I am a student midwife

[honeymaple]

I work full time on maternity, I see the wild and the wonderful and a really good insight into the NHS and the way students are treated.

Ask me anything!

[UpToMyElbowsInDiapers]

Have you had to deal much with baby loss? What sort of training do you get about caring for mothers in those situations? And caring for your own mental well-being? I think when people picture midwifery work, they picture a hard grind but also a lovely, warm and fuzzy outcome. But I imagine it isn’t always so.

[honeymaple]

Have you had to deal much with baby loss? What sort of training do you get about caring for mothers in those situations? And caring for your own mental well-being?

I have dealt with the loss of three baby's in the second and third trimesters and a number of miscarriages on the early pregnancy unit.

Honestly, we haven't really had any training from the university in terms of baby loss. It's more "on the job" training and common sense I guess?

There's no support at all for us following these situations, the day honestly just goes on, which I think is wrong.

[Endofmyteatherr]

How many patients does a midwife look after on the ward? For women just about to have their baby?

[Brandybucks]

Everyone is saying how maternity is in crisis at the moment - has this been your experience?

And secondly, do you find women get denied epidurals when they want one? I’ve seen a lot of threads (one currently active) that seem to imply that it happens quite a bit!

thanks!

[AgathaMystery]

How do you feel when you see midwives with many many years experience leaving because they are burnt out, broke, or simply tired of being at the whims of the off duty rota?

I’m always curious how students see us.

[Cuppasoupmonster]

How much is obesity and maternal age affecting your profession?

[honeymaple]

How many patients does a midwife look after on the ward? For women just about to have their baby?

So for women in Labour, it is 1-1 care at our trust. You'll be assigned one woman and care for her for the duration of her Labour or until your shift ends.

On the postnatal ward it is awful, last week it was just myself and a qualified midwife looking after fourteen mums and fourteen babies. Most of which had had emergency sections, needed blood sugars etc. And other non-straightforward care.

[Endofmyteatherr]

Sorry I have to ask... what inspired you to do midwifery?

Those are shocking ratio numbers. Hats off to you

[honeymaple]

Everyone is saying how maternity is in crisis at the moment - has this been your experience?

Yes, this is very much my experience. Everyone hates their job, at least one member of staff will cry pretty much every shift. The staffing levels are dangerous, our trust are currently 45 midwives short.

It's a disaster waiting to happen (or already happening). It has very much put me off staying in the profession.

And secondly, do you find women get denied epidurals when they want one? I’ve seen a lot of threads (one currently active) that seem to imply that it happens quite a bit!

I haven't seen this myself, and this isn't the way I treat my women. At our trust, women are given epidurals when we are confident that are making an informed choice and it is safe to do so.

They are only (usually) offered in established Labour, which is defined as being 4cm dilated and at least 3 contractions in 10 minutes.

The only thing that will delay one is if the anaesthetist isn't free.

[Chasingclouds100]

Ohhhh great thread - can I ask you lots and lots???!! I am seriously considering going back to uni to study midwifery as a mature student. I’m obsessed with all things pregnancy and birth so I know the course would be right for me but two things I’m really not sure about - the first is do student midwives have to assist much in theatre? And secondly do student midwives have to give stitches? I understand it is part of the midwife role but it’s just these two things that I’m really not sure about (as a student) Tia

[MolliciousIntent]

What happens when you can't provide 1-1 care?

I laboured in triage for 7 hours, most of which was back to back contractions, with zero pain relief, because they couldn't admit me because there was no midwife available to staff the room. I was admitted 6 minutes before my baby was born, was howling that I needed to push as they wheeled me down the corridor.

There was one midwife staffing the 6bed triage ward, alone, for 7+ hours. Every bed was full. She was an absolute superhero but it is a miracle nothing tragic happened.

[honeymaple]

How do you feel when you see midwives with many many years experience leaving because they are burnt out, broke, or simply tired of being at the whims of the off duty rota?

Thank you for all you do.

First of all, I have a great admiration for these midwives and what they have achieved during their careers.

I (and my other student friends) totally get it, or as much as we can. I honestly don't blame these midwives at all, the way they are treated is horrendous and it isn't surprising that's so many experienced midwives feel they have to leave.

It also worries us and puts many off the profession, I guess it is a little scary seeing so many midwives deciding that it isn't worth it anymore.

[Orla32]

When I was a student midwife all I saw was the other students being horribly judgmental/not nice and same for some of the qualified midwives. I left after a year of the degree. Is it still the same?

[honeymaple]

How much is obesity and maternal age affecting your profession?

I haven't personally experienced many poor outcomes relating to maternal age. I am aware that average material age is rising, and the risk of complications and chromosomal conditions rises with that.

However obesity is a massive issue. Our obese women are much, much more complex and tend to require a lot more care due to this.

They're at risk of a whole host of complications, and the rate is only rising.

It's also an obvious significant cost to the trust too.

[ElephantGrey101]

Can you explain what the criteria are for reduced movements and what it means if they are not met? This happened to me today. Fortunately they were met the second time round and I was allowed to go home but I don’t understand how bad it is and how would should be. She is moving now but hadn’t moved for 24 hours when I started to be monitored.

[AgathaMystery]

Funny but I don’t feel I achieved a lot. I wrote a few guidelines, introduced some new clinics and initiatives. All the stuff you do when you’re young & keen. The most Memorable bits were missing weddings and birthdays and DC on Xmas morning.

(still a midwife but not with the NHS). Good luck OP. I’m rooting for you.

[IWantItThatWay002]

Following

[honeymaple]

Sorry I have to ask... what inspired you to do midwifery?

I have wanted to be a midwife since before I can remember.

I'm passionate about women's health and empowering and advocating for women. The female reproductive system and the process of conception, pregnancy and birth fascinates me.

I feel I am very caring my nature and love being able to meet and interact with new people every day.

[AgathaMystery]

@ElephantGrey101

Can you explain what the criteria are for reduced movements and what it means if they are not met? This happened to me today. Fortunately they were met the second time round and I was allowed to go home but I don’t understand how bad it is and how would should be. She is moving now but hadn’t moved for 24 hours when I started to be monitored.

You need to call your assessment unit about this. This isn’t the right place to ask for advice about fetal movements. The only place to ask for advice about fetal movements is your local maternity triage/assessment unit. This is a thread by a student midwife. I know it’s AMA but fetal movements are serious things b

[honeymaple]

Ohhhh great thread - can I ask you lots and lots???!! I am seriously considering going back to uni to study midwifery as a mature student. I’m obsessed with all things pregnancy and birth so I know the course would be right for me but two things I’m really not sure about - the first is do student midwives have to assist much in theatre? And secondly do student midwives have to give stitches? I understand it is part of the midwife role but it’s just these two things that I’m really not sure about (as a student) Tia

Yes, ask away!!

Do it! We have a two week surgery placement during training and then we do attend c-sections to "baby take", so measure and weigh baby etc. but we don't assist in the actual surgery itself.

Yes, we have to suture first and second degree tears and other tears on the labia etc.

[honeymaple]

What happens when you can't provide 1-1 care?

I laboured in triage for 7 hours, most of which was back to back contractions, with zero pain relief, because they couldn't admit me because there was no midwife available to staff the room. I was admitted 6 minutes before my baby was born, was howling that I needed to push as they wheeled me down the corridor.

There was one midwife staffing the 6bed triage ward, alone, for 7+ hours. Every bed was full. She was an absolute superhero but it is a miracle nothing tragic happened.

I'm sorry that was your experience, it must've been absolutely awful.

You should have been offered pain relief, regardless of whether there was someone there to be 1-1 with you.

At our trust, midwives will be taken from other departments to go up and be with a labourer. If there aren't any to take, then it will be escalated to the community and an on call midwife will be asked to come in.

We have a midwife led birth centre, which often gets closed when there aren't enough midwives.

[MolliciousIntent]

@honeymaple

What happens when you can't provide 1-1 care?

I laboured in triage for 7 hours, most of which was back to back contractions, with zero pain relief, because they couldn't admit me because there was no midwife available to staff the room. I was admitted 6 minutes before my baby was born, was howling that I needed to push as they wheeled me down the corridor.

There was one midwife staffing the 6bed triage ward, alone, for 7+ hours. Every bed was full. She was an absolute superhero but it is a miracle nothing tragic happened.

I'm sorry that was your experience, it must've been absolutely awful.

You should have been offered pain relief, regardless of whether there was someone there to be 1-1 with you.

At our trust, midwives will be taken from other departments to go up and be with a labourer. If there aren't any to take, then it will be escalated to the community and an on call midwife will be asked to come in.

We have a midwife led birth centre, which often gets closed when there aren't enough midwives.

They couldn't offer me anything except paracetamol, because they couldn't admit me.
From what I can tell, there was simply no one to call.

[honeymaple]

Can you explain what the criteria are for reduced movements and what it means if they are not met? This happened to me today. Fortunately they were met the second time round and I was allowed to go home but I don’t understand how bad it is and how would should be. She is moving now but hadn’t moved for 24 hours when I started to be monitored.

So the guidelines for this are different from trust to trust and I can't give any medical advice, but I can tell you as a student what I would think hypothetically.

It happens on triage that the CTG doesn't meet the criteria first time, we are happy if it meets after trying again and it is approved by two midwives. This is seen as reassuring and not a concern in itself.

Any subsequent periods of reduced movements or a change in the pattern of movement should be checked, even if it is a few hours after being told everything is fine.

At our trust, an induction will be offered after a number of episodes of reduced movement, even if the CTG looks fine.

[honeymaple]

And I'll follow that up with call your local maternity unit for any advice at all. I'm unable to give you advise.

[honeymaple]

*advice