I'm a midwife AMA

[Jemima232]

Community Midwife with four children of my own.

Also worked as an Independent Midwife.

Breastfeeding Counsellor and Sleep Consultant.

@thenameisweasley

You think you're in labour?

Now you'll have to come back to the thread and update us.

That's very exciting - wishing you all the best.

@birdonawire

Indemnity insurance

Yes. The IMUK website has more information about independent midwives if you're interested, and can help you to find one.

www.imuk.org.uk

*@SingingSeahorses

Baby with problems and ? cause.*

I'm so sorry that your baby was born with birth defects. I honestly think that what you have described is not within my sphere of knowledge - I hope your paediatrician can help you.

It is completely normal to blame yourself for possibly causing harm to your developing baby, though. When you have a baby who has something wrong it is natural to look back over your pregnancy and wonder if X or Y caused it. Sometimes there is no clear answer. From what you say it seems unlikely, though, but I am not an expert on this by any means.

Please talk to your doctor and paediatrician. You do have my sincere sympathy and I hope you find an answer.

Very interesting thread. Thanks OP.

If you get a minute I would appreciate your thoughts on my previous post about lowish birth weight baby/thick cord/retained placenta.

Thanks again.

*@Peeass

Another PPH?*

Thank you for sharing your story - it sounds just like mine with my second baby. I opted not to have labour accelerated by drip after SROM and (eventually) went into labour myself.

I did end up with a caesarean but didn't have a PPH.

Anyway - enough about me - you did have a PPH and had to go back to theatre, which suggests that you may have had some retained placenta.

Women who have had a PPH do often have another with a subsequent pregnancy. There are quite a lot of risk factors for PPH, many of which may not apply to you. There is a lot of information on this website: iswww.nlg.nhs.uk/content/uploads/2014/04/Heavy-Bleeding-After-Birth-Postpartum-Haemorrhage-IFP-0773.pdf

In view of your previous PPH you will be closely monitored in case of a recurrence. I hope it doesn't happen again, but yes, it's possible.

Sorry - that link didn't work.

Post-Partum Haemorrhage

www.nlg.nhs.uk/content/uploads/2014/04/Heavy-Bleeding-After-Birth-Postpartum-Haemorrhage-IFP-0773.pdf

Just working my way through, everyone. I will answer all questions.

Sorry OP. Didn't mean to be pushy .

How important is skin to skin, breastfeeding straight after birth and baby being with mum after birth? My youngest baby was almost term but had breathing difficulties and sepsis so we were separated for most of the time for the first week as I had sepsis too and really struggled walking from the postnatal ward to nicu. Nicu used to call postnatal ward saying he was screaming and wouldn't settle but by the time I'd shuffled down there he'd cried himself to sleep.

My eldest and youngest both have asd but youngest is much more severe. Is this because of his birth/early days? (Eldest was born at home and had skin to skin etc). He also gets very upset if I leave him anywhere, even with his dad and at nearly 5 years old he still doesn't sleep through the night.

I keep questioning myself wondering if I'd made different choices, like c-section instead of induction or been induced earlier or if I'd tried harder to push through the pain and spent more time in nicu then he wouldn't be struggling so much now.

I'm currently pregnant with third baby and I have an appointment with a consultant in the next few weeks to discuss my previous precipitous labour.

My first baby was born in 1.5 hours from arriving at hospital in agony at 2cms to baby. I was completely ignored had no help or pain relief and when he was born bled and needed lots of stitches. I went into shock and missed out on the first 24 hours with him as I couldn't hold him I was a mess.

Second baby abroad I was induced as they said I wouldn't make it to hospital. I had an induction at 39+4 with an epidural and it was heaven. The drip started at 9 and I had my baby in my arms before 11am. No stitches completely empowered - it was amazing.

What do you think will happen for my third brith? Can I ask for another induction? I am panicking about not making it to hospital, the pain and total loss of control I had for my first birth.

Should I ask for an elective caesarean if they won't induce? I am not the type of person to cope with giving birth on the kitchen floor!

*And I know that there are questions from way back in the thread - I will get to them.

I haven't answered things in order because some are easier than others.*

@pinkahorri

Thanks for the flowers. DH has just done participated in some research at the dentist's and received £25 in vouchers which I have appropriated for my own use.

I'll have a look at your question soon.

Thanks for your message and the link. Although I'm still nervous re the risk, I also feel more informed which helps.

I don't have any of the health / weight / ethnicity etc risk factors, and I would hope to eliminate long labour and induction from that list next time as well!

I wondered if it's likely that I was given Syntocinon at the time of my last section? Or if they only do it if they consider you at risk? I was induced by oral tablet, in case that would impact (re combining medicines etc).

Thank you!

Routes into Midwifery

Sorry - this was asked a long way back in the thread.

This link should give you all the information you need about this:

www.healthcareers.nhs.uk/explore-roles/midwifery/roles-midwifery/midwife/entry-requirements-and-training-midwifery

In answer to your other question - midwifery practice is not all about delivering babies. As a community midwife I book women early in pregnancy, do ante-natal care and visit women in the post-natal period. I am also on call for these women and can receive calls about:

• bleeding (at any stage of pregnancy)

• excessive vomiting

• pain (not labour-related)

• waters breaking (at any stage)

• baby not moving as much

• baby moving too much

and post-natally

• cord bleeding

• baby not taking bottles

• baby not taking breast

• baby not settling after feeds

• a range of queries about feeding generally

• mother bleeding more than expected

• mother in pain

• mother upset/anxious/panicking about baby and needing reassurance

• mother's stiches painful

• wound problems

and so on...……...and I am sure that I've missed loads of things out.

That was just a selection of the kinds of calls midwives get which are not related to labour.

Obviously we are also called when women think they're in labour. In our area we attend at their homes and assess what's happening.

We make home visits when necessary and either stay with the woman until she goes into hospital, or deliver the baby at home.

We also visit when the woman has a feeding/unsettled baby problem and it cannot be solved over the phone.

I have been called out, over the years, for so many reasons.

Many things can be dealt with over the phone but a lot need a home visit.

So midwifery is not all about delivering babies and there is a lot of variety. Every day is different.

@heebiejeebie

That answer (routes into midwifery and examples of reasons women call us out) was for you.

@Peeeass

You would have been given syntocinon intravenously during your caesarean section. I mean, I wasn't there, but it is given routinely!

Best wishes with your next CS. I know one woman who had two home births after PPH happened with babies one and two. She did not have subsequent PPHs. It doesn't always happened again by any means.

Sorry I haven’t read full thread as just picking up on something you said near the top. My son had shoulder dystocia but was fine. It was never mentioned as a possibility in my second pregnancy at all. She was born easily and had no probs with her thankfully but just wondered if it is something that should have been picked up on?
Also when my daughter was born I asked not to have the injection that makes the placenta come out. So was sat in birth pool holding my daughter and the midwife was checking the cord and she was pulling it. I asked her to stop and she didn’t and it broke which meant my daughter had to be quickly handed over to my husband and I had to push the placenta out in a panic as the midwife wanted me to. Why the fuck was she pulling it?

Pain Relief

*There have been a lot of posts about pain relief in labour and women being ignored when they say they're in pain.

I do not think it is ever acceptable for a midwife to tell a woman that she should not be receiving pain relief or that she is not in

It is absolutely part of a midwife's job to discover why a woman is asking for pain relief - there are so many things which can be done.

Massage really helps to reduce pain. Getting the woman into a single room and lowering the lights also helps.

Telling a woman she isn't in strong enough labour to warrant pain relief is unfair, I think.

Gas and air can be given. Pethidine/Morphine can and should be given WHEN THE WOMAN NEEDS IT, not when the midwife thinks she needs it. Obviously the baby receives some of this via the placenta but the timing can be judged.

If a woman wants an epidural, there are usually guidelines in every hospital about when this can be set up.

If any of you have felt that your midwife did not listen to you, please know that this is not good practice and it should not have happened.

Ask for a debrief. I also encourage you to complain about midwives to their managers, so that they know what is happening to women who are under their care.

I myself had a big problem with not being given pain relief after a caesarean. I was on the point of discharging myself.

A doctor came to ask me why I wanted to go home with my baby, prior to the time when it was deemed medically okay. It so happened that he was a doctor with whom I had worked in a different hospital, prior to having DD2.

I told him that I might as well be at home, in my own bed, as I was not being looked after. I was desolate and unbelievably unhappy.

He treated me with kindness and respect and ordered an injection of morphine for me, to be repeated as necessary.

I am very troubled by the numbers of PP who are saying that their midwives did not listen to them, and left them in pain.

ryanreynolds
Big babies don't always equal problems. All of my dc were whoppers, the last being 10lb 15 (I was warned he was going to bigger than his birth weight was when i was 36 weeks and spent endless hours worrying) birthing the 3 of them, there was a few hairy moments where shoulders had to be encouraged out a bit but I got through without so much as 1 single stitch! Please try not to worry, I appreciate it's easier said than done though.

Jemima232
My question. Do you come across absolute arseholes for birthing partners much?
Strange question but while I was in labour with dc3 I could hear a lady in the room next to me (her 1st baby the midwife said) she was struggling and obviously in a lot of pain.... I could also hear her dh/dp saying things to her like 'come on you coward' 'you're not doing it right' and 'push you useless woman' really loudly to her.
I couldn't stand it, while in the middle of my own pushing and i was so angry on her behalf that I actually screeched to anyone that could hear me, hopefully him ''could someone please shut that arsehole up''
He did not stop! If I could have, I would have happily went in their room and volleyed him full force in his balls. Are you allowed to send people out of the room even if it is the dh/dp?
It's something that stayed with me, some 20 years later. I often hope that she left him. I just could not get my head around how he treated her that day nor why he was allowed to do so in that room.

I am very troubled by the numbers of PP who are saying that their midwives did not listen to them, and left them in pain.

From my experience with dc1 and that of my friends I think it's a huge problem. With dc1, I turned up in back labour and I was told that because I wasn't red, sweating or swearing I clearly wasn't in pain. They tried to send me home 60 odd hours into my waters having broken (of their own accord) because I clearly wasn't in "labour". Turns out I was 5 cms and I've never known pain like it. My dentist rarely bothers with anesthetic whenever I need dental treatment (my choice, she's not a total sadist), I didn't need anything at all after 2 c-sections...so it's not like I don't know pain but I was dismissed, diminished and ended up a suicidal mess with a baby in NICU who I thought was a doll because of the way I was treated in labour, during my emcs and postnatally.

My experience with dc2 was a million times better but again my pain was dismissed. First thing I was told on arrival at the labour ward was that I didn't look like I was in labour...okay she apologised very quickly but it didn't help.

Why do some women have PPHs? Are they serious?

@Jemima232 thanks so much for this! I had a baby 5 weeks ago and had the injection for the placenta. I remember the dr asked but didn't say why (is said I didn't want this in my birth plan) and my partner didn't know either. I requested my birth notes and it says I had the injection 2 mins after he was born and the placenta delivered a few mins after that but no explanation why. Blood loss was 400ml which I don't think is a concern, I was tired but not so exhausted I couldn't have delivered it naturally. Any ideas on why this might have been, and if there is anything else I can do to find out why from the hospital? Thank you very much

You sound such a lovely midwife. Thank you for acknowledging that some of your midwife colleagues might not be so nice. This is my experience...

Told to call hospital when 14 days overdue to arrange induction. Do this and greeted with “well we’re very busy with all the Xmas babies but I suppose you’ll have to come in”. Induced a few hours later. Had killer contractions for 48 hours. Paracetamol only painkiller given until ‘officially’ moved to labour ward. Repeatedly told to “have a bath” to help with pain. By the time I was supposed to push, 2 days after induction, I was so exhausted I fell asleep between pushes. Midwife went off duty 8am. New one came on and I gave birth 8:10am with ventouse. Held baby for a brief moment then they were whisked away for two hours as medics concerned about infection. (Baby had bloods taken - no infection.) Lay in room on my own for an hour after birth (couldn’t move as epidural) wondering where baby was and what was happening. Not even offered a drink of water by midwife. After an hour buzzed to call midwife. A different one came to room and I asked if she knew anything about baby and if I could please be helped with cleaning myself up after birth. Told my midwife was busy with paperwork and couldn’t help me wash. No news on baby. After another 30 mins I buzzed again (I was actually afraid to do this as staff so aggressive) and asked if I could at least have a bowl of water to clean myself up. Was brought a bowl of water but no soap or towel. Cleaned myself up as best I could and was too frightened to buzz again to ask for a towel. Took pillowcase off to dry myself! Was offered a cup of tea 3.5 hours after birth, having barely eaten or drunk for the past couple of days.

Whole experience left me feeling belittled and worthless. It’s so lovely to hear how much you obviously care.

Why do doctors who work in obs/ gynae have so little clue about sexual assault and its aftereffects? I mean a substantial minority of women experience it so why don't people working in intimate healthcare have some idea how to approach it?

The MWs in my last pg were mostly great but the drs were a huge problem, very my way or the highway, no interest in patient consent, totally insistent on a very old fashioned birth on back with lots of people present. I kept trying to explain that whatever their guidelines were, I couldn't give birth like that bc of my past. Eventually I locked myself in a toilet away from them and delivered my baby myself. It stil makes me ragingly angry at times.

@JohnnyMcgrath I noticed a difference between the midwives and drs at my hospital last time I gave birth as well. My midwife showed me a lot of respect and was big on respect and asking me properly before anything happened. When drs came into the room the tone and mood completely changed- eg ‘I’m just going to examine you’ said after they’ve already popped gloves on.