Student Midwives at Birth - pros and cons

[ButteryJam]

Hi,

Just amending my birth plan, and wondering what are the pros and cons of allowing student midwives into the labour room?

Anyone got any experiences to share?

Thanks! :)

Well I had one present with DS even though my birth plan said I didn't want one present (they never read my plan I swear!).

The downsides are I got all my investigations done twice - once by her and once by qualified midwife. Felt a bit like I couldnt say no but less bothered as had epidural so could feel little.

The real plus point came when DS heart rate plummeted and we got rushed into emergency c section. DH not allowed to be present while they sorted me out in surgery and everyone in the room was understandably busy with their roles except for student midwife who was understandably technically surplus.

But that extra person to talk to me in those few moments while people ran around me doing thing, she was a lifesaver and helped me not feel quite so panicked and lost.

I found that the doctor spoke more to the students than actually telling you what they were doing and what they thought. You almost became secondary to the students, yet you are in the vulnerable position.
My partner became very angry with the doctor at one point because of this.
In my birth plan for baby No 2 I am going to stress no students at all under any circumstances.

Thank you both! How about if the plan is to have the birth in the birthing centre (if all goes well of course)?

I had a straightforward birth with child#2, just one midwife and student midwife present. She was lovely, I had no problem with it at all. I don't remember being asked about it, but presume I was.

I had a student midwife in the room with 2 of my deliveries - they were both lovely, but tbh I didn't really notice as I was too focussed. Can't say there were any obvious cons.

Our dd2 was delivered by a student midwife who was incredibly supportive. There was one other midwife in the room to supervise. Overall the whole birth experience was so positive because of the support of the student midwife, who seemed to genuinely care. In comparison to the birth of dd1 at which the midwives had a slightly more world weary view of the while birth experience (at least this was my perception).

Roxy - was that medical students or student midwives? IME there's a big difference and Drs generally don't bother talking to the student midwives.

One of the big pros of having a student midwife is that you're more likely to get one-to-one care in labour. It may be a nearly qualified student who will do most of the care with a midwife popping in and out and obv been there for the birth. Or it may be a more junior student who stays with you all the time, the m/w may still have to pop in and out but leave the student with you. Not for medical care as such but to provide support.

Wheras if you have a midwife and no student if the m/w is looking after other women as well when she goes to see them then you're on your own.

If you don't want two sets of VEs, etc you could specify this.

Chigley1 and SirChenjin, were there any advantages to having them around? Did you feel the midwives focused more on you because someone else was observing them (albeit a student but still)?

Just thought I would clarify my story.
Midwife there were no students. So no problem
I had a doctor visit me who came with a troop of students, they did not ask if this was ok. About 8 of them came into the room when I was a bit delirious with pethadine and pain... I felt very vulnerable but my hubby was great.

When I had DS1 I think they brought every fucker in the hospital including the cleaners in.

It was terrible, made me feel like an exhibit and I was poked and prodded time and time again.

I said never again, and then with DD1 I was in overnight to be induced and the midwife came round and asked could a student attend, introduced me to the student. And she was lovely.

I don't know that I'd allow it again if it was my first, but for subsequent births when I was more in tune with what was happening, I probably would.

Which doesn't really help

I also wanted no student midwives or doctors when I was in labour with DC1 (that and yes please to drugs was about the sum total of my birth plan), but I had a similar experience as Doodle- DD was an undiagnosed breech baby and we were signing forms for an emergency section when they realised I was 8cm dilated, so I gave birth naturally (and v quickly). Student midwife had the important job of holding my other hand while DH and I were kind of in shock as to what was happening.

So like all things, I'd say try to figure out what's best for you, but maybe best be flexible on the day.

I had a flat no on my birth plan to student midwives, mainly because I work at a university, had student midwives from my university in two community midwife appointments as the pregnancy went along, and really didn't want one in with me at the birth if I've then got to face them 12 months later with my clothes on.

Saying that, there was a final year midwifery mature student on my postnatal ward, who'd had 3 kids of her own, and she was fab, really calming and cheery and supportive. The community midwife student was, at my booking in session, one her first placement, and her nerves really showed. I know you can't say "only 3rd year students" on your birth plan, but that student's experience on her course, and of being a new first time mum, was worth it's weight in gold. The others, i'd have run like hell to avoid having in at the birth.

VivaLeBeaver, that's an interesting perspective! The Birthing Centre folk said they have one-to-one care, so the midwife is only looking after one person. However, I suspect this may be different in the delivery unit?

Also, is a student midwife more likely to be paired up with a more experienced (older) midwife? I would like everyone I suppose, would prefer to have a more experienced midwife.

IME they don't really ask for medical students on rounds, they are part of the team and just seem to go round.

I have been a HCP student and really appreciated people allowing me to be involved in their care.

I would be happy for a female student to observe, but no examinations etc but then I wouldn't want the MW examining me either. I have had two births and only one VE ever so it is definitely possible. In an emergency situation I would obviously forgoe all preferences.

In a delivery unit its fairly normal to be looking after 2 women and not uncommon to look after 3 (though not all in established labour).

Students generally work with their sign off mentor who will have been qualified at least 2 years. So they're not normally with a NQ midwife but it may not be someone with years and years of experience!

My second baby was delivered by a student midwife. She did all my antenatal appointments too under the supervision of the qualified midwife. She was great!

I said no students with my first. I was totally ignored and a student surgeon also stitched me up after the cs. As the surgeon supervising her had already managed to slash my unborn dc when cutting me open ( not an emergency btw, all calm) I didn't really mind.

The student Mw trying to help me bf in the ward was useless though. Poor girl was way out of her depth-- she had never bf, had had no training - it was a disaster. She didnt mention she was a student til I asked her.

I think a lot of student midwives are more mature students as well, so may well be women who have had their own children (not that that should matter)......Anyway, even a first year student will have seen quite a number of births and hopefully have good support skills and empathy.

Med students can as well, maybe not as much ime but you get some that suprise you. I saw a med student recently end up becoming the main birthing partner for a lady. Fantastic support over hours and hours, rubbing her back, encouraging her, supporting her while she stood, etc.

I had one midwife and one student. Pros: the student was quite happy to make many cups of tea; and as I gave birth flat on my back with one foot in the midwife's armpit, the student's armpit provided a handy place to stick my other foot. Cons: she wasn't so experienced at spotting when a contraction was coming on, and I had a bugger of a job getting enough breath to shout "wait a moment!" when she was coming at me with the pethidine.

I had a student doctor at DS1's birth. I was at The Garden Hospital which specialised in natural births and although I was a private patient and wouldn't normally have been asked they said it would be useful for her as otherwise she might not get to see a birth without pain relief and a natural third stage. She was very nice, and very grateful.

I've been thinking about this, too. I get very stressed by any VEs at all - let alone during labour - and would hate the thought of being subjected to everything twice, especially with my first DC when I haven't got a scooby doo what's going on.

But at the same time, I know they have to learn, and, would feel mean about saying no - especially as I work with students - and I don't want to be hated by my MW for refusing to let a student in... So will watch with interest.

I had a student MW at my homebirth.

Cons- I felt crowded and the MWs wouldn't leave me alone. I had a running fucking commentary to the whole thing. Lots of unnecessary and unwanted prodding and poking.

Pros- Ummm... She seemed quite pleased to be there.

If I could do it over again, I would say HELL NO.

I found that having an inexperienced student MW meant that everything was explained in a lot more detail. Rather than everything looks fine, or we not the "mentor" took time to say exactly what she was looking for and why. Yes it was addressed to the student but I found it re-assuring that they were probably more thorough than a quick check and them dashing between 3 or 4 of us in labour.

It also ment that DH could pop out for a sandwich, and I wasn't left alone!

DC1's birth was utterly awful (failure to progress, induction, plummeting heartrate, almost EMCS and multiple internals, sometimes involving instrumental stretching of the cervix...). Until the consultant got involved I was helped by a MW and a student MW.

I was meant to be the student's last birth before she qualified (wasn't in the end since it was an instrumental birth which didn't count) and she was utterly awesome. She stayed with me the entire time, explained everything etc etc. The MW ran in and out checking on other women, but the student could stay with me.

Yes I sometimes got doubly examined but I'm not precious about that so didn't really care.

It was great: I still have a very soft spot for her.

I'm all for helping people learn, but not if it changes the environment of the place I'm labouring in to my disadvantage (I wanted dark, quiet, minimal distraction).
Both my birth centre birth plans said the same thing - I consent to student observers but if I or my birth partner feel I'd be more comfortable with fewer people in the room, we'll ask them to leave.
This worked fine for me - good luck :)