What do you wish midwives did better?

[AlmostNewlyQualified]

I'm a student midwife, almost qualified, only have a few weeks left on my course. I am very excited to start my job but also super nervous, as I don't want to let any parents down. I am determined to do my absolute best to look after pregnant women and give them the best birth experience I can. I have a lot of passion for midwifery and will take a couple months off before starting my job as the course has been so intense and I need a break to re-charge my batteries.

I've been watching youtube videos of difficult births to find out what the mothers felt had gone wrong and it's often that the midwives were not believing them and not respecting their wishes. I promised myself I will never be this way, that I will always respect what women tell me, advocate for them and remind them that they have a choice in what happens to them in labour. I've been given feedback that I'm always kind, caring and and calm, and I pretty much do whatever the woman needs me to - if possible!

I was wondering if anyone has any thoughts and feeling on what they felt their midwife should've done better - or maybe you had an amazing midwife and you can share why she was so amazing?
thank you.

Well done OP you sound lovely.
My midwife told me I had spots on my back - I'm sure you won't do that.

Luckily all my midwives were fantastic but one in particular insisted on a quiet time in the ward. Every afternoon she dimmed the lights, got all mums tucked in with babies for skin to skin, sprinked lavender oil on the pillows and made everyone just rest and snuggle with their babies. In my ward we were 4 first time mums and she also showed us all how to bath our babies and was just such a calming, safe person to be around. A little thing but meant a lot at the time.

Stitching up tears, I made my experienced midwife promise to be the one who sewed me up (3rd degree tear). I’ve heard many horror stories of junior midwives stitching the area too tightly - and women never regaining full sexual function.

The issue I had was with my first child due to I was 19 I wasn’t listened to or taken seriously at all. My daughter was lying on a nerve on my back and even when my contractions stopped the pain didn’t it was intense full on for over 24hours like having a knife in my back. I cried my back my midwife completely ignored me and gave me no pain relief at all at the end of the 24 hours my body was so exhausted it stopped the contractions itself. She then gave me a drip. I have had another 2 babies since my first so I was able to see how wrong my first labour was and how completely ignored I was.

That women know their bodies. Even young girls who are expecting.

I had to brilliant midwives when I had DS. Both very different, but both very reassuring and experienced. I think anything the midwives are not doing better is a result of an overstretched system and midwife shortages. I think they're all doing their best with the time and resources they have.

Listen. Really listen to the woman in your care.

Like a previous poster, I was fully dilated upon entry to hospital, but because I had only been in labour for 45 mins I was not believed. I wasn't believed until my baby started to appear and my waters hadn't broken so he was still 'in the bag'. Cue an extremely flustered midwife and nurse!

Please believe women when they say they are in pain and trust that we know our own bodies. Please please just listen. I have never met another woman who has anything good to say about their birth experience.

Given every midwife starts with the best of intentions, probably seeing the same training videos.,,

What goes wrong to change midwives into those where things go wrong and women get ignored ?

Please don't use the expression 'baby doctor'. Start with the assumption that your patients are not stupid. You'll quickly realise if they need words like 'paediatrician' explaining to them.

Oh, and tell noisy (usually male) visitors to pipe down or leave.

Yes to this. It made my postnatal experience awful with the constant all day visitors to other beds, men around, heating switched up, lights on, loud chatting.

I've had three births, and five midwives in total. They were all great, but not one of them told me how to use the gas and air properly! I did reading on here before birth number three and put it into practice... birth three was far less painful than the other two.

I would like midwives to really listen to how well you are inhaling and explain about taking massive breaths to really fill your lungs. It made a huge difference, and I'm sure plenty of the people who say gas and air is useless (and go on to have other interventions as a consequence) are just not doing it properly. Not all, obviously.

Generally not believing you and making you to be struggling when you’re progressing quicker than the midwives think is very disheartening. I think that midwives become immune to having a baby because they’ve delivered hundreds, if not thousands, but for first time mums they have no clue what they’re doing or what is to be expected. I thought my insides were falling out (clots and the amount of blood) after birth and I went to the desk to let them know and they shrugged and said it was normal.

I think most of the issues I had with midwives were as a result of the system though, rather than the midwives themselves:

• Pain relief - I had no access to pain relief other than paracetamol on antenatal ward. If progressed quicker than expected so had no access to other pin relief besides gas and air on delivery. They were understaffed so it took ages to get paracetamol on antenatal and 3 shift changes to get some pain killers on post natal.
• Encouraging breastfeeding even though I’d been sick throughout labour and had nothing in me. I had to have the health care assistant come into the room shortly after I’d delivered and try to hand express me rather than just letting me get some sleep. It didn’t lead to a good start with breastfeeding and I didn’t keep breastfeeding.
• Each midwife had a different approach for breastfeeding and I had a different midwife each time I was trying to feed. I just needed some consistency and then if those methods weren’t working, we could explore an alternative.

Similar to PP I loved my little round of applause from the midwife desk on my way from labour suite to the ward. Make those women feel special! Oh and make sure you gush about how beautiful the babies are and how much you like the name (even if they’re not so beautiful or the name is… unusual!).

Well done you, and I am sure you will be a lovely midwife.

Believe women. We know our bodies. With my DD3 I knew my waters had begun leaking at 35 weeks. I wasn't believed at first when I got to the hospital, with the (female) obstetrician determined that it was a bladder leak. I knew it wasn't, it came from the wrong place too. OK in that instance it wasn't a midwife disbelieving me but it still feeds into the problem of women not being believed.

My waters fully went that night on the ward in a massive flood that went on forever. Funnily enough, the obstetrician who had disputed me the day before stopped doing so.

Try not to push breastfeeding as the be all and end all. Not all of us can do it or want to. Formula is fine too.

Kick fathers off the ward at night, or at the very least tell them to be quiet and not intrude on women in other cubicles. They weren't usually allowed to stay overnight when I had my children. I'd have felt very vulnerable and threatened by some of the shitty behaviour I hear about on post natal wards today.

Those are just my thoughts. Good luck and I hope all goes well for you. 😃

Avoid interventions where possible unless there is a legitimate medical reason. Big baby is not a legitimate reason.
Tell each woman that focusing on softening the cervix is really helpful.
Fed is best. Stop pushing the boob agenda when it’s not wanted.
Creating the optimum environment during Labour, relaxed, music, calm etc

That kind of dismissive attitude towards a labouring woman blows my mind.

To me, blatantly ignoring and disrespecting your patient, feels like you've come to the end of the line with midwifery.

I'm sorry you went through that.

She sounds amazing.

There can't be another branch of medicine where the patients are routinely ignored and dismissed by the professionals.

All the best, @AlmostNewlyQualified

Good communication is obviously a bedrock of good midwifery.

The 2 midwives who looked after me were just lovely. Calm, knowledgeable and made me feel like they cared.

If you're stitching someone up afterwards please wait for the pain relief to kick in before you take a needle to their perineum.

Pronounce the name correctly. With DS I saw so many MWs and only the student got my name right.

Congratulations on getting to the end of your course!

I'd say the biggest thing for me was not being listened to.

It was my first baby and I showed up having 3/4 contractions within 10 minutes. My waters had broken. I told them the pain was beginning to feel intolerable, and I was vomiting.

I was assessed at 1-2cm and offered an induction. I told them I didn't need an induction I was already in labour. I negotiated being left in a room to "see what happens" but was even denied gas and air (I think they thought I was going to be there for a while and didn't want me on the gas an air for hours on end!).

Anyway, my husband went to find the midwife two hours later (I hadn't seen her all that time and wasn't being monitored). When she came in I was 10cm and pushing. They had to rush to get a monitor on me, and a clip on baby's head because she was too low down for the tummy straps.

They were all very surprised at how quickly it progressed. I wasn't particularly, because it hurt like a bitch!

Anyway, my point is, people might not always show progress with labour in a "standard" way and if someone is telling you that they know something is going on with their body (even if they're doing it for the first time) please just humour them and give them the benefit of the doubt!

As a mum of three and ex midwife, I would say the thing I and almost every woman I cared for valued the most was kindness. Just be decent and kind, even if you are having a horrific day where you need to grow another one of you just to keep on top of the basics, find a smile, get a crying mum on the postnatal ward a cup of tea and let her know you give a shit.

Give women explanations. Proper ones. Let them feel in charge of choices and decisions. This might make you unpopular with some staff who prefer doing 'to' women rather than doing 'with' woman but this is a tiny period of a woman's life and she deserves for it to be good not traumatising, infantilising or disempowering.

A woman that's got a niggle of any kind that won't go away whatever it is, listen, investigate, escalate if needed. Even if it turns out to be nothing, she feels listened to and reassured not stuck in anxiety. It probably won't be nothing though.... women have great intuition.

Maternity is the launch pad into motherhood and becoming family. Be the very best spring board you can be.

My HG was normalised as standard morning sickness. I didn't have enough experience and was too ill to recognise that I shouldn't have been suffering that hard. The midwife should have asked - how bad is the nausea and how many times are you vommiting. My pregnancy did not need to be that horrific.

With my first I was 23 but probably looked about 15 the midwives were mostly lovely but very patronising. Being my first they didn't believe I was as far in to Labour as I was. I was sent home but back very soon it all then felt a bit rushed and traumatic. They didn't ask me or communicate before touching me or doing internal exams. I had counselling afterwards as it had re opened previous trauma of sexual assault.
So definitely communication and where possible make sure you get consent. In my other labour's I asked for no internal exams at all unless I said to this worked much better. I didn't know I could ask for this first time round.

My first labour was 5 hours long, second labour was 2, third labour was 30 minutes. No one believed I was in labour with my 3rd so he was delivered at home by just me and my husband.

Always believe women. Particularly if the months up to birth they are telling you BTW I have fast labour's every appointment ! All been very big babies 9/10lb from my tiny 5ft3 frame. No complications. Never induced No tears etc

So to go into every labour with a open mind or as if its your first delivery everytime. Every women is different.

Good luck op you're on the right start.

I sent a text message to my midwife last week about possibly needing bloods done for liver function. It’s been a week she still hasn’t responded. She simply doesn’t have any monkeys to give and such people can’t be working in healthcare.