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

ooh yes the bishopston team in bristol are lovely......
but... when i had ds they also delivered in hospital too (anyone frome thier area)....now (28wks with no2) they don't and I will have some random stranger. Realise this is so the norm and that i was "lucky" the first time around but feel it should be that way

But treedelivery - I've read your posts before and I would have killed to have a MW like you at any stage...!

treedelivery, no I think your views ARE wanted.

It must be incredibly difficult to manage the expectations of women and employers and provide the kind of service you would wish to yourself. I can only guess how demoralising it must be to want to do more but not be able to.

What is the answer, in your view? Could the single team approach work, so with the right number of midwives working together, some kind of continuity could be offered between a small group?

Or is there another solution?

The only teams I have seen have eventually folded. That is not to say there are not succesfull ones out there, I only speak from experience. Limited at that. I know there are teams working well right now.

Main reasons I have seen for failure, imo, have been the cost of providing staff flexibility. If one midwife has to go out at 4am and labour till noon, then another has to cover her clinic. That other has to be a real person, who is paid, exists, and is able to drop whatever they were being paid to do - and tere is the struggle. The total unpredictability of nature.

The other is the burn out rates of the midwives. Really rewarding, but totally exhausting. It really is full pelt working patterns.
Also significantly encroaches on ability to say - book a hotel for a wedding. Can't do it, don't know who might need a call out/cover, can't rsvp = can't go. Same for sports days/parents evenings and so on. People strugle to justify the lifestyle choice it demands to their families.

It sounds like whinging, and it is. Why should I have a God given right to attend a nativity? Yet the constant friction between teh two worlds just wears you down.

All this does not and should not concern the people waiting in the anc, but it is the gritty side of my working life. Nor does it it in anyway excuse lack of care in any scenario.

I have had five kids. The midwives were amazing lovely women who got me through 3 natural births and two sections. They were angels every one. I realise I am lucky to be able to say this. The hospital was the Causeway Hosp, Coleraine Northern Ireland

\but surely you should be able to have a team and set the expectations? Even just telling a mother it's unlikely you'll be at the birth, but giving her a leaflet with photos of the team so she at least recognises who is? And why not have booked holiday - people get that you have to take holidays - as long as the reason you're not booking off is insufficiency of cover...

Thread dead?
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Sorry PW.

My antenatal care for both pg's was the same Com MW who was fab - yet forgot my name 2 weeks later - hey ho!

It was seeing the multitude of MW's after that that was the problem! My first child was born ELCS (enforced NOT Elected) and the MW who was there for delivery was fab! I had to stay in hospital for 5 days though and the post op care was pretty crap - I had to shriek to have my choking baby brought to me (2-12hrs post op), my blood stained sheets were not changed until day 4, I was constantly told to walk to cupboards with sheets in to rectify this despite having a catheter in. My cathether was left to burst 3 times and then I was left to overflow and wet the bed 4 times. I was left without a pad 3 times. I was not given the usual 24hr pain relief post epidural as was wrongly diagnosed as having high blood pressure 10 wks before birth so had to cope on paracetamol post epidural. was used as a stat as I breastfed easily and had several people come round and literally pinch my nipples in front of students without prior warning! For Child 2, I had a 4.5 hrs VBAC labour and despite it being fab at the time (ie I wanted hands off care) - they did not care and weren't around. I was in a high dependancy room next to theatre but I delivered my child on my own. The MW asked a student if she was happy to deliver and do the checks and she said no so they both left the room and I delivered my son with myself and my husband present. She attended several minutes later and made out as if she was there all along to the consultant who came to stitch me!

Hate the terminoligy too 2ChildrenplusLA

For most of my pregnancies my question would have been 'hello, who are you then?'

No continuity of care whatsoever and indeed very little contact with midwives. Had zero follow up visits with both (very problematic) pregnancies.

I would have liked you too Tree

Oh thank God.

There is a bit of a glitch with that too PerArdua, in the vast numbers of part time midwiives. It can take 3-4 of us to build a whole one. So thats 4 pictures on the leaflet, and another 5 WTE roles to fill. Last I hear 6 was considered a good team number I will may be out of date on that one.

Honestly, it is so frustrating. It does looks like it should work on paper, and it does in some places.

Of course holiday is the option we go for most, but it's the same old problem we all have regarding nativity plays being announced one month in advance Holidays would need booking 6 months in advance really. Staff staff staff. Not enough of them.

We need an experienced team midwife to come on thread and show us how it is done!

Don't forget that for the woman who is pg or just about to give birth this is a scary, exciting, exhilarating, painful (and many more!) experience. Be sensitive to her needs.

I have distinctly unhappy memories of struggling with first childbirth. MW who was spectacularly busy with women in more advanced stages of childbirth (she may or may not have actually said this, or perhaps we just worked it out) and so only popped in occasionally to see how I was (not) coping. When my husband eventually said to her 'my wife's not coping with the pain' her response was along the lines of 'it's childbirth, it will hurt'.

During the subsequent em c/s, it was established that ds1 was completely stuck in op position and was never going to get anywhere. MW may not have been able to (help) turn him or change the outcome, but she could have been way more sympathetic.

With ds2, had great mw during labour, but never saw same mw twice for antenatal checks. Think my pct was trialling 'one mw only' in neighbouring gp practices, perhaps that put the pressure on everyone else, but I really missed the chance to get to know the comm. midwife. Only subsequently heard that it's possible to have the same mw both antenatally and during labour - that must be the gold standard, and what the RCM sets out as the ultimate goal...

And the gold standard team are now being hounded out of existance because they don't fit in with what the NMC and NHS want from them

See my above calls to SAVE THE ALBANY

a fantastic team, who midwives nationally aim to emulate, working outside 'the norm', to provide caseloading midwifery, being scapegoated and closed down because they dare to suggest that women can get continuity of care and a good quality service.

Same as the ridiculous fact that independent midwives are unable to obtain indemnity insurance and are more likely than anyone to get hauled up before the NMC because they reject arbitrary guidelines and dare to give women the care they ask for..

rant ocer - but i'd like to hear the RCM's response to both the Albany issue and that of independent midwives.

Ok - my situation is a bit different: second to-term pregnancy, currently carrying identical twins who have shown evidence of TTTTS and I also have ankylosing spondylitis... so I accept pretty unique...

I have, this pregnancy, I estimate seen over 30 midwives. A lot I now know and see again and again. Every single one has shown compassion and care in what has frankly been the worst 7 months of my life. From the hyperemisis to threatened prem labour, to my pelvis giving up on me - every single one has been supportive and reassuring and gone out of their way to get answers and liase between 4 different consultants (obstetrics, rheumatology, orthopaedics and cardiology). I was so worried that the uniqueness of my case would lead to one area being forgotten - it's been the midwives who've held that together, fought my corner, and got me and my babies this far without me disintegrating in to depression. My community midwife who doesn't even have to have anything to do with me (being consultant led) has been at the end of the phone to help coordinate when I've been stuck who to talk to next. She's reassured my husband who, at times, has been worried about of his mind.

And my babies are still inside... and I know, that despite it being Christmas, every single effort has been made to address how to care for me and my babies post-natally due to my disability and their likely prematurity...

So for all the midwives who simply have been amazing I say thank you...

I can honestly say that throughout one high risk singleton pregnancy leading to EMCS and this MCDA pregnancy with the AS, I have only met one horrid midwife... the rest of you I can't fault one iota.

Decide whether you want to be (a) obstetric nurses enslaved to doctors, who love the machines that go ping and don't give a stuff about birth choices and who assume the worst at all times, or (b) proper midwives who live up to their name of being "with women".

And then let us know, so that those of us who want normal births can avoid the former and find the latter.

And the former group can stop slagging off Doulas - who provide the support, encouragement and empowerment to get something like the births that we yearn for and that we were conned into thinking that hospital midwives would help us towards.

Ahhhhh. Catharsis.
(one EMCS; one VBAC - with a Doula)

some sweeping medical generalisation there.many medics are empathic and have no desire to see any woman shackled to monitor.for ping or ding

i was fortunate to have consultant lead care,with an empathic holistic consultant

Havent read whole thread but I could really have done with a mw who understood what hyperemesis was really like.

Equally, I was admittedly given a fair bit of time appointment wise when suffering with antenatal anxiety but very,very little understanding and actually no-one ever mentioned the term antenatal anxiety - I was made to feel that no-one else had ever had AND or similar and that I was a complete loon and waste of resources. I think I would have recovered much better from it if I had known I wasnt alone and wasnt a hopeless case. I feel incredibly guilty about how anxoius and depressed I was when pregnant even now.

Postnatal night time midwives were also an issue for me, especially with my second baby who was born by EMCS. I knew he wasn't feeding right, and was getting into a total panic but the midwives on that ward were busy doing paperwork behind the desk and not prepared to really talk to anyone. I think the good ones when they work nights must be delivering babies, obviously very important and valuable but I found those nights in hospital very hard.

Oh yes I agree about the postnatal midwives. I had never held a baby before ds much less breastfeed and got next to no support. Also, the bd co-ordinator told me 'well its up to you what you prioritise your silly embarrassment or your childs health' when I said I was nervous about bf because of the exposure side of things!

Sorry, this is supposed to be one point:
1.Had an intercity midwife team second time round, didn?t see the same midwife twice, and didn?t know the one that was at the birth.
2.Was left during one of the check ups with a trainee MW asked to do my blood pressure when the acting midwife popped out. She sat squeezing the bulb of the blood pressure thing for ages until she realised it was not attached. I know you got to start the training somewhere but my blood pressure was causing me concern.
When I complained and became distressed about the multitude of different faces of all the midwifes I encountered, and the incident with the trainee/crap blood pressure taking, my mental heath was questioned by the only MW with aptitude problems. (Thank the stars it wasn?t her at the birth, I know you?re a loony allot of the time when your pregnant, but it was a underhand way to undermine a genuine concern)
3.I was also extremely concerned about some symptoms and was seen promptly by the midwife 2 weeks before my appointment.
But I was told not to bother turning up for the next one as I had used up my turn as they were only funded for a certain amount of times you can see the MW.
4.Oh yea, what?s with the ?different? birth crap? Things go wrong, tell it how it is.
5.More midwife lead units please.

A lot of the above is beyond the powers of the midwifes, its lack of funding etc.

I would however like to say how excellent my midwife was at the birth and I retain an enormous respect for the profession as a whole. Dealing with that amount of bodily fluids, insane drugged up women in labour, numb scull fathers, bloody doctors who want the ?illness? treated a quickly as possible and the potential for when things go wrong they go really wrong.
Tell the midwife from me please:
Your not paid enough for what you do.

Things midwives should not do:

After EMCS under GA, fail to mention to me that my baby survived. I'm still traumatised because I thought no one had said anything because they were waiting for a doctor to give me the bad news. (Fortunately my DC was resuscitated and survived).

Make DP wait in corridor during CS then fail to tell DH that I had survived. Someone handed newly resuscitated DC to DP without a word. DP asked if I was alright, was told that someone would come out in a minute to say. Waited over 30 mins for anyone to appear.

In early labour: take delight in ensuring that I was left alone. MW on ward was very pleased to explain that my DP would be kicked out at 9pm because I would still be on the antenatal ward and not transferred to the labour suite by then.

Refuse to transfer me to labour suite because "it's too soon".

Offer to run a bath when I request an epidural that might help bring down my extremely high blood pressure.

Forget to phone DP to come in after I had transferred to labour suite. Ended up alone for 8 hours.

To the hospital midwives who sent me for a lukewarm bath when I told them I couldn't take the pain anymore and then 15 minutes later told me it was too late for pain relief - refresher training please. I had dc 30 minutes after that.

To the midwives I had for my homebirths - can't praise them enough. Fantastic care.

I'm in the US so realize that this may be completely disregarded but as a 5 year contributor to MN I have read quite a bit about UK deliveries. I used a MW in the US for my first birth and ds1 almost did not survive the experience. We were in a teaching hospital here and had possibly similar care to that of the NHS. With ds2 I went with more typical US pre-natal care and an elective section (since I had PN PTSD after ds1's birth). It was wonderful. So, after reading and reviewing more natural types of births with MWs and discussing the more medical births we have here I say "Give me the medical birth with the private room and the lactation consultant every time!".