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

Mammoth post sorry!

Completely agree WobblyPig. Scarily it has got waaaaaay better. Particulary in the 90's. From the 80's it is almost unrecognisable. Mostly, hopefully.

Long long way to go.

Thank you for all of these. We will pass it on at the RCM meeting and let you know what happens.

(Feel free to keep adding - the meeting is next week I think.)

Oh noooooo - I thread slayed good didn't I?

Someone come and post for heavens sake!! Am ashamed of my mega rant and need it loosing in the pages

Will be really interested to hear what they are like and what they have to say PW. I'm thinking corporate babble myself. It's amazing how many times people can say empower, facilitate and proactive in half an hour. Hopefully not though, and the words said will add up to a meaningful debate.

From talking to a lot of friends who have recently had children, one of the worst parts for many has been a perceived 'gap' in care and concern between going into labour and being 'believed' and admitted to the delivery suite.

For example being sent home from hospital without being examined, and then it turning out that they were further along than anyone thought and having to rush back and it being too late for pain relief.

Or in my case, going into labour very quickly after induction and the midwife saying 'oh it won't happen for hours yet, I can tell just by looking at you that you're not in labour'. After about half an hour of being fobbed off I had to get nearly hysterical with pain and fear before anyone examined me and I was already at 6cm. I'm REALLY not one to make a fuss but it seemed that their barometer of whether you are in labour or not is how much 'fuss' you make.

I guess the reasons for this include the fact that the NHS doesn't have the resources for hand-holding in the first stages of labour, and just want to get you in and out as quickly as possible. I'm guessing though that this leads to many women starting labour in a far more distressed state than they would have been with a bit more support, which leads to more problems and bad experiences all round.

PS Treedelivery, you are right, there are many positives to focus on too. I suspect than many on this thread, like me, have remembered and focused on the worst and scariest bits, because unfortunately that's what people naturally tend to do.

Not being 'believed' at first for me was actually the worst bit, although ironically I went on to have a very painful and not particularly straightforward birth experience. However the midwife who attended throughout was brilliant, and I wouldn't have a single negative thing to say about her.

Question from a mum

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?

Reply from an excellent but disgruntled midiwfe who will kill me for posting it.

Maybe the midwife had to get home or her childminder would charge her extra? Maybe her husband had to leave for a night shift? Maybe she had a train to catch and missing it means when she has to be in for a long day tomorrow she will only have had 6 hours rest between shifts? Maybe her crystal ball was broken and she didn't know it was definitely going to only be 15 minutes? Maybe if she stayed for the birth she would have then been made to do all the baby checks and paperwork before being allowed to go home? Maybe it is an insurance issues?, some people believe you are not insured by the trust when your shift ends unless they have asked to work extra? Maybe she was just plain exhausted and starving?They hate us they really really do. They are angry with us. They blame us for every wrong. Noone is taking any responsibility at all, that honour falls to us the midwives. They even blame us for the dangerously short staffed wards because WE should be shouting louder about it. WE ARE WE ARE WE ARE but noone is listening. THE WOMEN need to direct thier complaints and demands at the NHS, at the trust they gave birth in, at the government. Not me when all I have ever wanted is for women to enter and leave pregnancy unharmed, physically or emotionally.

to anonymousmw (and your friend who posted on your behalf). I feel the same, sometimes I feel so sad and angry when I read some threads on mnet about childbirth and midwives. You are absolutely right, they do sound like they hate us don't they? Everyone has rights, except the midwives who have all the responsibilities. I just try not to take it personally and keep doing the best I can (even if I am late to pick the kids up, have to go shopping after a 14 hour shift where I have had no break and not eaten properly and have needed a wee for the last hour and haven't seen dp for days, and am acutely aware of how bloody dangerous the understaffing/low morale is in the unit where I work which is due to close, hasn't been refurbished for 15 years and only the consultants know what their future employment will be). Oh dear, I'm not sure I meant to make it that long but we are all in this together and we need to work together if women are to get the service they deserve and we are desperate to give them...

I would say that I was blessed to have recieved care from TWO amazing midwives with the ALbany Practice in Peckham. And to thank them and tell them that what they do is what all women deserve. And that I am shocked that they are being hunted like witches for providing the best possible care they can to women.

They offer continuity of care - I saw my primary midwife throughout my pregnancy. She would come to my house for up to 2 hours if I needed it! She knew all my kids names.
She made me feel relaxed and confident. She supported me during my labour.
Aftercare went on for 6 weeks. 6 weeks!!!
She came to my house the day after birthing my son and whenever I needed her.
They let me make decisions and supported them.
I always felt safe that if something went wrong they could handle it.

It is crucial that women get to know and trust their midwife.

ONE woman ONE midwife.

reikizen - but who do you feel sad and angry with more - the women who are complaining because they had a shit experience/MW, or the MW who provided the shitness and let the side down?

As an ex-NHS employee, although thankfully not one with a face-to-face-with-patients role, I remember well the stresses and strains of understaffing and demand for service (one of the reasons I left) - and everyone is human, after all - but some of the MW stories show specific MWs to be lacking in some basic level of understanding of how bloody scary childbirth can be.

I think the majority of MWs are great and do a great job under sometimes shocking conditions - but there are a few who could do with some basic training in empathy and patient-awareness skills, or something, it would seem.

Yes there are certainly some separate issues here - I think most people would recognise that a lot of the problems that do occur are caused by the system and not midwives personally.

It seems there are wonderful midwives who are sometimes prevented from doing a great job due to overwork / bad facilities / bad systems and management / lack of colleague support etc.

There are also midwives who appear to lack basic empathy / training / competence.

And of course there is bound to be a big middle ground of unfortunate misunderstandings / personality clashes / unreasonable expectations / projection of problems on to the midwife simply because they are there etc.

I must have seen at least fifteen midwives in one pregnancy and there is only one who I would have had a 'problem' with (ie the one that didn't believe me). The rest were great, in fact one came up and formally apologised to me for the lack of postnatal care on our ward - I had been quite happy and not noticed a problem but it was nice of her to do so.

It might be interesting too to see a midwives' list of their top ten gripes about their patients

As a m/w I'd never feel angry with a woman for complaining about shit care, but likewise I may not feel angry with the m/w.

What a woman may perceive as a m/w "providing shitness and letting the side down" I can also see from the other side and I'd wonder what else was going on with that m/w.

I'm sure I have cared for women who might think I haven't provided them with enough support in labour, or given enough help with b/f on the p/n ward. But on the p/n ward if I have 10 women and babies to care for I'm aware as I'm quickly trying to get a baby latched on that the 2 Transitional Care babies I'm looking after are due a tube feed and the post lscs mums are due pain relief and someone is screaming at me 'cos they want to go home and I haven't done the discharge and someone else having a blood transfusion is due obs.

Likewise in labour when I'm looking after 2 or even 3 women in labour at the same time.

Of course there will always be the odd exception of a m/w who just is a nasty old cow but I truely believe they're few and far between.

Mostly I'm mad at the government and hospital managers for letting us be so short staffed and over worked that its not good or even safe care.

Stripey, what I said was specifically asking Reikizen who she felt sad and angry with when she read threads about MWs - it wasn't meant as a generalisation.

There has been an absolute shift from 'best care' to 'safe care'.

It happened when trusts became...well...trusts, and had to go about insuring themselves. It was encouraged by the target orientated, league table mentality that suddenly exploded in the 90's. I have to say I think the idea of 'choice' pushes us in the wrong direction also.

Look at this thread. Very few cries for choice - more cries for people to be nice. Very Simple. I think there was some research that found that, waaaay back. We would rather have people be nice to us than prvide all the services inthe world.

One thing that would make a lovely mn campaign, would be to raise the profile of postnatal care. Too long the bridesmaid, and a poor cousin of a bridesmaid at that. Yet it seems to affect our memories of parenting the most!

As always, the money goes where the glamour [and the consultants] are, into high tech, quick result areas. Completely justified and equally worthy, but sadly the money has to come from somewhere. The expensive, experienced community midwife mainly.

My views by the way, not official ones.

Questions from a midwife

But at what point do women take responsibility for their own pregnancies?

Why do we continually have to admit primips who are not in labour because they have had a few tightenings?
Why can't you understand that labour hurts and you are in the latent phase that can last days?
Why don't you get that as soon as you are admitted the clock is ticking and you are more likely to get poked, cut and intervened with?
If you've got "all the books", why do you still talk about "dry births" and want to complicate your labour with pain relief that stops you acting instinctively and then blame us when you end up with an instrumental?
Why can you not mentally prepare yourself for labour?
Why is childbirth scary? People have done it for years, successfully, why is it so much worse for you?
I cannot support you when you are so out of control, you'd think that you had no idea you were pregnant that suddenly started labouring.
Yes there are huge flaws in midwives, but there are also huge flaws in mothers if you ask me.

Can I just repeat what Policywonk said a couple of days ago and thank everyone for sharing your experiences - some were obviously very painful and still v raw.

We're going to distill it all into key subject areas. This first meeting is an exploratory one so we might not have a huge amount to report back at first - but we will try and get the key concerns across.

Really interesting to hear about the Albany, the Bristol Bishopston Team and also the Sheffield Pilot - all sound like excellent best practice models which would be worth looking into. I'll go and ask on the Save the Albany thread, but anyone else got any experiences of any of these? Or any more detail about precisely how they differ from the usual set-up?

Thanks again.

Yes there are huge flaws in midwives, but there are also huge flaws in mothers if you ask me.

Anonymous mw, have you thought about changing career? It sounds like you may be rather tired of your job.

"there are also huge flaws in mothers if you ask me"

I typed several replies to this disgraceful post and deleted them, when the midwifes feel this way, nothing will ever change for the better.......

babies, i ended up posting my mildest option...

I actually think the number or midwives you encounter during pg or even birth should not be relevant as long as the level of care is of good quality and continuous between midwives. Sadly this isn't the case.

During my recent pregnancy we had a team of about 6 community midwives who did the appoinments. It was clear from talking to other women that there was one 'good' one. We would always say 'I hope I get X today'.

You should not be going into labour hoping that you'll get a nice midwife. Or worrying about who you'll get when your nice midwife leaves her shift.

Getting the birth you want shouldn't be dependent on the midwife you happen to get.

Why have UNISON made this sort of announcement, where as the RCM have...er...nothing.

I think anonymousMW's last post just about sums up the problems many people have with MWs. I agree it might be time for a career change, preferably to one away from patient contact.

FIrst response was "Well excuse ME for not knowing exactly how this was going to feel! So sorry to have bothered you there in terms of actually doing your job". But that wouldn't have been helpful.

Fuck me anonymousmw, that's a shocking attitude.

I realise people have been blunt on this thread but...

Would a hospice nurse say similar things to people who'd never died before?

I think I feel sad because I can't provide the care I want to (and know is right) and angry that midwives take the flack for the failings in maternity services. It is also hard to think that care a midwife provides can be so harshly critisised with no means of defending herself. For example, she may have been loooking after 4 women in labour at once. It is certainly true that there are problems with women's preparation for labour but that isn't the woman's fault, we should have the time and resources to dedicate to that woman like the Albany Practice in London who have staggeringly good home birth/normal birth/breastfeeding rates in a very deprived area. However, the way they achieve this is by being on call 24hrs a day 7 days a week for 6 months of the year! Not surprisingly, the midwives who work there don't tend to have young families! I love my job, but I couldn't commit to that (sorry !)

Me neither. Can't do it.
I need to do a job with a defined begining and end, which for £15 an hour or thereabouts, is not an unreasonable request. I know this is an ok level of pay in the bigger scheme of things, so don't flame me.

The Albany practice has had it's contract terminated I think?

Yes - there are various threads about it on MN, with links to a campaign site and more information about how they work. I think it was terminated because a baby died when MWs were not 'following Kings' protocols'. There is lots of criticism of the way the incident has been reported... I don't think the ending of the contract was related to how they practice.

It certainly seems like the right model - I got the impression from their website that they operate as a close team, so while there is 24hr on call, it is not the responsibility of any single midwife.

Surely facilitating such teams is the only way to solve your family needs, and the need for continuity etc?