Q mainly for MWs - if you don't gell with your allocated MW, how easy is it to change?

[Tangle]

For DD1 we planned and had a homebirth with IMs, but then transferred in for stitching.
For DD2 we planned a homebirth with IMs but wound up with a hospital induction, with our IM there as a birth supporter.

We're considering DC3 and have been advised to be in hospital (although I've yet to get a good reason for that advice). We have yet to decide whether or not to accept that advice.

One of things that concerns me is that in the time I've spent in the maternity unit some of the MW's have been absolutely fantastic and others have put my back up in the first minute. Part of the issue is that we don't tend to accept things at face value and want to understand the reasons behind requests and advice before deciding whether or not to agree to them - from our experience some MWs handle this much better than others, and we'd be very unhappy going through labour with a MW that had the attitude that we should do what we were told and not ask questions.

I know that, in theory, you can request a different MW - but how does that work in reality? Will an alternative MW always be found or are there times when staffing levels are such that there is no choice? Will they try to find a MW that is a better match, or are would we be more likely to get the very strict MW that no-one argues with?

I understand that things will be different on a unit-by-unit basis, but any insight would be appreciated :)

Its absolutely within your rights to request a new midwife if you don't get on with the one allocated to you, and usually this request can be accommodated easily enough.

However, if you come to labour ward in the middle of a shift and its busy, and the only midwife available to look after you is just not on your wavelength, there may not be that option to change. Yes if you kick up a stink they will probably pull another midwife who has been looking after x out of her room and send her to look after you, but that means that the relationship that the midwife has build up with the other woman is destroyed and she has to start afresh with you. This happens occasionally in my unit but it causes bad feeling all round - the midwife you have rejected feels hurt and upset, the midwife who has been dragged away from her other patient is resentful, the other patient who has lost her midwife and has to get a new one mid shift is angry and the coordinator who has had to do the reshuffling has probably had a mouthful from the 2 midwives involved. And you are upset and feeling a bit bad which can impact on your labour.

And there's no guarantee that the next midwife is any better than the last.

What I would suggest doing is that when you go into labour ward, ask to speak to the midwife in charge of the shift and ask if its possible if you can have a midwife who is happy to accommodate you wanting to use different positions in labour and maybe deliver on the mats as naturally as possible. This sort of sets the scene for a midwife that is interested in natural birthing to be allocated to you. (usually the threat of birthing on the floor will weed out the more disinterested midwives tbh).

Its a difficult situation because a midwife can really make or break the whole experience.

Don't quite understand why you would be refused a homebirth because you t/f for sutures for one and were induced for another, unless there are other medical reasons, but a homebirth would be much more likely to get you what you want as you will more than likely have met the mws first

they can only allocate from staff on duty,and avialbel at time
reality is some staff you like,some not.you absolutely can decline an individual mw and request another,but realistically this is an upheaval for you and staff.

might be good idea to write down and be explicit your requests and not personalise it as a specific staffing issue. by all means do challenge and query,but be aware births progress and change and deviate from wishes/plans.playing devils advocate your post does read a bit as your way or the high way and if any staff digress or suggest something else,yiou will have them shifted.sorry but maybe their is no ideal match mw. your parameters about staff seem very rigid eg strict mw

yes need to feel listened to,comfortable,respected but do accept their will be situations were you are perhaps given a specific request or decision for a sound clinical reason

you dont necessarily need to like staff (for want of a better phrase) - you do need to be able to work with and trust them.all pts are, different all staff are different.so as much as staff need to cut you some slack maybe you need to do so also

Thanks for your replies and sorry for the delay in getting back.

To give a bit more information (not trying to drip feed - just not trying to distress others that might be reading)

When I was expecting DD1 my biggest fear was that the process of birth would be taken out of my control - not in the sense that the shit hits the fan and its panic stations, or that birth itself was something beyond my control, but in the sense that I'd be stuck on an arbitrary time line and pressured by MW/Consultant Sinister into agreeing to interventions without understanding why they were required by ME and MY labour as opposed to hospital policy and what was considered "average". We saw HB as a way to mitigate some of this, but by the time our CMW had destroyed our confidence in her as a HB MW (wasn't confident in water birth, wasn't confident in sitting cannula, lots of "better hope the other MW can do that") we turned to IMs. Having the opportunity to get to know our IMs before going into labour meant I had total trust in them and would have taken their advice without hesitation (something we'd have been unable to do with our CMW).

DD2 was induced as she was an IUD. I contracted swine flu at about 36 weeks and my condition was such that my body couldn't support a pregnancy (BP 60/30, oxygenation