What makes a good midwife?

[Freedomchick]

I am a mother and a midwife. I'd like to know what makes a good midwife so I can make improvements and always be a good one. I know I can trust you all to be honest. Much love and gratitude to you all. My children are now grown and are amazing, sensitive, accomplished souls & contributing wonderful things to the planet (if I say so myself). Their father wasn't around so I know without a doubt that it was the sisterhood of motherhood that got us through. So thank you.

I had a lovely midwife, who supported me through my labour at home and then EC at hospital- staying with me throughout. I was also lucky enough to have the same midwife visit me frequently both before and after the birth. While some of my friends thought it was strange I had a male midwife, I was actually more concerned that I got to receive continuity of care from someone kind, generous with their time and with a sense of humour. Also someone who was able to assert my wishes to other health professionals- eg. supporting me in having a home birth for my first child. I think I would just re-iterate the qualities needed by a good miwife are very good interpersonal skills and the abililty to read people- knowing when to help and when to step back and just listen. Letting the birthing mother take the lead and supporting her.

So, in early labour - a MW who believes me when I tell her my waters boke at home and does not suggest,albeit politely, that I could have pissed myself...because, I can tell which frecking hole it's coming from ffs!!
Then, during the middly plodding bit, a nice friendly, humourous sort is good.

At the crucial ponts, when is hurts and is all a bit scarey... oddly for me, I appreciated the somewhat matronly, mildy bossy head of MW who called me 'dear' and 'lassie' and 'my darlin', even though this would normally mildly irritate me. She told me I could do it (while at the same time preparing for an emergency c-section...).

I agree with a lot that has already been written - reading notes beforehand, treating my choices seriously, compassion, read body language, explain why you want to do X. Alsao, try to build a rappour with someone and let them open up their backstory to you if they want rather than asking them a bunch of questions (I'm from the States, have an accent, and so many medical staff upon hearing an accent feel a need to play twenty questions for private information and it makes me really uncomfortable, especially the ones that seem to asking questions pointed in trying to see if I deserve to be here).

In labour, gently encourage drinking and eating when possible (I wish I had done more of this with my third, I ended up so thirsty afterwards!), quietness (even quieter in the pushing stage, everything seems really intense and loud then), and again reading body language, asking what they want, and try to include the birthing partner. The best midwives show the partner how to massage certain areas and to comfort rather than religate them to the sidelines (I even had one horrid midwife who asked him to push his chair away from me as it was bothering her and she wanted more access to the machine!)

If something goes wrong, please don't treat the mother as she is to blame even if she made choices against medical advice - she'll feel scared and bad enough already. I was in a high dependency unit after having a severe adverse reaction to injection to speed up the placenta and there was a lot of talking over mothers, rude comments about mother (I was referred to as "the hippie who was taught a lesson" as I'd gone for homebirth even with borderline anemia, my anemia had nothing to do with having a severe reaction and my birth had gone really well until the injection they gave me but the comments they made to each other and the looks...), and shouting matching with scared, poorly women that were a disgrace.

I'm a midwife and have had a massive crisis of confidence this week thinking for the first time that I don't want to do my job anymore.

Reading this thread has made me think of all the times I have laughed (and cried) with women and their families and how privileged I have been to share in their births.

So thank you OP (and everyone who has shared)

Haribojoe - I think about the 2 midwives that delivered my DD's lots and often think that I never really said thank you properly as they were utterly brilliant. I am guessing that loads of women feel the same.
Hope the confidence crisis is short-lived.

I'm a birthing companion (birth doula) with many experiences of good midwives. I think mums would agree with everything you have said and I know as a doula we can make a good team with the baby's parents and their midwife. everyone has a role to play in the birth and mine is helping mum achieve the best possible birth and supporting her wishes. I've had four babies myself, all were different and fantastic as well as scary at times. being well-informed was crucial to me so I've carried that onwards as well as ensuring dignity and respect for all concerned. midwives are usually very interested in doulas - they're an extra pair of hands for a start! I feel it is an honour and a priviledge to be present at the beginning of new life and my saddest time is when a midwife looks bored - that's when I offer to come and find her if anything happens.

I don't remember anything about my midwife with dd1. The midwife I had during labour was lovely though and reassured me until I went in for my emcs, she was very protective over me, I remember that felt great.

With dd2 my mw was awful. She had been my sister's mw and birthed her baby just 6 months before. Each and every appointment consisted of her asking about my sister and her baby, how great she had a natural birth and breastfed easily blah blah blah. She showed zero interest in me and I was so relieved to move to consultant led care so I had less appointments with her. After birth, she never turned up for the home checks on 2 occassions and never made the final appointment either. No phonecall to say she wasn't coming, or even afterwards to explain why. We all get waylaid sometimes, but that's just rude.

In my next pregnancy my heart dropped when I realised she was my midwife again. I told her I was having pains but she wasn't interested despite previous mc, so I organised a private scan which picked up I was having a mmc. She offered no support, and when I eventually mc 3 weeks later, I called the surgery to leave a message for her but she never called.

It's amazing how one person can destroy your confidence in their profession.

I am preg again now, and I have been reliably informed that she has finally retired. I'm still nervous though about meeting my new mw as my last one put such a negative slant on pregnancy.

So I guess I'm saying that a good midwife treats her patient like she is important and that her pregnancy is important, even if you see hundreds of pregnancies a year and to you it may just be a bunch if cells!

I'm sure OP is lovely, simply for caring enough to ask.

Things that I appreciated about the MW who delivered DD:

• Sense of humour, air of capability, calmness, being on the ball, being kind and encouraging

Even though it was a fast and very painful delivery, (induction ending in epi and ventouse, no epidural), my memories of her personally are very good.

Things that I DIDN'T appreciate about the midwife who was there when I went into labour on the ward (following induction):

• Being made to feel like a nuisance (I started dilating very suddenly, about 6 hours after induction), being offered paracetamol rather than being examined to see what was actually going on, being left to labour alone in a dark empty canteen (bugger off and make yourself a nice cup of tea dear), then in a tiny windowless bathroom (bugger off and have a bath dear). DP wasn't there as it wasn't visiting hours, and the MW refused to believe I was in labour, so I was alone and scared for most of the time until finally examined at 6cm dilated.

PLEASE don't ever say to a woman in pain that you can tell what stage she is up to just by her face / her voice. Even if you are right most of the time, when you get it wrong it's a very big deal and breaks a lot of trust.

I think it's great that you are asking OP, thank you

I had a home birth with my son, and due to a shift change ended up with several midwives. As I'd been pushing several hours, I was getting a bit tired and less positive than I'd been, though I still wanted the home birth rather than a transfer in to hospital. My first midwife kept telling me I was 'doing it wrong' (without offering any advice on how to do it right), and telling me to lie down on my back - totally antigravity, and unhelpful and against what i wanted to try and do - make gravity work for me! She also told me I wasn't allowed to have any gas/air once I was fully dilated (she'd only brought it for me once i was at 8cm). I learned later that that's entirely by choice - though she didn't give me that choice, just made it for me (there were 3.75 hours I could have really used a bit of pain relief!)

However, one midwife who joined at shift changeover was just brilliant. Though she left the first midwife to complete the delivery, she just had total confidence that I could do it - the only person in the room who actually gave me positive energy about the birth. After 3.75 hours of pushing (turned out I had a cervical lip still over DS's head (though I'm not sure that's how it's technically described)), plus he had his arm up over his head), all I remember were the first midwives who just wanted me to 'give up' so they could hand over to an emergency c-section (and who totally dispirited me), and the absolutely brilliant midwife who just by being in the room gave me back confidence that I could do it myself and that it was all ok. DS was born happy and healthy (though after all that, we did end up in hospital for jaundice!).

Best of luck in your midwifery and serious kudos to you for researching via this forum!

Ask before doing something. It's no good saying 'I've just done a sweep, you don't mind, do you?'

On the whole though, my midwives were great as they were on my side against the doctors who forced me to have an epidural and kept saying that I had to have a section. Luckily, with my midwife's help I avoided that.

The midwife for the first part of my labour came back to see DD and I the next day. I really appreciated that.

I am overwhelmed by so much that has been said.....and I am spreading the word to other midwives and thinking how i can do it in a more formal way. Yes midwives have skills that can be beneficial for pregnancy, birth and child nurture but ultimately birth is YOUR personal, momentous, intimate, powerful experience and it is a privilege for midwives whenever you invite us and permit us to be part of that experience.

Just for your reference I hope I am able to share with you a document called 'The Code' produced by our governing and registration body 'The Nursing & Midwifery Council'. Midwives are legally bound to work to this code. It's not long. Hope it informs.

www.nmc-uk.org/Nurses-and-midwives/The-code/The-code-in-full/

Don't be rude and dismissive of the labouring woman particularly in relation to a condition she has far more knowledge of than you do.

I have type 1 diabetes and after a while on gas and air felt like I was having a hypo. I know my symptoms for this and knew that if it happened in labour there was a risk of the baby having low blood sugar and needing possible interventions which I was very keen to avoid.

Midwife refused to listen to any of this and when I tested and showed my blood sugar was going down refused to do anything.

Thankfully she was just covering the lunch break for my other midwife who was much better.

And yes ds was born with low blood sugar.

Interesting!
I agree with all of the above, let me just add one thing : I also had 1 "dodgy" midwife during my first labour, out of a total of 5 ( 4 shifts, 2 midwives at the last one when I delivered). Interestingly, the whole 6h of her presence saw the complete lack of progress of my labour, and the minute she told me she was leaving I started dilating again... She even joked about it, but her indifferent behaviour and eagerness to send me for a cs ( arguments in the doorway with a consultant about it, constantly getting the surgery kit ready, etc...) is the very thing which created the mental ( and physical ) block I had.
The one who delivered my son together with a student midwife was sooo lovely, and knew how to make things feel lighter with little gentle jokes and smiles and encouragement. She was a Kiwi and I still remember her 11 years after :)
I don't remember much about the 3 lovely midwives for my second birth as it went too quickly ( never had time to examine me at all...) but I suppose they also knew that it was my second so let me get on with it, I was using self-hypnosis so they didn't really realise I was so far gone, etc.. they were lovely and professional and relaxed so nothing to say as I didn't feel that vulnerable the second time round....

One that doesn't sit at a desk with her back to you during most of your labour. One that doesn't laugh at you for being a wimp because you ask for an epidural (and then refuse to give it). One that doesn't take your child away for 20 minutes as soon as she exits your body with no explanation and one that doesn't shove your boob into your baby's mouth, then tut and say that's not how you do it, then walk off.

Other than that she was fab

I have not read all the posts so apologies if I am repeating, I had two great midwives and two pretty good births (although the first one was way too long) and they both seemed to listen to me and respected my birth plan.

First time around I would of liked a bit more advice, whilst I appeared calm and in control I was a complete novice and absolutely panic stricken on the inside and would have liked a bit more of a firmer involvement like getting me walking etc.

And one thing I would of liked, which may seem silly, but as I had no family around, just hubby and me, I would have like a bit more fuss after the event. I have one blury picture of me & hubby and DD1 and one picture of me & hubby and DS1 that shows a bit too much to put on display. I just didnt' feel special - if that makes sense. I know you deliver babies everyday but I don't.

But the very fact you care enough to ask means you are one very special midwife. Can I book you please if I ever decide to go for another??

Aaaw Ticklebug......if I have my way there'll be a growing number of midwives that care around for the women who invite us into their experience. I just care, that's all. Warm thanks for all your thoughts and opinions. I will be doing something with the info....keep your ear to the ground.

Love to you and yours x x