I’m a midwife. AMA.

[Clappyhapper]

I’ve been a midwife for 13 years. AMA.

Obviously not personal medical advice. :)

Do midwives who work in different settings (community, MLUs, delivery suites) have fundamentally different outlooks on birth which is why they go for those settings? I suppose I'm asking if the more medicalised the setting, the less woman-centred the midwife is likely to be.

Why is aftercare so terrible, particularly around breastfeeding? I had a fairly complicated birth via c-section but that wasn't the traumatic bit, it was being stuck in a hospital ward with an endless procession of midwives squeezing my boobs and telling me contradictory things, some of them being hugely insensitive (your baby is crying because she's starving, your large boobs will put lots of weight on the baby's face, etc) It seemed like the birth staff were much more professional than the aftercare staff.

Do you have thoughts on VBAC? I'm weighing up my options for second baby and ELCS is tempting versus hospital with monitoring, machines etc

I know it may vary between Trusts, but is there a time limit on having a debrief? I had a traumatic time and it took me a while to be able to talk about it afterwards. Although it still haunts me I can talk about it fairly comfortably now and am considering going for the debrief I was offered. My baby is now 9 months old, is that too long?

Do they literally sit down with you and go through your notes and discuss what did/didn't happen and why? Is it with your actual midwife? I have lots of unanswered questions as I wasn't really in any fit state towards the end to absorb what was going on.

Not sure if you would know much about this as it's usually the consultant I see. I'm pregnant with my 4th and previous 3 have been sections for various reasons. Before getting pregnant I was booked in to get a hysterectomy for severe endometriosis. My question is really what would be the chances of me being allowed to try a natural birth so I can then not have as long a wait to go back in and get the hysterectomy? I know without knowing background health reasons for section might be a hard answer but have I seen anyone having a natural birth after so many sections.
Would also like to say what an incredibly rewarding job!! Xx

This is a really fascinating thread. Thank you.

When my DS was born he was covered in meuconium and he didn't cry. He was taken away to be rubbed down and eventually made a faint cry. Is this common? Would you worry if this happened. He is fine now.

I also never noticed my waters breaking during my labour. The only thing I could think that would have happened is that they could have leaked out beforehand. Is this possible?

Oh, and massive respect for what you do. I'm a paramedic so have delivered a few babies myself and obviously have come across midwives through the course of my job. But until I had my baby I had no idea just how much your job entails really and it was interesting seeing it from the other side, even if a lot of it is a blur.

Tempted to retrain!

Have you ever had someone completely terrified or couldn't cope with labour? Pain wise mostly
I'm adamant I won't ever have children as I couldn't cope with labour (I managed cauda equina!!)

I wanted a midwife led birth but due to hypertension ended up having an induction and every intervention under the sun (wouldn't change a thing, still got my girl and my midwife was EPIC).

Just wondered how often you see a second baby being born in a totally different way. I'd love to get my dream of a natural pool birth next time!

As an aside, please know that you are bloody wonderful. Every single midwife I met during my first labour and subsequent hospital stay was just incredible!! Made me want to retrain...

firsttimebabybirther
Hg is awful, sorry you had such a rough ride. Unfortunately it is more common if you’ve had it before, but that doesn’t mean you will definately experience it next time or as severely.
The nhs page has some good info and links for more advice.
www.nhs.uk/conditions/pregnancy-and-baby/severe-vomiting-in-pregnancy-hyperemesis-gravidarum/

Be reassured though that is really unlikely to affect your baby if you are treated.

What do you think of bounty salespeople being allowed on maternity wards?

And do midwives routinely send labouring women home until the very last minute because then they won't qualify for an epidural as it will be too late? Or is it because of a bed shortage?

scrivette

The day before I went into labour I had a scan to reveal a footling breech so I had to have an emergency section when my waters broke.

If I hadn't had the scan what would have happened when I went into labour, would it have been spotted or would I have given birth naturally? My previous labours were very fast.

Either is possible. If it had been spotted they would have recommended an emergency CS since a footling breech can be a more risky type of breech birth.
However, nature does do whatever it likes and possibly if things had happened quickly the baby may have been born vaginally.

Thank you for answering.
I think you do a wonderful job and thank you for starting this thread as it's fascinating.

Today 20:17 AnotherOriginalUsername

Who would I write to regarding the care I received in labour (re: community midwife and hospital team)? I had a complicated pregnancy and delivery due to my own health, delivery went off plan and very quickly turned into an emergency but the care was incredible - before, during and after labour (including a prolonged stay postnatally). The individuals involved have been thanked, but in a time where the NHS (and seemingly midwives in particular!) get such a hard time, I feel like it shouldn't go unnoticed.
Love this. If your hospital has a PALS service they are a good place to start. Or address it to the head of midwifery. Everyone loves to hear positive feedback, keeps us all going.

Is is true that if you leave a very large gap between babies it's like starting again? I had a very (very!) fast labour with DC1- less than an hour- and that was four years ago so scared if I leave it too long I'll have a long horrific one! Do some women just labour very fast?

Love this. If your hospital has a PALS service they are a good place to start. Or address it to the head of midwifery. Everyone loves to hear positive feedback, keeps us all going

Thank you, I'll do this :)

If you're involved in the birth of a baby who may not survive (known medical condition/birth injury/very premature) do you ever find out what happened to them longer term? Would you want to know? Do you remember them?

Is bereavement care for families of babies who don't make it something a midwife can choose to do or does everyone need to take a turn?

when a woman is having an extremely long early labour (5 days) and a long active stage ( 2 days) what is the chance of a vaginal birth? And If the chance is quite low why isn’t a c section offered sooner?

Why is pain relief (other than G&A and sodding paracetamol) discouraged? I waited for almost an hour to be stitched up after an agonising 48 hour back to back labour, well over 2.5 hours of pushing and an episiotomy. I begged for pain relief, and was offered a cup of sugary tea.

Also, how long do you really let women push for? I was told 2 hours, but I ended up pushing for 2 hours 40 minutes. I was exhausted.

How often have you seen a massive fetal/maternal haemorrhages happen in your career and did the baby survive?

SausageSimon
Sorry you had such a difficult time, sounds awful.
At the point they said it was a Cat 1:immediate threat to life that’s what they mean- baby needs to be born ASAP or is at risk of harm. Usually this is interpreted as within 30 mins, depending on the reason.
However, it’s not unusual for things to change back and forth a bit depending on what the baby’s heart rate is doing. It’s possible they knew you needed a CS because baby wasn’t coping too well but In a non urgent way and were waiting in a queue to go to theatre and then it deteriorated and things were pushed forwards. It’s unlikely they felt there was immediate risk to life and didn’t get going straight away at that point.
However what you really need is a good debrief. Most hospitals offer a birth reflections type service where you can sit with a midwife and look through your notes together and discuss what happened and why, and this is what I’d recommend. Just for your own peace of mind, and particularly for any future baby plans.

TheBabyAteMyBrain

I'm hoping to have a homebirth very soon with dc#2. What snacks and drinks should I get in for my midwives? I have asked but they won't give a straight answer on preferences. Healthy or just loads of cake and bacon butties?
cake and bacon, literally perfect!!! I’ve never been offered more than coffee and biscuits at a home birth and wouldn’t expect anything more than that to be honest, but bacon is always good!!
Hope it all goes well.

Slightly random question but do you often see side effects of epidurals? I had one epidural, and a spinal for a ceaserian (different births) and both times within a minute of it being in my blood pressure plummeted to dangerous levels (crash trolley thing got brought in with the epidural!) and I felt like I was dying, it was quickly and easily fixed but I'm curious to no if that's common and midwives just don't see it as a big deal so don't mention it? My spinal also wore off before they even managed to cut into me which the doctors were very shocked about, if the surgery hadn't had been delayed by neonatal doctors they'd have been fully in progress, so I always wonder if I just react strangely to these things!
Epidurals have lots of possible side effects, some more common than others. The blood pressure drop is pretty common, and it the reason you have a drip running and they check your blood pressure several times after each top up. It’s rare to drop so much as it did for you, but it is a common side effect and our anaesthetists discuss it as part of the consent process.
Unusual for spinal to not be effective but it does happen and I’ve seen the doctors stop and wait for a general anaesthetic to be given a couple of times.
Everyone reacts differently to these things.

FrazzyAndFrumpled

I’m so envious, I’d absolutely love to be a midwife.

In pregnancy, they always say to go in if you experience reduced fetal movement. When you go in and you’re monitored, what are they looking for? Because if the movements have reduced, but not stopped, you’re going to find a heartbeat and that seems to be all they check? Seems a bit pointless to me.
Hi, if you are over 28 weeks they do a ctg trace of the baby. It’s much more than just whether the heart is beating or not. We look at lots of different aspects of the heart rate pattern which give us lots of information. Also you’ll have an antenatal check such as blood pressure, growth, urine etc which can also flag up issues.
We also consider the background risks for an individual pregnancy and make a plan from there.
Please, please, always call if your baby’s not following their usual pattern of movements.

ICJump

Do 3rd babies come earlier?
DS1 was 40+10 and DS was 40+15
I’m struggling with pregnancy and would love to meet this one sooner rather than later
Congratulations!
They all come whenever they please. First pregnancies tend to be a little longer than subsequent pregnancies on the whole, but obviously your DS2 didn’t read that book.
Ask your midwife about alternative methods. I’ve seen some good results from acupuncture for example. Sex, clary sage, nipple stimulation all worth a go if your midwife says they are safe in your individual circumstances. Good luck!

mistermagpie
Thank you for your post, lovely to hear. A last baby will be especially precious for that midwife.