Midwife AMA

[MidwifeMidwife]

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

AMA

We are in such a privileged position, it's truly life impacting the care you receive in pregnancy and birth, I'm lucky to work in a very good place. I'm pleased you had the care you deserved.

Haha
I've been a midwife for 20 years and didn't do nurse training first. I wanted to be a midwife, not a nurse.
I don't see any significant difference between the two groups on a working level.
The top up from nurse to midwife is short and those students can struggle to get it all in. They do have a wider range of nurse knowledge but only some is applicable to
Midwifery. A number of the top up students only do a very short amount of nursing as they use it as a route to midwifery.
Swings and roundabouts.

"Thanks for your reply. This almost happened to me with my first who was back to back and had been a long slow labour. I’d pushed for 2 hours and they could see her head but I could t push her out. They took me to theatre to try forceps of a section of that failed. Forceps failed but when they did the section they really struggled to free her. As they put a crash call out they managed to pull her free. I always think about what the next step would have been
it was the most traumatic thing I’ve ever been through"

That sounds really scary, sorry you had to experience that.

No, they are valuable at any time if done well, even ten years later.
There is definitely a benefit to having a debrief once out of the baby blur to be able to process the experience.

Do you mean it started to work less well in pregnancy?
Biggest cause is smoking. Can be related to being very post dates, medical conditions, or just something we can never know.

@MidwifeMidwife

I don't really know what I mean as nothing was explained to me as the time. Just that my placenta was in pieces, and didn't come out in one go and I lost quite a lot of blood.

I've not smoked since I was a teenager so it definitely wasn't because of that! My son was born a week late.

As a rough idea,
First labours tend to be slower,
Second tend to be super quick, third tend to start stop a bit then be quite quick once they commit.

There is an increased risk of subsequent 3rd degree tear. There are things you can do to reduce the chance such as antenatal perineal massage, controlled birth of the baby, warm compress to perineum in late stages of labour, position for birth.

Here we would only recommend CS if the tear was really big 3rd (they have levels) if not healed well or if ongoing weakness or symptoms. If all healed well and no concerns then vaginal or CS equally worth considering.

Have a look at the Royal College Of obstetricians and gynaecologists, they have useful patient info leaflets with the info on it to plan.

What is your favourite area to work as a midwife (e.g. Antenatal clinic, feral medicine, antenatal ward, postnatal ward, homebirth etc. And what is your least favourite?

When I was pregnant and planning a homebirth I was on a facebook group where women were encouraging women who were high risk to have a homebirth anyway with an independent midwife. Would you recommend homebirth for a high risk woman? If so, how much of a risk would you be willing to take? At what point would you recommend a woman should have a hospital birth. Personally I was happy to have my prom baby at home until there were traces of becoming but my attempted vbac at 36 weeks was always going to be a hospital birth. I was also only 10 minutes away from the hospital. I don't think I would have tried to have a homebirth at all if I'd been a lot further away.

I had this with DC2 and I don't really remember any additional pain or discomfort from it being applied and it didn't cause any harm to baby. He's 2.5 now and I'm pregnant again but I'm not sure on why he had one at all. I presume they couldn't get a good trace with the CTG, but then I'm not even sure why I had a CTG in the first place because I was low risk. I've recently requested a copy of my notes so hopefully I can find out what was going on! And then I may request a debrief too.

sorry I think I didn't word my question very well. the curriculum has changed significantly, in my experience - senior midwives have a far greater skillset and awareness when dealing with non midwifery related patient needs compared to more recently trained midwives. is this something you experience?

for example when dealing with medically unwell patients on the labour ward or in the postpartum ward, it can get fairly dangerous as some of the midwives (absolutely through no fault of their own) are not able to care for them appropriately.

I was just wondering if there is frustration around that within the midwifery community especially given the recent investigations around neonatal deaths?

obviously I understand if you have been focusing on homebirths it is entirely different.

Thank you! It was very stressful and everything I had said I didn't want, but baby is safe and well and I did have a good debrief with the midwives a few months later.

Thank you, for the info suggestions I'll have a look.

Can I ask another question, how many home births have you been too, where the mother didn't have a pool? Everyone I have spoken to that has had a home birth used a pool

Thank you again! 😊

How do you feel about male midwives... I had one for my second birth and to my surprise - I didn't want a man to help me. It was weirdly instinctive (right or wrong) but I didn't want this poor male midwife near me!
No fault on his part... I'm sure he was lovely.

If you are going to qte me you should qte me in full instead of truncating what I say.

I have reported your thread as it is unprofessional and dangerous to give midwifery advice on this type of platform. No one knows what your credentials are and anyone who was a professional would not behave in this way.

Do you have any advice I can share with a 16yo who wants to be a mw?

NHS don't offer work experience locally and I would like her to understand more about the role before signing up. She's doing Social Carr and Health for Sixth Form

First pregnancy and wanting a home birth. What would be your top tips? I’ve note your recommendations on Sara Wickham and Claire Feeley and the midwives cauldron podcast but any other recommendations such as courses or hypnobirthing?

I have my first baby in our local hospital but I'd really like the second to be a home birth (not currently pregnant but Ttc soon), any advice? Pros/cons?

Have a listen to 'The Great Birth Rebellion' podcast. Australian based but they more of less follow the same guidelines as the NHS. Its a great podcast for providing evidence based information.

@AverageJoan just in case you don't know there are quite a lot of threads on here on this topic, if that would also be useful as a source of anecdotal experiences.
Google search might be more effective than a site search though as the search function isn't brilliant.

@PoochiesPinkEars thank you I'll take a look! I was on the fence about having a home birth last time but I'm glad I didn't since I was pretty naive about the whole thing but I am fairly convinced I'd do it next time if it is an option to me

Have you known any woman to have more than the recommended 3 sections? If so how many is the most one patient has had ?

Thank you for doing this important work ❤️🫡

@Greenapplejuice I'm not a midwife but there was someone at my baby group who had 7 c-sections.

Oh wow that is a lot!!

Honestly, as a 42 year-old VBAC with a history of placental abruption and both ante- and postpartum haemorrhage (the baby was stillborn), would I be mad to try to push for a homebirth?

Why would you trust such an important decision with someone you have no knowledge of their qualifications 😱