Anyone used an independent midwife?

[nesomja]

I had a horrible birth with ds 2 years ago - had planned water birth at local birth centre and ended up with emcs at hospital after having had every intervention going. I am now pg again, so far less than 6 weeks, and am already starting to get scared about the birth. I feel very helpless since last time I thought I was so well prepared and then it all went completely differently to how I wanted it to go. I am looking into hypnobirthing and was wondering whether I should think about an independent midwife - I would really like a VBAC under water at home (we can't go back to the birth centre as now considered too high risk :() . Independent midwives around here cost £4000! This will be a big stretch for us but we could afford it if we really thought it was worth it. The thing is I know there are no guarantees - we could pay £4000 and still end up with an emcs at hospital. Has anyone had good or bad experiences of independnet midwives and do you think it's worth that much money?

One of the reasons I thought my last labour went badly was that we arrived at the birth centre to find that only bank staff were there, the midwife didn't seem at all confident in natural delivery and didn't even know how to fill the birthing pool, so the idea of having a confident midwife really appeals.

Congratulations!

Are you in London?

I used an IM in South London for babies 2 and 3, following a difficult first birth. Borrowed the money on the mortgage to pay for it and feel it was worth every penny.

Re: using birth centre, our local birth centre turns away VBAC mothers, unless they either a) threaten to have their babies at home or b) consult the head of the community team. In both those cases the offer of the use of the birth centre plus an individual care plan for labour is generally put on the table.

But you generally have to go over the head of your community midwife, unless you're lucky to have one who's very proactive. You need to talk to the supervisor of midwives, HOM, head of birth centre, or head of the community team. (don't know what the command structure is like at your hospital. In ours these posts are not always filled so you have to take your luck with whatever senior midwife you can get your hands on.

Yes east London. Where are you and would your midwife come up here? That's interesting about the birth centre, will definitely consider that option and see what happens. Have a feeling that they won't offer though, and also not sure I would want to go back there as it wasn't a good experience, contrary to my hopes.

Was also wondering whether a birth centre which is right next to the hospital like St Thomas's might be different? Ours is stand alone and so they are more edgy about risk I think.

Are you near the Barkatine then?

St Thomas' has a very good birth centre. Could you try there?

My IM covers your area. This is their site:

here

There are a few other mn's who've used this practice as well and have been as delighted as me with the care they've had from Annie, Tina and Teresa.

We signed up IMs for DD1 at 36 weeks (wanted a HB, which CMW was very unsupportive of) and found them so amazing we went straight back for DD2, planning another HB.

Unfortunately things didn't go quite so to plan and I wound up in hospital being induced at 36 weeks. My biggest fear was winding up in hospital and having control of the situation taken away from me (being told we "have" to do this, we "need" to do the other). Having had IMs with DD1 DH and I were a lot more confident and prepared to question things, but having our IM there with us really helped to give us the confidence to force the NHS staff to treat us as mentally competent adults and explain the reasons behind all their recommendations. She was also a complete rock during a very traumatic time, and the continuity of care afterwards was superb and made a huge difference to my recovery, both physically and mentally. I can still pick up the phone now if I need to - 9 months down the line.

IIRC, studies have shown that the biggest positive impact on a woman's experience of labour is having 1 to 1 supportive (not necessarily medical) care from another woman that you trust. IM's fit that to a T, even if they are in a hospital where they can't act as a MW. As you already know, no-one can guarantee an outcome but I do truly believe that having the right IM substantially improves your chances of making a birth the best experience it can be, even if it doesn't go entirely to plan.

Couldn't agree more Tangle.

I know several women who've had complicated hospital deliveries after booking IM for a home birth. All of them have been profoundly grateful for the care they've had from them and felt it made for the very best out of a difficult situation.

I had an IM for DD's homebirth and couldn't recommend it enough.

We had the option to pay in installments throughout the pregnancy and did do this.

Overall, it was worth every penny and I don't plan to have any more children until I can afford the hire fee again. I'd choose an IM again even if I needed to have a hospital birth or planned caesarian.

The antenatal and postnatal care they provide is invaluable and goes above and beyond what you will get on the NHS in most areas.

Yes tittybangbang, Barkantine is our birth centre and to be honest although they were lovely in the ante-natal I really didn't feel safe during labour - both MWs there when we went in were bank staff, usually working at hospital and it just didn't feel like they were comfortable with the setting. I would rather be at home than go there again after the experience we had.

I had IMs for DS1 (home birth) and am seeing them at the moment for my second due in November. It was a stretch for us cash wise first time round but I'm so glad I scraped the cash together (again we paid by instalments). The confidence they give you is just amazing - you get a real belief in yourself and your body. Also having appointments at home when you want them, a good hour of time each appointment and you can ask anything you like and get a sensible considered answer often with background reading to back it up if you so wish. The birth itself was brilliant and it made me feel so comfortable knowing that if I did have to transfer to hospital (which I didn't) they would be there by my side as an advocate and supporter. I had the same midwives as Tittybangbang but I know they also recommend this practice if they are full londonbirthpractice.co.uk/

I had one and it was worth every penny.

I thought I'd add my experience as it may be beneficial to you. First time round I had a 2 hours labour with no problems other than lack of support from the NHS midwives which left me with pnd. Second time round I booked an IM, planned a drug free homebirth. When it came to it, I had a 20 hour back-to-back labour, transferred into hospital, gas & air, epidural. Total opposite to what I'd planned and what most people would think of as awful compared to birth number 1, however I can say it was absolutely amazing and I'd have done it again right away.

One of the best things with an IM is the continuity of care. You have hour long antenatal appointments where they really get to know you. This really helped during my birth. When I got to the hospital I would have been quite happy to have pethidine (I wanted anything to reduce the pain at that point) but my IM knew that I really didn't want it. She managed to distract me, by suggesting going to a delivery room and having gas & air while I think about it. At that moment I thought "OMG why did I pay all that money for someone who is telling me I can't have something I want?". 5 mins later sucking away on gas & air I thought "Thank you, thank you so much for knowing what I wanted better than I did".

Oh and we paid by somewhat sporadic installments, so a bit less around Xmas, etc.

VotePedro mentioned another big positive which had slipped my mind - the flexibility and convenience of appointments with an IM.

I wanted to take as little time off work as I could for ante-natal appointments. (I was working hard in a job I enjoyed and chose not to mention my pregnancy to colleagues until I was 6 months pregnant.)

Hiring an IM made it easy for me to have morning or early evening appointments at home which fitted in with my work schedule and avoided adding any additional stress or travel to my day.

I had an IM and she was worth every penny. I had a very unpleasant first birth - extremely long labour and then a CS which had complications too. Nothing seemed straight forward and the main problem seemed to be lack of continuity of care.

Second time round the IM and I and OH talked through a LOT of thinks, going over all my options and making my plan. What happened on the day did not fit my plan AT ALL, but was made so easy by having a person with me I trusted and had confidence in, at all times. I had planned a water birth at the hospital, being too concerned about the distance to hospital to plan a homebirth. As it was my baby was born so fast I had him at home, with my IM in attendance, and the speed of his birth meant I had to transfer in to hospital for stitching. My IM arrived at my house within an hour of calling her at 2am, delivered my baby, came to the hospital with me, and eventually left my house at 10.30pm, only to turn back up again next morning. Well worth it!

I had an IM and was really not happy.

Despite the fee, I paid for her ante-natal classes as well, which lasted for 1 session due to lack of take up.

Ended up being induced at 17 days over. She reluctantly accompanied us to the hospital where she sat in the corner and read a book.

My only bit of ante-natal advice was "I may wish to consider an epidural". No explanations of risks. I had truely put my faith in her.

My drip blocked, and she and the locum midwife on duty did not even notice for 8 hours until the full time permanent midwife came on in the morning.

I ended up with a 3 day labour, the last 26 hours were in hospital. I pushed DS1 out holding myself up on my hands, and managed to avoid forceps / ventouse by minutes. I was exhausted and frightened and needed the support, but don't think I got it.

Later on I thought that perhaps she was suffering from depression as she is no longer practising. I am just angry that I went so long over with a posterior baby who could not get low enough to stimulate labour. The outcome for us both may have been a lot worse.

He was perfectly positioned until I let her do a sweep at 40+7 and she asked me to raise my hips. He slid out of my pelvis and turned posterior, so the worse advice ever! I should have had it on all fours or kneeling. I was devastated, and she just shrugged as if it didn't matter.

I found the NHS midwives competent and able to support me and completely dedicated. I just feel guilty I did not have this confidence in them first time.

I am now planning a home birth with 2 of our local NHS community midwives.

My concern is that some IM's may not have enough experience. My IM was there to be my extra eyes and support, but just sat there, engrossed in her book as my labout went on, and on, and on.

She did however had a good natural remedy for my tear and helped with breastfeeding.

I shudder to think what could have happened if we attempted a home birth as she could have missed something which endangered either DS1 or I and it would not have been worth the risk.

BunnyBaby highlights an important point - it is very important to thoroughly check the experience and qualifications of the IM you hire.

Interviewing in person, possibly several times, before making a decision to hire them is also important. Your IM should be someone you can both establish a rapport with and trust to advise you well in extreme situations.

I deliberately opted for someone who had 20+ years of midwifery experience (most of it on the NHS in a senior position at a very busy hospital), good references and was happy to share facts and figures on her birth outcomes as an IM. She was part of a practice where the two senior partners each had close to 30+ years experience so the back-up was strong too.

When I interviewed, I turned down the first IM I met because she had less than 5 years experience in total, was very touchy-feely in her approach to birth and unable to provide any data on her previous cases, and was also going through a difficult time in her personal life. She was a lovely lady but I knew that I personally couldn't trust her or respect her judgment.