Please tell us your thoughts on midwives for an upcoming meeting with the RCM

[policywonk]

MNHQ is meeting up with representatives from the Royal College of Midwives in the near future, and to help us get a sense of the issues that concern you most, we'd love it if you could post your thoughts here.

Basically, we want to know: what one thing would you say to your midwife about the care that you received (or are receiving)?

Ta x

Continuity of carer not care.

A woman needs to know her midwife before, during and after birth, not just a random person working within the trust guidelines and policies - that is not continuity of care. If caseloading cannot be provided then midwives need to share the care of small nubers of women and ensure that the woman actually gets to know the team.

Antenatal education provision is dire.

Midwives need much, much more time to spend with their women.

Hospitals need to stop conforming to guidelines produced at random in the dark ages and start providing quality, evidence based, woman centred care.

Women need real choice about where and how they have their baby.

LASTLY - AND VERY VERY IMPORTANTLY

SAVE THE ALBANY

REALLY - RCM. YOU REALLY NEED TO DO SOMETHING. IT WOULD BE AN ABSOLUTE SCANDAL IF IT WERE ALLOWED TO BE PUSHED UNDER AND FORCED TO STOP.

SAVE THE ALBANY

I'd say to all midwives, is there anything at all you can do to encourage more people in to your profession? Or to stay in the profession? Do you have friends, neighbours, clients who you think have the potential to be a good midwife? - could you maybe find a way talk to them about the job and encourage them to do the training?

We need more of you !

Bishopston Team in Bristol are the one team of MWs that I have never heard anything bad about, even when they're stretched.

Remembering names and details is vital as it makes every mother-to-be feel really special and cared for.

Continuity of care.
Listen to what your patients are saying and respect their choices even if you know they are PFB and think they are silly eg Lavendar, acupuncture, hypnotherapy etc.
Help establish breastfeeding and don't abandon the women as soon as the baby is out.

My community midwife is great.
Many of the mws I have met in hospital have been great too. However, I have 3 issues.

1. The mw attending the birth is a complete stranger. It can be any of a team of 20 plus and the variation in terms of care is huge.

1. Mws do not do any nursing training now (unlike in days gone by) and therefore many seem to have little knowledge or sensitivity when it comes to caring for the ill. I was recently an in-patient and some of the insensitivity I encountered was jaw-dropping.

1. Many mws give poor information wrt breast feeding. I had severely cracked nipples with ds from the first feed and was told to continue feeding (right) but noone looked at his latch or said it was okay to use cream. Also, the women in my ward who had chosen not to bf or who gave up after a few painful hours were treated pretty shabbily.

Also, many of them know NOTHING at all about medications for various pg conditions. My community mw (who is generally super) had never heard of ondansetron and did not know that stemitil and buccastem are the same drug. I would have thought this was pretty basic.

talk to me about Breastfeeding before i give birth. and know something about it.

i don't think it would hurt to run through a tick sheet pre-birth which i sign to show i have been informed

1)of the bens of BF
2)of the potential for difficulty
3)what number to call if i have a question
4)the how of BF and what demand feeding means (ie not waiting for them to yell..)

etc etc

and then goes in my notes for ref...

Sorry if it's been mentioned before:

Please please please can midwives have more breastfeeding training? I've heard they only have a day or so during their entire training.

And connected to this, please can they not tell first time mums that their baby needs a bottle on their first night in the world!

Picante - I've had a lot more than a days worth of breastfeeding information.

I have another one for the RCM -

please please stop refering to 'Delivery'

Parcels and letters are delivered. Babies are born. Postmen deliver - midwives assist and facilitate in birth.

Also - Did I mention -

SAVE THE ALBANY!

Please do something about post-natal care on the ward.

I dont want to feel like I am an inconvinience. It was not my fault I had a c section and could not move to pick up my boy in the night.

Please dont tell me on the ward the curtain must stay open all the time for health and safety reasons. Please dont tell people off for bringing gifts. Please dont tut when I ask if I can go home. Please dont roll your eyes when i asked if I could have my sheet changed because there was blood over it.

Pleas, I know your overworked but being a bit nicer would have made the whole thing a bit easier for me.

To the midwife who said to me (after 3hrs 10 mins of pushing) "Do you want your baby to die inside of you". You are a fucking disgrace to your profession - and I wish I'd had the wherewithall to say that to you at the time.

My midwives for both births were amazing. DS was a long labour with several midwives over the course of my labour but they were kind and supportive. Postnatal was woeful - trying my hardest to breastfeed my newborn on his first night who failed to latch on (although had been helped to latch earlier in the day) - I would like to say to the midwife who said 'i'm too busy to help so I'll get you some formula' that I wish she'd spent some time helping me and not left me on my own not knowing how to help my baby feed. As it was I ended up giving him the bottle she bought and then spent a miserable six weeks expressing milk before I finally successfully got him to latch on again and start breastfeeding.
To DD's midwife who listened throughout I would say thankyou for a wonderful birth in the MLU where you helped me latch DD on immediately and then left us for an hour to feed as I'd asked for in my birth plan. 12 months on I have wonderful memories of my day and feeding is still going strong. Thanks for understanding and listening to me.

Another vote for continuity of care.

My first midwife couldn't answer ANY of my questions; she would shrug her shoulders, make a face, and say she would find out but never did.

Then I think I never saw the same mw twice ante-natally. I saw 2 peri-natally (but I'd travelled 150 miles to ensure that I didn't give birth in my local hospital!) - they were both great, and the first came in to see me the next morning too, which really touched me.

Post-natally, back at home, I was subjected to at least 3 or 4 different ones, including the very first ante-natal one, who still couldn't answer any questions, and pushed me into bottle feeding. She was a particularly helpless sort of woman and utterly useless. I still despise her!

"I do not trust you because of the awful mess midwives made of my care during my first birth. I will not try a VBAC because I do not trust for one second that any of you can take good enough care of me to get me and DD out the other end of it in one, healthy piece. How on earth can it be too early for a TENS machine, why couldn't one of you help me to run a bath while on the ward rather than drinking tea and chatting and in what universe was leaving my DS in distress for 36 hours before calling a consultant deemed to be a good idea? Now I'm scared of giving birth and unable to even trust in my own body - well done"

To my primary midwie I saw throughout my pregnancy - rib pain isn't always indigestion, thanks for missing the HELLP syndrome, I was nearly not here to tell the tale. If a pregnant woman tells you she really doesn't feel well and that indigestion is REALLY BAD there might be a reason.

To the midwives in hospital - Thanks for doing everything right and saving my baby's and my life.

RCM - Midwives need help to do their job from their employer, the NHS. You as the union need to become active in helping midwives fall back in love with the job.

The hours are as far from family friendly as it is possible to be, and I believe this inpacts on how midwives function. I hear the call for continuity of care loud and clear, yet also feel that the total lack of work/life balance is pushing midwives to the edge and right over.

You as the union have focused on the huge all consuming massive commitments of negotiating agenda for change and other reform.
When you were doing this, you also allowed the employer to significantly infringe on and re-mould working practice, to their own financial gain. This has been a poor show, the complete witdrawal if interest in the working lives and daily experiences of midwives.

It's effect has been the disenfranchisement of the women who are midwives, and the women who need midwives. On your watch.

Are you a midwife treedelivery?

See, this thread is upsetting me now, even though I was very direct in my criticism.

Because midwives can't win. Like social workers, damned if they do intervene, damned if they don't. And squeezed by penny-pinching employers.

It is such a responsibility, a life and death one, and of course death is now rare but MWs still have to face real complications and deal with them calmly and appropriately. I couldn't do that. And I'd hate to think that women in my care held me responsible for every tiny thing that goes wrong because some of it is just gonna go wrong.

So how to separate out the bits that are the responsibility of the institution and which can be dealt with?

What are the right working practices for women who (often? mostly?) have children themselves? Dedicated teams have to be the only way? The Sheffield case study sounds interesting - would like to hear more about that.

All I really wanted was a midwife who actually gave a toss about me.

You may pick from:

Community midwife: who told me (third pregnancy, two previous miscarriages), that there was no point having a scan as I was probably going to loose the baby anyway when I was bleeding. Cheers love, I knew that it wouldn't make a difference, but I didn't want to wait weeks to find out.

Community midwife: (fourth pregnancy after 3 miscarriages, including one very missed and one missed) Stop being so silly, you need to start enjoying this pg, nothing will go wrong.

Hospital MW: (admitted at 35 weeks when waters went - I said I might be having cx, so when did I need to tell them, esp as baby hadn't engaged, so risk of cord prolapse) 'When you feel like pushing, ha ha. No one even checked on me, so was found vomiting on my own and 6cm dilated.

The 5 different midwives who wandered in and out during my labour.

The ones who left me covered in blood, having lost a litre of blood with my baby whisked off to SCBU, without anything to eat, drink, help to wash etc.

The ones who wouldn't take me to see my baby.

Who in 5 days on the PN ward (whilst my baby was in SCBU) didn't actually examine me once, and left me with a blood stained bed.

Who refused to arrange medically necessary meals for me.

Who left me on a ward with 5 women and their babies, and didn't even ask about mine

Who made up their entries in my notes - the inaccuracy included a statement that my baby had come to PN and then gone to SCBU, when he didn't at any point.

And the community midwife who didn't see me for 3 days when we had been sent home from SCBU, and DS had only been directly feeding without an NG tube for 24 hours

So, um, not a terribly positive experience for me

Nancydrewrocks - Can't believe she said that to you . That's awful.

GirlyLala - you reminded me - the MW who kept trying to open my curtains while I was trying to master BFing (because they should only be drawn if you're expressing) because the fuckwit design of the ward meant that windows opened into cubicles, and the central bit had no natural light. FFS.

This was cathartic but it's mostly just depressing.

I personally cannot offer continuity of care throughout the 3 stages of pregnancy. I cannot go oncall for labour as I can't leave the house in the middle of the night, unsure when I will return. It just isn't feasable with children. Ditti bfing call out's and so on. It is so so sad, and I feel awful about it.
I have had to face up to that failing in my practice, and except that I work at a sub standard level.

The only plus side, reading some of the encounters here, is continuity always that good a thing? Continuity with some of the people detailed here may well have been torture.

Apologies for several typos and errors, I know MN is after me . Gulity as charged on the 2 counts of being a) a midwife who works in hospital on shifts, and b) unable to master the language.

Am sure the views of a mw are not wanted, as idea here is to present views of the user group. I have been a user twice so perhaps can have a [small] voice.