Things you wish your midwife had done for you in labour?

[Wavypurple]

I know that the title is quite broad, sorry! I start a new job soon as a maternity HCA. I’ve worked as an HCA for a few years but never in a labour ward.

I’m not a qualified midwife as mentioned so will just be doing the standard jobs (blood pressure etc.) which usually leaves me with some time to speak to/comfort patients and do nicer things for them than just the clinical stuff.

Is there anything you would’ve really appreciated when you were in labour? Anything you would’ve liked someone to say to you?

Sorry if this post if a bit vague, I don’t have kids myself and I’ve never worked in this environment before so I want to do my best for these women.

Thank you in advance!

Hca told me I could ask my midwife for special car park ticket so we only pay for one day and get the rest of the month for free. Ds2 was in nicu at the time and it save a lot of hassle as well as money.

My midwife was new and didn't know about this. We both learned something new.

Been there more and been kind when she was there. The first one and student were lovely. The 2nd main one was a cow.

Just listening to me would've been good. I was told the very intense pains I was having regularly in my back were obviously not contractions since it wasn't felt at the front. She also helpfully pointed out that "you'll know when your contractions start", unsubtly making the point I couldn't cope with a bit of back ache so I was going to be fucked with contractions.

As you've probably realised unlike her was my baby was back to back and it was 14 hours of contractions with just paracetamol at home. She eventually gave in when I had a placental abruption.

Talked to me instead of my partner. I was induced but had hyperstimulated uterus so basically had no break between the contractions and they kept having private conferences by the monitor then yelling DH "your partner is hyper stimulated and needs an injection to slow things down" and although I was in lots of pain I just felt like they should be speaking to me! Then he could ask questions if he had any

Given me an anti emetic sooner so the vomiting caused by gas and air hadn't lasted over 12 hours.

Not been racist to my DH.

Not tried to get me to divert from things I clearly stated I didn't want in my birth plan when I was out of it on pethidine. Also not be rude to my DH when he reminded her of my birth plan and also questioned whether I could give properly informed consent in the state I was in.

Make sure the CTG monitor was working and actually monitor my baby's heart rate so that her deterioration was detected sooner and obstetric support sought earlier (MIL noticed this).

The midwives for my two subsequent births were amazing (different maternity unit).

Answered me when I asked if they were worried. Two of them kept looking for babies heartbeat but neither of them would answer my questions.

Just to add, she was fine, just in a funny position

Believed me when I said I was ready to push. My first baby and I was treat like a bloody idiot

Agree with PPs, the aftercare is so important. I felt a bit like they all had to rush off to the next woman and I was left just lying in a bed vomiting and feeling gross. I would have really appreciated someone helping me to get washed and dressed and have some food.

I had some lovely midwives.

Things they did that I appreciated:

• Helped me shower and washed my hair for me immediately after delivery when I felt so gross
• Helped me into my massive knickers and changed my first few pads for me
• Encouraged DH to take photos as the baby was first put on my chest
• Called me ‘strong’ and told DH that he should be very proud of me

My midwife was lovely. She genuinely listened and tried to give me the birth I wanted. DD had other ideas, but that was OK.
The senior midwife who came in told me I wasn't trying when I was pushing. Bitch. I'll never forgive that. DD had brow presentation, was well and truly stuck and I ended up with a 4th degree tear. So don't do that!

Also this is minor - don't put the blood pressure cuff on the arm with the cannula. Every time the cuff tightened it twisted the cannula needle in my hand, it was agony on top of the other agonies but I was too stressed to ask them to swap it over.

The thing that sticks in my head about the midwife I had with DS, was a moment when I was in huge pain and she was looking at the readout from the monitor and she said "i can see the pain you are in" it felt very validating and compassionate. There were a few balls that were dropped within the whole labour but I remember that moment and really appreciating her tentativeness, I felt very cared for.

Two things were said to me which were hugely helpful (I think they might have stopped me going down a road which led to PND to be honest).

Firstly, when (after a number of hours of induced labour which weren't going anywhere) it became clear that DD was not going to be born vaginally, and I agreed to their recommendation for a C-section, they said to me something like, "You need to understand; you've done so well, this is not your fault and you haven't failed. You're keeping your baby safe by having a C-section."

For context to the second thing, DD was born at 38 weeks weighing well under 5lb, rather to everyone's shock (my measurements had all been fine). At about the second night in hospital, I was really struggling with this and feeling like I'd already failed my child by not growing her well enough! The midwife realised (I can't remember what I'd said, but she clearly picked up what was in my head), sat down with me and said, "There are only two things a mum can do to cause a small baby. Unless you drank or took drugs," (she knew I hadn't) "this isn't your fault. Believe me, I'd tell you if it was."

I don't know if that's any help to you - I suppose the theme is that some mums, like me, will tend to blame themselves if things don't go perfectly, and someone realising that and telling you it's not your fault can be amazingly helpful.

A bit more reassurance that I was doing ok and not to shout at me to push. Shouting at me didn't make it any easier for me to do it and there was nothing wrong with my hearing.

Oh and not to keep trying to make me lie on my back when my body was screaming at me to be on all fours.

Help with careing for baby, bathing, feeding, washing, dressing, winding. Continuity of care

I agree with all the other posters!

Listening and then confirming you have heard. I told the midwife my epidural had failed. She dismissed me, put another boost in and then when I said I could feel everything she made me wait an hour for it to 'take affect'. This happened three times so I had 3 hours with failed epidural on induction drip where no one was notified as she simply didn't believe me

Reassured me I was doing well. I didn't get much reassurance but instead was just told 'women have been doing this without pain relief for centuries (as mine had failed). I didn't need to hear that. I needed to be told I was doing well and I could do it.

Informed me, not DH. At the pushing stage I was given a PCA button (think that's right). But I had used max dose and baby was stuck behind pelvis. I had no idea there was a max dose or time cut off. If I had, I would have used it more sparingly.

Been honest. Turns out baby was stuck as was back to back and that's why I ended up with spinal and assisted delivery. I found this out 18 months later. I would have felt so much better knowing that this is why I could push myself, I just felt like a failure. Apparently they didn't want to worry me

Aftercare. My aftercare was also horrendous. I had a UTI but no one believed me as I couldn't give a sample as I just kept constantly doing tiny wees. I asked for a commode but was told the walk would do me good (despite episiotomy and needing the loo every 5-10 mins). I eventually just kept wetting myself so they begrudgingly have me a commode but refused to empty it every time I went.

I think the fact you're asking these questions OP certainly puts you in a good place to start!!

I told my midwife that my hips/legs were hurting. I was actually in real agony. I'm still under physio 9 months PP from the traumatic labour. I told my midwife that I'd been diagnosed with SPD, but she didn't seem to care. I laboured in all the wrong positions.
Doctors afterwards have advised that labour caused me a lot of damage. I really wish she had read my notes and listened to me about the pain. Pushing on my back with my legs open was truly awful.
It's impossible to be assertive when you're in that much pain..

Listening, communicating and being kind are hugely important. At my first birth, an induction that went haywire, the midwife barely spoke to me. She just stared at the monitor. I felt like an complete object. She wouldn't tell us what was going on or listen to what I was saying. My husband and I were incredibly distressed. There was a student midwife who also became distressed. Finally an obstetrician arrived and I finished the birth with her and the midwife was asked to leave.

Second birth was much better. All midwives involved talked about my plan, my fears etc. I wasn't able to give birth way I'd hoped to but they explained everything and we talked it through. I feel like I gave informed consent at each point. They were hugely supportive during active labour and made me feel strong and capable.

Things they did that were great:

Held my hand when husband had to leave the room.

When baby came out and needed a bit of oxygen to get him breathing, they talked completely calmly, told me he was a great colour and not to worry, babies often need a bit of help.

Husband made a throw-away comment about hypnobirthing and my first labour (He was actually taking the piss out of the hypnobirthing class I made him attend). Midwife just heard the word 'hypnobirthing' and asked if I'd like the lights turned off. I really can't explain how much of a relief it was when those bright, blinding lights went off in the labour room. (Was in very established labour by then).

Worked around me and the position I needed to be in (all fours).

One thing that I wish was maybe more common is the default not being to examine you to see how dilated you are. But I guess it's just the easiest procedure when you have women coming in at all stages and need to know where to send them. My first was a homebirth and I was never once examined as everything progressed normally. They just observed me and regularly checked baby's heart rate. I know this isn't something you'd be able to change, but maybe just more of a thought around REALLY asking what the woman wants. I didn't want to be examined with my second (hospital) birth. But the way it's asked isn't really asking and I just went along with it to not cause a fuss (No one wants to piss off the midwife who's in charge of pain relief and seeing you through labour by refusing to be examined). By the time I arrived I was 9cm (not that I needed to know that!). I knew i was in established labour and it was pretty obvious. Knowing I was 9cm didn't tell them how long it would be until delivery (20 minutes). All I wanted was a comfy place to kneel and a midwife there to help me through it (and LOTS of gas and air). What I got was told to lie on my back on a bed (excruciating) and a midwife's hand up inside me, which then had to stay there during the next contraction because they were coming so quickly and she didn't have time to get it out.

I've also heard too many stories (in real life, not on mn) where the woman was not believed about being in established labour and denied an examination and pain relief. Then finally they get examined and told, oh yes your 8 / 9 cm, you were right.

No where else in the hospital would a patient be literally screaming in pain and be told to take paracetamol.

I didn’t encounter any HCA or if I did just assumed they were a nurse but I think treating people with dignity and assisting with little things - pain relief and water post birth when on the hellhole ward would go a long way. Too often you are ringing the bell - which most people leave til they can’t make do on their own any more- and left hanging :(

Afterwards!! It’s honestly the after part that is so important.
I’ve had 4 DC and generally all of the midwives I came across during labour were friendly and supportive. But afterwards, for 3 out of 4 DC, it was awful. It’s not always possible for the partner to stay for long and so you can be left hungry, struggling to breastfeed (if that’s what you’ve chosen to do), having difficulty to move or shower or take yourself to the bathroom. Sometimes you need to go up the hallway to get dinner but don’t want to leave your baby alone etc, you just need a bit of care and assistance!
My best experience was in a Scottish women’s hospital where they seemed to have more staff than I’ve seen before and there were people to make sure you ate, had water, were mobile, taught you how to bathe a baby or feed it and generally just were kind and patient.

I think do understand that things that would be right for some women won't be right for others. You have to try to tune in to how the woman ticks. Don't make assumptions.

I found it very difficult to ask clear questions in labour. I was terrified, in an unbelievable amount of pain and felt completely lost. My midwife was very hands off and just watched me with dh, which I'm sure would suit many women 100%. For me, I desperately needed someone who'd seen the process before to say 'this is what's happening and it's normal, you're doing fine.' Even more helpful would have been to know it was going very fast, though I guess any canny midwife would avoid predicting timescales.

So for example, the midwife rang the bell to get a colleague in for the actual birth. I was petrified, assumed something had gone drastically wrong and ds was about to die.