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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

Difference between hospital & community midwives?!

22 replies

sonnyday · 27/10/2010 20:46

I have noticed a real difference between the two and the attitudes they have towards childbirth... The community midwives I have met are very pro home birth & water birth and don't seem to hold the hospital midwives in high esteem. My last two babies where born in hospital the staff were great but seemed more pro intervention. Surely midwives all have the same training so why is there such a difference?

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DancingThroughLife · 27/10/2010 20:50

I didn't notice a difference tbh, but then a lot of them rotate onto the community side. My community midwife, who did all the antenatal care, was rotated to the hospital about 6 weeks before BabyDancing was born and did a lot of my care on the postnatal ward.

Maybe they just get a bit set in their ways if they don't rotate? I don't know...

Original poster

sonnyday · 27/10/2010 20:51

Don't get me wrong all the midwives where great, I am just curious about teh different approaches I encountered

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ThatDamnDog · 27/10/2010 20:52

Presumably they choose to work in areas in which they have an interest? Hospital midwifery would be a bit unfulfilling if your interest was homebirth!

thisisyesterday · 27/10/2010 20:54

i can't say i have noticed a huge difference, tho i only had one of mine in hospital so can't really compare that well

i guess that some of it must stem from what they see every day in their job

community midwives see successful homebirths, they see women in their homes and they see them once they're recovering at home

hospital midwives only see hospital births- including the many, many that need intervention and the ones that go wrong. they see the women in pain and they see them immediately after birth when they may be finding it difficult

i guess when you are in those totally different situations day in, day out then your views change somewhat

LynetteScavo · 27/10/2010 20:59

They are not the same breed. Hospital midwives live in a pit beneath the hospital, coming up only to deliver babies for 8 hours a day.
Community midwives on the other hand drive around town with smiley faces. I sometimes wonder if they have a sip or two of the G&A they keep in the boot of their car.

malteser1981 · 27/10/2010 21:08

8 hours a day?!! I wish......better than the 13hr shifts we do!

Original poster

sonnyday · 27/10/2010 21:22

Ha! I'd love to have G&A in the boot of my car

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thisisyesterday · 27/10/2010 21:23

yeah actually the midwife who came to ds2's birth did "forget" to bring the gas and air in with her
no wonder they were so jolly!

Original poster

sonnyday · 27/10/2010 21:26

Now you come to mention it I've had two friends who's homebirth midwives have turned up without the gas and air haha!

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DancingThroughLife · 27/10/2010 21:32

I thought the ones that do the home births are on loan from the delivery ward

Shows how much attention I was paying...

In defense of my hospital midwife, she suggested I try the birthing pool - actually she was very keen for me to do it even though it takes 2 hours to fill. All the hospital midwives I had (in my 12 hour labour) were very keen to avoid intervention of any sort.

I'd love a job where I could drive round with the g&a on tap!

Sparklies · 28/10/2010 00:49

Ha ha, mine didn't have any G&A on her either when she turned up just after I'd gone into spontaneous labour with my first at 36w6d! To be fair to her, she was supposed to be coming round to talk about a homebirth, not performing one.. the timing was remarkable! Unfortunately I had to be transferred in because I was 6 hours before the cut-off :-(

On my third baby now, and have spent a lot of time in hospitals over the years with high risk pregnancies (probably caused by an awful hospital bank staff midwife with my first, for the record).

I love the community midwives - never met a bad one. Hospital ones are a mixed bag, especially bank or night staff. Bank night staff are the very worst and have made so many mistakes with my care. But I have had some truly lovely hospital midwives too, so..

thisisyesterday · 28/10/2010 11:29

i'm seeing a pattern emerge here....

i think i'd like to be a CM"!

Marjee · 28/10/2010 12:15

I'm not really sure what to make of this but I consistently measured small throughout my pregnancy and was 37cm at 40 weeks. The community mw I'd been seeing wasn't concerned by this at all and hardly mentioned it but when I turned up at the hospital in labour the mw there was horrified and demanded to know why I hadn't had any extra scans! I was made to lay on the bed on a monitor and ds was born by ventouse because they were concerned that he was very small and wanted to get him out quickly. The community mw said the hospital mw was too panicky and the hospital mw said the community mw was not thorough enough . I don't know which is right but it was so scary for me as it was my first baby and I was already pushing when I arrived after they had told me I wasn't in labour! It would be so much better if all mws shared the same ideas

stoatie · 30/10/2010 20:52

Community mw more likely to be pro home birth as will have more experience of it, however at my local unit all staff rotate between labour ward, ante/postnatal ward, and cmws will also rotate into the hospital, so likely the CMW is also a hospital midiwife, but not necessarily other way round (ie lot of hospital midwives don't also work in community)

mungogerry · 30/10/2010 20:55

My mw's also rotate a week on delivery suite (consultant led) a week in the midwife led unit, then 2 weeks on community inc home births.

Perfect!

homebirthmummy · 31/10/2010 09:31

They are so very different! community mv's are much more chilled and relaxed.

I think one big difference is the environment they are working in. Hospitals are very hands on 'these are the rules and that's that' type of places, whereas in the community mw's are a bit free-er and can suggest something without the matron breathing down her back.

mum2oneloudbaby · 31/10/2010 11:10

That's really interesting Marjee I have measured bang on for most of my pregnancy until I hit 37 weeks and 37cms and have stayed at 37cms now 40wks.

MWs and consultant seen during last 3 wks not concerned and I have seen 2 different MWs.

Was told often measures smaller towards the end because the bump drops as head engages?

LoopyLoupGarou · 31/10/2010 11:12

I found community ones to be well-meaning but not very knowledgeable, and hospital ones to be incredibly efficient and knowledgeable.

onimolap · 31/10/2010 11:20

Surely the only difference is location? Which leads to different typical caseloads.

I wouldn't particularly want to be dealing with someone who held their fellow professionals in low esteem.

homebirthmummy · 31/10/2010 14:33

onimolap - I agree that the case load of the mw probably has an impact on how they are viewed.

A community mw and a mw caring for high risk women will all work 1-2-1 and therefore women will feel more supported, whereas mw's who work in MLU's will have many more women to care for at one time, so obviously women will feel different about the care they receive.

I think if you are wanting a 'natural' birth, it is much more achievable with community mw's, but maybe that's simply as they have more time and less demands?

Just my thoughts.

susiey · 31/10/2010 17:39

well I was delivered by a community midwife in labour ward ( I am high risk and was being induced ) I only know this because she said that she was on call for a homebith that night and if the call came she would be replaced.
Apparently in my hospital even community midwives do some time both in labour ward and postnatal I think she said to keep up the skills needed in those places.

As it was she was there there to deliver my baby and she was lovely she even made sure I got my drugs ( diamorphone when I wanted it!)! but so have all my hospital midwives on labour ward.

EvilAllenPoe · 31/10/2010 18:34

community midwives in my area have been hospital MWs in the past - the community MW that did my booking for DS was back in the hospital when i was pg with DD2 - she'd been sent there after her own mat leave to make sure she was completely up to speed before going back on to the community team.

community MWs that i have met have all been very experienced, calm, knowledgeable people. Had v. little experience of hospital ones so can't comment.

(if you live in the Worthing area and are low-risk - consider a homebirth - their team is excellent!)

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