I'm a Midwife AMA

[MidwifeAMA]

Experienced midwife, hoping to spread good quality info :)
AMA

I'm a few weeks away from birthing DC3 (if they decide to move from current oblique/transverse lie 🙄). I was induced with DC1 and 2, pessary only. DC1 was 3.5hr active labour and 2 was 40 minutes from 2 cm to baby, midwife said would've been a lot faster but baby was in a dodgy position...I keep hearing 3rd births are tricky/not as fast as second (this would probably be a good thing! Felt like I'd been hit by a train after DC2!) - what's your experience? Are third births as horrible as everyone makes out?

I'm also worried about an accidental home birth too 😱 should I do any prep for this just in case given the speed of my previous labours?

Thank you @MidwifeAMA
My issue was feeling midwives were quite dismissive and saying things like "well this is a different baby" in response to me saying "I'm very anxious about miscarrying again". This in turn made me feel worried they weren't going to monitor me properly.
I'm glad language used is being seen as an important issue. It really impacts on your trust in the HCP.

any idea what counts as an uncomplicated pregnancy for flying?! My midwife isn’t sure and I’ll be flying at 22weeks but am consultant led due to fibroids. No one seems to know if that is complicated or not!

Likelihood of manual placenta removal being required second time around?

The risks do increase with each CS.
Why don't you ask for a pre pregnancy chat with an obstetrician so you can use that info for your family planning choices?

@vivariumvivariumsvivaria why are they being taught how to catheterise a penis??

I assumed the terms "birthing person" etc was to include a woman (with a vagina) who indentified as a man?

But a baby can't come out a penis, so I'm baffled by this

@MidwifeAMA thank you. I did briefly speak with my consultant following the birth of DC3 and she said it’s doable with “extra hands on deck”

It will heal, but it will take a while as it will heal from the inside up and look a bit gapey for a while.
Tbh most practice nurse/gp's have very little experience with tears so I'd go with your midwives advice.
The "they should have cut you" is absolute nonsense. The nurse had no idea of what your perineum looked like in labour and generally tears heal better and are less painful than cuts.
Give it time, take pain killers as needed, it's still quite early days.

That's so odd, we like to advise everyone on safe sleep. The best resource is the lullaby trust, tons of great info.

I’m due next week when it’s forecast 38 degrees where I am and I won’t lie, I’m scared.
Will hospitals be completely overwhelmed? How worried should we be about having a newborn in temperatures like that?

Very often, from mild to severe.
Different places have different set ups.
We have a general well-being service which support mild mh issues, the perinatal mental health team support more severe needs as they have a psychologist on the team. They offer full mental health support, assessment and treatment through therapies, medication, follow women through their pregnancies and make plans for birth etc if needed.

Hmm not sure, we use the ph and base excess to guide our decisions but these seem to be different to what I look for. You could see if your hospital has a birth reflections type service to discuss with?

Do you find the support staff on the postnatal wards know what they are doing or have the right temperament? I’ve been shouted at after all my births (for things like calling for help when I felt I was about to pass out!). All the unkindness came from support staff rather than midwives.

Thank you. I had a water birth & I genuinely didn't feel it happen at the time, but the healing process is getting me down a bit as I just want to get back to normal activities.

DS came out in one go so maybe I delivered a bit too quickly. The midwife initially thought it was just the head until I said "he's in the water, can you grab him!" as he was behind me (I was leaning forward against the side of the pool)

You get lots of family advice that's outdated or ropey, but understandably people are going to trust the advice a loved one gives them over a stranger often. I think we can only present the information and explain why we suggest what we do.
Feeding is a big one, people making up formula feeds several at a time, using cold water or keeping them in the fridge shudder with the famous words "well I did it for mine and they are fine", same often said for smoking. I hear some absolutely ridiculous statements about smoking in pregnancy, like "if I stop the stress is bad for the baby"

Birth plans are very individual, some people like a full plan others like to wing it, and it's a little insight into their personality.
I think it's really helpful if people have an understanding of their options and how they feel about them, but also keep a bit of flexibility in it and appreciate that birth is unpredictable.
Sometimes we have very rigid birth plans or plans that are quite high risk but once all the pros and cons are discussed we roll with whatever choices the person makes.

Depends on your birthing unit and midwife ethos.
I'm very pro supporting physiology and not interfering so I've seen a few. Tricky in the pool as you have to catch a baby in a bubble

No 3s aren't horrible, they often are a bit longer than the second which often mums are grateful for as they have time to get childcare sorted etc. they can be a bit start stop so you might find you think it's all happening then it fizzles, but once they get going they are usually straightforward and quick,

Just wanted to say thank you for the job you do ❤️

It's less likely to accidentally gave a homebirth with number three than number two. But if you do get stuck Just call the midwife, they will send someone to you and talk you through.
Key points- Warm room, lay on your side if you can to stop baby firing through really quick, do t sit on the loo or stand, place baby skin to skin with you, dry and cover warmly, give them a big rub with a towel if they look a bit shocked, and leave the cord alone.

I guess the difficulty is that there's really so little we can do in those early stages, and so reassurance is all we have to offer.
"This is a different pregnancy and a different baby and so there's a really good chance all will be well" said compassionately actually could be reassuring for a lot of people. But everyone is different and unfortunately even the most well meaning words will probably feel uncomfortable to some.
Do you feel like it was these words or general lack of action? How would you have liked it to go which would have felt better?

I'd be massively unexpired about fibroids for flying.
To me the question is what risk is there in the air?
So if you're high risk for bleeding or preterm birth, that sort of thing.

I met over 10 midwives during my experience in a big London hospital. Every single one of them displayed the same passive-aggressive and patronising attitudes, I. E.

1. questioning validity of consultant's decision re elective csection. Happened on every appointment by different midwives
2. extremely poor 'birth/looking after infant' training. We had a whole day session where every question from the audience about instrumental delivery, emergency c section, epidural was dismissed a-la don't worry your pretty little head, it will probably not happen to you
3. there was a VERY strong emphasis on natural birth, by which they mean no epidural, with scaremongering about side effects which are simply not consistent with the widely published reports. Again, very patronising 'don't worry let's just see how it goes, maybe you won't need it /want it at all Is there a specific guidance in place that recommends such approach?

I met over 10 midwives during my experience in a big London hospital. Every single one of them displayed the same passive-aggressive and patronising attitudes

same.

also the disbelief, especially of first time mums. You’re not in labour, you think you’re in pain now, you’re “just” a first time mum and don’t know what you should be feeling.

i nearly lost my first child because a m/w didn’t believe I was in as much pain as I said I was because I was only 1cm and i wasn’t having the pain in waves I couldn't talk through. Turns out a detaching placenta is fucking painful but they didn't consider that, just assumed I was a ftm making a fuss and were going to wait until the morning. It was a passing pair of junior docs that picked it up.

post natally as well the unwillingness to help with bf and constant offering formula if they saw me feeding. I also got a fairly sound telling off for not bringing my own formula.

i know m/w are understaffed and overworked but why does the mentality seem to be that the patients are there to cause hassle and create work? Is anyone trying to change the ethos? Personally this I why i hated working in the nhs, everything was a pain and people acted like they were so overworked what you were asking was just one step too much.

Oh sorry, another relatively specific one. In all my previous pregnancies I have been consultant led- all my babies have been IVF, I have autoimmune thyroid disease, first was a twin that died in the womb so bled throughout, GBS+ in all pregnancies 🙄. This pregnancy there seems to have been debate regarding whether I am high or low risk and should be consultant led. I turned up to my 32 week scan and consultant appointment to be told it had been cancelled and I was being discharged back to midwifery led care - has criteria changed based on new data/ research showing my conditions don't make me higher risk and therefore I'm no longer eligible for growth scans (fine!)? Or is this a consequence of underfunding/staffing (not fine!)?

I have booked a private growth scan just for some personal reassurance but would be nice to hear if you are seeing this sort of thing and agree/disagree with it?