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Original poster

Birth plan - student midwives?

28 replies

Viralsunflower · 07/09/2023 09:08

Hi all

I'm 31 weeks and starting to put together my birth plan, to go over with the community midwife in a few weeks time. This is my second labour.
I am umming and ahhing about what I consent to when it comes to students.

My first labour was very long and I took a very long time to progress, contractions were full on straight away but I wasn't dilating. Baby went back to back so the contractions were intense and the examinations were really uncomfortable. Because of this I didn't consent to the student doing the examinations, because the qualified midwife also needed to do them, and I'd rather only go through that once each time.

Around 20 hours in the qualified midwife had to disappear for an emergency and left me with the student. The student was a bit crap at this point and stayed out the way, she was very quiet and didn't really offer any support. I did have birth partners with me. I was asked to stay on my back and as can sometimes happen in labour, I started pooing (sorry for the overshare) and was unable to stop this happening. She didn't offer to help clean me up until I pleaded with her to do it and I was really aware I was lying in it. I've been told by other people that when this happened to them the midwife whipped it away so quickly you barely even knew you'd done it. Birth partners were offering to do it but they didn't know where the supplies were to put underneath me, the student did.

I asked to get up and move around and at this point said I needed to push. She said "no, you don't". I did, and that baby was on her way out. Multiple times I told her I felt the urge to push. She kept reiterating I was unlikely to be feeling the urge to push and baby couldn't come yet anyway (but didn't say why). So...I was holding baby in with each contraction, worried that it wasn't safe for baby to come yet!! When I told her that I was literally clenching against contractions she ran in to the hallway and started shouting for a midwife to come and help her. Low and behold, I was 10cm and baby was on the way. A qualified midwife turned up to deliver my baby. I am convinced that if I didn't have a student with me for that part, my labour would probably have been about 5 hours shorter.

I think I had a really bad student midwife experience, but this has lead to me putting that whilst I am happy for a student to be present for labour and delivery, I am not happy for a student to be in charge of my care, to be left with a student, I want the student to be supervised, and not perform an episiotomy if one is needed (the qualified midwife did my episiotomy thank goodness, I imagine it would have been butchered based on the rest of my experience if the student had done it). Basically, the student can observe, but that is it.

I feel a bit guilty stating all of this so explicitly in my birth plan and do wonder if I am doing somebody out of an important experience. Did I have a bit of bad luck before? Is it reasonable of me to say all of this so clearly?

OP posts:

romdowa · 07/09/2023 09:14

Yanbu I stated no student drs or midwives where to be at my birth and I didn't feel the slightest bit guilty. Why would you?

TheFormidableMrsC · 07/09/2023 09:15

I think that given your past experience, it's absolutely something you discuss with your midwife and put in your birth plan if necessary.

I had a very positive student midwife experience. I was an older mother in my 40's. I was asked if she could shadow me and I agreed. She came to all my appointments, she visited me at home. On the morning I went into Labour I text her and she was at the hospital before me. She was absolutely amazing. The only bit that was an issue was similar to you, I said I needed to push and she said I didn't. However, she did seek advice from the midwife who was just outside the room who confirmed that I was indeed fully dilated. She did listen to me. She delivered my son and did a brilliant job of it. She visited us at home after and again a few months later as we became friends.

So I suppose it depends entirely on who you get but I would certainly want to avoid your experience again so be very clear on your expectations if you allow a student in. Good luck!

Seashellies · 07/09/2023 09:18

Yikes you shouldn't have been left with a student midwife in active labour, especially not for a prolonged period! I hope you reported that OP, it's dangerous and puts you, baby and the student in a precarious position.

That aside, it's not unreasonable to specify you don't want a student present or to conduct any exams even under the watch of a qualified midwife. Yes we all have to learn and start somewhere but given your experience completely reasonable. You will probably need to still advocate to yourself in labour mind so be prepared to stick by what you want!

MoorlandWanderer · 07/09/2023 09:22

Your body, your choice ❤️

Lavender14 · 07/09/2023 09:26

I had actually requested no student midwives be present for my planned section as I wanted the absolute minimum amount of people in the room. But when I got there, there was a student midwife present and I was too distracted to really care.

Everything went smoothly and at the end dh went out with ds while they finished working on me and my nerves kicked back in. It was the student midwife was the only person who noticed and was straight over to hold my hand and chatted away to distract me and I was super glad of her in the end up because everyone else was chatting about their Xmas plans and it was like I wasn't even there! So if we're lucky enough to go again, I wouldn't have an issue with one being present. I think it comes down to the same issue regardless, you just want good capable and empathetic people caring for you in those moments but that could be an excellent student or a really disillusioned midwife.

curlysue1991 · 07/09/2023 09:28

I've had 2 student midwives on both my pregnancies,couldn't fault them tbh, never had an issue with them examining me etc, how else will they learn is all I kept saying to myself 😂 I'm in Ireland and I do think our healthcare system is top notch compared to other countries, and that's saying a lot 😳 Labour is such a vunerale time, do what you and only you is comfortable with ❤️

Hairyfairy01 · 07/09/2023 09:28

Given your past experiences I wouldn't blame you at all for saying no. I had a wonderful student doctor and a student midwife. But I guess it's down to luck as to how good they are. Your one sounded particularly rubbish!

AnIndianWoman · 07/09/2023 09:29

A student midwife saved my life. She had just studied preclampsia recognised the symptoms and shouted down the lead mw and the consultant until they listened. So I think it depends who you get. Before you decide can you visit the unit and meet the students?

WeWereInParis · 07/09/2023 09:30

No you wouldn't be unreasonable, especially after that experience.

I had a student midwife with me for DD2. But they asked if she could be there, and then they asked again for every individual thing she did ("is it ok if she inserts your cannula?" "Is it ok if she breaks your waters?" "Is it ok if she examines you?") so even though I'd agreed she could be there, I could still control how much involvement she had.

She was fine, I let her (try) do everything. She tried to break my waters but didn't manage it so when they tried again, I asked for the main midwife to do it instead, which was agreed to instantly.

LunaTheCat · 07/09/2023 09:45

Of course you are not being unreasonable.. it sounds like a very distressing experience.

Twizbe · 07/09/2023 09:48

Don’t ever let guilt stop you asking for what you want in your birth. It’s totally ok to request no student midwives. It’s your right and you won’t be the first or last to request it.

you don’t have to explain it either if you don’t want to.

AintnocasseopoeiainWasingtonHeights · 07/09/2023 09:51

You don’t ever have to consent to student health care providers, even though their supervisors will often try to make you feel guilty.

After your experience it is particularly reasonable for you not to want to take the risk again.

I hope things go much more smoothly this time.

tb4122 · 07/09/2023 10:12

I wrote in my birth preferences that I was happy to have a student midwife involved but that if I needed stitching then that was to be done by an experienced midwife.
Which is exactly what happened.

My student midwife was lovely. She didn't do any procedures and she was never left alone with me but she was supportive and lovely. My son was born in his membranes and she was made up because she'd never seen it before.

The only thing was that she did DS' initial checks and measured his length wrong (turns out no babies are 60cm at birth, so she must have measured him to his toes not his heels) and was the only person to check him for a tongue tie and gave the all clear but it turned out he did have one. But the experienced midwife was otherwise engaged trying hard to get my placenta out, making sure I wasn't going to haemorrhage whilst trying to honour my desperate pleas not to be taken to theatre for manual removal, so I could understand it and it wasn't the end of the world.

Based on my experience I'll consent to students again for number 2 but you don't have to.

gogomoto · 07/09/2023 10:48

I had a student deliver my second, it was her first actual "catch" and she did brilliantly. She wrote me a letter of thanks afterwards (it was a very straightforward birth, perfect for a first time)

Thankyouthankyoujellybean · 07/09/2023 11:15

I've only had good experiences with students but yours sounds dreadful. If the very idea of having a student present makes you uneasy, you know what to do! Your birth, your choice.

Original poster

Viralsunflower · 07/09/2023 11:22

I didn't actually and in hindsight I probably should have. I was exhausted and a bit delirious by that point, I was half asleep between contractions saying something to DH about not eating that apple because it was rotten...there were no apples! It was only on reflection maybe about a year later that I realised how long I was left with the student and how poor that was. The other MW had been called off to an emergency that ended up as an ECS so took a long time to come back. The actual midwife was very good and supportive but just wasn't there for some of it.

Maybe I should just put no students at all for extra clarity, rather than "students can observe but I don't want them doing..." and then listing all of the things. I will chat to the community MW about it.

To the PP that asked can I meet the students first, no unfortunately not. I haven't been offered that anyway and wasn't the first time. I will raise it at my next MW appointment though because I really don't want to deal with that again.

OP posts:

Original poster

Viralsunflower · 07/09/2023 11:29

If the very idea of having a student present makes you uneasy, you know what to do! Your birth, your choice.

Yes this is a good point. I have been speaking to DH about my birth plan, he was surprised that my only preference that seems to have changed is my stance towards students being present and what they are/aren't allowed to do (I think he thought I'd opt for more pain relief given how long it went on for before). It has made me realise that I am quite relaxed about most of it, just not the student part.

OP posts:

beachdays27 · 07/09/2023 11:35

I said no to students with my second, after a complicated situation with a student with my first that indirectly led to harm to my baby. I felt guilty about saying no in my birth preferences and wrote a big paragraph explaining why, but the midwife was very reassuring, said I didn't need to explain my reasons to anyone and advised I just reworded it to one line saying no students.

USaYwHatNow · 07/09/2023 11:48

Hey OP, midwife here. Absolutely in this instance I would decline having a student present at all. I'd be worried that all you would think about is what the student may/may not be up to in the room (that sounds sinister but I don't mean it like that at all!) and it would distract you from your labour, even if you gave consent for them to watch but not participate, if that makes sense.

The fact that you were left alone for that amount of time in your first labour is frankly appalling.

Student midwives work under a qualified midwife's PIN. What that means is, that we are directly responsible for everything they do, and if they cock up, we're answerable and can be reported to the NMC. I'm pretty sure that nowadays that includes any unsafe practice up to a newly qualified midwife's first year of practice. So those who trained her/him may also be up before the NMC if the NQM is reported.

As a qualified midwife, I make damn sure I know EXACTLY what they're doing, as its my job in the line.

That doesn't help you now, but in the future, if God forbid you are left alone for any length of time and you think baby is on their way, you're worried about anything at all, then don't be afraid to press the call bell. If that isn't answered in a reasonable time frame, or things become more urgent, pull the emergency/crash Bell. I always point this out to birth partners, as sometimes we have our hands full and can't get to it 😂 so ask your midwife to point it out to you also.

KeepSmiling89 · 07/09/2023 11:54

Hi OP. Wow, that sounds very traumatic for you!

I'm all for students being present and wouldn't have objected to having a student present for my labour, but I would prefer if a fully qualified midwife was there as well doing all the practical stuff. If the student was further on, I would've let her get 'hands on', but only under supervision of the qualified midwife.
If your midwife had to go to an emergency, surely another midwife could've come to supervise the student?!

mummyh2016 · 07/09/2023 12:04

To me it sounds like the issue wasn't with the student midwife, it was the fact you were left without a qualified midwife.
What about agreeing but only when a qualified midwife is present?

MariaVT65 · 07/09/2023 12:07

I think the issue here is that you were left for a ridiculous amount of time without a qualified midwife present, so that request needs to be part of your plan. That if any student midwives are present, they are there to observe and not be your primary carer.

I had a mixed experience with student midwives. One forgot to measure my bump in my antenatal appointment (qualified midwife didn’t check). But I let a student midwife break my waters and she was great.

Angie147836 · 07/09/2023 12:10

My student midwife was so much kinder and more empathetic than the long-qualified dragon she was shadowing.

Seashellies · 07/09/2023 12:44

AnIndianWoman · 07/09/2023 09:29

Wow I hope you reported the qualified midwife and the consultant for not knowing this? They shouldn't be practicing if they aren't aware of the symptoms of pre eclampsia.

Thewolvesarerunningagain · 07/09/2023 12:45

My first DC was delivered, under supervision, by the student midwife. She had just come on shift with her mentor and mine was the last delivery she needed to do to be fully qualified. She was absolutely made up and I couldn’t fault the care in any way. My second DC was born in the same unit, no students were there and the whole thing was awful. I ended up catching him myself! I think the difference was less about the midwives and more what a couple of years of austerity can do to undermine a maternity unit to be honest.

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