Independent midwives

[FluffyKittensinabasket]

Has anybody supplemented NHS care with visits from an independent midwife? I’m a first time mum to be and feel like I’m going to need some extra support as the first couple of appointments are now telephone appointments.

I’ve found one midwife who is able to do some antenatal and postnatal appointments at home. I have a friend who gave birth and felt she was a bit a bit abandoned post birth.

I seriously considered it as it had always been my plan. I'm 24 weeks with my first and my first face to face appointment with a midwife won't be until 28 weeks.

In the end I decided against it as I felt a large part of the support, and the cost involved, would be to also have their support during labour and birth, which would have necessitated a home birth due to the current restrictions (at my trust anyway) of only having one birth partner and only during active labour in hospital, and I wasn't sure I wanted to decide on a home birth on that basis.

Instead I think I will focus on trying to find someone perhaps to provide breastfeeding support postnatally as my trust currently have a 6-hour discharge for all low-risk women after birth, and no home visits, so I think the extra support will be more helpful then.

I have found it an odd experience, I have never spoken to the same midwife and have actually only spoken to a midwife twice. My fertility history before falling pregnant was sad and complicated, but no-one seems to read the information I gave at my booking in appointment. I fell pregnant by surprise while taking HRT for early menopause and after saying I felt quite anxious about the pregnancy was referred to the mental health team, who have never contacted me. I wanted them to understand I didn't need specific mental health support, I just needed those involved in my care to know that my pregnancy has happened in very different circumstances from the majority of people and that my worries were heightened as a result.

I really felt I would need extra reassurance throughout, but unless you have specific medical worries, it might be more helpful to try and find support from friends and family, even if they don't have much experience, just people who are willing to listen and engage with your worries etc. That's what I've done, and hopefully it means I have a support system in place that will last well beyond the services of an independent midwife. I don't have family particularly nearby, but video chats and the odd socially distanced garden visit have been really great.

Thank you RestorationInsanity and I’m sorry about the experience you’ve had so far. I hope you are doing well.

@FluffyKittensinabasket thank you. Actually it probably didn't come across, but it's been fine. I don't think it's ideal maternity care, and I would certainly push for something more personalised and so on, but I think it's totally manageable unless you have very specific concerns about your pregnancy physically, or about your own physical and mental health, in which case you may not find you get the support you need in a timely manner.

As a fellow FTM I really felt I would need regular professional reassurance, and while it certainly would have been nice to have more contact, once I knew and accepted that wouldn't be the case, it's been fine, and I'm lucky as I feel I've have had a fairly easy pregnancy, and no complications so far.

How far along are you by the way?

I’m still very early days so maybe overthinking this all! 5/6 weeks I think so hoping all goes well. 🤞🏻

I've honestly found the fears and anxieties have worn off a lot as my pregnancy has progressed. I didn't find out until I was 6 weeks.

I don't think it's a case of overthinking, it's totally natural to worry and try to prepare. Do your research, but don't rush into anything. At least where I am, independent midwives are around £5000-6000 pounds for pregnancy, birth and post-natal support, and ultimately I don't feel that I would have benefitted to that extent.

If you would really want a known midwife at the birth, that's a different story, but I've chosen to give birth in the birth centre at our hospital, which would mean with current regs, I would have to choose between them and DH, and it's no contest really as I want DH there. Perhaps at your booking in appointment you could ask about continuity of care, and post natal support. Pre-COVID our hospital had introduced a 1 midwife system, so I would have seen the same person the whole time, unfortunately it wasn't to be!

Good luck with your pregnancy, and I hope everything goes smoothly whatever you decide.

Sorry you've had such not-ideal care @RestorationInsanity and glad you've been fine nonetheless. I have a named midwife but have only spoken to her once and never met her (I'm 21 weeks), so doesn't feel very meaningful tbh. My dates were out and it was like I broke the system - 4 or 5 calls to the main midwife team to tell them and ask what needed to be done, all just took my name and did nothing; calls to my named midwife always unanswered (turns out she only works Tues and Weds and noone told me), and 2 calls direct to the hospital who just said 'no' to moving my scans so my 12 week scan was at 19 weeks and my 20 would have been at 27 until I cried on the phone in desperation. Both would have meant none of the actual tests could have been done but I just got 'computer says no' from every person who could change my scan dates but whenever I did speak to anyone medical they were like 'you have to have your 20 weeks scan by 21 weeks, it's not optional'. It was hugely stressful and I'd also disclosed long-term (but not current) anxiety and depression at my booking appointment that doesn't seem to have informed anything - the effort to get my scan at the right time was hugely anxiety-inducing. I've also been referred to an ante-natal clinic for mental health support and advice on my dyspraxia and have heard nothing and don't have a way of chasing them directly as I don't know who they are. The only people I've seen are sonographers at 12 (/18) and 20 week scans, seeing my named midwife at 28 weeks which will be the first time I've seen someone outside a hospital. I was thinking an independent midwife might be helpful too as it really feels like incredibly little support / monitoring, I never would have thought you go so long without seeing or speaking to anyone and then actually communicating important medical information to be so difficult. I can' afford £5k though so trying to lean on friends and family though that feels unreasonable sometimes. Supposed to have another scan within 2 weeks as couldn't see baby's face yesterday - once again sonographer told me it was done and to get the date ont he way out at reception (happened after 12 week scan too), and the receptionist just said 'no, there's no space and we can't do bookings here, wait for a letter'. I have 1.5 weeks to get that scan by the time the sonographer said so expecting a run around of desperate phone calls again. I've been really disappointed in my trust's care tbh but a mandatory 6 hour discharge after birth would terrify me - I want to choose a birth centre that allows for 6-24, I can't imagine being kicked out at 6 hours to fend for yourself. Sourcing postnatal support sounds like a great idea.

@SarahFrances89 I'm so sorry that your care has been so inconsistent and left you feeling so anxious.

I was supposed to be referred to the maternal medicine and fatal medicine/pre-term birth clinics after my booking appointment, I chased at my 16 week appointment, but she said nothing was on my notes and if I didn't hear anything to assume it was fine. Not very reassuring when you know things do slip through the net.

Could you afford a private scan at a reputable clinic? I know that it should not replace the NHS one, but if you're worried you won't be rescanned in time, perhaps that could offer some reassurance in the meantime.

I was informed at the 16 week scan that if I wanted consistency of care I should opt for a home birth. My DH and I discussed it, but I didn't feel that deciding to have a home birth out of fear of the care I'd receive in hospital was a good idea, as it would put too much pressure on me for nothing to go wrong so that I could stay at home.

I was also told that as my hospital has suspended all antenatal classes, I should just Google anything I wanted to know. That really leaves the onus on women and their partners to know what they need to know, rather than being directed by a professional. The Homerton have made videos of their usual antenatal class info, which anyone can watch for free. You and @FluffyKittensinabasket might find that useful.

I have instead decided to do all I can to prepare myself mentally and physically for a 'normal' birth, as well as understanding the other interventions that may be needed so that I don't panic.

Fetal that should read, not Fatal!

Also 16 week call, not scan, apologies!

I briefly considered it but I just couldn’t afford it . I’m glad I didn’t though as I was super impressed with the NHS.

Instead I invested in private scans and I hired a lactation consultant. The private scans were nice but the lactation consultant was the best thing I’ve ever invested in.