What do you want to say to midwives?

[Whistleforit]

Have been asked to speak to a conference of them about What Matters to Women from patient perspective. Come on, what you got for me? :)

Those who say they prefer obstetrician care, there's a documentary (made by Ricki Lake as it happens!) available on YouTube called 'The Business of Being Born' which explores the doctor-led maternity care offered in the USA and compares it with midwife-led care and birth outside the hospital setting in other parts of the world.

I found it really interesting, although I am not an expert on this stuff so it may be ill-researched rubbish for all I know! Worth a watch if you have an hour to spare and are interested in maternity care for any reason.

Why would any woman NOT choose continuous care? Would you like to be seen by the same midwife throughout pregnancy and birth? Ooh no thanks, I'd like to see a different one every time and have a complete stranger at my delivery please.

Be kind, empathetic, respectful and patient. None of the midwives who delivered my children were any of those things.

I had PTSD after my first birth as a direct result of my 'care', even though the birth itself was 'normal'.

"I would respectfully suggest that for the majority of women, things go right."

Do you really think so? I don't agree. Of all the people I know who have children, I would say those who speak positively about the birth (in terms of the care received, feeling as though they were listened to etc) are very very much in the minority.

catfrom I feel the opposite to you. I almost feel an epidural was encouraged for my first labour. DH was scared, it was a long labour, I was in great pain - all the usual.
In hindsight (yeah...I know) I think I was nearing transition and if I had had some more encouragement might have been able to go without the epi. In the end I had the epi, everything slowed down, needed Pitocin.
I feel it was more about pain relief and enduring the event rather than going with it and being shown/encouraged to trust my body.

Luckily my second labour/birth was more speedy and how I wished it would be, including wonderful midwife.

My midwives were lovely!

I wish midwives made more visits after the birth and continued coming or be available until at least 40 days.

Midwives need training on:

• breastfeeding
• tongue ties
• reflux and silent reflux

I wish midwives actually stayed with the patient and baby for at least 6 hours after birth, helping with feeding, nappy change etc.

Go and get someone more experienced. Do not fabricate your notes. And to the gp that told me I was not entitled to my birth notes...covering up a midwifes mistakes with lies only highlights that she fucked up.

I won't be having a midwife led birth again.

Continuous care is the biggy for me. I'm 35 weeks and have seen 5 different midwives. None of them know my name and I have to go through everything from the start each time. It would make such a difference to have built a relationship up.

I would say I had a good experience of midwives throughout pregnancy, childbirth and postpartum. My points either come from noticing the really good bits or the not-as-good bits that stood out:

• understand the information fully that you're passing on to an expectant mother. At booking-in the MW was informing me about unsafe foods but went on to mention she wasn't sure if Philadelphia counted as a soft cheese (I hadn't asked, but apparently others had done before so she was countering. If she didn't know before, perhaps she should have found out!).

• when examining an expectant mother, especially the bump, offer reassurances and explanations as to what you're doing. I was fine, but some friends thought they and/or the baby were being harmed

• listen to the mother - even if she doesn't howl in labour! I didn't make much noise whilst labouring (not deliberately). Finally a new MW came on shift and said, "You're so quiet, they've been ignoring you!", checked me over and promptly announced I was fully dilated and effaced. Looking back, I had been feeling the urge to push but high on gas and air and following the earlier MWs I was thinking I still had ages to go.

• have real, full-on confidence and balance it with attentiveness. Whilst labouring, I had a fantastic midwife. She was so confident, so professional, but without being pushy with me. She was pushy with the student under her, to make sure she didn't make any mistakes, but even the student said to us that it was great because the qualified MW was just so good at her job. I knew she was taking care of everything, but she made me feel as though I was in control. Honestly, if I could have her for every labour I would.

• listen to the mother - again. About 5 days pp I had a sudden pain which became constant agony, I just knew something was wrong with my stitches. One MW said wait and see, go to the MW clinic. Went, to be told wait and see, and if something is wrong, the GP will give a prescription. At which point I realised the GP would have to check me anyway. So I went straight down there, promptly had an infection confirmed, went on ABs and stronger painkillers and felt much better for it. Wasted 2 days in pain thinking the MWs would be able to help.

As a separate point on continuity of care, I didn't have this. But, in my experience (I accept this as likely being an exception), it didn't automatically mean something negative. I think this is down to having a fantastic MW during the pushing stage of labour and the MWs during my appointments were all very good.

Sorry for lengthy ramble

I feel that postnatal care focuses totally on the baby and nobody seems to check if the mum is ok.

I was dumped on the postnatal ward in the middle of the night with the baby placed in bed with me, I couldn't reach the call button or the button to move the bed and I'd had a spinal anaesthetic (midwife pulled the cord and it snapped so had to be rushed to surgery to have my placenta removed) so I could barely move. When she cried I felt helpless, I had to drag her by her babygrow so that I could reach to pick her up in the end.

I was left lying in a pool of blood for nearly 8 hours because nobody checked on me only the baby and I was too tired and emotional to do anything about it until my partner made it back to the hospital and demanded someone come and help me. The midwife who then sorted out the bed at least had the grace to looked horrified at the state I had been left in.

I think the state of postnatal care must contribute to postnatal depression as everyone only cares about the baby and you feel like you don't exist. You've just been through a massively traumatic experience and they send your partner home and abandon you on a ward. I thought that the care I received when I was in labour was good but 14 weeks later I still feel traumatised by the postnatal care or lack thereof.

PS That almost all applies to antenatal care, childbirth and initial hospital stay (I gave birth in a MLU/birthing centre within a hospital).

My MW experience postpartum was pretty rubbish (as per my original post). I didn't see any MWs after that, I went straight to the internet for basic questions and to the GP for anything more concerning. However at that point I think HVs are supposed to take over, and I didn't bother with that route either.

Just want to agree with some of the posts above:

catfromacrosstheroad Accept it when a woman requests an epidural in labour, and don't try 'but baby is almost here' when nobody really knows for sure when baby comes out.

and angryneedsadvice (similar point)
That when a woman says shes in pain, during labour or post natally SHE IS and its not your job to gauge how much.

Wallison just on my own experience, listening to women in labour and after they've given birth would be a massive step forward.

One more thing, I would like midwives and doctors to be consistent in their information rather than saying opposite things. I (having some complications) also want accurate information that enables me to make informed choices. I do not want this to be cherry picked so that the hospital can meet its caesarean reduction targets.

BUT continuity of care, I am not so sure of. I had one midwife who was the most miserable negative unsympathetic specimen on the planet. Would I have wanted continuity from her? No way. I feel 50/50 about this - I would rather have nice, sympathetic midwives who all respect my choices, listen to me and read my notes even if there was a changeover.

Bonkers you said you had the opposite experience with an epidural being encouraged when you didn't really want it.

But I think that is the same issue. The key thing is that if you ask for pain relief you get it, and if you don't want it, you don't get persuaded to have it.

It is all about listening to what the mum wants rather than imposing what the midwife thinks you want.

We can, after all, talk for ourselves; talking only works though, if the person on the receiving end listens.

Be kind. Being stuck in hospital having a baby is the most vulnerable that most women will ever have felt. Being a cunt won't make it any easier.

And get rid of the face when women are there having planned CS's. Planned CS's are marvellous. They mean a better qualified person has decided it's best to avoid horrendous complications and an EMCS. They do not mean that you are too posh to push or decided on a silly whim that you'd like major surgery

Listen to me when I speak. Even when I don't say what you want to hear. When I explain to you that I am tokophobic (sp?) and really think i'll have to have a c-section don't take 20 minutes to tell me that you were desparate to have a natural, drug-free birth but were forced to have a c-section against your (real) wishes (to save your baby's life FFS); I am not interested.
Understand - and never forget - that whilst this is one pregnancy/birth is but one of many for you, this is not a routine experience for me - this is THE SHIT that matters to me.
Know that - without fail - happy mothers are those who felt in control of their birthing experience. This does not necessarily mean getting exactly the birth you wanted in your head (tho that's REALLY great), but at least feeling that decisions were, ultimately, yours.
Remember that, even if it's our first, we are not children. We can understand everything if it's explained properly. If we don't understand something, you haven't explained it properly.

Remember that a woman still has ownership of her body during pregnancy and labour, if you want to do something to her ask first and accept that she has the right to say no.

A woman has a right to be involved in her care and to make choices for herself, it doesn't matter if its not what you think she should do, your job is to explain all the options available and then support her in her choice.

Please remember to introduce yourself to the woman when you enter the delivery room and explain why you are there.

Listen, respect and do your job.

Don't belittle and ignore me, don't tell me there is nothing wrong when there is, but you've decided you can't be arsed to deal with it.

Don't threaten me when I need your help. Your cruelty and incompetence has left me mentally and physically scarred. But you wouldn't even know that cos because you intimidated me so much i shut up.

Don't deny me pain relief, it's my body not yours do I will tell you what I feel, not the other way round.

Don't dismiss my health condition & how it effects the pregnancy. Maybe you could read my notes, or ask me about it rather than use your 'authority' to bull doze over my care... Directly causing me injury and pain.

3 years later and I still cry when I think about how scared and powerless the midwives made me feel. There is no excuse for cruelty as well as incompetence. It was like I was in their way and selfish and pathetic.., if they could have wheeled me out in the street and left me there, I'm sure they would have.

The post natal midwife who refused to admit my baby was a boy not a sodding girl... I corrected her multiple times over the course of my stay and not only did she get it wrong but she insisted I had a girl! I ended up calling him 'she' in front of her as she was too bullying to deal with.

And when I needed the loo I had to take my baby with me ... Carrying my new born along with two crutches, drip and damaged hip (non weight bearing)... and lie him on the dirty blood stained toilet floor. That was fucking cruel.

I can't bear to read this thread as it bring s back so many horrible memories. So I'm sorry if thsi has been said befroe

I woudl like to ask why they are in their job, if they despise women so much ? If you belive that most women are stupid, pathetic, lie about their pain and don't know their own minds, why don't you find another job in where you won't have to deal with them?

Sorry I haven't read all tge answers but for me;

-Listen to her: yes you are tge me, yes you have tge experience but sometimes you might actually be wrong. If I say my contractions are on top of each other and I can't talk tgrough them then regardless of how long I've been having them don't look at me like you can tell how far I am from across tge room with my clothes on.

-listen to her: if its not her first baby and shes come to hospital and she says she needs to be there, don't send her home after a quick look remember Tgey can come very quickly, so quickly in fact tgeir partner has to deliver tge baby on tge floor at home.

Listen to her: if she says the baby feels like he's about to fall out you've probation missed the time to fill tge birthing pool

Listen to her: if she has laboured at home and come and cannot talk through contractions giver her some g& a the first time she asks

Listen to her: if she has taken the time to tell you what position she wants to give birth in encourage her into that position after you have done exaimining her

I'd appreciate it if they still explained things even if there's no problems. If things are going well and a woman is low risk it doesn't mean she's not interested in knowing the whys and hows of each stage or test.

Also, me and DP were discussing just lastnight that partners seem to be pretty much ignored. He's been along to most of my MW appointments and scans etc and not only do people not talk to him they seem to treat it with suspicion that he's there at all. The only time my MW has acknowledged him was to check with me about domestic violence on one of the occasions he couldn't make the check up. I understand that this is an important part of their job but the fact she'd hardly even made eye contact with him before made the whole thing really uncomfortable. I want ed to say that he doesn't come along because he's a controlling monster, he comes with me because it's his baby too and please can he be forgiven for being interested!

On a slight tangent, does anyone know why they don't ask the father any questions or take down medical history etc? It's all very well asking the mother if they smoke etc, but what if she doesn't but the father does? And surely, it would make sense to know a bit about the father's health or any medical issues, seeing as the baby is half made from his genes? Please tell me if that's a silly suggestion.

That said I should say that everyone has been very friendly to me and although not been as informative as I'd of liked I can tell that everyone that's dealt with me has had a genuine enthusiasm for their role and have been very caring towards me, if not poor old DP
It's refreshing to be getting so much care time and attention actually, I often find myself thinking 'ohhh, so this is where my taxes have been going all these years!'