Oh dear me. Perhaps Ushy would like to do a little more research into the topic before bandying about such tosh!
Role of the midwife - community - a midwives typical day would include a clinic in the GP surgery with 10-20 women to see, and community visits to see postnatal mums and babies - around 6-10 visits isn't unsual. Sometimes she will need to see antenatal women at home for BP checks etc. She will also have to do 'on call' rotas for homebirths and for women who accidently give birth at home, or any other community emergencies. Most community midwives will do at least 3/4 on calls a month - this on call period is not in addition to working hours unless she is called out. Often community midwives get called out in the middle of the night, and still have to go to work the next day - sometimes with no sleep. Among these checks she does, she may find problems. She may need to arrange for women to attend antenatal clinic, pregnancy assessment, delivery suite etc. She may have to make social service referrals, or other multidisciplinary referrals. She has to follow up women who don't attend for appointments. She has to complete a hell of a lot of paperwork which is deemed essential for the NHS Trust she works for.
A hospital midwife will usually rotate - 4-6 months in one area is usual. Different hospitals have different ways of doing things. Hospitals have a variety of settings - always a labour ward, and an inpatient ward - this may be 2 seperate ante and postnatal wards, or may be one ward. There will be an antenatal clinic. There will also be some kind of assessment area, this may be a day assessment ward, or a pregnancy assessment ward etc. Each of these wards has a number of midwives, and sometimes (but not always!!!!) support staff.
Labour ward midwives are looking after women in labour and the immediate postnatal period, 'high dependency' women for example after having a large blood loss after birth, women with threatened pre-term labour. They see women in early labour, and women who think they have ruptured their membranes. They are also having to work in the theatre and post operative areas. A labour ward midwife looks after more than just women in labour. She also has an excessive amount of paperwork to complete for the women she cares for, and for any births she has. It takes me on average at least an hour to complete the paperwork for a birth. In addition to caring for women on the ward - she is also answering the phone to women with concerns or queries (or women wanting to know if its ok to wear high heels 6 weeks after a c/s rofl!). Answering the door to endless people coming in and out of the ward, making visitors and women tea/coffee, cleaning rooms after deliveries, stocking the ward, checking all the equipment is safe and working, sometimes we have calls from the lab with results we have to follow up. Patients relatives asking questions, phone calls to be made to various agencies and other hospital departments for follow up, or for further support. Sometimes we spend quite a while actually trying to find basic things. Like pillows.
A ward midwife is much the same as above, but she is dealing with several patients at once. She may have 11-13 mums and babies to look after. She might have 10 antenatal women. Postnatal - women need observations - some need 30 minute - 1 hour observations, general postnatal checks, emotional support, infant feeding support, help just to get out of bed! Help to get to the loo - removing catheters and drips. Help with the care of the newborn, they want things brought to them - water, bottles, blankets, pain relief etc etc - we fetch these things - usually after being intercepted by 3 anxious new dads, an irate grandma, 2 visitors who shouldn't be on the ward, 4 phone calls, and answering 2 buzzers, with complaints from several women waiting to be discharged - all while you are on the way to fetch whatever has been asked of you. By the time you negotiate this maze, you generally have forgotten you were even asked for something. A postnatal midwife deals with high risk newborns, who need help with feeding, monitoring blood sugars, jaundice levels, weighing, temperatues, observations for prolonged rupture of the membranes, or meconium stained liquor. She deals with an abundance of paperwork, phones, buzzers, doors, and visitors, as well as complaints. She changes beds, babies, and direction 100 times a day. She discharges women home, and gives them advice that is required prior to discharge. She chases up all outstanding things such as newborn checks by the paed, hearing checks, mums wanting bounty bags, or photographer. She arranges the community midwife visits. All before a mum goes home. She can also be caring for high risk women who need complex and time consuming care. I'd be here all day if I went into that any further!
An antenatal ward midwife again is as above - she is looking after high risk women with problems requiring very close observation. Frequent maternal and fetal observations are required. She may be caring for several women who have come for or who are in the process of induction of labour. She might see women who come for blood tests, or blood pressure checks, or who are attending for elective caesarean section. The antenatal ward midwife is also doing the same as the postnatal ward midwife in that she is dealing with complex cases, involving multidisciplinary teams, answering doors and buzzers, dealing with a myriad of visitors, and complaints! She may have several women on CTG monitors - and may have concerns with each trace. She might be trying to get doctors - of which there is one senior doctor and one junior doctor to cover labour ward, the wards, gynae ward and a&e - to see these women. She will be chasing results, referring women in a timely manner to doctors if she has concerns with the women or babies observations, completing all the paperwork involved and care plans, and computer systems etc. All with a smile (hopefully).
I literally can not go on any more. A midwife is pulled in a million places at once - the more women she cares for at any one time, the harder it gets. And the less safe - in my opinion. So a reduction in work load by an increase in midwife numbers can only be a good thing for all mums and babies. Its a bloody good job I love what I do!
Thanks for reading!!!!!!
T
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