Independent midwife-what to ask

[PinkFondantFancy]

I've posted this on the pregnancy board as well as I wasn't sure where to put it.

I'm 14 weeks pregnant and considering getting an independent midwife. This will be my first child and my DH and I are quite anxious about what the birth experience will be like. I feel like having an independent midwife could be a good halfway house between NHS and private, and hopefully will make the whole experience less scary for us both by having a medically qualified advocate with us.

I've spoken to a couple of ladies on the phone and one that sounds particularly good is going to come round and visit us this week to answer questions and talk about next steps. What should I be asking her/looking out for? Sorry if this is an inane question, it's just that it's quite a lot of money and I want to make sure that I'm hiring the right person.

Thanks v much!

On phone so brief!

How does she organise back up?
What are her areas of expertise?
How does she do bloods/scans/any interaction with NHS
What % clients use G&A
Does she have holiday planned?
Timetable of AN/PN care

I've used one twice and the care - compared to NHS care received in other pregnancies - was fantastic.

Why not have a home birth? Why don't you consider an NHS midwife to be a medically trained advocate?

Thanks porkchopster.

laluna I live in a terrace with thin walls - not sure the neighbours would be very impressed with a homebirth... Oh also because I've got strep B, I think the NHS trust that I'm in won't do homebirth.

I'm not saying there's anything wrong with the training of NHS midwives, just have heard a lot of horror stories about friends being left alone for periods of their labour because the MWs are looking after a lot of people at once, not understanding what's happening etc. etc. I figured with an independent MW DH and I might be more relaxed because there will be someone with us all the time that we've built up a relationship with, who can vouch for what I want/need if I'm unable to coherently express it at the time, and can get help if needed. Also from what I've read the post natal support from an independent is helpful.

Would really like to hear any other views though, especially if you think an independent MW is pointless - this is my first child so am completely clueless about this whole thing!!

I think it's most important to get your first birth right because it affects all further births.

Most IMs can only be birth supporters in hospital though, unless they have a contract - tricky area, add it to your list. Why not stay at home? Planning a HB reduces your chance of CS by 50%.

The Homebirth.org website has tonnes of GBS info. A Homebirth is your choice - as is choosing to accept anti-biotics in labour.

I had an IM for an HB in a small terraced house with thin walls without any hassle. The neighbours didn't notice a thing (one elderly neighbour was really surprised to see me with a baby since she hadn't actually noticed I was pregnant never mind in labour in pool a few metres from her living room...)

The experience was so positive and I was so impressed with my MW that I wouldn't consider having another baby until I'd saved up enough cash to pay the fee again, even if I had to have a hospital birth for whatever reason. There are excellent MWs on the NHS but it's luck of the draw on the day and your experience depends equally on how busy the ward is.

You've had some good advice from pps already. I would recommend thinking about what is most important to you (minimal intervention, water birth, lots of experience etc..) and assessing any MWs against their views on the items on your list.

I decided against one MW I interviewed because I felt that she wouldn't be strong enough to stand up to me and tell me if I was wrong about something. I needed someone whose views I could respect and who wouldn't be afraid to contradict me.

I really valued:

• being able to select a midwife based on her experience, birth outcomes and agreement with my own views on evidence-based medical practices,

• getting 1:1 care throughout my pregnancy with the same person and really getting to know and trust them,

• having antenatal appointments and tests in my own home at a time that suited me as a FT commuting mum-to-be (blood and urine samples were dropped in at the local GP surgery for transport to the local hospital where I had my scans).

My IM practice often accompanied women for hospital births as birth partners or doulas. One of them used to work at the local hospital and they had good relationships there. I understood that this was quite normal.

Thanks for your advice ladies, I really appreciate it. How far away from the hospital were your houses when you had the HB? The other thing that would scares me about HB is that I'm at least a 1/2 hour drive from the hospital and I guess if anything starts to go wrong you've got the wait for an ambulance on top of that too...

About 15 minutes? But, you will have your IM with you all the time. Anything changes, anything she's not happy with, she'll discuss with you what to do. She might want to have an ambulance on back up. Compare that to spending a few hours alone on labour ward when all sorts could come up, and you wouldn't know, because you were not being monitored.

Read here and join here if you want to know more.

Here's the GBSlink

Thanks-I'll check the links out!

About 15 mins from hospital for me too. My MW did phone the labour ward at the local hospital once I was in established labour just to make them aware. She updated them on the phone at shift change time too, just in case I needed to go in later.

I would ask what experience she has, does she have indemnity insurance as many don't. What back up does she have if off sick or hits a very busy time. All midwives are NHS trained remember and it is unlikely she will be able to look after you in hospital so for total continuity homebirth really is the best option.
Not sure where you live but not all care in NHS hospitals is bad. Personally I had two babies with great contiuity from my NHS midife and a homebirth for second baby the hospital even leant me a pool with all the equipment needed for free.

Cheepy, no IM in uk has indemnity insurance. No one will offer it to them at a price they can reasonably afford sadly.

I think IMs are a fantastic option and wish I'd considered it with my first.

It's hard to know what to ask, but I found just talking things through gave me an idea of who I could completely trust and work with throughout labour and birth.

The Strep B issue may be a great thing to discuss and maybe ask what implications they feel this diagnosis could have on the handling of pregnancy and labour.

Don't worry about thin walls too much but if you do decide hospital to be the best place for you then your IM can still be an important and informed advocate that will not let you get walked over in the name of routine policy.

All the very best, hope you find someone you can really work with!