I'm a Midwife AMA

[MidwifeAMA]

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

That's really thoughtful, I think staff just appreciate the appreciation if that makes sense. The thought behind the gift rather than the actual gift itself.

Alcohol

Super rare and hugely unlucky!

Yes you definitely run on adrenaline and new baby buzz until sleep deprivation hits. And then it's survival mode. Eat,sleep,dressing gown.

Mostly it's bad luck. Either the placenta doesn't separate properly, sometimes because the uterine muscles aren't working so effectively. Sometimes it's logistics- the cervix shuts too much before the placenta is out or the cord snaps and mums just can't get it out.
If there's an obvious reason like the cord snapping you can try to avoid traction on the cord next time. If the placenta was separated but just sitting stuck in the cervix you might choose to be really upright and actively working on getting it down quite soon after birth, or you might decide a different management for the third stage- having or not having the injection. Your midwife should be able to throw more light on it.

It may well be that your uterus was a bit relaxed but if the overall blood loss was normal then I wouldn't give it any more thought- they give the drugs to make it contract and the bleeding resolves- when you're in theatre it's a very slick process.
They don't do electives on Xmas day, it would be a case of the couple of days either side probably based purely on what slots are available!

I think if you can address the fear then the pain becomes more manageable. So making women feel safe, that's you're a team, really good communication of what's happening and why, what comes next etc. and also making sure their pain relief needs are met, comfort measures, all those things add up.
To be honest I rarely look after women who appear to be in agonising traumatic pain, but I do work in midwife led settings where everyone is moving around, using pool, really calm environment and I think that makes a huge difference.

Why do midwives totally ignore the fact that some mums don't want to BF? I had it in my birth plan that I didn't want to BF & after a high risk emcs was very ill in HDU drugged up to the eyeballs & every time I woke up there was a midwife trying to clamp ds on to me. Ds was left over 48 hours without a feed because they refused to give him a bottle, it took until I was conscious & demanded a bottle for him to get fed.

i was induced due to low movement and had a very positive experience with wonderful, caring, attentive midwives. I also had a student alongside the midwife and have never felt so pampered and precious in my life!

when delivering the placenta the cord snapped. Why does this happen? The midwife was holding my placenta so no real harm done - but the more I think of it I think why was she holding it, is that a normal set up? I was so tied up enjoying baby cuddles I didn’t question it (or notice her being so…deep!)

Thanks for doing an AMA. I had a blood transfusion after my elective c section due to substantial internal bleeding and was surprised that the midwives are not familiar with the protocol to write off the product at the blood bank because they say that they don’t do it often. However a lot of my friends said they’ve had transfusions as well? So is having a blood transfusion common after birth?

Thankyou so much for your response 💐
I should mention that I had my last scan on Tuesday where fetal medicine determined that growth was now around the 75th centile. However, I realised myself that it is actually around the 90th as the weight has been plotted incorrectly on the growth chart. (Baby is already 7lb 1oz)

I haven't been able to speak to anyone as yet about my concerns regarding diabetes but will see my consultant on Tuesday. I am just wondering should I try to speak with someone at the hospital before this appointment? I am a high risk pregnancy due to having a blood clot (cvst) and suffered a loss at 25wks last year so am just anxious for all to be OK. If it is relevant, I am 5ft6.
Thankyou x

What to say to a pregnant friend who wants to drink ?
In my country there is a zero tolerance for alcohol while pregnant. I am aghast when I see a pregnant mum with a glass. Am I wrong ?

Did you deliver the same mum more than once ?

Is it part of the new normal now to have babies after 40 ?

Is it common to still be afraid after multiple births ?

Thanks.

How do you respond to other colleagues poor practice? My experience with my first has made me never want to see another midwife again and if I hadn’t of demanded to see a dr both me and my baby would be dead. I had to deal with before labour, midwives who failed to monitor correctly, argued with each other and drs on more than one occasion.
During labour my midwife turned her back on me and kept threatening to send me home. I was offered no pain relief until I demanded to see a dr who on arrival pulled the emergency buzzer and I was whisked of for a caesarean. The postnatel care was another level of terrible, I was left without food and water and wasn’t allowed to leave my room. I wish I would of had you as my midwife.

Absolutely not. Maternity unit’s are staffed the same on Christmas Day as it is on every other day of the year

@MidwifeAMA thank you so much, I really appreciate your reply. I had all of the things you mentioned can cause blood loss so that makes sense. They stopped birth reflections at my hospital due to the pandemic and now its back, my appointments keep being cancelled due to staff illness. Hopefully I will have it soon ...

How do you keep a straight face when told a ridiculous name of a newborn?

In some universities the training has hugely declined imo. Currently have a child training and it’s been horrendous with no support from the uni. Wonderful placement support but it’s so patchy as they are short staffed. No continuity. She was on zoom for a year and mentors and placements keep changing.

But the NHS says it’s ok to make up feeds and store them in the fridge (not ideal, but ok)

www.nhs.uk/conditions/baby/breastfeeding-and-bottle-feeding/bottle-feeding/formula-milk-questions/

A question on induction. I had two pessaries about 12 hours apart. I had a load of backache and went for a bath (normal ward bath), baby was born 15mins after I got back out the bath.

How common is it for the pessary to put women into active labour?
My friend and I have similar stories babys born before anyone realised we were in active labour- Dads missed it.

Could the bath have slowed my labour?

@MidwifeAMA thank you for doing this AMA. Would my mum’s childbirth experiences be similar to mine, especially as she had a similar body to me at the time? She was a couple of years younger than I am now (she was early 20s and I’m mid 20s), petite and thin. She tore, haemorrhaged and almost died giving birth to me after nearly 2 days of labour. Needed a blood transfusion. I’m terrified that my experience will be the same. Can it be genetic?

Have you experienced many Vasa Previa and/or placenta accreta births? If so, what was the monitoring procedure, outcomes and gestation at delivery? I've been diagnosed with VP and potential accreta since 23 weeks and feel totally in the dark. I'm now almost 30 weeks and the info available online seems mostly targeted towards the USA.

Thank you in advance for your kind help!

If 2nd babies are usually quick and 3rd are the slower wild card labours, then what about 4th labours?

History labours of 4hrs, 90mins, 2 hours. Expecting number 4 and curious!!

No idea, that's really weird.
We very much support whatever you choose. Your baby, up to you.

They snap occasionally, not often though. I imagine the cord snapped but she saw it starting to break so grabbed the end of the cord nearest the placenta so it didn't slip inside.

I think we give blood fairly regularly, unless your unit is quite small and then maybe they don't do it so much. You usually have to be quite anaemia and feeling rubbish to be offered it. The midwives who work in high risk settings are familiar with the blood giving processes. Could have been someone new to the area maybe.

I think as long as your friend is aware of the recommendations to not drink (which it's highly likely she is) I'd prob leave her to it.
We recommend no alcohol as there is no evidence on what is a safe level, but we always used to say a small glass of wine once or twice a week max, and I don't think we had huge numbers of babies with fetal alcohol syndrome.

I've looked after the same mum twice, it's really lovely :)

The age of having babies is gradually creeping up, we see lots of women in their early 40s.

Sometimes ignorance is bliss, and if you've had previous negative experiences it's hard to not carry that forwards either you. Also, birth is so often a hospital event and your subconscious brain might think hospital=illness, or you might feel anxious about being with strangers, being away from family, pain, the experience etc.