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? :)

I had my first baby two days ago by csection and cannot thank the midwives enough. Apart from one who was not very helpful and didnt spot that my dd was not latching on correctly when I asked her to check, they have all been incredible. The things that mean the most to me is that they have taken the time to read my notes and act accordingly. They have been kind, supportive and very knowledgable. They have taken the time to answer my questions without making me feel stupid for not knowing everything.

My only complaint would be that at night on my first night in the staff were very noisy. The midwives themselves were shouting and laughing for most of the night and other staff would come crashing through the ward banging bins and slamming doors. It wasn't very restful. In contrast, the midwives on last night created a calmer, more peaceful atmosphere and both my baby and I slept so much better.

What is just another day in the office for a midwife is a huge day in the life of every birthing woman. So you may be feeling impatient, cranky, bossy, snappy and wanting to gossip about your colleagues but you are with a woman who is emotionally completely raw and your mildly toxic and thoughtless behaviour can leave deep scars for her.
Oh and when the baby's heart rate drops dramatically don't say "Baby's heart is a bit naughty". Just don't.

Re fathers medical history I was certainly asked and if we were related

Thank you! I loved the midwifes so much at my fairly medical birth that next time around I am definitely hoping to get into the birthing centre and give birth hippy style in a birthing pool :-)

The one thing I did find tricky was that the midwives often had very strong ideas about breastfeeding in particular that conflicted with one another - so one would come in and say that my milk wasn't enough so I needed to top up (I didn't, but was too clueless and knackered to argue at the time), another came in straight afterwards to tell me that formula had now destroyed DS's gut (I doubt that, but was still too clueless and knackered to argue with her either!)... So particularly agree about more education on and support for bfing and feeding in general.

My only complaint about midwifery in general is that there aren't enough! Gave birth very recently with very minimal supervision because hospital so busy it closed and the homebirth and community midwives very busy too...

Don't treat people like they are statistics, don't assume they are lying because they are young, or not at x stage in labour yet because contractions haven't happened a certain way. It undermines the patients confidence in themselves and you.

You to continuous care. I owe my life and that of my son to the fact that my midwife knew me well enough to tell by looking at me that something was seriously wrong at 31 weeks. The dr didn't know me and hadn't spotted it.

The midwives before and during the emcs were brilliant. Breastfeeding support (I had to express as DS was in NICU) was worse than crap. One midwife laughed in contempt at me when I finally managed to produce a teaspoonful of colostrum.

Treat women as individuals who know their own bodies. If we need pain relief we will say so. If we say something is isn't right, no matter what your tape measure/ hands/ monitors say or what happens to 'most' women, please listen to us and check/ help. Read the notes, having to go through the same thing what seems like hundreds of times throughout pregnancy is pointless when the info is in front of you!

With my last labour the midwives were excellent, they treated me like an adult who knew their own mind and were very supportive. My previous birth was with a totally incompetent, seemingly very inexperienced midwife and it was a horrific experience. How the mother is treated and feels makes such a difference to the birth outcome IMO. If the NHS is going to promote 'natural' birth then have the resources to adequately support mothers to do so.

Listening to you. Seriously.

I went into my booking the other day and told them "I was feeling down and not coping" she said "oh its hard with ms and a toddler isn't it" then later in the same appointment she was ticking boxes on the forms and it transpires, shock, that I have been feeling down in the last week so I should see the doctor.

Also tell them that asking leading questions like "you will have a vit k injection for your baby YES?" And "we will put you on an induction drip now, RIGHT?" While you are I'm extreme back to back pain and being forced to be monitored lying down, is NOT CONSENT.

I'm getting an independent midwife this time, such was my last experience.

I had 2 "normal" labours and one scary one. It wasn't until my 3rd labour that I personally had the confidence to say what I wanted / how I felt to a MW during labour. During the 1st two labours I spent a lot of it being told how I was feeling by them!

Also, do not - EVER perform a vaginal examination on a labouring woman during a contraction when she has never met you before - and had her eyes closed and wasn't even aware you had entered the room. I couldn't give a fuck how senior you are. You assaulted me.

I'm am ex NHS midwife. This thread makes me so sad.

There have been some heartbreaking things said in here that should just not happen. As a midwife there is no way I would EVER do anything to a woman without gaining her consent - that is absolutely assault and it completely unacceptable. I introduce myself every time I enter a room and find it disgusting that others don't. I think these issues book down to two associate streams,:

*issues with the process
*issues with the midwife

Midwives have to do certain things, such as asking if the father of your baby is also the partner, and asking if you're related. There are a lot of processes we have to adhere to that we don't necessarily agree with but have no power to change. Midwifery in England was at crisis point when I left as I couldn't deal with it anymore. It was too upsetting not to be able to provide the care that I want to give and that families deserve.

In any job you will get people who are good at it and those who aren't. Please please don't tar every midwife with the same brush and say we are all useless, incompetent or uncaring. It's not the case.

It's so hit and miss - a good midwife is amazing, the bad ones are awful (I was in hospital through a few shift changes so I experienced both)

I want a midwife to be understanding, to at least pretend she's interested, to listen to what I've said. Speak to me like a human, not a naughty toddler.

A bit of tough love is fine at certain points, but bullying into procedures just because of policy, or to make their life easier - I'm looking at the midwife who battered me into having a canula (took 3 tries to get one that kept working... and all for a saline drip - would have been quicker to give me a drink), and clearly wanted me to have an epidural so I'd sit quietly and still on the bed and let the electronic monitoring work rather than kneel next to the bed with the gas and knock it out of place occasionally vs. the wonderful midwife on the next shift who understood that on the bed was way, WAY more painful for me, and brokered a deal whereby I'd hold the monitor in place for 10 minutes (her kindness meant I'd have tried almost anything for her). Honesty, understanding, and kindness go a long way when you have a worried woman in pain.

Post-natally, I'm shocked that none of the checkups have actually involved them looking at the baby rather than just more form filling and leaflet giving - even when i had questions about spots/unexpected baby-boobs. I can see how abuse falls through the cracks when no-one even gets within 5 feet of the child apart from me.

Oh I just read back,

Yes, here's a very, very basic one.

Don't try to move me/my legs/talk to me and expect an answer during those contractions.

Even if your examination says I'm just in pre-labour, that it can't be a 3 out of 3 pain level contraction because of that, perhaps I'm different and it is. If 2 paracetamol are barely taking the edge off, then perhaps offering a warm bath (why didn't I think of that at home.. oh, wait, I did, and it did nothing!) isn't going to cut it either.

Thank god for my partner who fought for me when I couldn't fight for myself any more and got me a pethidine shot to knock me out for an hour (I'd had no more than 15 minutes sleep together for 3 days at this point), and then gas to see me through what ended up being 2 more days of (non-progressing, but still bloody painful) labour. You should have listened to me. I know my pain level, I know what I can deal with, and I know when I need stronger pain relief!

I've not given birth yet and I'm lucky to have had at least a kind midwife so far. But the thing I've noticed so much is the lack of basic information given out I.e. The schedule of antenatal visits was never explained to me.

As the service is pushed for time give out basic information sheets at each visit covering key issues. I may be research obsessed but lots of other women I'm sure just want to be given the basic information at the appropriate time.

Refer people to the NHS website or your trust's site, encourage them to educate themselves.

Most of all focus on informed consent - explain the benefits and risks of treatments and procedures. Explain the why.... Don't just say your baby is small, explain what this might mean and what needs to happen next. If you use medical terms and acronyms check a woman understands... Yes I know what ECV because of OBEM but the next woman might not. Again, if you don't have time give a resource for them to take away.

My experience was not very positive but in no way do I Blame the midwives, they were great on the whole just too busy to give anyone the time they needed.

I think what would have been useful for me as a first time hospital stay as well as first time mum was to tell me how things worked. I had no idea where the toilets were or what I did with baby whilst I went. I didn't know I could pull the cord to get dd passed to me so managed with my emcs wound from the minute I was put on the ward. Someone taking two minutes to tell me where things could be found and how to ask for help would be great. Rather than closing my curtains and disappearing so the next person I saw was three hours later.

The OP has gone strangely quiet. One hopes she is reflecting on the impact of the disgraceful practices her vocation adopts rather too regularly.

Don't tell me it doesn't hurt. Seriously. I'm pushing two humans out of me, it's not a comforting comment

I'm really surprised to hear about other fathers being asked about their history etc. I wonder why it was different for us, perhaps different areas have varying procedures. Good to know that it is taken into consideration for some though.
Hope OP hasn't been too disheartened by the answers on this thread, I expect it's only natural that what seems most important to mention are the negative experiences.

Whistleforit you asked about why some of these things are happening.

I think:

1)Midwives are overstretched and sometimes do not have time to provide decent care. So what happens? Sensitive ones leave the profession and more of the miserable, bossy, case hardened, insensitive ones stay.

2)The NHS looks at funding in 'boxes' - how much maternity costs, how much care of the elderly costs etc. If you looked across the board and included things like litigation, you'd immediately save money by investing in more midwives and doctors and saving far more on litigation.

Roughly 650- 700,000 women give birth every year and caesarean is the commonest operation so it has become a prime target for cost cutting. The NHS wants to drive down caesareans and 'interventions' to save money at a time when there are more older women, more women with fertility treatment which can cause birth complications, bigger babies and more obesity. The consequence is that huge numbers of women are being bounced into a vaginal birth with little chance of giving birth spontaneously - hence the terrible case of the young girl who gave birth to a 15lb baby which ended up in intensive care. As a consequence there has been a massive rise in women suffering severe injuries as a result of childbirth and again this has led to more litigation claims (urinary incontinence, double incontinence, colostomy etc).

3)Finally, there is an irritating power struggle between professionals about the medicalisation versus 'promoting normality' agenda. So women get some professionals 'promoting' VBAC and homebirth and others obfuscating and obstructing requests. Information women are given is often far from balanced and is often shockingly biased towards the ideology of the professional giving the advice. This personifies the lack of respect for women. Whether a woman wants a VBAC or repeat caesarean or a homebirth or a hospital birth with an epidural should be HER choice. The ideological views of health care professionals is irrelevant. However, women should be entitled to balanced information which they are frankly not getting.

Sorry for the long post. I have personally experienced the best and worst of maternity care and am involved in clinical litigation in my day job. What I see fills me with despair at the sheer ignorance and stupidity of policy makers who can never see the 'bigger' picture. This is not about 'lack of resources'; better care would be cost saving.

Hope your talk goes well whistleforit - I think these Mner's posts should give you lots of ammunition

Not had a chance to read everyone ones thoughts but here are my three.

When I speak listen, please just listen, the whole sentence or paragraph, we are together for such a short time please pay me the respect of listening to me because I might just be about to tell you something valuable and even if you think it isn't valuable it's respectful.

Trust me if I trust my body. I have known my body for a lot longer then you so please understand that I understand what my body is capable of.

Do not ever ever give news which is bad/unfavorable to someone when on the mobile without checking they are somewhere calm. Learning you unborn child might have serious illness is not some that should be done in a rushed mobile phone call in the middle of a busy high street.

hazchem cannot believe you were told by mobile - that justs slips off the scale in insensitivity. How could anyone do that.

Isn't listening coming through as a strong theme in all these posts? It is cropping up again and again - you are so right about that.

Ushy - yyy on listening.

Married - I am not a midwife - I am a service user just like you & have been asked for feedback and don't want to base it just on my experiences so appreciate everything that has been contributed so far. Am trying to process it all. Third baby due Jan. Went quiet coz was managing 1 yo & getting 4 yo out of door.

Going through all the detail - Ushy - v interesting point about not getting a balanced view. A POV being imposed (on pain relief, bf, delivery, etc) is a big theme. Any thoughts from your work on ways this could be addressed?

DropYourSword - am also interested in your experiences. Are there any other processes that you think could be changed to improve user experiences? DH and I always get asked if we are related. It is v odd but I guess not personal.

If I ask a question, it's because I'm worried about something, no need to take the piss

A little explanation and reassurance goes a long way

Thrusting a form in front of a labouring woman and saying "sign this" is not informed consent
Just sayin

Quite a few women aren't interested in 'establishing relationships' with you other than as a competent non judgemental professional there to monitor our pregnancy, deliver our children and look after us PN including really learning how to teach BFing. Many of you seem to be very poor at the latter and not nearly vocal enough about making sure you have the time and resources available to do this.

Too much emphasis is placed upon these Ante and Intra Natal relationships whilst totally neglecting the bit that comes after-the more important bit which lasts a lot longer than 40 weeks!

Pregnant women are not necessarily there to fulfill you. Please be more vocal in addressing the very real problems with OB care in this country. Be an advocate politically and socially (get involved in union activities) and do your research. There are far too many HCP's (including MW's) who get a bit lazy and start relying on the anecdotal or personal observation/belief.