I'm a Midwife AMA

[MidwifeAMA]

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

[MidwifeAMA]

@Theawkwardblonde

@MidwifeAMA thanks so much for your response. Will give hypnobirthing and birth reflections a look.

Sending you positive vibes

[MidwifeAMA]

@jammiewhammie65

Two of my daughters want to be midwives. Would you encourage or try and talk about other options ? WhAt would you say to your daughter

I'd say it's incredibly hard work, you never get off on time, you'll miss Christmas and bbqs and bank holiday weekends don't apply. You'll see life and death and get other peoples bodily fluids between your toes. You'll feel the highest of highs and the lowest of lows. You can't have pretty nails, sigh. But if it's meant for you, and you find your tribe then it's just the most incredibly joyful thing. The passion and laughs and feeling of being part of something so exceptional.

[MidwifeAMA]

@20viona

I'm 31 weeks and baby has dropped from 30th centile to 8th centile in 3 weeks.

I was induced last time at 37w and daughter was born on 2nd centile, should I be preparing myself for a similar scenario?
Also had manual placenta removal, is there anything to suggest this was due to induction?

I'd try not to worry about the growth, it's so unpredictable and scans are up to 15% out weight wise so it could be a blip. Take them one at a time.
Placentas can be affected by labour process, if your uterus is shattered by hours of hormone drip and your mobility is restricted it could in theory affect how easily the placenta comes

[MidwifeAMA]

@GranSu

Thank you so so much for helping all these Mums with your views & experience.
You and your colleagues do a great job.
Daughter has just given birth and Midwives for whole 9 months were super. Not sure that B/F help was there after birth tho'. Such pain when feeding.
9 days old and baby has tongue tie. No help via NHS. And no way to know how to find someone privately. Some seem out for sucking lots of money out of Mums. How do you find someone to do a frenotomy/cut?

It's really hit and miss between hospitals. We have a great rlf service compared to many, there are private practitioners too, contacting a local lactation consultant is a good first step

[Cattenberg]

During my labour, I struggled with the internal examinations. They hurt more than the contractions. Why are they so painful and is there really no alternative, such as a transvaginal ultrasound perhaps?

[GinIronic]

@MidwifeAMA

Please talk to your midwife so an individualised plan can be put in place, there is additional support available.
All things are optional. Always.
It might be that you decide to decline vaginal examinations completely, and that's totally your choice to do so.
Everything that is offered should come with a rational- and so you can then decide if you think it's a worthwhile task.

It may be your choice to decline vaginal exams but in my experience you won’t be admitted or offered pain relief without one. I always felt that I was violated against my will as I could not truly consent as I felt that I had no choice. I also do not appreciate the OPs comment that women drugged up with pain relief can tolerate a slower VE exam so that someone may learn how to find a cervix!

[annoyedneighbour1]

@GinIronic then how do we learn? Models are not realistic at all, I can find the cervix on a model but in real life it's not comparable, it's completely different.

I HATE having to ask women to go through 2 VE's just so I can learn and I totally respect their decision when they decline. But there's no other way to learn other than practice unfortunately.

Students learning such an important midwifery skill is reliant upon women agreeing to let them practice on them, unfortunately.

[MothersRuin267]

@MidwifeAMA with the injection to get the placenta out, how common are the sickness/headaches side effects? I’m in two minds whether to have it or not!!

[GinIronic]

@annoyedneighbour1

@GinIronic then how do we learn? Models are not realistic at all, I can find the cervix on a model but in real life it's not comparable, it's completely different.

I HATE having to ask women to go through 2 VE's just so I can learn and I totally respect their decision when they decline. But there's no other way to learn other than practice unfortunately.

Students learning such an important midwifery skill is reliant upon women agreeing to let them practice on them, unfortunately.

Nice dodge there on the subject of a "forced ve" and making it all about you and your needs.

[annoyedneighbour1]

@GinIronic I was responding to the part that was relevant to my question to the OP.

My practice isn't about me, it's about the care that women will receive once I qualify.

[silverbuttons]

@MidwifeAMA I had a placental abruption at 35 weeks. This was after two weeks of being admitted and then sent home due to repeated heavy sudden bleeding. Ultrasound scan said I did not have placenta previa.

Placental abruption happened while I was resting in bed. Within a minute the whole bed was covered with blood, it was really scary.

Ambulance men were very relaxed and not in a rush. I became unconscious within a minute of arrival at hospital and was apparently fitting. I had to have a general anaesthetic and a crash c section.

Surgeon said it was caused by placenta previa and that he was definitely correct because he saw it when he cut into me. He said scans can be wrong.

I am still traumatised by the whole thing. I had several blood transfusions afterwards. Baby is fine luckily after some weeks in the special care unit.

I have never met anyone else who has had this. How common is it? How many placental abruptions have you dealt with and how often do you get the result that both mother and baby are fine after treatment?

[MidwifeAMA]

@Cattenberg

During my labour, I struggled with the internal examinations. They hurt more than the contractions. Why are they so painful and is there really no alternative, such as a transvaginal ultrasound perhaps?

I think everyone is different in how they experience a vaginal exam. For the majority of women they are mildly uncomfortable, for some they are unbearable- physically or emotionally.
They are, of course, optional as is everything but can at times be very useful for decision making and supporting physiological labour processes.
Unfortunately lots of the information gained from a digital vaginal exam is only possible from this method.

[MidwifeAMA]

GinIronic
It's barbaric and coercive to deny pain relief based on declining VE, please if you feel able to complain do. Birthrights website are an excellent resource for support.

I think your use of "drugged up women to practice on" is very emotive and loaded.
The reality is that this is a skill that has to be learnt by doing. When you are learning you are slower than once you are skilled, as in most things. Women who are comfortable with epidurals often don't feel the internal examinations as uncomfortable and therefore when we discuss the care students offer and discuss the skills they are learning as part of the consenting process they do tend to be more comfortable with their student examining them. There is certainly no expectation for women to consent to these. The student would be a part of their birthing team providing the full range of midwifery care, not a random person walking in to practice something.

[MidwifeAMA]

@MothersRuin267

@MidwifeAMA with the injection to get the placenta out, how common are the sickness/headaches side effects? I’m in two minds whether to have it or not!!

In my experience not that common. It's quite infrequent that people feel unwell after a single dose of Syntometrine. There is the alternative drug Oxytocin- this works similarly but without as many side effects, maybe ask your midwife if this is another option for you.

[MidwifeAMA]

@silverbuttons

@MidwifeAMA I had a placental abruption at 35 weeks. This was after two weeks of being admitted and then sent home due to repeated heavy sudden bleeding. Ultrasound scan said I did not have placenta previa.

Placental abruption happened while I was resting in bed. Within a minute the whole bed was covered with blood, it was really scary.

Ambulance men were very relaxed and not in a rush. I became unconscious within a minute of arrival at hospital and was apparently fitting. I had to have a general anaesthetic and a crash c section.

Surgeon said it was caused by placenta previa and that he was definitely correct because he saw it when he cut into me. He said scans can be wrong.

I am still traumatised by the whole thing. I had several blood transfusions afterwards. Baby is fine luckily after some weeks in the special care unit.

I have never met anyone else who has had this. How common is it? How many placental abruptions have you dealt with and how often do you get the result that both mother and baby are fine after treatment?

This sounds very traumatic, I'm sorry this happened to you and your baby.
Unfortunately no technology is foolproof and sometimes scans aren't totally accurate.

Personally, I've not seen very many abruptions, they aren't very common in midwife led birthing environments which is where I mostly work, a little more common in a delivery suite environment as women have more complex health needs which can lead to abruption such as high blood pressure.

[MidwifeAMA]

@silverbuttons

@MidwifeAMA I had a placental abruption at 35 weeks. This was after two weeks of being admitted and then sent home due to repeated heavy sudden bleeding. Ultrasound scan said I did not have placenta previa.

Placental abruption happened while I was resting in bed. Within a minute the whole bed was covered with blood, it was really scary.

Ambulance men were very relaxed and not in a rush. I became unconscious within a minute of arrival at hospital and was apparently fitting. I had to have a general anaesthetic and a crash c section.

Surgeon said it was caused by placenta previa and that he was definitely correct because he saw it when he cut into me. He said scans can be wrong.

I am still traumatised by the whole thing. I had several blood transfusions afterwards. Baby is fine luckily after some weeks in the special care unit.

I have never met anyone else who has had this. How common is it? How many placental abruptions have you dealt with and how often do you get the result that both mother and baby are fine after treatment?

Have a look at the birth trauma association online, it would probably be helpful at some point when you feel ready to work through some of the feelings around such a traumatic experience.

[Cattenberg]

Thank you for answering my question, @MidwifeAMA.

[MidwifeAMA]

No problem xx

[AlwaysAnonymous]

Hi OP,

Thanks so much for putting this thread together!

Another question from me… ladies who have low papp-a are often told they could be at risk of pre-term labour and I’d read recently that orgasms can cause uterine contractions which can be dangerous to those at risk of pre-term labour. As the symptoms with low papp-a are very much a ‘might happen’ not a ‘will happen’, what advice do you give to those ladies who do have low papp-a but want to DTD? Should they carry on as normal?

Appreciate I’m probably being overly cautious about it - I would’ve asked my midwife but I called twice today and had no answer 😂

[Thejoyfulstar]

Is there ever a time when it's necessary to carry out a VE during a contraction? With my first, the Dr was about to do a VE and I told her to wait as a contraction was coming. She insisted it had to be done during a contraction. I let her and screamed the hospital down and honestly felt like that experience broke me for a long time (I think I had PTSD after the entire birth experience). I'll always remember my husband's face crumpling in horror. I was 9cm so it wasn't a little contraction either. I've always wondered. This was outside the UK and nobody really cared about explaining things where I was then.

[MidwifeAMA]

@AlwaysAnonymous

Hi OP,

Thanks so much for putting this thread together!

Another question from me… ladies who have low papp-a are often told they could be at risk of pre-term labour and I’d read recently that orgasms can cause uterine contractions which can be dangerous to those at risk of pre-term labour. As the symptoms with low papp-a are very much a ‘might happen’ not a ‘will happen’, what advice do you give to those ladies who do have low papp-a but want to DTD? Should they carry on as normal?

Appreciate I’m probably being overly cautious about it - I would’ve asked my midwife but I called twice today and had no answer 😂

Low pappa is not a contraindication to having sex, you're fine to carry on as normal.

[MidwifeAMA]

@Thejoyfulstar

Is there ever a time when it's necessary to carry out a VE during a contraction? With my first, the Dr was about to do a VE and I told her to wait as a contraction was coming. She insisted it had to be done during a contraction. I let her and screamed the hospital down and honestly felt like that experience broke me for a long time (I think I had PTSD after the entire birth experience). I'll always remember my husband's face crumpling in horror. I was 9cm so it wasn't a little contraction either. I've always wondered. This was outside the UK and nobody really cared about explaining things where I was then.

I'm sorry this experience was so traumatic :(
There are occasions where examining during a contraction can give some additional information about what is happening with baby, the cervix, the waters etc and so if they specifically asked to do it during a contraction (we usually don't as it's easier and more comfortable) it sounds like there was a purpose to it.
It might be worth trying to access your notes to see if there's anything there to explain it

[Thejoyfulstar]

@MidwifeAMA

I'm sorry this experience was so traumatic :(
There are occasions where examining during a contraction can give some additional information about what is happening with baby, the cervix, the waters etc and so if they specifically asked to do it during a contraction (we usually don't as it's easier and more comfortable) it sounds like there was a purpose to it.
It might be worth trying to access your notes to see if there's anything there to explain it

Thanks for that. Part of my 'PTSD' was thinking they had been trying to hurt me on purpose as they did a lot of other things that seemed unnecessarily painful.

It had been a long labour with very slow dilation so I guess they wanted to know what was going on.

I did get my notes to show my consultant for my subsequent birth in the UK (previous delivery was in the Middle East) but they were full of errors.

[AwkwardPaws27]

@MidwifeAMA

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.

Me again! For anyone else reading this - I just wanted to come back & say my 2nd degree tear has finally healed, no pain or bleeding for a fortnight (DS is now 12 weeks old).
I'm still a bit wary of DTD so haven't attempted that yet, & I need to book an (overdue) smear test too (eek).
It doesn't look exactly the same as before but it's definitely improved a lot.

[MidwifeAMA]

The joyful star

That's really difficult when you can't even really revisit the notes properly and try to make sense of it. It does sound like you'd benefit from working through some of this trauma. Have you heard of the birth trauma association? Might be work a google