Home Birth only one mw per night on call in a big city is this normal?

[Ledodgy]

Mw has just come round with my home birth pack and has given me the on-call list. She said that at night there is only ever one mw on call and if this mw is attending another birth I have to go to hospital as no other mw will come out! She and another mw are on the list alternately every few days and she told me she can't actually deliver the baby , well then she said she can but only on a bed as she can't bend her knees as she's had an operation! Now is it me or does this sound like in reality i've got a hope in hell of getting this homebirth. I live in Liverpool and she said herself when I asked that homebirths are always quite busy but most people aren't as realistic as me and end up needing to go to hospital. She said as I had a 'nice' labour last time I should be fine but as far as I can see I won't be if just one other woman in Liverpool also wants a home birth goes into labour at the same time as me!

Wow - she wasn't full of enthusiasm and positivity was she?
Can't help, I'm afraid, but just wanted to post and say that I hope you get your home birth.

Thanks HC. Oh well i've got my gas and air now so i'm not going anywhere!

I had two homebirths in London. When I went into labour with DD3 (my second homebirth) the oncall midwife for my area was already attending a labour so they called out a midwife from the next area who attended the birth. My own midwife arrived a few minutes after DD3 was born (and was rather disappointed as she had delivered DD2).

you need to look at [www.aims.org.uk]] the trust are obliged to make sure there is enough cover for homebirth ,there are some form letters you can copy and send to your hospital.

one MW on call sounds wrong, as they will need a second midwife anyway when delivery is imminent, sounds like scaremongering. you can insist that you will not be going in when you are booked for homebirth.

Thanks Rosa and Lulu. lulu I'll look into that she did tell me that if the mw on call was unavailable that i'd have no choice but to go to hospital.

it is a well tried tactic. and a number of wome n do capitulate. you do not have to go to hospital, the trust needs to provide you with a midwife.

very cruel to a woman who has prepared herself to give birth at home and then in the throes of labour has to go to hospital

Home Birth Bullying

Many women expecting to give birth at home are subjected to a variety of tactics to persuade them into hospital, such as: 'we are short of midwives' or 'if you go into labour at the weekend/between 6pm and 8am' or 'midwife Bloggs will be on holiday' (and any number of similar alternatives). The following is not an unusual experience:

Dear AIMS,

I've planned a home birth with my midwife but I have just been told (at 37 weeks) that there are 5 other women due at the same time wanting home births and there is only one midwife on call. I've been told that if more than one of us goes into labour at the same time, it's on a "first come, first served" basis and there is a likelihood I will have to go into hospital.

I thought that I had a right to a home birth, and feel very upset to be told at this stage it may not be possible. They have suggested that I book an independent midwife but I really cannot afford this, and should I have to pay for this service?

I am really worried that if I go into labour I won't get the services of an NHS midwife anyway! What I can do?

This kind of tactic is very common. Women have a right to a home birth, the Government suppports a home birth service and the Trust has a responsibility to provide the service.

This is the only area in our consumer society where an increasing demand for a particular service is not met by increasing production (i.e. providing more midwives) but by telling the customers that they have to use a different service!

COPIED AND PASTED FROM HERE www.aims.org.uk/

In AIMS' experience women who are determined to give birth at home, who make it absolutely clear (preferably in writing) that they have no intention of going into hospital to solve the Trust's staffing problems, are eventually provided with a midwife. To do otherwise, would leave the Trust in an indefensible position were a disaster to occur as a result of their failure to provide a midwife.

If you are faced with this dilemma we recommend that you send a letter to the Chief Executive of the Maternity Unit along these lines:

Dear

I have been informed that you have a shortage of midwives and when I call in labour the Trust may not be able to send one and I shall, therefore, have to come into hospital. I understand that it is Government policy that the NHS should support women who intend to birth at home. In a House of Commons debate (20 Dec, 2000) Lord Hunt of King's Heath stated: 'The Government want (sic) to ensure that, where it is clinically appropriate, if a woman wishes to have a home birth she should receive the appropriate support from the health service. At the end of the day, it must be the woman's choice'.

Your midwives have been aware of my intention to give birth at home since ...(insert date). I have no intention of taking the additional risk of a hospital birth in order to alleviate your staff shortages, although I am prepared to transfer to hospital should a medical complication arise. I suggest that, if your hospital is short of midwives, you contact the Independent Midwives Association and arrange an extra-contractual referral.

I expect a midwife to attend when I call her in labour. Should a midwife not arrive and any untoward event occur that is related to your failure to respond to my needs and those of my baby, my family will take appropriate action and we shall hold you and the Director of Midwifery personally responsible for this failure.

If, when you ring for a midwife when you are in labour, you are still told that a midwife cannot attend because they are short staffed, we suggest that you, or your partner, responds as follows:

'What is your name and your status? (Make a note of who it is). 'I have no intention of putting myself or my baby at risk of travelling in labour to the hospital and exposing us to the additional risks of a hospital delivery. If you fail to send a midwife and any untoward event occurs which can be attributed to your failure to provide a midwife you can rest assured that my family will take appropriate action'.

So far, in every case to date that we know of, the Trust has provided a midwife. You may also wish to ensure that the authorities know that there are problems in your area so you could also send copies to the contacts listed below.

COPIED AND PASTED FROM AIMS

I hoped Lulu would come along and get all kick arse about this!
Hurrah!

Thanks Lulu.

I do a good line in arse kicking, no?

also, there is a link on AIMS to let them know if you have trouble getting a homebirth, and they are compiling data and going to give it to the dept.of health.

Indeed you are. I'm astounded that they do this but unfortunately not suprised iyswim.

AiM's are fab, with their help i've gone from the high risk in hospital list (totally unecessary in my case) to the homebirth MW led care list.

Go with Lulu's advice

if i understand it correctly, and i might not as the machinations of the NHS totally go over my head... the more women who push for homebirth and refuse to go into hospital due to shortage of on call midwives, means the people running the midwifery department can put forward a business case to the PCT to ask for more funding for more midwives as it is understaffed. i might have got that totally arse over tit, so apologies if i have!!

i urge any pregnant woman to look at the AIMS site, it really is extremely beneficial and it wants to improve the birth experience for all mothers, not just homebirthers

I'd also urge you to contact AIMS. I got the same speech as you about having to go into hospital if there was no midwife available. I got told this at 37 weeks when I'd been booked in for a homebirth since 11 weeks. I spoke to the supervisor of midwives but on the night I went into labour it made absolutely no difference. The hospital basically played a game of brinkmanship with me and I got so scared I lost and ended up in hospital and on a slippery slope of interventions. Kick up an almighty fuss NOW and do it with AIMS support. I wish I had.

when ihad my home birth there had to be 2 mw when the baby was born

1 for labour and 2 for delivery is what i've been told here?

I was told the same as you and it was fine - had 3 here at one point and a student. Just preparing you for worst case scenario and you do need tp be prepared for worst case scenario. Read up on emergency c-sec just so if you or bebe get too tired or get into trouble you will know what to expect. Found NCT classes helpful for this. All the best x

can you afford a doula?

I feel so cross, reading this and all the AIMS info.

Because when I went into labour, and dh rang to ask why noone had come following my having left a message with the group practice, we were told that we would have to go in.
I was a bit panicky, had no gas and air and wanted some badly, and so we got my mother over to stay with dd, and got into hospital about an hour after the phone call. DS was born 40mins later. I was already 10cm when we arrived.

Then had to nag and nag and nag to be allowed to go home rather than stay in overnight to see the paed.

I wish wish wish dh had been able to be more forceful. Or that I had been capable of making a phone call but was in throes of a quick 2.5 hour labour.

Feel very disappointed in myself for not standing firm, but was really scared about the prospect of delivering without any medical assistance.

Next time... well next time god knows whether I'd feel less vulnerable and more able to hold firm.

Could kick myself.

AFAIK, there's only usually one midwife on call and one standby for each locality,so in a big city like liverpool there'll be teams all over and how it works is that the on call MW will come to you and the SOM at their base will allocate a second, who will be called for when the baby is imminent, they could be from your team or another one as each SOM manages more than one team. i'd be more worried about your midwife's personal attitude ledology and a call to her boss(ask for community midwive's office at the hosp your notes are from) may be in order to ask that someone who is more physically able to cope with the demands of homebirth is allocated to you(assuming here that you've not long to go,and a letter wouldn't get there in time) she should make sure that your midwife excuses herself
Good luck

POOKA I feel exactly the same. It actually puts me off having another baby as I know I'd want a homebirth again and I'd spend the whole pregnancy terrified of being forced into hospital again. This is an appalling way to treat women in labour. I feel so powerless about it all though.

Thanks everyone. I have actually never met this mw before. My usual one has been fab and really supportive of home birth and she even gave me a lesson on what to do myself if for some reason the mw on call didn't turn up on time! I hope I go into labour when she's on call. Woo no I can't afford a doula but my best friend will be there as well as dp. She's been there for all my labours and has been invaluable.

Are there no MN Doulsa's who could help?

Trouble is the season I guess (had ds1 in december- Millenioum year just to add to it) and received poor care due t nobody wanting to come in on a Sunday

Bee, I have been thinking about this a lot recently and one thing I'm seriously considering is hiring a doula to be my voice of reason/champion.
Part of my problem (and that of many women) is that I had no idea whether I was fully dilated, or in early labour (having had a very long early labour with dd). So I was really in no position to make a judgement call of "oh well, I can wait another hour or so and see whether a MW becomes available" or to stand firm. I think though that anyone experienced with labour would have taken one look at me and known that there wasn't much time.
Actually, though, when I first got to the hospital the midwife who checked me said, quite wrongly as I was unconsciously already pushing, that I was 3-4 cm. But when checked 5mins later by the sister was actually 10cm with waters unbroken and ds just waiting to be pushed out.
Anyway. Mustn't dwell on it - water under the bridge and all that. Just hadn't realised that I could say no, and that there was this kind of staffing problem in the first place.
The thing is, I do feel like I was weak in a way in just bowing out and giving up and going in. Feel like I should have been stronger, which is daft really when you think about it, because I really didn't want to give birth with no medical assistance and was vulnerable.