I'm a midwife, ask me anything

[MidwifeAMA]

Midwife of 20 years, currently specialising in home birth.
Ask me anything :)

I've always been bemused by written birth plans. They were fairly new, I think, when I had my first two, and maybe they were explained to me badly, but when I said that you can't predict a labour so what would go in them the answer I got was mostly about candles.

Beyond choosing home, ward or birthing unit, pool or not, is there much point in them?

Oh this is a bit of a heavy one but have you ever any fatalities during a home birth that could have been avoided if they’d given birth in a hospital?

I only ask because my perfectly normal pregnancy ended with a bunch of doctors rushing into a room wheeling me to theatre and performing an emergency C section (cat A which means the baby should be put within 15 minutes). There seemed to be very little warning of this but they suddenly couldn’t detect my daughter’s heartbeat. She’s absolutely fine but it still haunts me that a homebirth might just have killed her.

I think the benefit of them is the prep that goes with it. Educating yourself on your options and empowering yourself. It's always good to keep a bit of flexibility in it too.

Morbidly (and because I’m paranoid) I’d also be interested to know about fatalities. I know tragically some babies are still born but have you been present when many mums haven’t made it?

Nope, touch wood.

What preceded this, was it all natural or was there something complicated going on?
Quite often the dramatic problems that happen in hospital can be linked back to the interventions that have led up
To that time. It's very unusual for a baby to just plummet without provocation.

None fortunately.
It's rare but it does happen.
Cardiac issues sometimes, speople grow up undiagnosed and pregnancy adds

How dangerous is a retained placenta after you've given birth?

Why was I shaking so much in theatre while they were getting the baby out ? ( forceps delivery )

@MidwifeAMA wow that’s reassuring! 😅

Is home birth an option when my last baby was born by EMCS?

The risk is that you have a partially detached placenta and the uterus can't squeeze the placental site to stop it bleeding as there's still a placenta in the way. We assume everyone could bleed and so act quickly, but not everyone does.

I’ve recently had some really crap care from community midwives, but exceptional care in hospital (was in for a week before DD was born).

My take is that the best midwives are in hospital (or probably doing home births!), and the slightly B list ones do the routine antenatal checks.

Is that fair, or just the ones I happened to see?

Home birth is always an option.
The recommendation would be to birth in a hospital as there is around 1:200 chance the old scar could start to break down in labour which would require urgent birth, usually CS and can be serious for mum and baby. However that also means that 99.5% of the time that doesn't happen, and home birth has benefits such as a reduced chance of epidural, episiotomy, pph, instrumental birth, CS.
It's all about balancing risk based on your personal values and what is important you.

But you always have the choice. No one can tell you you 'aren't allowed' to do xyz

I've not really had many tiny babies as I've mostly worked in birth centres and home births do the tiny ones are usually born in the obstetric unit.
We should always listen to women, you know your body best.

Just bag luck. It's a mixed bag everywhere. I know lots of really good community midwives.

Can you explain this. This is almost 2 decades ago.

Got to hospital around 11pm. They said I was not in proper labour. They wanted to send me home but I refused because we didn't have a car. They gave me a bed but sent partner away. I was in a lot of pain. No painkillers given.

Around 3am I went to the nurses station to tell them my waters broke. They were just all chatting and laughing. I asked for something for the pain and about half an hour later one brought a paracetamol.

I was crying and walking up and down the ward because I couldn't lie down. At around 7am I went back to the nurses station and said I needed to push.

One came about 5 minutes later and checked me. Pressed the emergency button, a team came to take me to the delivery room. They kept saying don't push.

I think I was crowning in the lift. I asked for painkillers and they said it was too late. Baby was born about 5 minutes later. No painkillers. I lost a lot of blood and I thought I was going to die. No more DC after that

My question is wtf? Did the medical staff behave correctly?

@MidwifeAMA Does jaundice in a newborn eventually go away without treatment? I've a week old and she's just below the line for treatment, in the 200s and increasing daily - not sure what the outcomes might be ie daily testing ongoing / hospital once it gets to x days etc?

Any tips for painful breastfeeding?! Latch seems good but my goodness my nipples are agony!

PS thank you for doing the job you do 

Absolutely not. They should have listened to you and treated you with kindness and compassion,
I'm sorry this happened to you.

Most babies clear it themselves, some need treatment. If they keep an eye on it it should be ok. Lots of milk is a help.
Get some hands on support if you can, call your midwives and see what's available locally.

Google 'flipple' this fixes many issues! What some flipple videos

Kelly mom website is great for all things feeding

Thank you for the validation. If you had been on duty, what would you have done differently?

Sat with you for a bit, watched, put a hand on your bump and feel what was happening if you were comfortable with that. Give you some reassurance, guide you with breathing, bit of tlc and respect.
Offered you a vaginal assessment if you felt things were getting intense, which might have shown things were progressing. Optional though, not essential. Got you to a private birthing area and one to one care as you established in labour.

Hi there!

After giving birth to my over daughter 2 years ago !! I remember violently shaking for about 5 days at home where I would feel extremely cold and needed all the heat I could get. I think I was just so overwhelmed with having a newborn child to look after I never really questioned it with the doctors or midwives. Is this a normal phenomenon? My mother who is now nearly 60 claims she used to experience the same the first few days after giving birth. Strange!

Some people get shivery when their milk 'comes in'. Could be this

Thank you. I'm glad you care for your patients.

I try to treat everyone in the way I would want my sister cared for. It's a good starting point.