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

My community midwife is great.
Many of the mws I have met in hospital have been great too. However, I have 3 issues.

1. The mw attending the birth is a complete stranger. It can be any of a team of 20 plus and the variation in terms of care is huge.

1. Mws do not do any nursing training now (unlike in days gone by) and therefore many seem to have little knowledge or sensitivity when it comes to caring for the ill. I was recently an in-patient and some of the insensitivity I encountered was jaw-dropping.

1. Many mws give poor information wrt breast feeding. I had severely cracked nipples with ds from the first feed and was told to continue feeding (right) but noone looked at his latch or said it was okay to use cream. Also, the women in my ward who had chosen not to bf or who gave up after a few painful hours were treated pretty shabbily.

Also, many of them know NOTHING at all about medications for various pg conditions. My community mw (who is generally super) had never heard of ondansetron and did not know that stemitil and buccastem are the same drug. I would have thought this was pretty basic.

Continuity of care.
Listen to what your patients are saying and respect their choices even if you know they are PFB and think they are silly eg Lavendar, acupuncture, hypnotherapy etc.
Help establish breastfeeding and don't abandon the women as soon as the baby is out.

Bishopston Team in Bristol are the one team of MWs that I have never heard anything bad about, even when they're stretched.

Remembering names and details is vital as it makes every mother-to-be feel really special and cared for.

I'd say to all midwives, is there anything at all you can do to encourage more people in to your profession? Or to stay in the profession? Do you have friends, neighbours, clients who you think have the potential to be a good midwife? - could you maybe find a way talk to them about the job and encourage them to do the training?

We need more of you !

Continuity of carer not care.

A woman needs to know her midwife before, during and after birth, not just a random person working within the trust guidelines and policies - that is not continuity of care. If caseloading cannot be provided then midwives need to share the care of small nubers of women and ensure that the woman actually gets to know the team.

Antenatal education provision is dire.

Midwives need much, much more time to spend with their women.

Hospitals need to stop conforming to guidelines produced at random in the dark ages and start providing quality, evidence based, woman centred care.

Women need real choice about where and how they have their baby.

LASTLY - AND VERY VERY IMPORTANTLY

SAVE THE ALBANY

REALLY - RCM. YOU REALLY NEED TO DO SOMETHING. IT WOULD BE AN ABSOLUTE SCANDAL IF IT WERE ALLOWED TO BE PUSHED UNDER AND FORCED TO STOP.

SAVE THE ALBANY

Antenatal care was excellent. I had the same community MW (except when she was on holiday) all through my pregnancy, and she was the one who assessed me postnatal as well.
During labour the care was good. I asked for an epidural as soon as they had finished assessing me, and they were fine with that (although they did say the pool was free. I wish I had said yes to the pool). I didn't get it in the end, but that's because my labour was progressing too quickly (it slowed down after a bit though).
The only complaints I have are that I was strapped to the monitors for the whole damn thing even though I didn't have the epidural in the end. Also, especially at the end, it felt a bit like the birth scene in Monty Python, with lots of people in the room, and me with no idea what was going on. Apparently they explained everything to DH (almost had ventouse), but I am an adult and regardless of the fact that I was a bit woozy from pethidine I think they shouldn't have deferred my care (and DSs) to DH without at least trying to ask me.
However, they were fantastic about helping me BF even though they were obviously very busy and I didn't feel like they were trying to kick me out of the door as soon as I had had the baby IYSWIM. I would happily go back there next time.

the midwife who seen me through my pregnancy was fantastic. the midwife who helped with my delivery was not so good. she lacked the ability to listen and never took any of my wishes into consideration. she kept discouraging me on having epidural for no reason. the delivery went wrong i nearly lost my ds and have suffered p.t.s.d. since.

My community midwife care was good 1st time and this time (33wks) I have seen the same lovely mw every time who knew me from 1st pg (I am high risk so complicated).

I was an emergency and the delivery suite mws were all fantastic, I had severe PE. I had a mw with me always and afterwards I had the sister mw.

The post-natal ward was awful, there were too little mws and the care assistants gave opinions rather than medical advice which I didn't realise at the time. I waited 3 hours for mw to take out my epidural so I could shower etc. despite dr and physio saying "aren't you up yet" and yes I did make a fuss!

Mws need to be up on breastfeeding advice, as all the post-natal ward were concerned about was writing how many minutes I'd fed for, not how effectively. We were nearly sent back to SCBU after discharge due to weight loss but thanks to same wonderful community mw we weren't. Were sent to bf group instead.

continuity of care.

a named midwife for high risk women to contact antenatally, even if it's just office hours only. My last pregnancy was high risk and I had almost no contact with a midwife until labour, just doctors that would barely look at me let alone spend the time to go through things.

when you have a child with SN any future pregnancy is going to make you extra anxious, this should not just be greeted with, well that's unlikely to happen again, end of conversation.

just want to say my postnatal care on the ward was absolutely fab when I had my last baby.

I have experience of four; two community midwives and two who actually delivered my children.

My first community midwife was wonderful, open, friendly, informative, supportive, and we had a great relationship. The midwife who actually delivered DC1 was wonderful warm and supportive. DC1's pregnancy and birth was a great experience all around.

I saw my community midwife (we moved) only two or three times throughout my pregnancy with DC2, she wouldn't follow up on questions when she said she would and I usually saw someone filling in for her when I went in for appointments. No relationship.

The midwife who delivered DC2 was brusque, not overly friendly but very efficient and competent. I felt I was in very good hands through a precipitous labour. (I'll always take competency over friendliness when in labour!)

So in general, please tell them great job and thanks from all of us.

In a nutshell:

1. continuity of care.
2. It may be the millionth pregnancy you've seen, but too us we are the first woman in the world to do this
3. Time. The midwives I saw were constantly in a rush to get you out the door or to get on to the next woman. I felt like I shouldn't really bother them.

Please don't put someone who's baby is fighting for his life in Special Care in with 5 other mothers who have their babies safely next to them. It just adds to the misery and loneliness.

Or at least ask them if, when another bed becomes available, if they'd like to be moved.

Absolutely listen to intuition.
Don't forget that woman in Mexico who did a self- c/section. There is no way in a million years a woman would do that unless she KNEW that the baby wasn't coming out V.

Which goes to show I think, that unless it is a crash situation, women should be involved in the 'decision' to go for c/section and should be encouraged to suggest if if they feel it is necessary. If more c/s decisions were truly made with the woman I bet there'd be less.

Oh - and post-natal MWs PLEASE have up to date BF info, please. I was pushed into topping up BabyG and I don't really think I should have been.

When I was in labour with BabyG I felt that something was wrong. Nothing indicated that anything was wrong, the monitors were all fine and I was progressing nicely. But I KNEW something was wrong.

MyMW listened to me and got hte head MW to come in. SHE listened to me and got the registrar. He DIDN'T listen to me, so the Head MW phoned the consultant at home in hte middle of the night I ended up with an emCS and BabyG had cord around his neck 4 times, then tied in a knot and tangled all around his body! I would never have delivered him naturally, never. If they HADN'T listened, I would still have ended up with the CS, but it would have been at a much later stage of labour and a birrova bloody nightmare, frankly.

My thing would be: encourage MWs to listen to mothers intuition.

I consider myself to be extremely fortunate to have lived in parts of Sheffield covered by a one-to-one midwife scheme.

They provided ante-natal care at my home - which when you've got a toddler already is fantastic. I saw the same midwife for most appointments, meeting the others on the team before due date. Homebirth actively encouraged. Birthing pool loaned free of charge (£40 for liner).

For DD, MW visited me twice at home when I was in labour, then came in to hospital with me, and never left my side, staying well over the end of her shift, despite having to drive to London the next morning.

DSs were both homebirths with same wonderful team, so in those cases, 2 wonderful midwives.

Yes, this personal touch means they invariably run pretty late for appointments, and occasionally have to postpone them. But it is a truly fantastic scheme and I wish it could be rolled out nationwide.

Disappointed with lack of continuity during first pregnancy. Saw 4 different midwives and 2 students at ante natal appointments. Measured by different people every week resulting in a growth chart that said I was getting smaller towards the end of the pregnancy resulting in late scans. My allocated midwife was rude and barely spoke to me. She made me feel as if I was an inconvenience. To be honest, I spent a lot of time trying to work out what I had done to annoy her.

Lack of knowledge regarding the antiD injection I was to receive, I was told that they didn't really know anything about it as they didn't give it very often.

I was given no information regarding the parenting classes and had to constantly ask for things including my maternity certificate.

3 Different midwives during labour - all fantastic and supportive.

A good friendly midwife is worth her weight in gold. A rude unfriendly midwife can make you feel worthless at a particularly vulnerable time.

I would say: Your attitude matters SO much when you are dealing with vulnerable people and most women are vulnerable at some point pre, during or post birth. They REALLY need you to be supportive, kind and encouraging. This may sound obvious but it is, I think, not always put into practice, particularly on postnatal wards. I had my babies (twins by c section then a singleton vaginally) 10 years apart in different hospitals and found that both times the actual in-labour care from midwives ranged from adequate to really excellent. My community midwives were lovely both times too. By contrast, both times the postnatal ward was host to some noticeably piss poor practice, mostly due to a significant cohort of the midwives on shift having a terrible attitude problem. The lovely midwives really stood out there. 10 years... plus ca change!

I think it's important for midwives to focus on the fact that they and their actions will be imprinted on the memories of women they help (or hinder) for years to come. Of course, to a greater or lesser extent, to the midwife it's just a job and it must sometimes seem like the same old, same old, like any job, but to each and every pregnant or postnatal woman it is an amazing, individual, terrifying, wonderful. lifechanging event. Again, this sounds obvious but is, I suspect, all too easy to forget. But forget at your peril- at times of high adrenaline, change and stress, things stick in the memory; I can still picture the faces of the midwives who were lovely and the ones who were complete cnuts from my twins' birth all those years ago, as well as those at my daughter's much more recent entry to the world. And though I am usually a mild mannered laid back type, I do bear grudges, as well as holding fast to many wonderful memories of lovely supportive fabsters!

Depressing reading, this thread. Thing is the RCM will know all this already. I hope they hear the hurt though. It isn't their fault on the whole. All the good experiences I have had with midwives have on the whole been with women who are calm, competent and warm who had a strong sense of vocation and seemed to really understand the sensitivity of their role.

But the RCM already know what impact underfunding and undersupply of staff is having - they make this point all the time. I'm sure they wish to provide continuity of care because this would give them a much better working relationship with women.

It is the NHS management and the govt who need to act.

I suppose I do think the RCM could make an impact upon the culture of institutional blindness that affects any large institution and hospitals in particular. I wonder if an emotional 'supervisory' relationship much like the one therapists and social workers have to have might make a difference to care provision? Or maybe this is in place already but it doesn't work well?

Someone needs to remind people who are institutionalised what it is like for the 'customers'. My students fill in evaluations about me all the time; and I have to respond to that. I had a 'no shit sherlock' moment this week when the report about noise in hospitals came out. Normal working practices don't always suit those on the receiving end and need to be challenged and reviewed on a regular basis.

I found the team dealing with my antenatal care lovely, altho saw a different one each time.

When i came into hospital and stayed in (before getting sent home again the next day, when really i shouldnt have left with the pain i was in) I had seven different MWs tho they were all nice they all had different advice, one told me they would break my waters in the hour and then she left and another MW came on and told me that no, they wouldnt be doing that! so was very upset by being told a different thing each time and having to re-tell me life story to each one, surely they had my notes?

However Kathryn, who managed to deliver both my children (three and a half years between them) was absolutely amazing and did a superb job.

Our local ones are top. The one thing I would say to them is a big thank you. I love the way they are so obviously on our side.

The ones that don't know about hyperemesis need to be told about it, though. The mw I had before I moved to this area gave the usual advice about ginger and said it was important to have a sense of humour about it . The information I got about it, which turned out to be absolutely crucial, all came from the internet.