To think a lot of midwives are.. just not very good?

[JackandSallySkellington]

Please hear me out.

I am SURE there are dedicated, talented, intuitive midwives out there. But AIBU to think beyond doing obs, most actually do very little in the course of labour/birth and a lot of the time seem very passive and like they just can’t be bothered?

I have had 2 babies at different hospitals. In the first delivery, the midwife ‘popped in to check on me’ now and then and simply called the doctor in to do an instrumental delivery when the pushing clock ran down. She didn’t do anything else - didn’t help me change positions, didn’t offer me a drink, didn’t give me adequate pain relief despite me asking (just kept saying ‘it’s coming…’), didn’t ask me how I was feeling in any way. Couldn’t have been less interested.

Second delivery far worse. I was admitted for induction and after a few hours found to be 4cm dilated. I laboured all night - a full 10 hours - in a cubicle on a ward and despite regular pleas that I was in labour, the midwives insisted I wasn’t. They didn’t exam me again, just offered paracetamol, and only took me to labour ward when I was vomiting and discovered to be in transition and 10cm dilated the next morning. I had really hoped for a water birth and I’m gutted my final labour was spent alone in the dark. The hospital apologised but what’s done is done.

I understand about overstretched NHS etc but my stories are not down to that - in both cases the midwives spent a lot of time milling about and chatting.

I feel like the only stories about midwives being great are when the birth was going well anyway so there wasn’t much for them to actually do.

AIBU to think a lot of midwives just aren’t really up to the job? Sure I’ll get my arse handed to me as I’m aware criticising medical staff is v controversial!

Tbf, you can't go on videos of other countries anymore than someone can judge ours by watching One born every minute. What happens when recording is different from real life.

I requested a c section due to birth phobia. Every midwife was highly negative about it and I had to really push to get them to include in my notes that I was requesting one at each appointment.

I had to go to a birth choices clinic about it and the midwife running it was the stupidest person I have ever met. She listened to me list all the medical complications that I was terrified of me or my baby dying from and went “have you considered a home birth? You might find that more relaxing”. What the actual fuck, why would I be more relaxed about medical complications being 30 minutes drive from a hospital?!

She also gave me a leaflet about the risks of c-section. Except it was comparing first vaginal, c section or VBAC and showed c-section was only marginally riskier. I’m not sure if she was lying or genuinely didn’t understand risk, because she told me it was scary how high the increase in risk was. When I pointed out the paper didn’t really say that she scowled, and when I asked if the c-section stats were just for elective c sections or included emergency ones as well, she said she couldn’t see why that mattered. If you can’t understand why ann emergency c section would be higher risk than an elective one then my god you shouldn’t be allowed give advice.

Yes I have had 3 deliveries and only my second did I have a good midwife. First one, I was made to feel like an inconvenience for actually labouring and delivering on a labour ward. The 3rd midwife was so disinterested and told me she knew better than I did when I told her that I was almost ready to push after having had 2 babies already! She was totally unprepared when my waters broke and baby was out before she had anything set up in the room. I was so unimpressed I self discharged and went home where I felt safer.

It is sad that so many women on here have had negative experiences. To balance it, I have also had crap experiences with nurses on wards as well just not as often as with midwives!

Yes this was me too! In between outright excruciating pain, I tried to be polite and almost professional, because I felt like I was overreacting otherwise.

I agree that this is a problem. I’ve had serious issues through medics not understanding me, and me not understanding them - and boy, is it stressful.

But that’s where we are - there’s a recruitment and retention crisis and this is the effect of that.

Had my first in the UK and it was a shambles. I was left at home in pain and vomiting for an entire day and I was not allowed to come to the hospital despite calling 5 times. I ended up in an ambulance because of complications. During the birth I had four different midwifes because I had to change hospitals and the postnatal care was nonexistent. My DH was kicked out within an hour of DD being born and I was sent to a depressing ward where I barely slept. The day after I got home I had to go back to hospital because there were no community midwifes to do checks.

I had my second in the Netherlands and it was so much better. I felt protected and cared for. I had to have an emergency c-section because of complications. DH, DD and I had our own private room to recover, I had a proper bed and DH a folding chair thing which to be fair was not very comfortable. Both of us got food three times a day. Because DD had complications we were actually on the children's ward, but I still had nurses from the maternity ward come look after me. Even had a special phone I could use to call if I needed help. We got discharged after 4 days and we had a maternity nurse for 6 days to look after us at home for a couple of hours a day. She was actually a lovely 68 year old lady who helped care for the baby, care for me and did some light cleaning. I was allowed to relax and recover. Midwifes and health visitors came to our house because it is not done in the Netherlands to require postpartum mothers to do any travelling!

The difference between my first and second birth was Stark. I had PND after my first. I genuinely believe the substandard care contributed to that.

I’ve worked as an anaesthetist with some obstetric involvement in Australia and Singapore.
In my view both offered vastly superior care.

The first step to improving UK obstetric care is accepting there is an issue.

Couldn’t agree more with your comment.

Maternity care in Singapore is definitely obstetrician-led and the numbers -maternal and infant mortality rates- compared to the UK speak for themselves. Singapore was a poor to middle income country just a generation ago.

I think if you are in a MLU unit they are far better. And if you are alone for the birth then I've found they are much more helpful and involved. Out of my3 I've only had the father at the birth for one and I did feel totally neglected compared to when I was by myself

2nd baby I laboured through the night being told routinely by the midwife that I wasn't progressing. At one point she came in and said if I didn't make any progress they would take away the gas and air - yes, they threatened to remove pain relief based on their judgement of my progress. I was devastated and starting to panic - looking back I realise I was in transition already. The midwife went on her 15 minute break and by the time she got back baby had arrived. The midwife and student midwife that were actually present at the birth were fantastic.

"utterly disinterested" is also the main impression I had from midwives in both labour ward and post-natal ward. Very passive-agressive as well in their communication style.

They didn't seem to find much enjoyment in their jobs, and avoided any "complicated" patients to spend most of their time with the "easy" ones.
To me, they looked bored more than overworked, apart from a few (often the more senior midwife - not sure how they're called but they seemed to be in charge).

I didn't have that impression at all from the few nurses i saw - they definitely looked overworked and rushed, and often apologised for the delays.

Of course. I accept we have an issue if you read my first post above the one you quoted. It's not even just maternity as i said.

I also know that some countries have vastly better care than we do. I'm just objecting to judging that by videos (what people decide to show) and not personal firsthand or secondhand experience. As some people have also judged us as having better care than we actually do because of some videos they watched.

I'm so sorry for your experiences. My first birth was traumatic. Nothing overtly out of the ordinary I should think, just all generally awful..
Were they good or bad midwives? or just constrained by the system and policies and the amount of women they had to look after? I don't know. I know I couldn't work within it, if it meant offering women the sort of experiences we had.

My husband did hear a consultant outside the door saying to put me on a drip to speed things up. He hadn't seen me and Idt never been under anything but midwife care. My midwife argued for more time for which I am grateful.

I decided not to do it again.

I think the main problem starts at the university training. Not everyone who would be a great caring nurse/midwife is able to study to a degree level. Just because you can write an excellent essay about a subject doesn’t mean you can do the hands-on work. I think a lot did the degree because they didn’t have to pay for it like other subjects, they got a bursary, they didn’t go into nursing/midwifery because they had a vocation for it and I think you need one, some of them think the actual caring their role calls for is beneath them.

I agree. Many in the "caring profession" are anything but caring. It's all just another job for them.

2 children and every midwife I encountered were absolutely shit. And one in particular a fuckin bitch who should be nowhere near a labouring woman or babies for that matter.

Just.... wow...! 😳

I studied to become a midwife just as Covid hit. I can well believe the stories that are on here. Some midwives should never have entered a profession that involves caring. Some midwives are remarkably intelligent and entered for all the right reasons but are full of fear; the NHS is risk averse - even as a student I went through an investigation procedure and it was awful. This leads to a whole host of unnecessary (and often cascading) interventions, as I experienced myself with my DS, but I understand that the watchful waiting that midwives of the past were so expert in, doesn’t exist anymore.

This absolutely doesn’t excuse any of the care PPs on here have received, it’s a heartbreaking reflection of the state of maternity care, and the wider NHS, in this country. A lot of the brilliant midwives I met were desperate to work elsewhere, I witnessed a few crying because they KNEW that the care they were giving fell short of the minimum expected. Those that could continue day to day are often battle- hardened, they have forgotten that something that happens everyday in their world, will only happen to the woman they are caring for once/ twice.

@Callipygion you're absolutely right about the entrance expectations to a midwifery degree, I know of a few people who were refused but would have made fabulous advocates for women.

I hope any pregnant woman reading this isn’t filled with fear. Please advocate for yourself, have your birth partner know what you want and if you ever feel that the person caring for you doesn’t have your best interests at heart, ask to have someone else (and have this recorded on notes). It may not always be possible but perhaps it may make someone think twice.

But other countries also have nurses and midwives trained to degree level and you get better care and response from them than here, e.g. Australia. I have no idea what it is but something is not right here.

Completely agree with this .

I was amazed that they let me leave with my baby given that they spent the whole of my time there speaking to me as if a I was none too bright 5 year old

I completely disagree.
I feel midwives need to be more intelligent and be better educated.
The obstetric population is becoming older and more medically complex. We are also rightful expecting very low levels of mortality and morbidity.

To understand what is going on and act appropriately needs a fairly high level of training. You’re dealing with a population with altered physiology and determining what is abnormal does need a good level of understanding.

Ive worked with midwives who couldn’t understand fairly basic blood tests or understand how common medical conditions would affect maternal physiology.

I would suggest a return to the old system of midwives being nurses first. That will never happen though because of the cost implications.

Varied but erring on not great for me. My assigned community midwife was good, recently qualified and up to date. She was ill for my last appointment and so it was covered by a colleague who told me that my baby might not have any limbs as she couldn’t feel them. Luckily I had seen them on two scans by that point but quite the thing to tell someone at 41 weeks!

Once in labour first midwife was friendly but made a dangerous decision on my care. Second one who took over was not friendly but did make the right decisions and called for a Doctor and had the neonatal team on standby. Baby ended up in the NICU and me in hospital
for 10 days. Maternity ward was absolutely chaotic, sometimes I’d have my obs taken 4 times in an hour then not at all for 24hrs. Some midwives seemed happy but clueless, some should have appreciated that a FTM on her own with a baby in the NICU might cry if you’re mean to her and one or two were clearly doing their best in trying circumstances. I rarely saw the same person twice.

NICU team were great!

I don’t relate to this. All of the midwives that helped in my labour were great. I was also under the ante natal teams at the hospital for both children and met some great midwives.

The issues I have encountered, prior to having hospital care, related to 2 midwives with very zealous pro ‘natural birth’ views who were spreading misinformation. One ran our NHS ante natal classes and insisted that pain in childbirth is caused by fear; that contractions were nothing but ‘waves of pressure’ that could be wafted away with a lavendsr scented candle. The other attempted to lie/change my medical history so that I wouldn’t need obstetric care (I had had previous heart surgery and gynaecological surgery, as well as having OC in my first pregnancy). These were not faults caused by laziness or nor caring. Quite the opposite - having a political agenda that got in the way of their decision making capabilities.