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

To the midwives who deal with SANDS at St Thomas's London thank you for making what was undoubtedly the most horrific experience of my life, slightly more bearable: for comforting me and caring for me and doing a job that no one on this earth would wish to do.

having read many of these posts i am struck by three things:

women who aren't being listened to whether it is about birth choices, pain relief etc
women being given poor/contradictory advice about breastfeeding
women being left to labour alone

what can the RCM do about these issues - they seem so basic to me. Undoubtedly low staffing is an issue. Where i am the 5 CMs look after over 1000 pregnant women in 3 localities ...

Continuing professional development, yes yes yes. I noticed a big difference between some of the junior midwives and some of the senior midwives in terms of how clued up they were on modern birthing practices, breastfeeding etc. The senior midwife who delivered my son was dangerously old-fashioned in her views. I was told afterwards (by the physio examining the permanent damage to my pelvis) that she had contravened hospital guidelines in forcing me to give birth in such an unnatural position.

And it was a junior midwife (who looked about 16) who finally worked out why breastfeeding was going so disastrously wrong for me. Thank you to that lovely woman, you saved my sanity. You were great.

I totally appreciate that many of these issues require lots of money to sort out.

However, if every midwife could make an effort to say one kind or reassuring thing to each woman they work with, I believe this would improve care immeasurably and cost nothing.

There were numerous times when a kind word or look would have made all the difference to me. I still don't understand why some midwives would treat another human being, let alone a very vulnerable woman, with such cruelty.

I found bf really difficult - my DD and I ended up back in hospital due to weight loss. Although all the midwives were nice people, they all gave me different (and often contradictory) advice. So I would say - speak to each other ffs. Develop hospital guidelines so that all midwives are offering good advice.

To the CMs who visited me ante and postnatally - you were mostly all nice. But having 4 different MW in four days undoubtedly was a major factor in the whole bf debacle. After I got out of the hospital again, why was I immediately discharged to the even more harassed HV?

To the midwife who was on night duty when I arrived for my induction at the Whittington: why were you so mean to me? (It sounds pathetic I know but as a scared first-timer, I wanted to be looked after not spoken to like a naughty schoolchild.)

To the midwife who was with me for the labour: thank you, you were really good, but why did you leave 15 minutes before the baby was born? It was obvious it was nearly over, I know your shift was over, but couldn't you have stayed a little bit longer?

To the midwives on the postnatal ward: there aren't enough of you! we need more!

To the midwives who were supposed to come and see me at home: you didn't turn up

In other words, the postnatal care was RUBBISH. Health Visitors were much better.

rubyslippers when i had my debrief to find out why my birth plan went so wrong i was told it was down to staff shortages. the staff shortages were that bad my waters broke on sunday and i wasnt able to be induced till thursday because they were understaffed.

starlight that is what happened to me. when i had my debriefing half the things that had happened were missing out the notes. lucky for me i had 2 birthing partners who have became my witnesses as i have taken legal action about my birth botch up.

To the midwife on my ward when I was in for induction:

You CANNOT tell just by looking at a woman whether or not she is in labour.

You HAVE to stick your hand up her fanjo and have a rootle about.

Thank you.

I would like to say the the CM's i had were brilliant. I had a group of 4 who were always readily available, one of which was my own - as it were - who followed me through the whole process and she was fab. The best bit was shortly after my booking in apointment when I had a call to say that they felt they hadn't been enthusiatic (sp?) enough about my choice to have a home bith and they wanted to let me know they were 100% behind me all the way. They never questioned my desc and my midwife was there for me when things got messy at the end and I ended up going in for scans and cs due to DD being breech.

Have got to say though scanning through everyone elses posts, I do also feel that the midwives in hospital, although mostly brilliant did give lots of conflicting advice. Either way it's not an experiance I'll be repeating!

It wasn't acceptable to me or for the care of my baby that I saw a different midwife every 8 hour shift for the entire 8 days I was in hospital. That I had to explain myself again and again to each one. It was wasn't acceptable to not have practical support to care for my baby when I hadn't actually slept at all for days and was demented with turedness to be told that my husband couldn't come on the ward and feed my baby when I felt like collapsing. Chelsea and Westminter's neo tayloristic work system are deplorable. The NHS needs to change.

first time round midwife "try to seem a little more interested in me as a person in your care instead of just going through the routine without as much of a smile on most checkups, midwives when i gave birth, amazing although i felt they were very pushy with pain relief and kept letting me know it is available.
second time round AMAZING midwife throughout who i got to see at EVERY appointment and she made sure she was there for postnatal visit on one occasion and went out of her way to come and do my discharge visit so THANKYOU THANKYOU THANKYOU, midwives when giving birth the second time just as amazing as my main midwife and let me do everything my way at my speed ect and were just generally lovely. All i would change second time would be to have my main midwife at the birth!

Oh, I forgot one more thank you.

When I got the notes back from my first labour and delivery, the midwife in the MLU had written "excellent maternal effort" as her comment on the second stage. My baby was completely stuck, and I had ended up in the CLU with a consultant who treated me like a silly girl who had wimped out of delivering naturally. I was in a complete state about the delivery for months afterwards, and felt like an utter failure, but her comment gave me a lot of comfort - the was someone who had seen how hard I tried, and had appreciated it.

It didn't cost any money, and must have only taken her a few seconds, but it meant a great deal to me.

I'd just like to say to the midwife who told me to be quiet when I squealed just once when the pain became overwhelming - "No - You Shut Up!" A bit of empathy wouldn't go amiss. I also didn't appreciate her talking over me to my husband and cracking jokes with him while ignoring me.

"However, if every midwife could make an effort to say one kind or reassuring thing to each woman they work with, I believe this would improve care immeasurably and cost nothing."

Peabody this is so true. Reading this thread, I realise even more how lucky I was to receive good, kind, compassionate care from more or less every midwife I saw throughout my pregnancy, birth and postnatal period. But it shouldn't be that way - that shouldn't be a 'lucky' experience, it should be standard!

As an example of the small things that make a huge, immeasurable difference: on my second night post-birth, in St Mary's MLU, Melton, I called the mw in tears for what seemed like the fiftieth time. DP had long since gone home, I was in agony front and back with stitches and piles so couldn't sit, I hadn't been able to eat anything much all day due to the pain and DS was screaming for food. The lovely lady who answered my bell listened to me sobbing about how I wanted to feed my baby but I couldn't sit up and was exhausted and didn't know what to do; then she folded back the bedclothes, put DS in the bed next to me, showed me how to latch him on while lying down and reassured me that he would be warm enough and that she'd check on us all through the night to make sure he was safe. She told me to get some rest and I did, with my baby snuggled next to me.

Her kindness didn't just get us through the night: it made me feel confident that I could do this and that I would be supported if I needed help. It made all the difference to us. To that mw: I didn't know your name, but I'll never forget you, thank you so much

I would say "thank you" to the midwife who told me "this baby will be a breast fed baby" - and sorted me out good and proper with the breastfeeding after I had given one top up in the middle of the night in hospital.

I would say "thank you" to the midwife who stayed past the end of her shift to deliver DD after reading my notes from my first delivery and telling me that we wouldn't be doing that again.

And I woul kiss my community midwife who counselled me through my terror of delivery following a traumatic first delivery and an even more traumatic miscarriage.

To the RCM - find Lyn Smith in Lower Gwendraeth Team - clone her, then clone some more and then reward the original beyond her wildest dreams. Failing that - listen to anything and everything she can think of to improve midwifery standards to her standards. Seriously, spend an hour to figure out how she, and the whole team operates and you need never research this any further.

I would like to say that having a supportive, educated, pro-natural home birth community led midwifery team makes for a fantastic pregnancy.

Having a hospital consultancy team who refuse point blank to listen to a woman who is intimately in touch with her own body and pregnancy and to use scare tactics to try to stick to hospital guidelines is just ridiculous. Get rid of the 'one size fits all' approach, please, hospital teams.

And to the CLU midwife who delivered me - thank you for being so utterly unobtrusive and allowing me to labour in my own way, despite being hooked up to machines left right and centre.

I wish mine had had more time for me, in both pregnancies and that they were more open to homebirths as I had such a horrific hospital birth last time. I wish they'd had the time and patience to listen to my concerns (cousin died postnatally and sister was 2 hours from death with HELLP syndrome the week before I gave birth and she delievered twins at 28 weeks) but they told me to 'stop being silly'. I also wish they had had the opportunity to give me an epidural when I needed one. The worst thing was that because they were overworked, they insisted my waters hadn't broken and didn't even investigate them when they had turned green and I started bleeding. I had to absolutely insist they did something and when they scanned, I was right, my waters had gone.

I felt very let down, confused, stressed and I got PND.

Our hospital specifically needs more money putting into the maternity and labour wards and the children's ward (where DS ended up thanks to the negligence of the midwives). I want to know why they are not putting more money into making an essential experience a positive one.

To the team of midwives who were responsible during my first labour: You were all lovely but I should not have been left to labour alone for so long. I don't think I would have haemorrhaged had you paid more attention earlier.

To the midwife who arrived for the final stage: You shouldn't have shouted at me to push. You especially shouldn't have shouted at me to push while the doctor was trying to examine me. You shouldn't have tried to top up the epidural after the doctor had expressly said it shouldn't be topped up. You should have helped me to start breastfeeding after delivery, rather than telling me you were too busy with paperwork.

To the midwife on the postnatal ward: If you are going to tell women that they shouldn't go home yet because they don't know anything and won't cope, that might be excusable if you were in fact imparting any knowledge rather than just turning up occasionally and making undermining comments. Oh, and when asking whether breastfeeding is going well, it's probably best not to look astonished when told that it is fine, and respond: 'Really?? but you have such flat nipples!'

To the head of the team of midwives who I saw to talk through my notes when I was pregnant with my second child: Promises of better support for the next labour would be more believable if you were able to find my notes and turn up with them to a meeting arranged a month in advance. And if you returned any of my phone calls subsequently.

In contrast, to the midwife of my second labour (at a private hospital) I would like to say thank you for always saying exactly the right thing at the right time when I was losing confidence, for suggesting exactly the right changes of position, the right times to get in and out of the birthing pool, for massaging me, for your warmth and enthusiasm and for never leaving the room. I cannot imagine a person doing a better job.

I seem to have had either fantastic midwives, or awful ones. None were just 'OK'. And there were far more fantastic midwives than awful ones.

What was special about the fantastic midwives?

They listened to me.
They trusted my ability to decide for myself.
They treated me with respect.
They were flexible.
They were patient.
They were gentle.

What made the awful ones so bad?

They had their own agendas.
They made unnecessary demands of me.
They expected me to accommodate them.
They labeled me, so that others struggled to see past the label.
They were rough (or at least ungentle).
They ignored me to my face.

The biggest improvement to midwifery that I could suggest, would be to have more midwives. How can people be expected to perform to their best abilities, when they are constantly overloaded? When they are so dependant upon monitoring, that it replaces their observational skills and their relationship with the labouring woman? When they are under pressure to process births so that the next one can happen?

For many women continuity of care is important, but that cannot happen until there are enough midwives. For me it is not important to know the midwife, what is important is not to have to go through my history over and over again during labour, because so many midwives have to hand me over to someone else as each of them is taking care of too many women.

Midwife counsellor saved my sanity - being able to phone in tears and panic after losing dd1 and during pg with dd2 just wonderful.

Midwives in EPU when I had a molar pg were brilliant, and also when I found out I was pg with ds "oh, come in tomorrow - you'll be wanting a scan"

Midwife who delivered dd1 (anencephaly), sat and held my hand, told me how beautiful she was, found a camp bed and scrubs so dh could sleep next to me, and then came to find us when dd2 was born, to give us hugs.

Midwife who delivered dd2 (with consultant) - brilliant, calm friendly woman; she and doctor worked wonderfully well together - two professionals respecting each other.

These were all in hospital - much more mixed bag with community midwives for me; some great, some not so much. One or two bonkers ones in hosp, including the one who measured my BMI at 34 weeks with dd2, sucked her teeth, muttered darkly, and then asked me why I was crying.

Midwife when I went into labour with ds not so great - didn't really listen to me, tried to tell me consultant was on holiday (thankfully I had an appt with him that very morning...) and then didn't realise I'd gone into transition, necessitating a rushed trip to labour suite. BUT she got me there safely and in plenty of time, and they were madly busy, and the triage ward was temporary.

I had a lovely MW antenatally at my surgery and generally saw her each time, there is only one other there.

Unfortunately after both my births I saw her and a load of others at home.

My DS1 was induced and when I eventually arrived on the postnatal ward at 2am I was told my DH would have to say goodbye at the door. I was awake all night trying to feed him, even though I'd tried immediately I was told I could try on the ward (nearly 4 hrs later, so much for feed them in the 1st hr if you can). But I couldn't see in the dark and couldn't move to turn on the light. I was told to get some to take me to the loo because of my epidural, but when I got someone's attention she walked infront of me and pointed 'it's over there' and went back to the cubby hole they seem to hide in. I asked to go home when they came round asking if I wanted painkillers at 9am. But didn't get out til 2pm, it was a busy ward, I was the 8th person she'd discharged, I wish she'd told me at 9am and I wouldn't have paced the corridor all morning seeing the ward empty.

After that I had a different MW each day at home, the 1st one arriving at 9am and telling my DH putting his thumb in DS1's mouth was as bad as giving him a dummy. I didn't have the strength to say we'll give him a dummy if we want. So loads of differing advice and only any good BF advice when HV arrived at 10days postnatal and I had a open wound cracked nipple which I hand expressed for the first 3 weeks.

DS2 was DIY home birth so at least I didn't have to endure the hospital MWs, but still had at least 4 different ones visit me in the 1st 6 days. Eventually my lovely surgery one (poor timing bank holiday weekend plus she'd been to a conference) who knew how worried about BFing I was. And she did follow up phone calls even when I was in hands of the HV.

So I would like to say to the RCM we women do need a proper listening ear and the same one. Having to go through the story time and time again is a waste of time (and money) before receiving yet another different opinion.