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.

As well as listening to women, which is clearly a big one, I'd say being prepared to call for help. It's not a failure to need obstetrics or paediatrics, it's actually a vitally important part of the role to know when to escalate. They're two of the things that come up again and again in reviews.

Two I remember were prepared to back themselves against people in higher positions. One saved me from an emergency C-section by asking the doctors who had rushed in to do it to give her one chance to get the baby out, the second on the ward called back the doctor who had discharged me to re-examine me and I needed to stay in for an emergency operation. Wonderful ladies. Good luck in your future career.

Well, when being rushed to another hospital on blue lights at 32 weeks it would have good if the midwife hadn't said to the ambulance driver 'floor it or we'll be delivering dead babies on the side of the motorway' in earshot...

Apart from that everyone was lovely and I couldn't have asked for better care.

I don't know what it's like where you are op but there was no consistency with midwives where I am. That would have been nice but obviously out of your control.

Aw that's so lovely that you are reaching out for real feedback and experiences. Hands down, the best midwives I've come across were those in the homebirth team. I had a difficult second pregnancy with countless consultant appointments, lots of awful, coercive behavior and unnecessary stress. The homebirth team really listened to me and helped me unpack what the real risks to my baby were, everyone else seemed to be reading from a script.

Listen to and believe me when I told them I was in labour. Instead of just telling me (without carrying out any checks or just believing me). Apparently first time mother don’t labour that fast. The problem was that I did. In the end I told the midwife I was pushing and she loudly sighed and reluctantly examined me. She got the shock of her life when she discovered I was 10cm and she could feel a head! I was then zoomed round to the delivery ward at high speed as they thought I was going to deliver there and then. Never ended up on the MLU (next door) or in the birth pool.

Repeatedly denying me pain relief for no reason even though I told the midwife I was in so much pain I thought I was going to die and almost passed out from pain. All I wanted was gas and air!

I complained and I have a letter from the CEO of my Trust apologising for the substandard care I received and acknowledging that I was refused pain relief for no reason at all.

The midwife I had was sooo judgey I had to get rid... she didn't like that I wasn't married to the baby's dad, she said "how's that going to work?'" She didn't like that I was in my 40s, she said "you older mums are soo selfish, your poor child will never have a sibling." And the worst... in front of my baby's dad... "You need to have a blood test to prove he's the dad." When I asked how on earth me having a blood test would prove who the father was she mumbled something along the lines of "even the queen and to prove who the father is.." What an absolute load of nonsense. Good job I wasn't with an abusive man as that could have led to all kinds of problems!

So... I just want a nonjudgemental, friendly face!

I have had 3 babies. Honestly, I can't remember the midwives individually. I think it's down to time and I'm not sure with the best will in the world what you can do about that. I felt I wasn't welcome and the assumption was I must've gone there too early. I felt like I was left for long periods feeling scared and alone al be it with my husband. I didn't feel looked after afterwards, struggled with breast feeding and no one had any time, any help felt rushed and like I was a problem. I had straight forward births but it's still traumatic and shocking, no one asked me afterwards ,how I was, gave a chance to talk it through. I felt the midwives were kindest when we were leaving , pleased to see us safely in the car.

I had two extremely straightforward pregnancies and births, but I do remember one little thing that still grates me seventeen years later. During my final appointment the Midwife at my surgery said that she would do a sweep at the next appointment ( by which time I would have 40+6) no mention of if I was still pregnant or if I would like one, I wouldn't have agreed as I had done my research. Cheeky woman. As it was, I was booked in at a beautiful MLU and had my second water birth with an extremely experienced hands iff Midwife. Bliss. Always ask, Never assume.

I had a student midwife who was lovely, and came to see me after I had an emergency c section. I will always remember that she came to see me to check in.

With some of the midwives, I felt that they dismissed my pain during induction and made me feel silly for how painful I found it. I also had one who told me I 'must feed my baby' after her blood sugars were borderline low (I'd been feeding her every hour and asked for support with breastfeeding with no support provided). Sometimes it's not what was said, but the tone. I also had a midwife who came and opened my cubicle curtain whilst I was standing naked waist down trying to get changed (post c section), because the rule was to have your curtains open (she then shut it when she saw I was changing, but why did she not ask permission before doing it?).

Please do not whisk back the curtain without announcing yourself.
Please do not berate the patient for doing something another midwife advised.
Please don't speak to me as if I'm two years old, and don't boss me around. I've just given birth and may move a little slower than you'd like.
When doing your rounds, alternate which side of the room you start on. I was last bed on the right, but all the midwives went around bed to bed from the left. So inevitably they got held up or distracted and often didn't make it all the way around.

To be supportive and understanding of hyperemesis.

I've had severe HG with my 1st born and currently with my 2nd. With my first born I had some midwives who just brushed it off as 'morning sickness' and made me feel like I wasn't worthy of going to triage, I vividly remember being 34 weeks pregnant with my 1st, calling triage and asking if I could come in for fluids and ondansetron injection as I had 4+ ketones and hadn't kept anything down for days and couldn't control it, and the midwife said 'do you really need to come in, we are so busy, have you tried having some ginger biscuits and some water?' I was absolutely raging!

I'm currently 34+2 this time round, I've been in hospital 12 times so far and the midwives have been so lovely and really understanding of it, supportive, and asked for my opinion on what works best for me for example 'we normally offer cyclizine by injection, but you've been in alot so is there anything that works best for you?' 'Let us know when you feel ready to eat something and we'll make you some toast or a sandwich' etc

I think when you are in hospital with HG you're already feeling so poorly, down and sorry for yourself so it's nice to have someone to just say I know you're having a really shit time and I feel really sorry for you!

Congratulations!
Pre-birth I would say listen to the mother, she knows her own body better than anyone. Post birth I would say be kind to the mums on the postnatal ward. Don't make her feel like she's being a nuisance by asking for extra pain relief after a difficult labour or c section. Also, my second child had a severe tongue tie and the midwives on the post natal ward were trying to force him to latch when he couldn't, causing both of us stress. Making a mother feel like she is being listened to and like you care will go a long way. I've never forgotten those midwives that were vile.

One small thing from me - I was rushed down to theatre for an assisted birth (they thought they might need to do an emcs, so wanted to be ready). DH was told to 'change into these scrubs and leave everything here' - so he did. Except after DD was born, they asked him if he wanted to take a photo of her/ the board with the details on, but of course, he didn't have his phone. So mine would just be to make sure you're a bit clearer, not a huge deal in the grand scheme of things, and it might have been obvious to them but not to us!

Oh, and understand that some women don't feel contractions as such - I just had constant back pain and only told I could go in (begrudgingly) when I told them I was bleeding a lot. By the time anyone examined me, I was 8cm dilated.

Definitely believe your patient I have been told on more than one occasion I could not possibly be ready to push in a condescending manner. Every time I had my baby within a few minutes.

Listen to your labouring women, sometimes we actually do know our own bodies and when something isn't right. My midwife told me to push (I had no feeling the need to and the labour was progressing so well and swiftly I honestly think my dd would've climbed out herself!) I pushed because I was told to and it resulted in a 3rd degree tear that still impacts my life today. Wished I'd known about breathing the baby out.

Hi OP,

Congratulations! As others have said, you're already on the right track by asking this question!

When I was pregnant, the midwife I was seeing was quite dismissive and I felt like she couldn't wait for me to leave. Also when I said I wanted an elective c-section she was extremely judgemental and short with me.

Midwives during my c-section and afterwards were great. The night staff...not so much - I was really struggling with sickness and pain and was struggling to care for baby without my husband (he'd been told he had to leave at a certain time) and I just felt like the biggest inconvenience when asking for help.

The morning staff were brilliant!

So a mixed bag all in all! But just reserve judgement (sounds like you're doing this already!) And continue to be kind and caring! Enjoy your well earned break and good luck when you start your new job!