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

I would say that I was blessed to have recieved care from TWO amazing midwives with the ALbany Practice in Peckham. And to thank them and tell them that what they do is what all women deserve. And that I am shocked that they are being hunted like witches for providing the best possible care they can to women.

They offer continuity of care - I saw my primary midwife throughout my pregnancy. She would come to my house for up to 2 hours if I needed it! She knew all my kids names.
She made me feel relaxed and confident. She supported me during my labour.
Aftercare went on for 6 weeks. 6 weeks!!!
She came to my house the day after birthing my son and whenever I needed her.
They let me make decisions and supported them.
I always felt safe that if something went wrong they could handle it.

It is crucial that women get to know and trust their midwife.

ONE woman ONE midwife.

to anonymousmw (and your friend who posted on your behalf). I feel the same, sometimes I feel so sad and angry when I read some threads on mnet about childbirth and midwives. You are absolutely right, they do sound like they hate us don't they? Everyone has rights, except the midwives who have all the responsibilities. I just try not to take it personally and keep doing the best I can (even if I am late to pick the kids up, have to go shopping after a 14 hour shift where I have had no break and not eaten properly and have needed a wee for the last hour and haven't seen dp for days, and am acutely aware of how bloody dangerous the understaffing/low morale is in the unit where I work which is due to close, hasn't been refurbished for 15 years and only the consultants know what their future employment will be). Oh dear, I'm not sure I meant to make it that long but we are all in this together and we need to work together if women are to get the service they deserve and we are desperate to give them...

Question from a mum

To the midwife who was with me for the labour: thank you, you were really good, but why did you leave 15 minutes before the baby was born? It was obvious it was nearly over, I know your shift was over, but couldn't you have stayed a little bit longer?

Reply from an excellent but disgruntled midiwfe who will kill me for posting it.

Maybe the midwife had to get home or her childminder would charge her extra? Maybe her husband had to leave for a night shift? Maybe she had a train to catch and missing it means when she has to be in for a long day tomorrow she will only have had 6 hours rest between shifts? Maybe her crystal ball was broken and she didn't know it was definitely going to only be 15 minutes? Maybe if she stayed for the birth she would have then been made to do all the baby checks and paperwork before being allowed to go home? Maybe it is an insurance issues?, some people believe you are not insured by the trust when your shift ends unless they have asked to work extra? Maybe she was just plain exhausted and starving?They hate us they really really do. They are angry with us. They blame us for every wrong. Noone is taking any responsibility at all, that honour falls to us the midwives. They even blame us for the dangerously short staffed wards because WE should be shouting louder about it. WE ARE WE ARE WE ARE but noone is listening. THE WOMEN need to direct thier complaints and demands at the NHS, at the trust they gave birth in, at the government. Not me when all I have ever wanted is for women to enter and leave pregnancy unharmed, physically or emotionally.

PS Treedelivery, you are right, there are many positives to focus on too. I suspect than many on this thread, like me, have remembered and focused on the worst and scariest bits, because unfortunately that's what people naturally tend to do.

Not being 'believed' at first for me was actually the worst bit, although ironically I went on to have a very painful and not particularly straightforward birth experience. However the midwife who attended throughout was brilliant, and I wouldn't have a single negative thing to say about her.

From talking to a lot of friends who have recently had children, one of the worst parts for many has been a perceived 'gap' in care and concern between going into labour and being 'believed' and admitted to the delivery suite.

For example being sent home from hospital without being examined, and then it turning out that they were further along than anyone thought and having to rush back and it being too late for pain relief.

Or in my case, going into labour very quickly after induction and the midwife saying 'oh it won't happen for hours yet, I can tell just by looking at you that you're not in labour'. After about half an hour of being fobbed off I had to get nearly hysterical with pain and fear before anyone examined me and I was already at 6cm. I'm REALLY not one to make a fuss but it seemed that their barometer of whether you are in labour or not is how much 'fuss' you make.

I guess the reasons for this include the fact that the NHS doesn't have the resources for hand-holding in the first stages of labour, and just want to get you in and out as quickly as possible. I'm guessing though that this leads to many women starting labour in a far more distressed state than they would have been with a bit more support, which leads to more problems and bad experiences all round.

Oh noooooo - I thread slayed good didn't I?

Someone come and post for heavens sake!! Am ashamed of my mega rant and need it loosing in the pages

Will be really interested to hear what they are like and what they have to say PW. I'm thinking corporate babble myself. It's amazing how many times people can say empower, facilitate and proactive in half an hour. Hopefully not though, and the words said will add up to a meaningful debate.

Mammoth post sorry!

Completely agree WobblyPig. Scarily it has got waaaaaay better. Particulary in the 90's. From the 80's it is almost unrecognisable. Mostly, hopefully.

Long long way to go.

Yes, just to second Stripey here. Acting outside prptocols is not a simple case of supporting women in their choices by being brave and gutsy. When we do that we efffectively hand over the vicarious liability insurance and protection working for an employer gives us. We are always personally liable for your care, but in this instance, should any adverse incident occur, that either you or the statutory body felt was preventable and persued with a complaint - we as the individual would be left with no legal support. The risk of job loss, registration loss, facing tribunal alone...and so on, is often considered too great a risk for a woman trying to pay the bills like everyone else. Not to mention the trauma of having something like this on your concious.

I'd also say on the end of shift thing, it isn't always possible to stay, like it isn't always possible to provide continuity. Childcare childcare childcare. My dd1 is at home today with vomiting. I would have failed to attend all the women I said I was going to [had I not been on mat leave at the mo].

In the bigger picture, the flexibility in shifts required to provide team approached midwifer is a nightmare to find childcare for.

NONE of this is womens fault, so we should not suffer by it. We need people with teeth fighting our corner for us - for women. If the RCM fight the corner for women and womens rights, everyone benefits. Cheaper more flexible childcare, no tolerance towards poor pay for long hours, no tolerance for poor life/work balance, no tolerance for hypoglycaemic staff or babies, no assumption 'they will do it because they love the job, so let's give them another 10 beds and no morning break',... the list goes on....

A blaaardy Christmas card and a fiver for Christmas might be nice. My dh works in the most miserable sector of factory working and even he gets £10 in his pay. Pah!

Am saddened by stories here. Also for your lost positive experiences. All I can say by way of [unasked] for advice, is in the cases where one individual did/said the wrong thing, but did not affect the outcome of your birthing experience, try to focus on the other brilliant positives. A shame to let one person overshadow this momentous time - although entirely right to not stand for it. You know what I mean. I will always remember the withering glance and awful attitude of someone I asked for a cuppa after my first delivery [19 hours, 4am, epidural legs, cup of tea not unreasonable?] But bugger her, there will always be miserable whatsits with a headache and a bad attitude, others were nicer and I got my intact perineum. That was My Fear.

We need the RCM to work behind the scenes telling trusts this level of interpersonal skill will not be tolerated. We, the service users, are too busy caring for our newbies. So crack on.

It is the structure of the midwifery system that prohibits tailored care . You are in many circumstances treated as a piece of meat on a conveyor belt and not as a person with a particular set of needs.

The problem with providing indiviulised care is that you then get a huge bollocking for not following the protocols. I still give women choice and document accordingly but given up counting how many times my manager has screamed at me "you must follow protocol". Eh, actually no I don't have to. Its making me very unpopular at work.

So maybe management ought to be reminded about informed choice, etc.

Also for the person who said their m/w left as her shift ended 15 minutes before the birth of their baby and she thinks the m/w should have stayed. Sometimes I've been in this position and can't stay as I have to pick DD up from school. Sorry, I do feel awful if I leave at such a point.

individualise ny care don;t just follow the algorithm

Continuity would be nice.

Am pregnant with first. Have had so far 6 ante-natal appointments and have so far met 5 difference midwives. Am due to meet another new one next week.

Admitedly I did move into a different area mid-pregnancy but even so I don't feel any sense of connection with my midwife to the extent that when I was suffering from ante-natal depression I made an appointment with my doctor as I felt I had a chance of being able to see him again if I needed to unlike midwife.

Community midwife - fantastic throughout as she has been my midwife for two of my children and really knows me. This is just what you need especially whe there are complications.

Hospital midwife - Having given birth twice with no pain relief - have just had third and the midwife was ok but I came away feeling bad as I had an epidural and she made it clear she felt I had made the wrong decision. [angry}I am left feeling negative about a birth which was actually a great experience. As a third time mum I felt she should have respected my views. Having given birth twice before with nothing I knew my limit and am annoyed that she has made me feel I have to justify myself to everyone. A shame as it was my last and I still feel I have to explain to others why I decided to have one!!
A more supportive approach would have made my birth experience better!

continuity of care, wasn't bothered antenatally but post natally to see the same face and get some consistent advice would have been nice.

I was a midwife for many years.

Bullying and burnout are major problems in the NHS. Most of the people I trained with left midwifery after a few years. One colleague killed herself due to pressure of work, stress and bullying by management.

It seems to me that things have not improved. The only thing that exercises the minds of those who are at senior management in the NHS is saving millions of pounds. They spend thousands on management consultants, and thousands more on "cost-cutting" managers.

People with clinical skills and experience, including senior clinical staff at consultant level, are treated with total disrespect by senior management, most of whom have no clinical knowledge whatsoever..

In every area of care, the most important thing is targets and tick boxes.

IMO nothing will improve until clinical need is considered more important than saving cash. But we, as taxpayers, have to be prepared to pay for it.

That said, there is a huge amount of waste and incompetence in the system.

Just skim read the rest of this thread and noticed nothing else about high BMI and the necessity for big cuffs, so I'm gonna reiterate my point to make sure I'm heard- please raise this issue with them PW, BIGGER LADIES REQUIRE BIGGER BLOOD PRESSURE CUFFS FOR ACCURATE BP READINGS.

We had a thread about this a while back where every woman with high BMI had the same experience as me, having to insist upon large cuffs, being pooh-poohed, ignored, shamed (for being fat), and mostly not even knowing that it was necessary to have a large cuff and having misdiagnosis seriously impact upon their care.

re: Edam: "Why the HELL are MWs keeping quite about issues that serious?"

I'd better be careful what I say here, because it was told to me definitely off the record, along with plenty of: "We're not allowed to talk about that", but:

A letter was written from our community MW teams to "management", expressing concerns about staffing levels, and about the threat of community MWs being forced to work shifts in the county hospital to cover low staffing levels...

Apparently the person who put her name to the letter, on everyone elses' behalf, has been "punished"....cue great caginess from my MW.

Words fail me.

I haven't given birth yet;- I am 34 weeks pg with my first.
So far I have had pretty good support from my community midwives- sometimes at the antenatal appts they are a bit rushed, but my "usual" midwife came round to talk about the birth plan today, spent 2 hours with me and was great.

However, you can't help noticing that all is not well in midwife land here in W. Cornwall.

This area has a 17% home birth rate, which is apparently fantastic. However, in the 6 months since I've been seeing them, the community MW team has gone from being down 1 to down 2 MWs, including an actual designated MW for my doctors' surgery(hence I've seen quite a few). Apparently the post has been advertised for the whole time, but somehow has not been filled..?!?

There are also rumblings that the community MWs are going to have to work shifts in the county hospital, due to short staffing- with no more community MWs taken on.

The worries are that this will make having a home birth far far more difficult, due to lack of staff.....Yet hasn't the Government made a commitment that every woman should be able to have a home birth if she wants?

My MW alluded to all kinds of politics and skullduggery going on at management level, that she couldn't really go into, but surely central government should be pushing for a community MW recruitment drive if it wants to honour its commitments?

This should make sense- after all, low-intervention, MW-led births are much cheaper!

I would like you to say:

The agency midwife I had for the first half of my labour was shocking. She left me alone; she asked for consent for an episitomy when I was about 3cm; after 6 hours in hospital (back to back, very painful, had been having heavy contractions for 24 hours) she broke my waters and said "congratulations, you're in labour" (I v nearly cried).

What is the RCM going to do about ensuring that agency midwives become accountable for their behaviour and that they are up to date with proper expected standards of care?

The community team I saw pre and postnatal were lovely, but sadly I rarely saw the same woman twice.

Related to cece's point there seems to be a great emphasis on improving the experience for low risk women - home births and also lovely birthing suites which a high risk woman like me would be barred from using.

In my area the Spires maternity unit has opened with nice lighting, windows to the outside world, ensuites and it frankly infuriates me. All this improvement could have been provided in Delivery Suite so that any woman could have benefited from it, but instead the new resources have been lavished on low risk women to the total neglect of those with more complex obstetric needs.

I want to know why the midwife I saw for all of my antenatal appointments only does homebirths? I therefore had a midwife who I had never met delivering DS2 as I had a hospital birth. I was told that they have different midwives in the hosptial to the community teams so this is the case for everyone who has a hospital birth.

I then had a succession of midwifes come to do the homevisits after I came out of hospital. I never did see 'my' midwife again and have no idea whether she knows I had a boy. I feel this is particularly sad as she looked after me really well after a second trimester loss and encouraged me to try again when I was scared.

With my first two pregnancies (in a different area) I saw a different midwife at every antenatal appointment and then had a different midwife again for the deliveries.

I think having a midwife (or a team of say 3 or 4 midwives) that I could get to know would greatly enhance the level of care I perceived to receive.

I had the same community mw for pre natal care, and she messed up taking my bloods, then lost the results, was always late and generally didn't give me any confidence, lovely lady but did not inspire the trust I needed for my first birth, but I was unable to have anyone else because she was the only mw attached to my doctors practice and I wasn't allowed (I tried) to change practice. Post nately she did try to help me to get a good latch bfing, sadly she didn't help much, giving me advice to aim nipple at dd's chin! And she ran one of the antenatal bfing clinics.

My sil's community mw didn't return calls and actually failed to attend some appointments

Luckily my mw giving birth was fab, she listened, agreed to my birth plan, stayed on after her shift for at least an hour to see me through to the end, gave me the drugs I asked for and essentially let me take the lead and get on with it which was exactly what I needed. Another at the hospital was fantastic at showing me how to bfeed lying down when I was so knackered I was close to passing out.

I think that the community midwife could be great, but where possible women should be allowed a choice.

Please stop freaking out women in their third trimester by telling them your measurements indicate a massive baby. Most of the time women (including me) are told such things by MW sucking air through their teeth like a mechanic shaking their head telling someone "It's gonna cost you.".

The fact is that 3rd trimester sonography is only 60% accurate on size. That's a huge margin of error. I speak as someone who has worked as a medical technician. I think all MW telling women that their babies measure big on 3rd trimester measurements should be required to say that measurements are not at all reliable at that late stage.

So many women come on MN freaking out about how their baby has been measured as fanny destroyingly huge, and I think makes women worry about birth unnecessarily, and doubtless increases c-section rates.

A lot of the time, I think it's used as a way to scare women into obedience as to a suggested procedure it was for me.

I wanted a home birth, but had a high BMI. I insisted, was a perfectly healthy pregnancy so they relented, but then ladled on the pressure about DD being so big there was a danger of shoulder dystocia. This was based on fundal measurements, the most unscientific measurement ever IMO. I got sick of the harrassment so agreed to an ultrasound at 36 weeks after being scaremongered informed it might be an indication of kidney problems. Ultrasound comes back 99th centile, cue MW shaking their heads, sucking through teeth, doomsaying etc. 4 weeks later DD is born and weighs in on the 50th centile. I was a little annoyed.

Also- use large blood pressure cuffs on big women PLEASE! A misdiagnosis of pre-eclampsia due to poor measurements is utterly unacceptable, but given that I had to remind and insist on it at every goddamned appointment I imagine it happens all the time.

I had MW's try and persuade me it was unnecessary, it was bloody necessary! One time I let 'em try a small cuff on me, late in pregnancy sick of fighting my corner, and surprise surprise I had high bp. I then insisted they go get the large cuff and hey presto I was normal again. If I hadn't made a fuss that high bp reading could have seriously impacted my care, how many other high BMI women have had their pregnancy and birth unnecessarily interfered with due to this laziness?

I would also like to thank all bar one of the MWs who looked after me during pg, birth and post-birth of DS. Especially the lovely lady who was also a lactation expert who came to my house to check how I was getting on with bf'ing DS and who expedited the referral to the paediatrician to get his tongue tie snipped.

The one I wasn't keen on couldn't even tell if my waters had gone. I told her they had, the loo had been full of blood and there had been an almighty splosh, but that wasn't good enough for her - nor could she tell after feeling around. SO I said "is it bulging?" (the membrane) - she said No; so I said "well it was before so if it isn't now, I'd say the membrane's gone, wouldn't you?"

What else - well, I had a luckily lovely experience overall but many of my friends haven't and I would therefore borrow from their experiences.

DO NOT patronise your patients - DO NOT pat their faces and say "you don't have the look of someone in labour", send them home and have them require an ambulance to fetch them back to the hospital because they can't get out of the bath due to contractions.

Nor should you say - "come back when your contractions are less than 2 mins apart" (when they're already 2 mins apart) and only on patient's refusal to leave the building check the dilation, to discover full dilation and imminent birth!

ALL MWs should be prepared to expect the unexpected and to assume that every birth will be different. There are no "standards" - there are no "rules". And LISTEN to the patient, even if she does appear to be utterly neurotic.

They should all have some kind of empathy training too.