Any midwifes (sp?) around, or people who have used One to One midwives

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Currently 29 weeks pregnant with DC3. Two previous home births and one c-section for early PROM - low movements

I decided to go with One to One as I had heard some lovely things about them being more easy going. Everything is going fine, they are happy for me to have a home birth, but I think they maybe they might be a little too easy going for me....I just wanted some reassurance that the following things are ok

-29 Weeks pregnant and fundal height only went up 1cm since my last appointment (its now 27cm) midwife says thats fine don't worry about it

-She seems very lax with checking urine samples (asks me to hold it up to bottle, barely glances at it and then writes NAD). I ended up with a kidney infection 3 days after my last sample when she said there was no sign of infection

-When she took my blood for 28 week check she didn't wipe my arm first with a wipe or wear gloves, then asked me to throw the needle etc in my bin

-She is constantly telling me how busy she is, she hasn't seen her child this week, how tired she is. Whilst I feel for her, its not really my problem and it makes me feel like a nuisance to her.

-She hasn't listened to the babys heartbeat once. She said they don't do it as I should be aware of movements and listening to the heartbeat tells them nothing

I'm honestly not someone who needs constant reassurance or advice. I've had no problems during this pregnancy at all and have not ever phoned or text her, the only time i've seen her is for appointments so I'm really not someone who needs their hand holding.

Am I being precious here and this is all normal?

Tiny bump

Re taking blood, I never wear gloves and I've never seen another midwife wear gloves either. It is the gold standard to wear gloves but trying to feel for a vein with gloves on is difficult which is why most people don't wear them. She should have used an alcohol wipe though and putting the needle in your bin is a bit odd, it normally goes in a sharps bin which I would have expected her to have.

NICE recommend that midwives don't listen to the heartbeat as it's not always an indicator of the baby's wellbeing, so your midwife is right there that focusing on movements are far more important. That said, it's completely understandable that you'd like to hear it, have you ever asked her? Say you understand that movements are more important etc. but you'd like to hear it as it's nice to listen to. She shouldn't really say no.

I wouldn't worry about the growth. 1cm is fine, as long as there are signs that there has been growth, which 1cm shows there has been, then that's fine. Normally we say 3cm either way for gestation so 27cm is perfectly fine for 29 weeks. My community mentor never measured before 28 weeks anyway so I wouldn't worry too much about growth at this point.

The urine thing is odd, she should be checking it with the strips not just looking at it. Very strange. Bit unprofessional for her to be telling you how tired she is too. One to one is a very hard job due to the constant on calls and burnout happens quite quickly but that's not your problem and you shouldn't be made to feel like a nuisance.

Have you seen another one to one midwife? Might be an idea to ask to see another one and see if she's similar.

There's actually research saying that an alcohol wipe isn't necessary prior to taking blood. That the bugs which are naturally on the skin aren't a problem and that it can make the proceedure sting more.

I never wear gloves either. But I wouldn't expect you to throw a needle in the bin.

Fundal height sounds fine and to be honest it doesn't take long at all to see if a urine strip is NAD.

She sounds unprofessional moaning about stuff to you though.

That's interesting Viva. I always touch the vein after I've wiped to see where I'm going anyway so I suppose it is a bit of a waste of time.

Off topic but I've seen midwives use an alcohol wipe before giving babies vitamin K which I've never done. Seems weird when we go on about how babies shouldn't be washed in the first 24 hours because they need their natural skin bacteria so I don't understand why they do it. Plus it must sting!

I've never used a wipe for Vit k!

Must admit I do for venepuncture but mainly because I think the woman expects it and it saves her going home and worrying that I'm slap dash.

I think I read somewhere once that after using one you need to let the skin dry for two mins for it to be effective.

Currently with one-one myself and my experience has been very different by the sounds of it, I'm more than happy. One thing they say is if you feel that you aren't a good match with the midwife then they will happily allocate you someone else, I think you should give them a call and voice your concerns- that would give them a chance to put it right.

Ps I've had a nasty uti before where the infection didn't show in the first sample but did several hours later in a second sample so that sample you had may have been clear.

I've heard that as well Viva but no-one ever waits do they. You've made me feel better though, I once forgot to use an alcohol wipe, now I can tell myself it was actually because I was following the latest evidence based research.

I'm with one-to-one. I've only had one appointment so far because I transferred to them quite late on, at about 32 weeks. So far my experience has been great though. I had a really long booking-in appointment at my house, where we talked about all sorts! I'm next seeing her on Wednesday, as she's coming with me to my scan to check the placenta site, and consultant appointment. I have severe anxiety and she's coming so that we can discuss with the consultant, having it put in my notes that my husband doesn't have to leave me after the baby is born. She said that if the consultant writes it in my notes, the hospital basically can't argue with that. I've also just text her about a million questions and she replied straight away answering them all.

I'm no expert, but the only things that would concern me really from what you've said, are being asked to put a needle in your bin, and her moaning about her personal life.

I would recommend that if you're not really getting on with your midwife then you should ask if there's maybe someone else you can see. I had a horrible midwife at the birth of my second daughter and it was so awful. She was rude to me (dangled my hair bobble out of my reach, laughed and said 'oooh look at that, she'll do anything for her hair band' when I was having 10cm transition awful contractions, called me 'primal' because I hadn't had an epidural), talked over my back to my husband about her holidays whilst I was trying to push, snapped "What are you? A doctor?" when she misread my notes and informed everyone that I have a blood disease which I DON'T have! I WISH I'd been aware enough to ask for a swap!

I don't know if the midwives on this thread can help though, how do you ask for that without making it sound personal and upsetting the midwife?! I don't think she's an awful person, she was probably just a bit...not my kind of person!

I'm currently pregnant with my second and planning a homebirth. My sister doesn't live near me but is a midwife and advise me to avoid One 2 One of offered.

She said that on paper that sound great, flexible and that initially it sounded like her ideal job but having seen it working that it is riddled with issues. Some fairly serious.

Due to the 'on call' flexible nature of care, the midwives involved are often very newly qualified, not always a bad thing but can cause issues. My sister said that in a very straight forward pregnancy they are generally great but that if something does go wrong it's not always picked up and if hospital or NHS emergency care is required the lack of communication and cohesive care between one 2 One and local hospitals can cause real issues.

She was particularly upset after seeing a lady come in with severe pre eclampsia, the blood pressure details in her notes (that they initially struggled to obtain!) Showed she had been eclamptic for weeks and that the blood simply hadn't been flagged. Sadly, this lady lost her baby. She said their have been other incidents (slightly less serious) that have led to her and her colleagues really at odds with the programme.

Of course medical care is difficult and things can always go wrong no matter who is treating but I implicitly trust my sister, she has worked in several areas of midwifery for 10 years and of course has my best interests at heart so take her word seriously.

If you feel unsure about it yourself, I'd trust your instinct.

My one-to-one midwife has years of experience, and excellent communication between her and local hospitals, to the extent that when I recently saw the mental health midwife at the hospital, she asked me to pass her regards to my midwife Michelle.

Just wanted to point out that the things said above don't always apply.

Of course, as coastergirl says, I'm sure it is, in some instances a great service. I didn't mean to come across as scaremongering. As I stated above there are both good and bad experiences in the NHS itself as well.

I was just sharing first hand information from a midwifes perspective rather than a service user.

I really felt the need to come on and reply to this, mainly because one bad experience or person or staff member doesn't represent a whole company or health care provider.

I had my first baby with one to one and was cared for by lisa sheridan (north west). I don't mind naming her if that's allowed because the care and support I received from start to finish was faultless. No problem was too big or small at any time day or night. Nothing went un followed up and if she was ever unsure she researched or asked relevant people or referred to relevant people. Every single appointment was with her in my home and I never got the impression she was newly qualified, she seemed very experienced.

I now live in an area where one to one is not really well known so I tried nhs midwives with this pregnancy and found that in comparison the care was far less, so switched back to one to one for my second pregnancy. I feel well cared for and supported now and can't imagine having it any other way.
They do offer you the chance to change midwives no questions asked if you don't gel with yours, which maybe worth a try after all she is on a huge journey with you. It's not something I ever felt I needed to do but the option is there.

As for the care. I don't know, it is easier to feel for veins without gloves and it is easy to check a urine sample at a quick glance if you are used to it, by writing and that's a good thing most of the time. Not unusual. The thing that makes urine infections so dangerous in pregnancy is how quickly they can come on and turn into something nasty, so it may not have shown up?
I have to say though that they did always listen to babies heartbeat, From about 24 weeks ish I think.
It can be such an amazing service both antenatally and postnatally if those are words so maybe give the number a ring about changing midwives and speak to somebody about your concerns. They may explain better or value the feedback at least.

I am also with One to One and have experienced really good care so far. My midwife worked for the NHS for years before moving to One to One because she didn't like the impersonal nature of the NHS system and wanted to have her own caseload. So she certainly isn't inexperienced. She listened to the heartbeat at 16 weeks (she did warn me she may well not find it beforehand).

In Manchester where I live there is a massive culture of protectionism and GP's refusing to refer women to One to One. I had to fight to get my referral which is really sad as many women are denied that choice. The argument about lack of pathways to hospital even my GP admitted, when pushed, does not apply. One to One offered me a referral to either an NHS or One to One consultant for a problem I have- so more choice than NHS only. If my home birth doesn't go according to plan, I will be taken to the local hospital along with my maternity notes and will be in no different a situation at all from someone who has been in NHS care from the start.

For me the great benefit is the personal relationship and being able to ask questions at any time to a specific person- if I didn't like my midwife I would definitely ask to change, which the website says is not a problem.

The only thing I have identified that One to One don't do is the GAP growth charts that are done by the NHS in both my local hospitals. I know they're not done at every NHS hospital-they record the growth of the baby and make growth problems that could lead to stillbirth easier to flag up. The risks are remote but still exist. I raised this with them and they are currently working on implementing the GAP system.

What I like most about One to One is they do not apply the rigid statistics / risk assessments that the NHS do. They make assessments based on the individual women and take recent research into account much more than the NHS does, as it is such a large organisation. I feel very lucky they operate in my area. OP, I hope you can get another midwife that you can benefit from a great relationship with.

I had to fight for my second referral too. Which is really really sad because I feel such a massive benefit from being under their care. going back to nhs after being with one to one felt like third world maternity care. It should be available to choose from wherever you live whoever you are.

If you're not feeling comfortable, then ask to swap midwives. But like some others here have said, nothing you've mentioned sounds suspicious apart from asking you to discard a needle and constantly moaning being a bit weird...

I agree the fundal height sounds fine.

Guidance from NICE says that we should not listen in to the baby's heart rate at all during pregnancy. Most midwives do because mums expect it, but it doesn't really give any information about wellbeing. The urine thing sounds fine - once you've seen enough strips you know what you're looking for.

I never use alcohol swabs and am always banging onto my colleagues about how they are not evidence-based and are not recommended to no avail! People are just stuck in their ways but your MW is actually following infection control recommended advice by not using a swab. Also wearing gloves is a personal choice - gloves during blood taking are to protect her, not you. Most people I know don't wear them.

I think the idea about midwives not listening in to the FH is because research found it can give false reassurance.

So woman hears the fh at her appt and is happy. The following day has reduced movements but doesn't ring anyone as yesterday she heard baby and it was fine.

I think midwives need to do both. Listen in because it does help women who are anxious but educate woman at every appt that fetal movement is the most important thing and they must ring if a change in pattern. Also I have seen women be admitted to the labour ward because the community midwife heard a deceleration when listening in and when they got to us FH was really low and a crash section saved the baby's life. If the midwife hadn't listened in they wouldn't have known. Now that's really rare but it shows it can happen.

If you aren't feeling comfortable with your midwife please ask to change. Especially as you are considering a home birth, so you really have to trust this lady to ensure you and your baby are safe and healthy. I use one to one and it has always been made clear to me that I can ask to be changed and it is no problem. I would say that giving you the needle to put in your bin is very strange though. I am usually given all rubbish from blood taking etc in my bin but the sharps definitely go into a sharps box the midwife has with her.

I'd just like to add my experience of using one to one. My midwife is very experienced and had worked with the nhs for over 20 years before switching. She is also training to be a supervisor of midwives so it isn't true that they are young and inexperienced. I did have abnormalities picked up at my scan when I was using one to one with my first pregnancy but there was absolutely no problem in being transferred to the Foetal Medical Unit at my hospital to be seen by a consultant. There was no issue with information being recorded in my notes either so that when I went into labour they had all the information to hand. My midwife also attended all my scans so she was well aware of the issues we were facing which meant I didn't have to explain it at every midwife appointment as I was seeing the same person. I have the same midwife for this pregnancy so all my history with the complications is all ready known, so she is looking out for everything even more this time.

But the main thing and the only way that the one to one service will benefit you is if you feel comfortable with your midwife.

My one-to-one midwife has been absolutely incredible today. She came with me to my scan and consultant appointment and was such an advocate for me. I really struggle to say what I need when I'm anxious, and having her there today meant that I'm getting the support that I really need and having a really good plan put in place for the birth of my baby. Not sure what I'd have done without her!

As with pp I agree the only very odd thing is asking you to put the needle in the bin. My one to one mw comes with a sharps box.

I suspect she is relatively newly qualified, but have no concerns over my care. She's been happy to fill in the growth / fundal height chart provided by the hospital and complete my hospital antenatal notes as well as her own - I'm going to have an elcs. When I had migraines appear out of nowhere she was here to check me out within hours - not something I'd get from the community midwives.

I didn't struggle with the referral, but my gp is a bit concerned about the current arrangement & has suggested (for Trafford anyway) that it might be withdrawn due to concerns over quality & protocols being followed - but this is not something I've witnessed.

If you're not happy I'd ask them to switch. There's no point feeling a lack of confidence in her.