I’m a midwife AMA

[Doubleyouexwhyandzed]

I’m a midwife, with 15 years experience. AMA

You mentioned something being a feminist issue earlier. I’m really interested in how much, if at all, feminist perspectives are brought into midwifery training? I had a traumatic birth/postnatal experience with my second baby, and strongly feel a lot of it was around the very patriarchal, narrow systems which can exist in western medicine.

@Doubleyouexwhyandzed thanks for replying. I had the Injection pretty much straight away but I had no more pains and contractions to push with it just stopped as soon as she was born. It was an awful experience and I only had gas and air until I lost my shit and demanded a spinal. The midwife was lovely but it was the registrar who kept saying 'Iv nearly got it if you just give me 2 minutes... ' 60 mins later I was in theatre ad it took another hour to get out.

You sound lovely OP, are you able to say which geographic region you work in?

I feel like all we hear is horror stories of birth. I’m 36 weeks and trying to read more positive things, so hypnobirthing etc, but do you think it’s the scare stories we hear more as people like to talk about them or is there a genuinely high proportion of “scary” births?

Honest thoughts/attitudes on 1st time 'geriatric' mothers 40+yrs?

I recall seeing on 'one born' the eyes roll at a gravida 1 who was 40+ yrs.

Do you watch 'call the midwife' and thoughts on it?

Sorry if someone has already asked this but given the choice would you/did you opt for a c-section or a vaginal birth? I heard that most healthcare professionals who work with women in labour would opt for a c section for themselves while still telling their patients that a vaginal birth is preferable

My birth experiences were all quite traumatic in their own ways.

DS1 was back to back, face first, shoulders stuck, I was in labour for 38 hours after my water's broke. I had a PPH and was only 17.

DD stopped growing, became distressed and I was leaking amniotic fluid for 18 days before she was born and bleeding (amniotic fluid confirmed with swab)
No one would listen to me. When I finally gave birth, the midwife handling the birth was furious with the way I had been treated and helped me to put in a complaint.
I was extremely lucky that DD didn't come to any harm.

And then DS2 was an extremely easy birth, despite him being 10lb 10.5oz! Only, he was tangled in his cord and not breathing. The midwife sorted it in no time. She was truly amazing and didn't complain about me listening to ozzy Osbourne to drown out the sound of the woman next door

I just want to say a massive thank you for all your hard work. It is truly appreciated. Without people like you, chances are me and my kids wouldn't be here now.

Do you treat younger / teen mums differently to older mums? There were times that I didn’t feel listened to, and that I wasn’t treated the same (although I admit that could also be my perception of the situation). Is there clinical guidance or a different pathway when the mum is young, or would it just be down to individual midwives?

What is your opinion on Doulas?

Have you had any family dramas? Like the MiL dramas I read about on another board?

@annie9876 my labour and birth experience was nearly identical to what you describe it led to pnd for me.I hope you are seeking counselling,I wish I had my ds is 6yrs now and I dealt with it all myself

A bit of a random one but what measures are taken to preserve privacy and dignity when a woman needs to have a vaginal birth but with a lot of people in the room? Eg is it ensured that those who aren’t needed to help with the actual ‘delivering’ part stay up above the woman’s head until needed, if people are coming in out of the room at certain intimate points like stitching/catheterising how are women given the maximum amount of privacy possible? I had an assisted birth with a lot of different people (both men and women which made it worse) filling the room, I was very on display and just felt like there was constantly tons of people wondering around whilst I was giving birth/getting stitched up and so on. I found it absolutely degrading and humiliating and it really contributed to how traumatised I felt.

I just want to thank you for doing the job you do. I had both my children at home and the midwife that attended my first birth has such a special place in my heart. She was so fantastic and i had such a perfect birth. Second time was fine, but my first birth was amazing and i know i owe it to the midwife. My dd ended up in scbu (nothing to do with the birth) and there was a midwife on the ward who was totally amazing and sat with me in the wee small hours as my dd battled for her life. Just truly amazing people that stay in the hearts of the people they help.

What do you do about anxious or overweening (have I made this word up; interfering, I suppose) dads attending births?
DP was not, despite his best efforts, (wanting to model himself on the stoic fathers featured in Ina May Gaskin's work), a good birth partner the first time around, probably getting more frightened and anxious than me as labour became a complicated sequence of increasingly bloody interventions. He became quite depressed afterwards (I feel he could have benefited from a therapeutic birth debrief more than me, to be honest). I spent a lot of time mulling this over when contemplating my second pregnancy. Second time around, a home birth, he was kept busy by the supervising midwife making teas and arranging a nice spread of biscuits. Much better.
Also, is PTSD a 'thing' among midwives? I can imagine that, as a profession, you find yourselves in some very stressful, and potentially traumatising situations?

Firstly - thank you. I’ve had such good experiences of midwives if I was able to give everyone I’d seen a thank you card following the birth of my DD then I would do.

In your experience does a drip induction make labour progress faster? I was induced with ARM/drip for being post-dates and went 3cm-delivery in less than an hour. I’m curious about whether a spontaneous labour with DC2 is likely to be similarly quick (or quicker!) or whether it’s common for babies born with a drip to fly out quickly if the drip’s put in at the start rather than being an escalation due to failure to progress?

I experienced a precipitous birth with dd, and my DH ended up delivering her on the side of the road as we didn't make it to hospital on time. I'm 20weeks pregnant now and we're both really anxious about this happening again as everyone says subsequent labours are quicker. We're contemplating a homebirth, but also worried as I experienced a pp haemorrhage and 3rd degree tear. What would you advise? Would a c-section be safest?

@StillNotANewUser, I had exactly the same experience with my first, straight to drip and baby born within 2 hours of start of labour. I wondered exactly the same thing in my second pregnancy! In my experience, my two subsequent babies were home births and both still quick - 4 hours and 3 hours. I had lovely, peaceful home births with no pain relief needed, just a birthing pool. No tears, no stitches (I had this in first labour)

Do you think Group B strep testing should be given to all women towards the end of pregnancy or start of labour?

My midwife is suggesting I go for vbac despite the vbac class I attended saying I had a less than 4% chance at success due to failure to progress past 3cm after 24 hours on induction last time.
Is one of them mistaken?

How likely would a pp haemorrhage for second births be if you've had one before? Same for preeclampsia?
Also do you have any favourite birthing stories/patients?
And thank you for doing the job you do. I adored my midwives and meant to get them a box of biscuits but unfortunately the business of a newborn meant I kept forgetting and now I can't remember their names.

You say up thread that putting your leg up on the pool steps tends to sort out shoulder dystocia, is this the same with 'dry' birth situations (putting one leg up on something as if to step up)? If so why are we not being told to try this before intervention during labour?
Also thank you!

Great questions!
Feminism- you’d be a pretty poor midwife if you aren’t a feminist, in my opinion. We are the protectors of women and their rights. Totally agree that some parts of maternity care are very narrow medical models based on the old patriarchy of medicine telling ‘silly women’ that the doctors know best. I think it varies between hospitals somewhat. This is definitely improving all the time, I see very little of it where I work as I’m in a midwife led birthing unit so we are leading the care. I feel it more on the delivery suite, but a lot of the Obstetric ‘over involvement’ is based on fear- fear of litigation, fear of poor outcomes. The obstetricians barely ever see anything normal so their perception of risk is skewed. They are always anticipating problems, must be a very scary perspective.

20viona-sounds awful. But every birth is different and hopefully you will have a totally different experience if you choose to do it again.

I work in the East of England.
I think scary births are over represented in media/forums etc, probably because traumatised women need to vent and debrief. Also, women who have had a really straightforward lovely birth probably don’t feel able to shout it about as they don’t want to be seen as ‘braggy’ or insensitive to those who don’t. Nearly all the births on my unit are straightforward. Most women describe their births positively.

‘Geriatric’ mothers- urgh are people still using that phrase? W have a pathway for mum who will be aged 40+ on their due date. Slightly more monitoring in pregnancy due to the slightly increased risks but generally 40+ mums are no more at risk than everyone else. We don’t have an upper age restriction for our midwife led birth unit.
I’ve not come across any negative attitudes either, that would be stamped out very sharply around here.

I do watch call the midwife, I love it :)

I don’t think that’s true re staff choosing CS over vag birth, at least not amongst midwives. Most of our midwives are desperately keen to come to the midwife led unit and have as low intervention birth as possible. Obstetric doctors more likely to chose elective section, although def not all of them. Again, if all you ever see is things going wrong your perspective is likely to be one of fear. I would choose a vag birth over a CS any day of the week. In fact, I was offered a CS with my first and declined. They are great when they are needed but not something I would choose.

Herroyalfattiness thank you :)

Young mums- we have support pathways through the health visitors but not a specific pathway for pregnancy and birth as essentially age doesn’t make a huge difference. I don’t see poor attitudes to younger women but I know they existed in the past. One of our midwives has her first at 15 and had a poor experience. This would be stamped out very sharply too. Young mums, like all mums, need nurturing and respect.

Doullas are a mixed bag. I’ve met some incredible Doullas and some dangerous doullas. I’ve had doullas ‘deliver’ babies at home and claim to have not had time to call a midwife, when the woman has laboured at home for hours. That’s dangerous, they just don’t have the training to manage emergencies safely. When everyone sticks to their role it works like a dream.

Not many family dramas- sometimes over enthusiastic family members turning up uninvited. I gently shoo them away on behalf of the parents.

Privacy and dignity is massive. We all try to be as aware as possible. Our birth unit has a very strict door knocking, stay behind curtain ethos. Sometimes it’s unavoidable to have several people in the roOm- theatre for example seems so crowded but all are essential. People wandering in and out of a birth room when you are being suturing is unacceptable, the mind boggles that the anyone thinks that’s ok.

HAIRY thanks :)

Anxious dads- being a birth partner is intense. It’s not for everyone and it’s always worth recruiting two so they can tag in and out if they need to. It can be really frightening to feel helpless when the one you love is suffering. We try to support them as much as possible. Homebirth is handy because there’s always jobs we can task them with. Pool water temp maintenance often provides a great fully received focus.
PN depression in dads is real, they often could benefit from a debrief and safe space to talk but dads forums seem less available.

PTSD in staff does happen. We’ve recently had a midwife leave as she couldn’t overcome the PTSD she developed after a woman died on the postnatal Ward. It was horrendous and despite lots of support she just couldn’t face returning. Really sad. We are getting better at staff welfaRe.

@Doubleyouexyandzed thank you so much for answering me. My birth was in theatre and it did feel very crowded- I meant if some of the HCPs are there for reasons other than the actual delivering part (eg for the baby after birth, on standby in case something else needs to be done) do they stay up past the woman’s head and keep a respectful distance? What about when women are catheterised before an ELCS? Do theatre staff not involved in this particular part give her a bit of privacy and stay up head way?

Not a question really just wanted to share my experience. You seem nice but I felt so angry with all midwives/obs staff after my traumatic labour. It's taken me a long time to get over my anger, though the trauma still remains.

I echo what another poster said about lots of people in the room. I distinctly remember a male doctor wandering in have a look (he didn't do anything nor did he speak to anyone so I don't understand what else he could have been doing) when I was having my (not consented to) assisted delivery and I was physically unable to speak to say I didn't want him there.

Traumatic births are seemingly so commonplace these days

Why do you think this is? Age, obesity, medicalisation of birth. Or as you say upthread, we only hear about the trauma's, and actually most births are trouble free.

I suppose I wonder as I was really lucky and although first was induced with epidural, it wasn't long, and I didn't have any injuries. Second was really quick, back to back, with arms outstretched delivered first, like a diver , but delivered in under an hour! Again, no issues or injuries.

@Pemberleypearl yes this is how I feel, I remember a lot about being surrounded by people. I remember a male staff member being stood at my waist watching whilst I was pushing even though a different dr and midwife were doing the delivering with forceps/coaching me to push. No idea who he was, what his job was or why he needed to observe everything. There seemed to be a lot of people just stood about whilst I was bottom half naked with my legs in the air in stirrups and I really wish I’d had a bit of an explanation afterwards about who and why they were there, why they had to see everything. But I was just supposed to not care or question anything.

Have you ever been present at a birth via a surrogate. If so how has it made you feel? What is your take on the whole arrangement?