Private midwives - what can they do?

[Happymum1111]

I have some questions about private midwives that I hope someone can help me with. Can they offer gas and air in my home? Can they offer other pain relief? Can they do examinations at home? Can they advise on when to go into hospital (it's unlikely I will be able to have a home birth)? Can they offer support during early (not active) labour if required? Once we arrive at hospital can they act as a midwife? If not, how much influence will they realistically have over events? Can they offer emotional support and advice on positions etc at the hospital? Is there ever any tension between the private midwife and the midwives or doctors at the hospital? Or do they tend to get on well? Has anyone used a private midwife and would they recommend it?

Sorry there's a lot of questions there! Hope someone can help with at least some of them. Thanks!

So it sounds like you're referring to an independent midwife.
All work differently, but I'll try and answer some of your questions.
They can provide analgesia, gas&air, some can give pethidine but normally has to be prescribed by your GP and kept at home by yourself. You would hire a birthing pool, TENS machine. Some can do aromatherapy. Yes they can do vaginal examinations and can advise when to go to hospital (they are qualified midwives). Once you enter a hospital, they act as a doula. They are unable to provide actual care, a hospital NHS midwife will take over care. Obviously your IM will be able to advise and help you make decisions but they cannot do any care themselves. Some IM have tension between hospital staff, but only if they overstep their boundaries. I have worked with a few IM in hospital and they have been great, but I know of others who try to take over care which they are not insured to do, try to make decisions on behalf of the woman etc. IM are great for providing one to one care throughout your pregnancy, labour and postnatal. I wish all women could have this care and not have to pay for it. But do your research. Where abouts in the country are you? Neighbourhood midwives are very good, they are based in South London

I'm in Yorkshire near brighouse. I was looking at private hospitals but none seem to do private delivery round here. But it sounds like an independent midwife might be a good alternative. Probably more affordable too!

www.imuk.org.uk

Contact a few locally to you and discuss your needs with them. You can discuss the possibility of homebirth with them, Due to insurance restraints, they wouldn't be able to provide care in the hospital but can certainly be there for support. There is an independant midwife called Virginia Howes who was in a BBC documentary on homebirth and has written a lovely book about her career, perhaps you could look these up if you are interested. IM's can provide antenatal and postnatal care too, providing continuity of care which is very valuable.

Just to second everything mummymidwife says...I had a home birth with independent midwives and couldn't recommend it enough! The standard of care was excellent and having the same midwives throughout was a huge plus. They had a lot of strings to their bow - obviously the standard care for the mother and baby, but other aspects of care like aromatherapy, alternative treatments etc. Also not to be underestimated is the post natal support, especially with feeding. And they're always on hand if you need them which compared to my first birth and post natal period (unable to directly contact a midwife for hours) was a huge benefit and one of the main reasons I chose to use them in the first place.

Thanks everyone. I don't want a homebirth for various reasons so I wondered if an independent midwife would be worth it for me. But I think the continuity of care sounds amazing and being able to stay at home longer during labour would also be good. Also just generally having support before during and after the birth is very reassuring. So it sounds like a very good option for me. It's such a shame that the nhs isn't set up to offer 121 care throughout. I wish every woman could have this not just those who can afford to pay for it.

If I had the money I would second what curlykale said about post natal care. That in my experience is as hard as the birth and you are usually left to your own devices at a very tiring time, both physically and emotionally, with no one to call in the late evening on a Sunday. I think it would be worth it just for that aspect. I would only want it though if I built a good rapport with the midwife and knew she had the same ideas and approach as me on labour and breastfeeding in particular.

Yes, exactly TheOddity - worth it for post natal care alone (and that's what I was going to do until I decided to go with independent midwives for the birth as well, which in hindsight helped establish the relationship for the post natal care).

My first birth was fine - I was happy with my care for ante natal and the birth but post natal care was very lacking especially in breastfeeding expertise which I desperately needed. I was determined that wasn't going to be the case with dc2.

Happymum, I agree - continuity of care would improve things hugely for women giving birth. I believe it is available on the nhs but not widely, which is a shame.

My experience with one was exactly as the first poster describes. I tried for a home birth, but ended up needing an emergency transfer to hospital in the end. The IM came with us and was there until I was transferred to recovery following a crash CS and then left once she was sure I was okay. She was a great support to DH, which was one of the reasons I booked her (he gets v stressed out and anxious and I wanted someone to advocate strongly that I didn't want an instrumental delivery, if it came to that). She was extremely helpful antenatally, doing blood and urine tests at home at convenient times in the evening and explaining to us in detail about things like induction and what happens during birth. I didn't need her as much postnatally as I was expecting to, but I think that was probably because she did such a good job up to that point.

I did have demarcation problems with both my consultants (one private for IVF, one NHS for general care) who did not accept that she had any status and wouldn't look at any notes she'd made and repeated all blood and urine tests, at one point writing in my notes that I had refused care when I queried (very politely) whether it was really necessary to have the same check ups from three separate qualified people - I felt it was a waste of scarce resources, although I expect they have to cover their backs.

I was dithering with DH about the expense of having an IM but he said 'this is not the part to economise on' and he was right! My poor best friend is still having problems caused by delivery and her eldest is 6. She has probably spent more on surgery and physio than we spent on the IM.