I’m a midwife, ask me anything

[CatchingBabies]

Seeing as this has become a theme recently I’m jumping on the bandwagon because I need a distraction from my new house that is slowly becoming the worst decision I ever made.

Soooo I’m a midwife ask me anything! (Dons hard hat)

Hi op, thanks for don’t nag tjis thread, and thanks for replying to my hip widening question above .
I was really unclear, o can see my hips have widened, my question should have been is the reason for my shrinking 2 inches in height because my spine has sunk down into my hips? Can’t quite see how it would, but can’t think of any other reason.

What are the chances of having a MW led birth again if my last delivery ended in a major PPH due to retained products? I ended up having them removed under GA as an emergency. My first delivery was fine, it was my second and it all got a bit hairy quite quickly.

Would you recommend doing midwifery training with young children? And how did you manage financially?

I’m an NHS HCA and been wanting to train in midwifery for several years. Ive done lots of bank shifts in our maternity hospital. I’ve got a three year old and 6 month old.
I’m worried the pressures on my family life and financially would be too much.
The dire state of affairs in the nhs puts me off and the amount of midwives and nurses leaving and telling me not to go into it!

I have a pretty high pain threshold and with both dc have been born pretty quick dd 15 minutes after getting to hospital ds1hr. And have been 10 each time I have arrived why do midwives not believe me when I tell them they are ready to come 🙄

When I had an injection for pain in labour with my first child I remember saying how good it felt and I was a bit 'dreamy' asking exdh to check the anchor (we'd been sailing a lot) and I don't know if I rightly or falsely remember two midwifes looking at each other as if to say "she's had too much". Anyway the next year I gave birth to my ds who was stillborn and because he was very early, already dead and they were very busy on the midwifery unit I was put on gynae in a single room with a midwife. I was in agony it was so much more painful (probably from grief) and they refused to give me anything more than 5mg morphine. I was begging for help as I was in so much pain. What I wonder is if they made a note of the effect of the diamorphine on me with my first birth and refused to give much because of that. Do you think that's what happened? I can't understand why they would leave me in so much pain when my baby had already died.

Oh Merry, you poor thing

I'm no midwife but I think you were treated appallingly. There's nothing wrong with a mum high on pain relief, I don't think; I was bonkers. My midwife just laughed at me and said "I love a mum on gas and air!"

I can't believe that in the circumstances, they couldn't offer you anything more. I do know I'm no expert, though. Sorry for your loss.

@CatchingBabies what do you think of home births?

Do you or your colleagues become jaded and start to loose sympathy or even disbelieve how much pain a woman says she's in?

Just wanted to say you sound amazing & this is fascinating. I so appreciated the MWs I dealt with having DS. Completely over-worked & amazing individuals

DS2 was delivered by ELCS and the cord was wrapped around his neck 4 times. I know nuchal cords are fairly common, but is 4 times quite rare? Would this likely have caused problems if I'd attempted a natural birth?

@angelikapickles I try to avoid it if I can, sometimes coached pushing is needed however, e.g. if a woman has a very dense epidural.

@gmtobe Your risk of tearing depends on many factors so impossible to predict, women do tend to tear along the episiotomy scar IF they do go on to tear, not always however.

@glitterbaby17 many things can lead to pelvic floor issues, pregnancy alone does, any tears, length of time pushing, size of baby etc. it’s impossible to pin point it on one cause.

@pandapiefortea certainly not enough! You are correct we often don’t see the long term outcomes. I suspect most gynaecologists go for ELCS as they only see women when vaginal birth has gone wrong whereas midwives see many vaginal deliveries that are complication free, it’s all about your own experiences.

@serenawaterford wether or not you need a transfusion depends on your Hb (iron) level. However it’s also individual, some women can feel awful with a marginally low Hb and others can have very low Hb and feel fine. If you were not symptomatic and wanted to avoid one they may have felt you would be ok on iron supplementation.

@bobbiepin she will have been writing about your care, our paperwork can be horrendous! Baby’s heart rate needs writing every 15 mins, number of contractions every 30 mins and so on. every time you change position, go the toilet, have a drink etc. Notes are kept for 25 years so plenty of time to request them.

@bubbles121 both are classed as higher risk for different reasons.

@ncpuffin forceps vs ventouse vs EMCS depends on the position of baby, how low in the pelvis they are, how quick they need to be delivered etc. many factors as to which is the safest option for each unique situation. You can of course decline anything you wish.

@thegrumpysquirrel they say a gap of over 10 years is like a first labour again but no one really knows.

@mrssunshinexxx evidence shows that pre-eclampsia does tend to run in families, you will likely see a consultant and be put in aspirin in pregnancy which can help prevent it developing. Doesnt mean you can’t have a normal delivery even if you develop it, it all depends on the clinical situation at the time. And yes I believe in hypobirthing I’ve seen women cope amazingly with labour simply by using it.

@hula I wouldn’t say everything is ok if I didn’t think it was no but I wouldn’t scare a labouring woman unnecessarily either so I may be observing closely without letting her know at that point there is a concern for example. The electrodes on baby’s head sound like a fetal scalp electrode, they are used for many reasons so I can’t answer why they were in your case sorry.

@aftereights91 it’s not unusual but all women experience labour and birth differently.

@halfstar I’m not really a believer in old wives tales although some of the older midwives certainly are. The purple line when fully dilated is true yes.

@ginunicorn episiotomies are no longer routinely performed and we tend to let women tear rather than perform an episiotomy. Episiotomies are mainly used if we need to speed delivery up due to concerns over baby or if a forceps or ventouse delivery is needed. Natural tears are far far more common than episiotomies. Yes the risk is higher in first labours.

@comeluckyapril every labour is different so things dont usually happen again the second time around. Some women seem to naturally have longer pregnancies and always go overdue however but induction is more likely to work when you’ve already had a vaginal delivery.

@mooey89 assuming your hospital has waterproof ctgs as many now do and that is not the reason it’s usually in case you for some reason collapse and they cannot lift you out of the pool. Most units have a BMI cut off for the pool although some are more flexible than others.

@rotavix it sounds like you had a very difficult birth x

Thanks, I had no idea how much there was to write about, although there was no moving or going to the toilet. On the bed for less than 2 hours before DD arrived!

@ohyesiam I’m not aware of spines shortening in pregnancy.

@LBOSC2 you will be high risk of a repeat PPH and most hospitals would want you in the consultant led unit for this reason. They will be prepared for you to bleed next time but it doesn’t mean you will.

@troton as much as I adore my job I couldn’t have coped with the training if my children were young. I had 2 almost teenagers and a primary school aged child even then it was hard going and I spent some days crying writing my “I quit” letter before changing my mind again. It’s hard going but so worth it. Financially I was lucky enough to get the NHS bursery that is now sadly gone also and my partner worked lots of overtime to pay the bills. Qualified with a LOT of debt.

@gregpenguin I don’t know why they don’t believe you, I would trust your judgment with your history.

@mercyinthechelseahotel Sorry for your loss first of all. I don’t know why they did that with the pain relief, it’s possible they were aware of your previous reaction but that isn’t an excuse to leave you in pain. I’m very sorry that happened to you. x

@chilly32045 I love them if the women are suitable for them, they can be scary if it’s a high risk home birth but either way I support their choice. From a workload point of view it’s nice to be dedicated to caring for one woman with no distractions or other women to juggle.

@kaytee87 I’ve met midwives like this yes, I personally feel that’s when it’s time to find another career.

@loveproseco thank you very much

@evemoneypenny 4 times is more unusual yes, I’ve seen a baby that was wrapped head to toe in their cord once, made me chuckle to imagine baby rolling around playing in there. In terms of vaginal delivery it’s more the length of the cord that can be an issue. If it’s long enough it doesn’t matter how many times it’s wrapped around.

Ok I think I’ve answered everything up to now, if I’ve missed your question I apologise. Tag me in it and I’ll have a look x

I was induced at 38 weeks and a few hours after the pessary I suddenly got severe pain and passed various large looking clots (golf ball sized). Once down in the delivery suite, and baby born within fifteen minutes, I was told it had been a heavy show. Any idea what this might have been caused by?

Do you as a midwife think you can predict when a Labour won’t go well before hand and if so, do you think this should be explained more to the mother so she has an option to request a c section?

With my first for example I had a very low Bishop score all through, and there were lots of talks about my baby being very big for me and back to back. In the end after 35 Hours on the drip with rapid contractions and no epidural only reaching 2cm I ended up with a crash section under GA. knowing what I know now, I feel like had bishop scores been explained to me I would have asked for a section and not be left with PTSD

@CatchingBabies, I've copied and pasted mine, but it may not be one for you, so please don't feel compelled to reply.

FrayedHem Sun 01-Jul-18 01:44:11
I was strongly advised to put in a formal complaint after I was readmitted to hospital after DS3's birth - about how the birth itself was handled, how I was spoken to (and about when they

I was strongly advised to put in a formal complaint after I was readmitted to hospital after DS3's birth - about how the birth itself was handled, how I was spoken to (and about when they thought we couldn't hear) and the immediate post-natal care. The hospital took information that I had to call to confirm all was correct. I couldn't get through to the right person and life just got in the way. This was over 5 years ago and I had another child since, but things that happened still really bother me. as an example I couldn't face going to have my third degree tear checked up in the clinic they run and the thought of a smear test fills me with horror. (I had a c-section with DS4)

To get to the point(!) is there any value in my contacting them all these years later? I was told with DS4 that my notes for DS3 were missing.

I should add it was the staff on the labour ward where I was readmitted to (needed a blood transfusion and as I'd been discharged the infection risk meant I had to be on the labour ward - I think anyway!) that advised I should formally complain.

Thank you for answering :)

Anything unexplained, OP? Woo happenings?

Thanks so much for taking the time for this thread, catching.

Hi @CatchingBabies, I had a question up thread which I don’t think has been answered - no worries though if you don’t have the time, I realise you got a lot of questions! I’ve pasted it below just in case

flybabyfly

Thank you for this thread, @CatchingBabies!
I’m wondering whether there are any extra risks in pregnancy if you suffer from PCOS? Both myself (living in the UK) and a friend of mine who lives outside the UK have it - I was told by a midwife at my booking-in appointment that my condition is of no interest to the professionals dealing with my pregnancy, and it was not even recorded on my notes, but my friend was told it makes pregnancy more risky and she is therefore having more appointments/scans. Why would this be?

@CatchingBabies what would be your process of deciding between VBAC and ELCS? What are the factors that would make you recommend one over the other?

Hi @CatchingBabies
Have you ever had a lady give birth who has a stoma and/or rectum removed?

I'm not pregnant but hoping to start trying soon but the complications of these two things above (along with the regular labour/pregnancy concerns) scare me!

Ooh, I have a question. Not really relevant to my current situation, but something I've wondered about.

If a pregnant woman doesn't disclose to their midwife about certain things in their medical history, will the midwives have any way of finding this out by other means? And if, say, the said pregnant woman does disclose about their mental health history, but does not want to discuss it further than mention past diagnoses, will this be accepted? And if they refuse a referral to prenatal mental health team, will it lead to any particular actions? Thank you!