If midwifery is in such a bad state, what could be done about it?

[Pruni]

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Pruni, both your ideas (healthcare assistants doing the non-childbirth bits and customer feedback forms) sound fantastic to me. Sadly, I can't imagine them being introduced because they would cost money.

I think midwives should be paid a lot more, which might have some effect on the current midwife shortage. But again, money...

I think they're fantastic ideas!

Just out of curiousity, after I left the hospital I was visited every day by my midwifes (I'd been seen by about 4 at my GP surgery throughout my pregnancy and knew them quite well) for two weeks and twice a week for the next two. Does this happen to everyone?

You never know these things unless you ask I guess!

er no, tuppenceworth. I got 3 visits I think after coming out of hospital with a cs, by different MWs. I'd only met one of them before, and then only once (she was v nice though). Continuity of care was virtually non-existent. I didn't get the impression any of them knew me from Adam even if I had seen them before.

This was in London though.

That happened in Durham and I thought it was brilliant post natal care. I had ds at University Hospital of North Durham and it was a brand spanking new PFI hospital and all the delivery rooms were posh single rooms with private bathrooms and everything.

This begs the question are PFI hospitals the way forward??

I'm not suggesting this is a solution, because it isn't, but with home birth you get 2 midwives who don't leave you, which is a vast improvement on most hospital situations from what I gather. The home visits were a midwife for 10 days after birth and then a health visitor. So there was plenty of opportunity to ask questions and get advice in that situation but no continuity of care, I hadn't met the midwives who delivered either of my children either time. Or I might have met one of them briefly with ds but it certainly wasn't someone I properly knew. I suppose the obvious answers are:

Pay more
Offer flexible working/work/life balance
So prioritise maternity services really

I do think many of the stories on here about the way women are treated in labour are shocking and I can't believe that midwifery, paying as it does, attracts horrible people - there's got to be element of altruism I'd have thought - so it must be down to overstretched people doing their best within the confines of a service that doesn't really care about how women are treated and therefore doesn't allocate enough cash to it.

I'd agree w/WWW, more pay and being more flexible w/the hours. I mean, a 24-hour rota just isn't going to work for a LOT of people, not just those w/kids. There are plenty who want to work nights, and plenty who want days or evenings. Set shifts also decrease the likelihood of getting someone whose circadian rhythm is completely out of whack.

Also, better funding during training. The attrition rates are awful b/c nowadays you're getting more mature students who want to train up, and they have obligations that go along w/that. Make training an option that actually works for people who aren't 20.

i am always surprised by the amount of people who have had 'bad service' from a midwife, i would have thought that the lack of money would put anyone off doing it who didn't really want to do it. also the shocking hours whilst you are training the heavy college workload, the appalling treatment from doctors, nurses, senior staff, and patients! would be enough to put anyone off who wasn't devoted to wanting to provide decent care and support to all women and their families.

i certainly didn't go into midwifery for the money, but because it was a kind of 'calling' (sorry corny i know). my aim is to provide women with choice, to be an advocate for them to work in partnership with the fmaily and the hospital, unfortunatley there are restraints put on teh care that cna be given by the trust that you work for, but i have found in my limited experience that these are normally worked through and a compromise for both sides is reached.

the trust that i work for already employs hca's who are very good at helping the midowves provide adequate support for breast feeding, and general baby care issues, such as bathing, dressing the baby and taking care of the mothers health as well. they provide a valuable service in enabling the midwife to talk tot the woman through her issues and then for the hca to attend the woman more regularly to implement and help the mother witht eh plan of action, knowing that the midwife is on call for the woman and hca should they need it. the midwife always does at least 3 visits and the midwife always does the final visit before discharge to the health visitor.

i know that this situation is far from ideal and the idea is to free up midwives to work inthe hospital and to provide enough midwives to attend homebirths, i also know that for lots of women this isn't adequate support, and having been on both the receiving end of midwifery care (now pg with no3) and having worked for the nhs providing the care, i amstill no closer to ebing able to define a good standard of midwifery care across the board.

i would love to know the answer to provoding adeqaute care for all. recrutiment obviously not working as many feel that the wrong character of person is being recruited and that with all the publicity about eht shortgae of midwives there are a record number of applicants, how can they be getting it so wrong?

I remember watching a home birth on Desparate Midwives and they said there's a midwife for the mother and a midwife for the baby at a home birth.

I'd love to train as a midwife, and I've been told I'd make a good one too, but I couldn't feasably manage it as a single mother. You can take the degree over four years instead of three and have set hours whilst you're training but after that it seems anything goes. More flexible hours for qualified midwives would be a start. And I've also been told that constant staffing shortages are one of the reasons midwives leave the profession, so it's a self-fulfilling prophecy really!

oh and by teh way. pay whilst training is now better than ever,as a childcare grant is avaliable and also dependants allowance. i work with some girls who have children who earn more money training then they will when they qualify!!! one girl with one child (single parent) receives nearly £1500 a month to train. i'm really not sure waht this will do to staff retention rates when qualified thoug, will they all got to agencies or the private sector?

tuppenceworth, about what you said on the other thread about the floors in a brand new hospital not being strong enough to take a birthing pool - who designs these things ffs??

I suppose that's part of the argument against PFI - features that would benefit patients get sacrificed to the private investor's need to maximise their profit .

So glad this thread wasn't killed by the hand of Cod.

loads of people aply to study midwifery but as I understand it, when training in hospital they need one-to-one supervision and there are not enough midwives to provide enough training for the students (are you still with me?) so it's a vicious circle. I had terrible aftercare, both in hospital and at home (had an emergency c section afer 24 hour labour and baby was jaundiced, but still ahd only TWO health visitors who came to my home). post birth care in hospital was terrifying, really so bad that I don't even want to think about it, it was traumatic!! Re. home births, they don't do home births in my area anymore because of shortage of midwives. I live in Newham, London, which has the highest birth rate in the entire country. AND the delivery suite at Newham Hospital was designed for 2000 births a year - they now deliver 5000 babies in those facilities, it's absolutly shocking! Frankly, I can't think of a solution except more money and change in management.