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!

I’ve had a lot of experience in the NHS due to chronic illness, and yes - care can be mixed in many different areas. But the attitude and disdain I received on the labour and postnatal wards genuinely shocked me. Totally unlike anything I’ve ever experienced - and I had textbook labours and deliveries, and I was a very calm and relaxed labourer. I thank my lucky stars for that because I dread to think what could have happened if I was unlucky and something went wrong whilst I was under the care of the rude, sour-faced midwives I had.

I will however say that the midwives who WERE good were bloody excellent.

Due to a health condition, I am admitted through a&e to hospital acute care unit, from time to time, and some of the treatment I’ve witnessed by nurses to patients is awful. I would say a large amount are thoroughly uninterested in caring for patients and prefer to stand around chatting about holidays, Netflix shows and all deciding what to order from the Chinese takeaway for their break (no joke). Patients are buzzing for help with pain, needing the loo or help in general and they completely ignore it.
Sadly it’s not just midwives, it’s the whole of the NHS. There is a culture of ambivalence and they know none of us can actually do anything about it.
Of course there are the good nurses too, I don’t wish to tar all with the same brush, but there are some out there that should be no where near a hospital.

Eurgh my first baby I was offered paracetemol and told baby was not coming for a long time. I said fine if you won't give me any help why am I here and started to leave, at which point they finally offered gas and air and examined me. Baby born 45 mins later.

Mind you I had similar in A&E recently. Doctor prescribed me paracetemol and high strength codeine. Nurse just gave me paracetemol and said, you'll be fine when i asked about the codeine. When the consultant saw me 5 hours later he was horrified and stood over the nurse until she gave me morphine.

Two births, two amazing midwives. Though two straightforward deliveries so maybe I'm confirming your theory about them being ok if they don't need to do much! Not totally true though as they were incredibly lovely people, huge support (I was pretty scared) and explained everything well and helped me.

Health visitors on the other hand can get in the fucking bin (two of them have made me sob - one because she said my baby's name was weird and ugly and then proceeded to call him a different name she made up as she could 'say that' - he has a cultural name - and the other one because she said I was starving my baby as I refused to put him on formula as he was gaining weight (just not as fast as she wanted. He was calm, sleepy, content etc and continued to thrive on breastmilk.)

And most of the nurses I've ever met have been very dim, very lazy and actual bitches. Horrible to elderly relatives, constantly sitting eating biscuits at the nurse's station and acting like you're a huge inconvenience for even daring to talk to them.

The man now in charge of the entire CQC was the Chair at the NHS Leeds Trust which is now the subject of a Public Inquiry due to failure in that maternity unit during his tenure.

Another case of the great NHS failures promotion carousel.

Preserving reputations seems to be far more important than patient care.

As a pp has said , always try to have someone with you.

Both of mine were poor, but not as poor as many of these. My mum came to visit when I was on the ward and complained that I was diabetically hypo and that my care was substandard.

I don’t think this is limited to midwives. Most front line NHS staff I’ve encountered from A&E staff to consultants are exactly the same.

I am wondering if this is hospital specific.

I’ve given birth twice at a specific London large NHS teaching hospital that I chose for its reputation. Both times my midwives were excellent. The births had their complications but they were in total control, had excellent communication, and worked collaboratively with the doctors. They were proactive and supportive in terms of pain relief and the birth was completely led by me.

I’m wondering though if the OP would have agreed with me, because I didn’t want them massaging me and giving me sips of water. The water was my husband’s job - and basically the only one he could do because I hated being touched and absolutely did not want a massage.

I also had lovely community midwives, in particular the ones after the birth which were connected to a different trust.

I was very lucky to have excellent care throughout including during birth, but I do think partly issues are arising because (for budget reasons) there is no more continuity of care. I was chatting to an older midwife and she said how the same midwife would treat you during your whole pregnancy and then be called to hospital/home to deliver and it just made the whole experience a lot more personal and the midwives a lot more invested. Such a shame

Mine were also utterly shit. For my first I got told “you’re just a neurotic first time mother” (my baby was born with congenital defects that we knew about on scans before hand. The midwives refused to send the baby for any further tests despite my being told I would get them)
For my second “you weren’t contracting so we didn’t bother to fill the birthing pool up” so my 30 mins labour was spent at the end of a bed, when she returned she told me off for “pushing prematurely”. I had the baby a second later….

I wonder if it’s less of a performance issue at this stage and sadly more an ingrained culture in UK maternity care. My grandmother, in her 80s, was treated horribly by midwives during her first birth age 20. Similar experience to many here - not listened to, spoken to with disdain and as if she was stupid, left to labour alone and frightened. Her second birth, she insisted on doing at home as a result.

It can’t be coincidence that so many women over so many years have had such consistent experiences - with the odd exception.

At this point I believe it must be learned behaviour and apathy as such a mass level of underperformance would surely be really unusual.

I think part of the issue is A) it’s a “woman problem” so it’s been ignored and swept under the carpet for forever, and B) no one in authority likes to criticise medical staff, despite them being paid professionals who should be held accountable for their performance. Accountability in the NHS doesn’t seem particularly important and - I speak from experience - unless you want to push legal action, everyone closes ranks and you’re shut out. I’m private sector and if I fucked up as badly as some of the examples on this thread, I’d be performance managed out. The fact that this doesn’t seem to happen indicates that it’s acceptable behaviour / performance to NHS employers.

Being busy is not an excuse for the behaviours described on this thread.

The midwives in the delivery room were great. The ones on the maternity ward were annoyed when I asked for help and pain killers.

I was shocked by how bad they were. It was small things, like I had to stay in for a few days with my baby and in the middle of the night they’d all be gathered in the nurses’ station laughing loudly and chatting at full volumes while mums and new babies were desperately trying to sleep nearby. Luckily my bed was a bit further away but at one point my cannula popped out of my hand and blood soaked the bed, my PJs etc. I pressed the buzzer but got no response. Eventually tracked them down all chatting and they admitted they didn’t respond to buzzers because one woman in labour kept pressing it too much and they were fed up of going to her.

I agree with the posters who mentioned the maternity wards. I was treated so badly (feels outing to give details as I have shared with so many friends) that I had flashbacks and nightmares months afterwards and I think it contributed hugely to me developing a mild pnd and thinking I wasn’t a good mum and my baby would be better off with someone else.

I wonder if this is on the back of the homebirth thread?

I agree btw. I also wonder if part of this is the language used. I found I barely saw a midwife on the 'midwife led unit' other than when they popped their head around the door and sneer at me for needing to transfer to the 'consultant led unit' when the clock ran down after my waters went.

On the consultant led unit I had 1-1 midwife care throughout, and a specialist induction midwife who was great. Like a different breed compared to the midwife-led unit to the point I am surprised midwives who actually do their job want any association with the 'non-interventionist' kind.

This is absolutely not how it was sold by my (admittedly also very good) community midwives who talked up how active my birth in the midwife led unit was going to be. That might have helped. That is not what happened.

The irony is, as many have outlined here, the midwife-led unit midwives don't offer non-medical intervention when it might have helped. I feel very strongly that if I had been allowed to get into a pool with gas and air when I had originally asked to, my baby would have turned earlier and might have come out quick enough that I didn't need an induction and epidural.

Instead I was given a couple co-codamol and told to go home when I had a kidney injury during a posterior labour.

Sounds similar to my experience. The culture is all wrong. Grown women having babies are spoken to like naughty children and treated like an annoyance. Young adult dd recently had surgery in an orthopaedic hospital and the culture couldn't have been more different. The staff were so professional and kind

The problem with medical care of pregnancy and labour is that it is very heavy handed. I’m not a woo person or a hippy or anything, but I think the over-medicalisation and unnecessary interventions of pregnancy and birth has caused a lot of harm stopping a woman’s body doing what it does best. I’m not saying that this is the case for everyone, clearly lots of women need intervention, but rather than treating those cases as the exception, we are treating it as the rule. Men got involved, tried to control and uncontrollable process, and made things worse.

I totally agree that the NHS is a very mixed bag - over my life in a variety of contexts I’ve experienced excellent care and absolutely shocking neglect and borderline abuse! I always hesitate to generalise (I know some very good nurses as friends) but my experience on the labour and maternity wards wasn’t a highlight.

The midwives were frankly scary and could be both harsh and dismissive and almost bullying. I remember having a horrible time trying to to feed my first - she just wouldn’t. I was in tears and she was becoming rapidly dehydrated (late August heatwave and the hospital heating was on). A senior midwife stood over me and just glared at me - I hadn’t felt so intimidated since school! My daughter ended up in NICU due to dehydration and guess what - in there, the staff were lovely, empathetic, kind and gentle.

I really hate it when the public moan and condemn categories of people through lack of understanding but reading this thread, it’s clearly a problem in midwifery. I wonder if midwives are hardened by having to deal with nasty, aggressive, chavvy parents and develop a harsh attitude to everyone as a result? It’s the only explanation I can think of.

Should add to that…
What I mean by chavvy parents is: I was being monitored for a day due to pre-eclampsia and the only other pregnant woman in the bay was horrendous. She racially abused staff (shouting at them) and when a visitor arrived she started effing and blinding about people who dressed their girls in blue- which she considered to be a boys’ colour. I lay there, terrified of catching her eye and knowing that my husband and toddler daughter who wore a lot of blue would be coming to collect me!

Dealing with people like that must have an effect on your view of people in general.

But the point being made is that a more proactive, holistic approach may help women to avoid some of those complications, but that despite midwife-led units being sold with this promise, it failed to materialise for many of us. Read my post. The doctors and 'medical intervention' was not the problem with my birth. It was available when it became necessary when adequate support in early labour was not made available, despite the explicit and implicit promise it would be.

A lack of proactive, holistic support, justified by a 'non-interventionist' ideology by the midwives was the real problem in my experience.

I haven’t read all the posts but my point is midwives are part of the system and part of the problem, midwives are trained at universities, they are trained to be medical professionals and I think we have lost the essence of birth and how to connect to our bodies.

It was the foreign Doctor who spoke such little English, that I actually couldn't believe he was employed by the NHS, that was the worst person in the Maternity care.

We need rigorous English exams for Health Care Professions before they can work in the NHS.

My midwife was a nice enough woman. However, I’d been pushing for over 2 hours with my second daughter and nothing seemed to be happening. My mum ended up telling her that if she (the midwife) didn’t get a doctor, then she (mum) would! Anyway, when the doctor came, she actually asked the midwife why she hadn’t been fetched sooner 🙄 DD was born by ventouse about 10 mins after the doctor arrived, which was 2.5 hours of pushing! She weighed 10lb.5 oz.

Community midwives were great - loved them for the pre and post natal care. Birth unit midwives were fucking hopeless. Didn’t listen to me. Left me on my own, breathing through contractions I should have been pushing with. Ended up with an instrumental delivery and a haemorrhage after a five hour second stage. They don’t listen to women. They’re too wrapped up in what they think they know to actually pay attention to what’s happening.

Had an elective C section for my second. Infinitely better. Still had to fight for it, though, through the cult of natural birth. Maybe if they were less terrible at managing natural births, more women would be prepared to go through them.

I agree. In my experience, I'd say it's because many of them are there just to collect their salary (by collecting all the shifts available), do the basic that's required and go home. It's not about the care and service to people.

The good ones are absolutely amazing though.