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Childbirth

Share experiences and get support around labour, birth and recovery.

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Original poster

One for Mears and other MWs

13 replies

wiltshirelass · 15/05/2003 17:07

Having had a happy experience asking for a home birth ("OK, fine", in my last AN appointment (I'm 24 weeks) I decided to find out some more details.
My antenatal care throughout is with the single midwife attached to my GP surgery, who seems perfectly OK. I asked how things worked when I went into labour - would I automatically get her? The answer was no - I would get one of a pool of TWENTY SIX midwives, whoever was on call. Slightly surprised, I asked how many births per year this pool of midwives did. The answer was 30. I almost choked at that (my lightning quick mental arithmatic telling me that I was looking at getting someone who did one birth a year if lucky) and asked her when she personally had last done a home birth. She said that she had done one in April, but before that it had been December 2001. One birth in 17 months.

Surely this can't be right? How can they get the necessary experience and keep up with best practice if they have so little experience of birth? I'm afraid I have now booked an independent midwife (lovely woman, inspired complete confidence immediately) who has been doing between 20 - 25 home births per year for the last few years, and before that about 30 - 40 a year in a midwife led birthing centre. Which is costing me over £2,000, but there is no way I would go through a home birth with a midwife I'd never met who may have only delivered 3 or 4 babies at home in her entire career.

I'd be really interested in your thoughts - is this normal, or am I just bloody unlucky with where I live?

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Katherine · 15/05/2003 17:36

Thanks this really doe smake you think. Have to say though I find it a bit bizarre - they can't all be not delivering or they wouldn't be employed. Chances are they are delivering in the MW led centre which if its anything like the one round here is not much different to home, certainly in the facilities they have etc. So although they might not actually be delivering at home they will be doing the same things and working in similar conditions. It may just reflect the fact that HB in your area is not that common - possibly because there is a great MW led centre nearby.

The pool of MWs in our area is much smaller. I have to say my current MW was down for my other two births as well but wasn't around for either - but I had met all the other MWs I encountered so it didn't feel that odd but that is easier if the numbers are smaller.

At the end of the day the important thing is that you feel confident in your MW and comfortable at home, if you felt bad about what was on offer then good for you for looking for an alternative. Its great to know that you have found someone you are so happy with and can rely on. Hope all goes well for you - I am now 27 weeks and also hoping to have this one at home as I did with no.2 and it was a wonderful experience.

baboon · 15/05/2003 17:36

If you look at the decent antenatal care thread in the pregnancy section you will see I had wanted a home birth. I was told that I couldn't have one because I had an untried pelvis, but even with subsequent pregnancies they don't like doing them. I wish I could afford an independent midwife. Its such a lot of money to fork out but its worth it if you can manage it. Sorry you had to go down this route

Original poster

wiltshirelass · 15/05/2003 17:42

no, they aren't delivering anywhere. it is the independent midwife I found who had experience in a birthing centre, in another bit of the country. they are just doing whatever it is community midwives do when they aren't delivering - antenatal and postnatal checks I guess. This is why I was so shocked, the homebirth she had done was her first birth OF ANY KIND in 17 months! I double checked that with her!

OP posts:

baboon · 15/05/2003 17:44

So she hasn't delivered in that time at home or anywhere else?!

Original poster

wiltshirelass · 15/05/2003 17:45

just to clarify, I wasn't expectng dedicated one-to-one care a cast-iron guarantee of the perfect midwife of my choice, but I did think that the pool of midwives would be around 6 - 8, that I'd be able to meet a good proportion of them, and that they would be doing about 60 or so births between them - one every 6 weeks or so. Just naive I guess. I think the rates are much higher in more...alternative bits of the country, like brighton, bath, etc.

OP posts:

baboon · 15/05/2003 17:45

Maybe I won't have a homebirth after all unless I win the lottery and can pay for an IM, which is unlikely as I don't do the lottery!

Original poster

wiltshirelass · 15/05/2003 18:01

well I'd really like to think that things are better elsewhere, after all my bit of the country is the same bit where they don't do nuchal scans AT ALL (even if you are 45!), so not exactly the most progressive when it comes to maternity care.
It makes me cross that I can't rely on the NHS for this and have to find this enormous sum of money for myself, when it is a proven fact that home births cost the NHS about 50% less than hospital births anyway.

OP posts:

baboon · 15/05/2003 18:02

I'm pretty sure they don't do nuchal scans here either

suedonim · 15/05/2003 18:07

I don't think all community MW services work that way. In the area I had my last baby the community MW's all spent a number of weeks each year on the labour ward in hospital. The MW who was at DD's birth did all my PN care, too, which was lovely.

Original poster

wiltshirelass · 15/05/2003 18:12

wonderful, suedonim. that's what I was hoping for.
I think it is just my area. what I'd be interested in hearing is Mears' opinion on whether community midwives with so little experienc eof birthing should do home births at all!

OP posts:

leese · 15/05/2003 19:41

wiltshirelass - in our area the midwives work an 'on - call' system, doing roughly 5-6 'on-calls' per month to cover their area. Our area is divided into 'Northside', 'Southside 1' and 'Southside 2'. Each area will be covered by around 6 - 8 midwives, so not the 26 you talk about. The rota then is shared between these midwives. For example, if a lady from the 'Northside' went into labour with a home delivery, it would be one of the 8 midwives covering the Northside to attend. She would, in turn, call a second midwife to be present at delivery, and this could be a midwife from any of the three areas (whoever is 'second on-call covers all three areas) - confused?....you will be!
Anyhow, some areas are busier than others, so some midwives have more deliveries, whilst others are relatively quiet (but not a gap of 17 months quiet)
I think it is important to remember that, in order to become a community midwife, a midwife will need to have had a lot of previous experience working both on labour, and post natal wards. She will carry this with her always. She will not forget how to deliver a baby - it's a bit like riding a bike (in the nicest sense of the word!). She will, however, need to keep updated with all the latest policies and procedures, and her registration as a midwife will require her to attend frequent updates on issues such as neonatal resuscitation, obstetric emergencies etc. This will be the same for your midwives wiltshirelass.
A home delivery is just as much about monitoring progress and recognising what is normal/abnormal in order to take any necessary action, as it is about the actual delivery. In fact, if you do the first bit correctly, the baby should deliver itself just fine. A community midwife will have had much experience of this, and even tho' it may not be very recent, it should be second nature.
I do understand your concern tho' wiltshirelass - it seems you live in a very quiet home delivery area!

pupuce · 15/05/2003 22:19

In our area our 15 or so community MW deliver 5 to 6 babies a month....

Having said that (here is my story) my community MW was (lucky me) at BOTH my home births...the first was on a Friday AM... her day on-call.... so that was fine - except that at 8PM she asked to go home (she had been with me since 9 AM and I was pushing but was being transfered to hospital) and so she never saw baby being born but she was there next morning in postnatal ward for a quick hello... what a MW!
Second baby... she was not on call, I was told to come into H because they were all too busy but I had a secret weapon.... the name of 3 MW who would be happy to come if they were free... it was Friday 6PM... so I got the other MW who was with me at my first birth... and when came the time to call the 2 nd midwive (I was 45 minutes from actual delivery time), my community MW was called in - she was not on call, but knew me, knew I was delivering at home (knew it was 2nd baby and her colleage said : she is cracking on... - so presumably knew it would not be a long drown out affair like last time )... she saw me deliver in water...
To MY astonishment she then admitted that this was her first EVER water birth 9letr alone at home!).... and my DS was 20 months prior to that and in that intervall she had never seen one.

She was fab... and now she sends women to me as a doula.

Baboon- have you spoken to Diane at all?

mears · 15/05/2003 23:25

The women in my area would have midwife on call for her, would be likely to be 2 out of 6 midwives. We do not operate team midwifery which often means you may see a midwife out of a large pool.
The community midwives regularly update in the labour ward so their skills for homebirth should be good.
Seems a strange system in your area wiltshirelass.

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