Two midwives present?

[firsttimemama]

Should there be two midwives present when you deliver in hospital? I mean when the baby is crowing and actually coming out?

Yes there should

Yes, usually there will be more than one.

With dc 1&2 I had 2 mw there but with dc3 I had just the 1. The baby decided to come a little bit too quickly.

The delivery suite was very busy and my DS didn't shoot out unexpectedly but there was only one midwife in the room when he came out. Is it just a "nice to have" or is two present a rule?

It's considered good practice, but sometimes it can't happen. So no, not a rule I don't think. For example, some independent midwives fly solo.

Thanks for the info

Our unit doesn't have enough midwives to enable 2 mw's at the birth.

"some independent midwives fly solo."

Are you sure? The IMW may "fly solo" for tax and etc purposes, but as far as births are concerned I thought that two HAVE to be present. What will happen if both the baby and the mum need urgent attention and there is only one MW? In the hospital setting s/he can always buzz for extra support but at home the consequences can be too dire to consider.

DISCLAIMER: I AM NOT A MIDWIFE.

But I did work for some years at the RCM and remember long policy debates about whether two midwives at every birth should be strengthened from a nice to have to more of a must have. A number of independent midwives saw this as a massive intrusion on their right to practise as they saw fit. I also remember NHS midwives arguing that they didn't want other midwives 'looking over their shoulder' unless they felt it was necessary. So at that point it certainly wasn't a rule.

That was quite a few years ago, though, so am happy to be corrected if things have moved on. I would certainly be surprised if it wasn't the norm.

It will depend on the unit. Until recently I worked at a well known, very respected, excellent maternity unit. However, unless problems were anticipated it was not usual for 2 midwives to be present. Frequently there would be one midwife and one maternity care assistant, but this did depend on staffing levels and how busy the unit was.

Meant to say that the reason for one midwife was simply staffing. There was no way on earth that they could have spared two midwives for each birth, even if they just came in at the end.

Why do you want to know ayway? Was everything ok with your birth?

With wrt the IM question - I've had two births with independent midwifery care. With one, there was no issue, the IM did not call for back up. With the other, issues were noted and she called for back up from another IM who was on call for her. She was not working in isolation.

Yes, Crotch, I didn't mean to imply that the independent midwives were irresponsible. They just felt that the number of midwives present is a clinical decision that should be reached by the midwife and mother working together, not imposed from above. I've never met an independent midwife (and I know quite a few) who didn't work in some kind of partnership with others.

"They just felt that the number of midwives present is a clinical decision that should be reached by the midwife and mother working together, not imposed from above."

Interesting, I was interviewing three IM for the birth my dd and all of them said they would have a colleague present for the birth itself and it was the case for any of their births, even clinically straightforward.

Having attended around 180 births myself when in the medical school (not in the UK I must add) and having seen no serious complication over the whole period apart from an occasional tear and v rarely forceps I nonetheless witnessed occasions where 2 pairs of confident professional hands available at a split second notice were absolutely essential. Therefore I do believe that two human being absolutely require 1-2-1 care in the first hour after the birth, even if this care is not intensive.

It is not a matter of mindless dictatorship "from above" it is a matter of adequate preparation for all eventualities without suffocating the mum and the babe with unnecessary medicalization.

But IM usually attend home births only, no? A home birth is a completely different situation to a hospital birth where the room can be filled with professionals within seconds if required.

If you are asking me daisy my post was in response to a mw "home alone" suggestion. I have no doubt that in the hospital setting it is adequate.

No, the standard is two midwives at a homebirth, one at a normal hospital birth. In the unit where I'm training right now I've never seen two qualified MWs at a birth. It just wouldn't be posible with staffing levels.

I had one mw in the birth centre where dd was born, the only staff there were her and a HCA. It was part of a hospital so worst case scenario a crash team could have been called,

I was left alone with dh and baby after dd was born. I dont think i needed care in the hour after birth especially?

One would have been nice but she was faffing around too busy getting the antibiotics that I was supposed to have been given when I first arrived at the hospital. It was all a bit academic by the time she decided to grace me and my luckily OK newborn with her presence .

Oh how we laugh about it now.

Sorry, didn't mean to sounds so negative. What I should have added was the point that, if 2 MWs had been assigned to care for me (even if both weren't expected to be present at the final moment of delivery), I wouldn't have had to rely on a single community MW who admitted that she hadn't done a maternity ward stint in over a year and who kept trying to persuade me to go up to the antenatal ward as I was clogging up a room .

I could not make her believe that ds2 was arriving quickly and would have loved another MW to have been there to give a second opinion.

In my unit it depends on the practice of the individual midwife (unless there are complications/problems which dictate otherwise).

I personally always call for second midwife as baby is being born, partly because that's how I was trained and also because I like to have a second pair of hands/eyes there at the crucial moment just in case.

I had two scared one off at one point I'm sure I did but I am positive she must have come back for when my dd came out as they got me to stand up and someone had to fetch a couple of pillows for dd to be delivered on to, I was high on the G&A so fuzzy on the details.

In our area the rule is two for a home birth and one for a straightforward hospital delivery (because the call bell is right there if they need someone else)

Many units have a culture of having a second midwife present. Sometimes a second midwife will interrupt the atmosphere that has been built in the room. I let instinct guide me and often support mum's to delivery their babies, without a second midwife. The emergency bell is only a second away.

Two for the end of DD2s, NHS home birth.
Two, I think when DD1 was actually born, but I was rather out off it and can only clearly remember the one I kicked across the room into the examination light.