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

Ante-natal try be more empathic and listen to your clients. losing notes,too many agency staff,and generally not being able to genuinely offer individualised care is common place

Post-natal.a 15min visit doesnt always suffice and many mums wont speak up in that time to tell you. we know your caseloads are horrendous and paperwork overwhelm you

i suggest enhanced training ante natal and post natal about working with vulnerable mums with psychiatric issues.you have 2 clients mum and baby.

liaise with HV collegues so yuo dont contradict each other advice

Incompetent psychopaths.

Generally.

It's quite simple really, just tell women the truth.

One of my MWs (who were all fantastic up until then!) from the bank of 6 I saw both ante and post natal tried to tell me that the reason for my DDs erbs palsy was because of how she had been lying in me, when it had been put in my notes and those sent to the physio that it was due to a shoulder dystocia made worse by the Dr using a ventouse to speed up the birth as she was in distress. I understand that some people are in that mindset where they want to sue at such things and that she was probably protecting the staff, but I understood that if they hadn't gotten my DD out quickly, she might not have made it at all and for that I was extremely grateful. I did not need a MW making me feel as if I'd damaged my baby 4 days post natal. As if I wasn't weepy enough at that point!

We are intelligent people and should be treated as such.

Both times my Community Midwives were brilliant - emphathetic (sp!) after mc at 12w, ensured I got early scans with both DS1 and 2, consistent, sensible advice - bracing when necessary!

Birth with DS1 ended more 'managed' than I would have wanted, not least because of the second midwife I had. Biggest quality she lacked? - empathy! I am sure that she was utterly clinically professional & I realise that it is just another birth for them, but, when my legs were up in stirrups, a paediatrican had been called for and she was telling me that I was not pushing hard enough, that the babies heart was dropping and had to come out now, she didnt have to follow it up with "What are you crying for?"

Birth with DS2 was magic. In midwife unit, there because my community midwife had given me the confidence to go for it. Consistent CARE, with the midwife (there from start to finish) telling me that they (the midwifes) didnt deliver babies - they helped their ladies to do that! A big, big difference. I was a person not a hospital no. Oh Yes, and she also worked out when she needed to be bracing not sympathetic!

So, for me its consistency, empathy and a "people centered approach"

Whilst midwifery is a job for you and you will see many, many women have babies, sometimes several on one shift, for the women having the baby, it might be their only time, it will almost certainly be one of a handful of times that they give birth.

Be kind, be supportive, be knowledgeable and don't assume that just because you've seen a zillion births, you know everything about how this woman feels about hers. Or, even if you do, don't let her know you do!

Don't set "mother and baby both alive" as your target standard of care - as a baseline, it's fine, but don't have it as your aspiration!

And do learn about breastfeeding and how to support women to do it. It's important, you know - especially if the birth's gone a bit off-piste. A good breastfeeding experience after a bad birth heals a lot of wounds. Don't add insult to injury by effing up the breastfeeding for the woman too.

I had a doula for my second birth. She didn't do anything much at all on the day, but because she was booked, because I had built up a relationship I went into the birth in the first place, unafraid, confident, positive etc and I believe it was THAT that led me to have a fantastic outcome.

Before that I was so terrified because whilst I could accept that how the birth goes is unknown, I could not also deal with the other unknown things like:

Would the midwife take me seriously if I said I was in pain? Would she withold a requested epidural due to staff shortages (like with no.1), would she send me home? Would she 'allow' me to birth in my chosen position? Would she 'let' me use the pool, and would she 'let' me when I wanted to? Would she refrain from directecd pushing as written in my birth plan etc etc etc.

YY to calm and caring please. One of the MWs I saw ante-natally acted like she was scared to touch me, just on bump-measurement and BP taking. I want a MW to look like she's happy to roll-up her sleeves and get stuck in James Herriot-style

I've had great support from the community midwives in Brighton who've always supported me to have a home birth and shown respect for my decisions.

They have also been very sensitive and caring during a time when when there was uncertainty about whether i would have a termination. They were brilliant and nonjudgmental.

I think there are issues with regards to 'what type of care service' they are providing. It's near on impossible to see one midwife throughout your pregnancy if you wanted to - illness, holidays etc need cover. As i knew i wanted a homebirth i knew there was no way I'd know who was on duty that day/evening so it didn't matter to me, but if I'd had more complicated issues during my pregnancies or during labour i would have liked to have the midwife I'd established a relationship with look after me.

YOU ARE IN A CARING PROFESSION. Greeting people and using their name and smiling and acting like you give a shit is CRUCIAL. Being busy / overstretched etc is not an excuse to be rude. If I took my exhaustion after a 12 hour shift out on a client I'd almost certainly be sacked.

The community midwife team was great. Reading these comments makes me realise how lucky we are to live in the country (at least I assume the instances of very overstretched teams are mainly in cities).

At the hospital, there was a lot of variation between midwives (and it took 57 hours to push DD1 out, and 44 hours for DD2, so I got through several shifts!) As a gross generalisation: you get some old witches who probably have not had children themselves, but most of the younger ones (i.e. under 55s) were fine.

Perhaps only women who have had children themselves should be allowed to become midwives. And make empathy and roleplay a part of midwife training.

To the mw on the ward for first labour who (I called at 11am) suggested I need to eat 12 raisins every hour to keep my strength up and just give you a ring at 6pm to check how things were going.

YOU WERE TALKING ABSOLUTE BOLLOXS. If I had listened to you, my daughter and I would have been put in grave danger.

Do not underestimate how laburing woman cope / not cope when all you have done is speak on the phone to them once.

I am currently pondering whether to ask my mums lovely friend (who is a midwife and a real gem) to act as a "doula" for this labour (if I can have it at home). I feel the best thing is a having a relationship with your mw. This seems to be lacking alot unfortunately.

It's a bit the luck of the draw isn't it...

My ante (and post (at home) natal MW was a nice person, but went through my history with me, and should have known from that I could do without the horror stories - like the 'you're carrying too much fluid' diagnosed on the 'tap test' (I've confirmed that this is an oldwives tale) and that as a result of this 'the baby's lungs won't have developed properly and they'll have to have an operation as soon as their born' (consultant seen following week confirmed it was just a big baby, no extra fluid...) and the 'I'm expecting to see you in with pre-eclampsia in the next few weeks, so read this leaflet and see what to expect'. Post birth she was no better and even managed to press one of the staples further in rather than remove it (then tried to rectify the problem without proper instruments etc).

In contrast, the mw during labour were lovely and supportive. And I had a reasonable level of attention on the ward given neither ds or I had any 'problems'. However, not keen on the Sister on nights who accused me of not knowing how to bf properly at 2am (that's the only thing that had gone to plan about the birth) when it was actually colic kicking in early.

Due (with DC2) today so may update later...

This time my antenatal care has been excellent. Same mw for each appointment, she has taken time to listen, knows any new literature/policy and has remembered the (minor) complications that I've had.

The thing that is worrying me most about the birth is the unpredictability of who (mw) will be with me during labour/birth, how many changes there will be, whether they will stay around or disappear to see others, what their personality will be like etc. Essentially it's the lack of continuity of care people discuss above. You are very vulnerable in labour and the mw that you have appears to have so much power over you. Last time I had one very unpleasant officious woman who refused to examine me after 36 hrs of regular contractions because I would be 'screaming if I was properly in labour'. Fortunately I was examined shortly afterward by another mw, was 7cm and gave birth shortly afterwards (that mw was there till birth and excellent). The period between seeing the two was awful because I felt so unsupported and vulnerable, started to loose my calm and all became more painful.

I would feel far more confident about labour if I knew that either (1) the mw would know me (I am a very calm person and was unlikely to be screaming) and/or (2) would have respect for and listen to me. As it is I feel that I don't know whether I will be sent home in labour, whether my wishes regarding pain relief will be respected, whether my concerns about the birth will be taken seriously etc until I get to the hospital. That inevitably ups the tension and I feel DH and I have to be ready to argue - not the best position to be in.

Also agree that postnatal provision and support for bf was terrible.

Essentially though, much of this must be about lack of resources so I'm not sure what the RCM can do except for lobbying for more.

The mw that checked me when I arrived should have just said to my face that she didn't believe I should be there yet, it would ahve been more honest than the look on her face. It would ahve also been nice to ahve had an acknowledgement that i was right

My midwife that delivered dd was not only looking after me and another lady but also a lady in labour with twins.

After arriving at hospital at 9cms, which had only taken 5hrs, it was then decided at just after 2.5hrs that the baby was in distress and I was then asked if I was sure that I couldn't feel the urge to push and told that a ventose would be used and if that didn't work the forceps were waiting. This resulted in a 2nd degree tear in two drections.

This was the only time i was asked about pushing, at no point was I given any other option, at no point was the position I'd already asked to deliver in allowed(and the bed changed to allow)

I believe if I had receved more 1-2-1 care I would have delivered quicker, without distress to the baby, without me thinking i have to get this baby out to avoid forceps and therefore without a tear which still bothers me almost two years later and also makes me wonder how I will deliver another baby.

I typed a response but it was becoming a 10,000 word essay. I will try to summarise.

The books you read before giving birth put give you certain ideas as to the care you will receive. For me, the contrast to the care I actually received (or frankly didn't receive) both in labour and afterwards was appalling. I even bought a midwife textbook afterwards to see if the stuff I'd read was unrealistic. It wasn't; it was all in the textbook too.

All I want is for midwives to have the basic knowledge of labour, and the basic attitude of caring, described in their own entry-level textbooks. This was utterly lacking in the midwife who delivered my first child and in the post-natal ward afterwards.

That said, the midwife for my second birth was great as she read my birth plan and carried out all my requests to the letter.

To my community midwives - you were wonderful, but I would have liked to see one or two of you at most throughout my pregnancy rather than never knowing who I was going to see next.

To the midwives at the hospital - when I came in the first time, and my very regular and painful contractions momentarily stopped, I wished that I had had the courage to insist that you checked how dialated I was, because I was a lot further on that you realised just from looking at me. It could have saved me the later delivery where I was too far along for any significant pain relief.

Please do not just look at labouring women and say 'Well, you can't be that far along, or that dialated, you should go home again' Check properly!

Oh, I suppose I'd better summarise...

o Continuity of care
o Listen to the mother and believe what she's telling you
o Don't be a fuckwit.

Good midwife - the one I had until 20 weeks pregnant, who held my hand through the Edwards scare after triple-test (why do they never tell you what '3' is beforehand?), and the one who did home-visits and really helped me get confidence in BFing and looking after DS.

Bad midwives - so many.

The one who TUTTED at me when I bled on the bathroom floor. The same one who wouldn't get me any decent pain relief so I could get some sleep when DS wasn't progressing, even though I knew I could do it if I could just get some rest - DS was back to back and I hadn't slept in 24 hours at that point. She was also the one who put in the canula for a spinal which then got infected - didn't help with trying to BF when my left wrist was agony.

And the one who - after the slash and grab under general - when I asked to help BFing looked at my nipples and said 'they're not very good are they'. And insisted on my having the blood-thinners even after I was up and about, and even though every injection left me with a bruise the size of a satsuma. And said the morning after 'don't get the dressing wet', and the morning after that 'haven't you showered yet?' And broke it to me - after DH had gone for the day - that I needed to wake every 3 hours to feed DS (what did I know?) and tutted (a theme) when I asked if I could be woken then, as I didn't have an alarm clock with me.

And after the first, lovely, midwife left my GP practice, I didn't see another one more than once until the lovely midwife who did the postnatal visits.

That was quite cathartic.

Can they please consider popular terminology too. Current terms imply that things happen by bad luck or as the fault of the woman.

'failure to progress'
'failed to bf'
'end up with c/section'
'natural birth' (should be straightforward birth)
'established labour' (there MUST be a better term for this surely'
'pre-labour' no such thing etc etc etc.
'incompetent cervix' - fgs

Another vote for seeing the same midwife more than once.

Would also have been helpful to see a midwife with some knowledge of hyperemesis (midwife in my first pregnancy told me to pull myself together and try crystallized ginger - I lost a lot of weight and was unable to keep down fluids and discovered during my second pregnancy I should have been hospitalized).

I'd also like mws to be more honest when they talk about pain relief. Unless you are asking for an epdiral there is no such thing, only tools to supposedly help you cope.

Why lie?