year. On their part, they were very keen to use us as a sounding board so you might be seeing some stickies and surveys early next year.

We'll keep you informed as things develop. Thanks again for posting your experiences, it was incredibly useful.

Sometimes I am tired of the job...... and then an amazing woman will come in who has armed herself, with our support with the knowldge of pregnancy and child bith. Then, we can help to support her through this period regardless of outcome. On those days, I love my job.

I resorted to a an independent MW for the pregnancy, birth and postnatal care of DS2. This was after I asked the (junior) Dr at my 20 week appt if I would have a midwife with me all the time I was in labour - she laughed at me. I was classed as high risk as I'd had a previous CS but I got fed up of being seen by junior docs who had skim read my notes and didn't have a clue. They recommended some very dangerous options to me and had I not been so on the ball I wouldn't have questioned them. Give me an experienced MW any day.

I trusted my independent MW. I didn't get told what to do but would be given the facts and allowed to make my own decision. It didn't have to be protocol driven and was personal to me.

She went a long way to helping me heal myself after a traumatic birth of DS1.

She acted as my advocate in the hospital as I had to have a elective CS. My care in the hospital was fantastic but I think this was mainly because my indie MW negotiated the system for me with senior midwives. I'm afraid I had to throw a bit of a strop to get the care I needed.

However I did get very good care in hospital. There were a few blips but they were easily dealt with. And thank you to Pauline who sat with me for 2 hours in the middle of the night helping me to BF. She taught me what to do and how to look after my breasts.

I think this model of indie MW care is great for women and babies. I think that somebody at the DH needs to do some financial wizardry. I suspect it could be viable as there would be less hospital births/interventions. Obstetrics must be the only speciality where hospital care is encouraged! The rest of the NHS is about treating patients closer to home. Ironic really.

Midwives in general are great, however, the system they work in is crap. They're aren't enough of them and they are looking after way more women than they should.

Disclaimer - I work for the NHS and I think it's a great organisation. However - one size doesn't fit all.

And thank you to the midwife at the birth of DS1 who physically stood between me and the SHO who was trying to give me another prostaglandin pessary, even though DS1 was already showing signs of distress.

So really what every body else has said - continuity of care is really really important.

Yes - there are various threads about it on MN, with links to a campaign site and more information about how they work. I think it was terminated because a baby died when MWs were not 'following Kings' protocols'. There is lots of criticism of the way the incident has been reported... I don't think the ending of the contract was related to how they practice.

It certainly seems like the right model - I got the impression from their website that they operate as a close team, so while there is 24hr on call, it is not the responsibility of any single midwife.

Surely facilitating such teams is the only way to solve your family needs, and the need for continuity etc?

Me neither. Can't do it.
I need to do a job with a defined begining and end, which for £15 an hour or thereabouts, is not an unreasonable request. I know this is an ok level of pay in the bigger scheme of things, so don't flame me.

The Albany practice has had it's contract terminated I think?

I think I feel sad because I can't provide the care I want to (and know is right) and angry that midwives take the flack for the failings in maternity services. It is also hard to think that care a midwife provides can be so harshly critisised with no means of defending herself. For example, she may have been loooking after 4 women in labour at once. It is certainly true that there are problems with women's preparation for labour but that isn't the woman's fault, we should have the time and resources to dedicate to that woman like the Albany Practice in London who have staggeringly good home birth/normal birth/breastfeeding rates in a very deprived area. However, the way they achieve this is by being on call 24hrs a day 7 days a week for 6 months of the year! Not surprisingly, the midwives who work there don't tend to have young families! I love my job, but I couldn't commit to that (sorry !)

Fuck me anonymousmw, that's a shocking attitude.

I realise people have been blunt on this thread but...

Would a hospice nurse say similar things to people who'd never died before?

I think anonymousMW's last post just about sums up the problems many people have with MWs. I agree it might be time for a career change, preferably to one away from patient contact.

FIrst response was "Well excuse ME for not knowing exactly how this was going to feel! So sorry to have bothered you there in terms of actually doing your job". But that wouldn't have been helpful.

Why have UNISON made this sort of announcement, where as the RCM have...er...nothing.

I actually think the number or midwives you encounter during pg or even birth should not be relevant as long as the level of care is of good quality and continuous between midwives. Sadly this isn't the case.

During my recent pregnancy we had a team of about 6 community midwives who did the appoinments. It was clear from talking to other women that there was one 'good' one. We would always say 'I hope I get X today'.

You should not be going into labour hoping that you'll get a nice midwife. Or worrying about who you'll get when your nice midwife leaves her shift.

Getting the birth you want shouldn't be dependent on the midwife you happen to get.

babies, i ended up posting my mildest option...

"there are also huge flaws in mothers if you ask me"

I typed several replies to this disgraceful post and deleted them, when the midwifes feel this way, nothing will ever change for the better.......

Yes there are huge flaws in midwives, but there are also huge flaws in mothers if you ask me.

Anonymous mw, have you thought about changing career? It sounds like you may be rather tired of your job.

Can I just repeat what Policywonk said a couple of days ago and thank everyone for sharing your experiences - some were obviously very painful and still v raw.

We're going to distill it all into key subject areas. This first meeting is an exploratory one so we might not have a huge amount to report back at first - but we will try and get the key concerns across.

Really interesting to hear about the Albany, the Bristol Bishopston Team and also the Sheffield Pilot - all sound like excellent best practice models which would be worth looking into. I'll go and ask on the Save the Albany thread, but anyone else got any experiences of any of these? Or any more detail about precisely how they differ from the usual set-up?

Thanks again.

Questions from a midwife

But at what point do women take responsibility for their own pregnancies?

Why do we continually have to admit primips who are not in labour because they have had a few tightenings?
Why can't you understand that labour hurts and you are in the latent phase that can last days?
Why don't you get that as soon as you are admitted the clock is ticking and you are more likely to get poked, cut and intervened with?
If you've got "all the books", why do you still talk about "dry births" and want to complicate your labour with pain relief that stops you acting instinctively and then blame us when you end up with an instrumental?
Why can you not mentally prepare yourself for labour?
Why is childbirth scary? People have done it for years, successfully, why is it so much worse for you?
I cannot support you when you are so out of control, you'd think that you had no idea you were pregnant that suddenly started labouring.
Yes there are huge flaws in midwives, but there are also huge flaws in mothers if you ask me.

There has been an absolute shift from 'best care' to 'safe care'.

It happened when trusts became...well...trusts, and had to go about insuring themselves. It was encouraged by the target orientated, league table mentality that suddenly exploded in the 90's. I have to say I think the idea of 'choice' pushes us in the wrong direction also.

Look at this thread. Very few cries for choice - more cries for people to be nice. Very Simple. I think there was some research that found that, waaaay back. We would rather have people be nice to us than prvide all the services inthe world.

One thing that would make a lovely mn campaign, would be to raise the profile of postnatal care. Too long the bridesmaid, and a poor cousin of a bridesmaid at that. Yet it seems to affect our memories of parenting the most!

As always, the money goes where the glamour [and the consultants] are, into high tech, quick result areas. Completely justified and equally worthy, but sadly the money has to come from somewhere. The expensive, experienced community midwife mainly.

My views by the way, not official ones.

Stripey, what I said was specifically asking Reikizen who she felt sad and angry with when she read threads about MWs - it wasn't meant as a generalisation.

As a m/w I'd never feel angry with a woman for complaining about shit care, but likewise I may not feel angry with the m/w.

What a woman may perceive as a m/w "providing shitness and letting the side down" I can also see from the other side and I'd wonder what else was going on with that m/w.

I'm sure I have cared for women who might think I haven't provided them with enough support in labour, or given enough help with b/f on the p/n ward. But on the p/n ward if I have 10 women and babies to care for I'm aware as I'm quickly trying to get a baby latched on that the 2 Transitional Care babies I'm looking after are due a tube feed and the post lscs mums are due pain relief and someone is screaming at me 'cos they want to go home and I haven't done the discharge and someone else having a blood transfusion is due obs.

Likewise in labour when I'm looking after 2 or even 3 women in labour at the same time.

Of course there will always be the odd exception of a m/w who just is a nasty old cow but I truely believe they're few and far between.

Mostly I'm mad at the government and hospital managers for letting us be so short staffed and over worked that its not good or even safe care.

Yes there are certainly some separate issues here - I think most people would recognise that a lot of the problems that do occur are caused by the system and not midwives personally.

It seems there are wonderful midwives who are sometimes prevented from doing a great job due to overwork / bad facilities / bad systems and management / lack of colleague support etc.

There are also midwives who appear to lack basic empathy / training / competence.

And of course there is bound to be a big middle ground of unfortunate misunderstandings / personality clashes / unreasonable expectations / projection of problems on to the midwife simply because they are there etc.

I must have seen at least fifteen midwives in one pregnancy and there is only one who I would have had a 'problem' with (ie the one that didn't believe me). The rest were great, in fact one came up and formally apologised to me for the lack of postnatal care on our ward - I had been quite happy and not noticed a problem but it was nice of her to do so.

It might be interesting too to see a midwives' list of their top ten gripes about their patients

reikizen - but who do you feel sad and angry with more - the women who are complaining because they had a shit experience/MW, or the MW who provided the shitness and let the side down?

As an ex-NHS employee, although thankfully not one with a face-to-face-with-patients role, I remember well the stresses and strains of understaffing and demand for service (one of the reasons I left) - and everyone is human, after all - but some of the MW stories show specific MWs to be lacking in some basic level of understanding of how bloody scary childbirth can be.

I think the majority of MWs are great and do a great job under sometimes shocking conditions - but there are a few who could do with some basic training in empathy and patient-awareness skills, or something, it would seem.