Babies to be delivered by midwives assistants. Capable and willing, I'm sure - but with very little training.

[Bubble99]

I don't trust Hewitt and I was dubious about her recent announcement that women will be truly able to choose a home delivery every time,if they so wish, by 2009.

Now, it seems that there are moves to recruit more midwives assistants. This is certainly happening at my local hospital and I'm wondering whether this is how the govt plans to replace the midwifery posts NHS trusts have had to cut due to funding shortfalls.

This is according to The Mail, so I'm taking it with a pinch, and all that.

Local beat police officers have been replaced by CSO's who, while willing and able, do not have the same powers as 'proper' police officers, to free up the police to complete the increasing amounts of paperwork demanded by the Home Office.

Isn't this just more of the same thing?

This is terrible, and worrying. My jaw hit the floor at four managers doing a mattress audit btw. I think therein lies the problem.

And I get sick of being told that there are not enough nurses/midwives/OT's/SALTs/Physios- when I know plenty- some qualified, some training, and they can't get jobs. Even though everywhere is understaffed. You would think it wasn't rocket science wouldn't you.

But it is in labour itself when so many things can go wrong.

yes, so better to have someone there all the time than busy midwife dashing in and out of several labour rooms. yes, ideally let's have a midwife each per woman from the minute they arrive to the minute they leave. we don't live in an ideal world. in an uncomplicated labour like mine, an assistant would have been fine. i was more or less alone until i was pushing anyway. midwife said to pull bell if i had any problem.

So then perhaps the MW assistants are to replace the doulas that go in with mum and offer the support? Now I wonder if it would include the same kind of support or (and this is not about/against the midwives) if they would be more inclined towards medical intervention? Also one wonders if they would do the necessary antenatal visits to get to know each mum and the postnatal visit to de-brief from the birth and help the mum with any issues around bfing or whatever else was going on at home?

yes, from what i can gather, the assistant role would be like a doula.

"we don't live in an ideal world."

No but maybe if we didn't have four suits counting mattresses we could do.

If the NHS isn't able to provide a decent safe service (and having been a user of it with a child with a lifelong condition for the last 6-7 years I would say it most definitely can't), then some sort of radical change is needed.

I personally know (in RL) one person whose baby died because of midwife shortages/service breakdown, another whose child now aged 10 is unable to sit/swallow and has profound and multiple learning difficulties - because of midwife shortages. In a different area of the NHS (but with the same sort of problems) my non-verbal son was unable to access speech therapy for 5 years. Meantime an assistant SALTs job advertised locally attracted 120 applications- many from qualified SALTS unable to obtain work.

This isn;t about wanting an ideal wrold, it's about wanting a service that vaguely functions at some basic level.

yes, i think we all want that.

Ohhh, Bubble, those boys! What gorgeous children you make!

But bizzy - the person who should be there all the time is the midwife. That is what they are there for.

This is totally upside-down thinking on the part of the govt (surprise). What is needed to improve birth outcomes and solve the midwife shortage is - guess what?? - MORE MIDWIVES. Not more MCAs (although they do a fab job in other areas, don't get me wrong). Let midwives do the job they are trained to do, that they want to do.

This is a short-term, sticking-plaster solution to a problem which is only going to get worse.

Absolutely snaf. One Mum One Midwife.

I couldn't sully my last post with how I feel about support for women in labour being nibbled away in order to provide clipboards and men to write on them...

I am constantly appalled by the stories I hear of women who had nobody with them in labour, or incompetent staff. Of course, even a qualified midwife gets things wrong sometimes, possibly where somebody with less training would check and double check because they are unsure of something that somebody with more experience might leave (I'm really not explaining this well!) - so it depends on the quality of midwife and the quality of midwife assistant - obviously.

I had a midwife and a trainee for DS1's birth with me the whole time I was on the labour ward - so about four or five hours in labour and a while after the birth. I actually had two midwives, because they changed shift halfway through, but they were both lovely.

I had a midwife and a trainee with me for DS2's birth the whole time too - well, two lots as there was a shift change - so about an hour each. Again, lovely, lovely women.

Postnatally, Not So Great. But I can't fault either labour experience and I SO wish that the same was true for all women.

I have experienced consultant-led antenatal care with DS2 as well - I had one consultant who was amazing and several I saw who were less than good. One scoffed at me for wanting a waterbirth because I had gestational diabetes - totally diet-controlled, so no need for insulin during delivery - he couldn't explain why I couldn't get in the water, he didn't seem to understand that if there were any problems, it was possible to get out of the water - he just told me no. I made him go and check the hospital protocol, told him that he was being illogical and he came back and told me I was "allowed to". But I'm bolshy as feck and know enough to know what I'm entitled to. I know from talking to other women and reading on here that that's not necessarily the experience of everyone

I think women need to take responsibility for arming themselves with knowledge about what they are entitled to and then if it doesn't live up to expectations, they need to complain. Or have someone who can complain on their behalf. Do the birth trauma charities help people complain after a bad birth experience? I am assuming they do?

And I agree, Snaf, if you say "oh, actually midwife assistants can deliver babies", and they do, and not many women and babies die, they'll go "ooh, this is easy, let's get the cleaners to multitask and say "push" between mopping under the beds".

It detracts from the job midwives do. It's like saying we could get the Chancellor of the Exchequer to be Prime Minister or something...

In my first labour, the baby was showing signs of distress throughout, leading to an emergency CS. I can't help but wonder how much more worrying this would all have been without someone experienced to manage the process.

Remember that midwife units are all about average staffing levels and average number of births. So although most people will be okay, what do you do when you have only two midwives on duty and three problematic labours? Imagine the rest of the staff are only trained to deal with routine labours.

Many of the duties are already carried out by midifery assistants - more or less anything that isn't strictly 'medical'. I am very dubious about getting a substitute "professional" who isn't authorised to do the very things that they need to be able to do.

The CSOs in the police force are a perfect example. People with the power of arrest are in the office, while people without the power of arrest are on the streets.

Now we are saying people with no authority or training for medical intervention will be handling labour and birth.

This is what the government are working towards - generic healthcare workers. Not OT assistants, Physio assistants etc but workers who can work in an interdisciplinary way.

I had a student-led delivery - I was pretty impressed.

hunker - poor Gordy...

The thing is - and of course Ms Hewitt et al will raise their hands in horror at such an eventuality but it will happen - we will get to the point where 'experienced' assistants will end up being left in charge until the veeeeerrrrry last minute and, hey, maybe if the midwife (who's dealing with an emergency in another room) doesn't quite make it back in for the birth well, it's okay because the assistant has seen, ooooh, several deliveries and is quite capable...

It will happen. It will actually be an excuse to employ fewer midwives and the ones who are on the ward will end up in a supervisory/co-ordinators role (not with associated pay rises, though!) - popping in and out of rooms, no continuity, no relationships with the women, no actual midwifery.

The thing is if midwife assistants are like nursing assistants well, the ones I work with are all fab. But they are assistants. They can do basic nursing care, fantastically. But then, the ones I work with have all been doing their job for 3 years and have benefitted from some training. How much training will these assistants be given? And if to be money saving it would have to be pretty minimal, how will they be able to spot the potential problems as reliably as a 3 yr + trained midwife?

Have only skimmed the thread but it seems to me that the govt are saying about four different things:

1. One woman, one midwife. Really? How?

1. But more assistants. Er, right, so how does that fit with the above?

1. More home births. Right. So how, without more midwives?

1. No independent midwives. Hmm, so catch 22, so you can't have an NHS midwife becauser there aren't any/enough but neither can you hire one because we're makign it illegal.

Now is it me or is this all totally fked up mad non joined up thinking?