Midwife AMA

[MidwifeMidwife]

I'm a midwife with 20 years experience.
I currently provide NHS home birth care.

AMA

Do you judge women who do/don't shave. Be that legs, or anything else you see?

What's the section rate in your hospital?

What do you know about sacrel dimples? Little dents right at the bottom of the babys spine? My LO had one and I was told its very common but i've never met anyone else who's baby had it - we have had it checked by a paediatrician

Nah, no one does.

Something nuts like 50%

Common. They are only a problem if you can't see the bottom of it. Have to rule out it's not actually a whole directly towards the spine which hasn't closed properly. It's exceptionally rare for it to be that.

Why is the section rate so high do you think?

Over medicalisation of everything.
Cascade of intervention.
High IOL rate.
Too many births in hospital.
The CS rate for women who plan home birth is much less, even if those women have complexities.

My friends' dd has one. She is 21 now, but I remember them talking about it at the time.

My twin daughters are in their first year of training. Would you recommend your daughters to go into this career or try and persuade them not to.

Perhaps it’s high because the mothers have a choice and decided on a C-section? I chose an early epidural because I could.

Hmmm I'm not sure.
I absolutely love it, but there's a lot of it I wouldn't want to do again which as a junior midwife you have to do.

Perhaps it’s high because the mothers have a choice and decided on a C-section? I chose an early epidural because I could.

The elective CS rate doesn't concern me. I'm 100% pro choice.
What concerns me is the huge numbers of women reporting feeling totally uninformed and out of control, not being counselled properly to know what their options really mean for them.

I've been told by people around me and confirmed online that the hospital I am supposed to give birth in is dangerously understaffed, a woman I met was sent on arrival to another hospital 1.5 hours away. I'm scared that I will turn up and there is no space for me, does this ever happen? What do they do in that situation? I am considering a home birth but the hospital is 45 minutes away from where I live.

Discuss it with your community midwife.
Generally, if it's at capacity when you call up in labour they will refer you to the nearest hospital with availability.
You could look at making a further away hospital your plan A, with considerations for safe travel time.
Home birth a safe option for most women, have a read up on the pros and cons of each birth place. Being 45 mins from a hospital wouldn't put me off a honebirty if I was not having a complex pregnancy.

I have a sort of secret dream of training to become a midwife and I work closely with them. However I have young children and I figure realistically it wouldn't be possible to do the course without super solid childcare spanning 24hrs a day really given you need to do nights and long days on placements presumably? Also I can't pass my driving test and I figure having a car for placements would be super useful as they may be some distance away and at unsocial hours?

Also, a birth related one. I've had two ventouse births and I'm pregnant again and terrified. I was considering an ELCS for my second but I knew the likelihood of needing an instrumental again were pretty low so took my chances and obviously it didn't work out. There are no obvious reasons for why I had difficulty either time, other than long labours/pushing for hours so me and baby were both getting tired and they started worrying about my baby's heartbeats. Does the fact that ive had two instrumentals already mean there's something about my underlying physiology and/or my lack of ability to push properly that means I will end up with a third? Or have you ever seen people who have had two but birthed a third child themselves?

You do need really solid childcare when you train as you need to be able to work 24/7. There may be some wiggle room.

Ventouse is generally used when the head is low and birth is close.
I'd do all the things that generally help with progress and keep babies happy. Ie, get baby in a good position (look at spinning babies website). You're less likely to need an instrumental birth if you plan birth outside a consultant unit, or at a midwife led unit or home. You're also less likely to need instrumental if you avoid epidural.
Generally if you labour spontaneously, keep upright and active, it's quite unlikely to have a ventouse if you've had a baby before.
It could be that your anatomy impacts it, or it could be that your labours have happened in similar ways which don't support physiological birth very well, like being at hospital on a bed.

any medical practitioner that does is in the wrong profession.

What do you think about the protocol
of automatic induction for over 40’s?

I absolutely agree. But I've worked with carers who did make nasty comments about body hair, or saggy boobs and stretch marks.

I also knew a woman years ago who managed to get some work experience on a ward whilst doing an access course. She was disgusted by women who hadn't shaved prior to a MW appointment. I seriously hope she didn't continue into midwifery.

Thank you for this - I'm another one who could see myself as a midwife in another life!

I was wondering, we're about to start trying for our third - my first was an EMCS and just as you describe with a cascade of intervention, overmedicalisation etc.; my second was meant to be an ELCS but I went into labour and progressed so quickly that there wasn't time, so I had a vaginal birth and something like a 3.5 hour natural labour (which could have been shorter as I was on my back with continuous monitoring, and I know that slowed things down) - I did have late diagnosed gestational diabetes, though only really borderline. I'd love to have a home birth for my third - our area has a great team and several of my friends have had really good experiences. With that type of history, would you think it would be possible?

Why is the first advice for labour to take paracetamol and have a bath? My first was CS for breech, but my second was precipitous labour (and shoulder dystocia), I could barely speak but was told to have paracetamol. I wasn't even convinced I was in labour (at 40+6...) as I never had the feelings I felt I should, it was all in the pelvic bone. Do other women experience this? I do still have numbness and tingling at the cesarean site 5 years on...

Edit - dp was terrified the baby was going to be born at home as the pains were so close together and lasting so long, triage was telling me to have a bath, and I was denying labour due to no cramps.

Do most women poo during birth? Apparently I did and am still embarrassed about it!

Has there been an increase in induction in your trust? I noticed a real push for early sweeps with my 2nd daughter and a few of my friends were offered to be induced at 40weeks (one at 39weeks without a medical reason).

I feel as so many people don't actually deliver on their due dates there is a real fixation around the due date.

If you offer a woman a sweep before she's due, why is that?

I had 2 wonderful midwifes deliver my children, very thankful for people like you who remain in the profession even in the sorry state the nhs is in!

Have you considered combining your role with that of a nun ?
Or are you one already ? 😇