Now Ye're Talking - To A Midwife

Dav

Hello all,

This week we have a lady who works as a midwife. There's a whole lot of responsibility for a midwife anywhere and it's one of the oldest jobs in the world. With a wide variety of birthing methods and all the potential complications of a pregnancy and birth, they're vital for both mother and baby. So, with all that said, I'm sure we'll see an interesting range of questions and answers for this one.

We've got a special account for this AMA - our midwife won't be answering any questions about who she is or which hospital she works in - I'm sure you'll all respect and understand that.

So, let the questions begin!

Dozen Wicked Words

Have you been a midwife long and do you still enjoy your job?

angeldelight

Do you have children yourself? If you do how did you find being pregnant while knowing in detail what was going on?

Redser87

Do you find that you can switch off and forget about work when you get home, or do you find yourself worrying about your patients/ going back over things that happened during the day?

irish_goat

What's the worst thing a father has done during a birth?

Larianne

What is (or has been) the most challenging part of your job?

How do deliveries work when it's multiple? Have you experienced twins/triplets/quads births?

Are you constantly rushing around from room to room or do you get a chance to sit down and chat with the patients? (I have visions of maternity hospitals being ridiculously busy in this country at present!!)

What is the career progression in midwifery?

seventeen sheep

Do midwives usually get rotated around different wards/roles, or are you usually doing the same job all the time? I've often wondered if for example the antenatal staff ever assist with births on other shifts, etc.

Is there any particular job as part of the labour/birth process that you really hate doing and would rather avoid?

What are your favourite and least favourite types of patients? E.g. do you prefer if a patient is assertive or submissive, pro- or anti-intervention, that sort of thing.

Can you tell us about some of your most memorable births ever? Memorable either for good reasons or bad reasons.

Do you watch shows like One Born Every Minute? If so, how do you think those hospitals compare with the reality in an Irish hospital?

Is understaffing much of a problem?

How many patients/babies would you deal with on a typical shift on the delivery ward?

Kevhog1988

How many farmers have compared childbirth to calving a cow??

Synchronic

What is the best thing about being a midwife?

Have you ever kicked a birth partner out of the birthing room?

cyning

Would you prefer to see a movement towards birth centres and away from consultant led care?

What are your feelings on the Philomena Canning case? Do you believe that the gun was jumped so to speak considering there were no complaints etc?

Is there an increase in inductions and c sections around private patients and consultant holidays?

Do you recognise the problems that tongue and lip ties have at getting breastfeeding established: is there supports for getting tongue ties snipped in your hospital?

I'm A Midwife, AMA

Some great questions here already! I'll be checking and answering as frequently as possible, though shift work doesn't allow for all day boardsing!

Dozen Wicked Words wrote: »

Have you been a midwife long and do you still enjoy your job?

I've been a qualified midwife for just about eighteen months now, though I worked in the maternity services for some time before I started my four years training. I love my job, I am of the opinion that I have the best job in the world and feel very privileged to do it.

angeldelight wrote: »

Do you have children yourself? If you do how did you find being pregnant while knowing in detail what was going on?

I'm pregnant on my first, due soon and the pregnancy has been stressful, although all is looking well. While I believe knowledge is power, I also think a little bit of "ignorance is bliss" would have been great for the duration of my own pregnancy!

Redser87 wrote: »

Do you find that you can switch off and forget about work when you get home, or do you find yourself worrying about your patients/ going back over things that happened during the day?

I always think about my women when I'm at home, it's not unusual for any of us to ring in to the ward to check on people or to double check that we handed everything over at change of shift time. I've woken up in a cold sweat at 4am and considered ringing into the ward to make sure someone got an antibiotic tablet before!

keith16

Have you ever had any overly demanding patients? What was the weirdest thing people have asked for?

Lisha

I'm normally a very capable, can handle most things kinda gal
But oh my dear lord I coped so badly in labour. I went to pieces literally could not breathe. All I can describe is that every contraction was like being trapped under a giant wave and drowning. Then just as I revovered bam twas like bring hit by a bus. I was a mess could not breathe and I'm so lucky I got my daughter out safely.
MY waters went first and I never really got contractions for hours, following day o was grand them all of a sudden bam labour ended fast n furious. My gp reckons I just don't dilate properly and so that it's a hormone thing.my first was section following failed induction 24hrs+ after waters went.

Do my questions are do you yhink done women cope better in labour than others?

And are done physically not able to labour safely without section?

Are sections done too freely?

Thanks midwives fascinate me its a great job ye do for scaredy cats like me!!

I'm A Midwife, AMA

irish_goat wrote: »

What's the worst thing a father has done during a birth?

Apart from collapsing and generally getting in the way I've never had any particularly bad experiences with dads in the delivery suite!
Had one new dad who was far too interested in looking at his wife being sutured and not too interested in looking at his new beautiful baby, that was strange.

Larianne wrote: »

What is (or has been) the most challenging part of your job?

Every day presents new challenges. I think when we are pushed to the limit, working really hard and only trying to help someone and they or their partner sit and look at you as though you are doing absolutely nothing it's very hard to take. We skip breaks, barely make it to the toilet and end up dehydrated but in the moment, if I can't get someone straight to the labour ward (for reasons out of my control) or the doctor wont come to send someone home quick enough, I'm seen as the worst in the world and it's upsetting.

How do deliveries work when it's multiple? Have you experienced twins/triplets/quads births?

I've attended twin births but never any greater multiple unfortunately. If the first twin is head down a vaginal birth is an option, it is born as any other baby is, then a scanner will be brought in to confirm the location and position of the second twin. If it's head down it will emerge like the first, if it's breech then an assisted breech birth will be facilitated, not something we generally do alone as midwives, though we are all trained in the procedure.
Triplets, quads, quints and sextuplets will be born by Caesarean section.

Are you constantly rushing around from room to room or do you get a chance to sit down and chat with the patients? (I have visions of maternity hospitals being ridiculously busy in this country at present!!)

Maternity hospitals are extremely busy at present and yes, there is always something to be done! On the wards a midwife might look after 7-15 women and perhaps babies too in a single shift, how much rushing around we do depends on the workload at the time - we are constantly prioritising our time.

What is the career progression in midwifery?

There are great career prospects in midwifery, within the hospital/ward system over time there may be opportunity to move into management positions. We can go on to study to become prescribers, sonographers, work in colposcopy (taking images and samples from the cervix), family planning, lactation consultants, specialise in diabetes, run outlying clinics, move into the neonatal intensive care unit, with a masters a midwife can become a tutor and with a PHD a college lecturer.
Outside of the hospitals midwives with relevant experience may wish to become self employed community midwives, facilitating home births.

I'm A Midwife, AMA

seventeen sheep wrote: »

Do midwives usually get rotated around different wards/roles, or are you usually doing the same job all the time? I've often wondered if for example the antenatal staff ever assist with births on other shifts, etc.

Is there any particular job as part of the labour/birth process that you really hate doing and would rather avoid?

What are your favourite and least favourite types of patients? E.g. do you prefer if a patient is assertive or submissive, pro- or anti-intervention, that sort of thing.

Can you tell us about some of your most memorable births ever? Memorable either for good reasons or bad reasons.

Do you watch shows like One Born Every Minute? If so, how do you think those hospitals compare with the reality in an Irish hospital?

Is understaffing much of a problem?

How many patients/babies would you deal with on a typical shift on the delivery ward?

It depends on what hospital or unit you're working in, where I work we are rotated from ward to ward about once every eight months to a year, it allows us to maintain our skills in every area. In some of the smaller units midwives are rotated daily.

Nothing I hate about the labour or birth process, it fascinates me continuously.

I love it when women have done their research and reading, attended antenatal classes and know what they would like. Knowledge is power when related to childbirth and breastfeeding. I support women bringing a list of birth preferences, though I always encourage people to keep an open mind and if things change then they change, we will continue to support and facilitate their wishes as best as we can.

I've been lucky enough to attend many amazing births with lots of wonderful couples, I couldn't possibly share any here!

I find One Born Every Minute very stressful to watch, I don't like many of the couples or the scenarios on the show - though I always cry when the babies are born! The obstetric centres on there are very similar to ours, though they have plenty of time for tea and cake! I really love Call The Midwife, I'm always in tears watching it!

Understaffing is a massive problem, morale is low in the hospitals and staff retention is becoming an issue, personally I think if we work through this difficult time it has to improve, I love my job too much to leave, I couldn't leave the women.

On the delivery you can look after anywhere from 1-5 women in a typical 13hour shift.

I'm A Midwife, AMA

theemigrant wrote: »

How many farmers have compared childbirth to calving a cow??

It's something all farmers do and I think it's great, they take a great interest in the whole birthing process and they always ask if we administer Oxytocin to women to help let down their milk! (We don't).

Synchronic wrote: »

What is the best thing about being a midwife?

Have you ever kicked a birth partner out of the birthing room?

The best thing about being a midwife if getting to be a midwife - spending such a special time with families, pregnancy is only 40 weeks long and midwives can play such a massive role throughout, then birth is such a privilege to attend and in the postnatal period we spend time with parents and babies that can never be replaced!

I've never kicked a partner out of a birthing room!

keith16 wrote: »

Have you ever had any overly demanding patients? What was the weirdest thing people have asked for?

Some families are more demanding than others, even when they can see that we are run off our feet, generally people are very understanding that we are always doing our best.
I think when people started asking to bring their placentas home it was considered weird, I remember a time when to bring them home women had to have a sign off from the matron, I don't believe that's a requirement any more, they just have to supply their own cool bag now. Though permission has to be sought from the council if they want to bury it.

shalalala

I was talking about female genital mutilation with a friend today and I was wondering if you have seen it be an issue within Ireland in certain cultures? It would be interesting to know if it is something that has spread to Ireland, knowing that it us fairly commonplace in England.

Are you trained to deal with such cases?

Raminahobbin

Do any women request alternative forms of pain management/assistance during labour, such as acupuncture, or is this something that most hospitals don't allow?

I've seen youtube vids of women having 'orgasmic' births, where they turn the pain into pleasure...do you ever have anyone experiencing it this way??

baby_pebble

Have you ever seen an epidural go wrong as in didn't kick in or patient reacted?
What is the most common pain relief in birth for a first time mom?

Omackeral

Congratulations on your first pregnancy, lovely stuff.


Would you consider having someone you know deliver your baby... or will ya just do it yourself like?

Are there many male midwives? Are they called midhusbands?

Did you watch the movie Knocked Up and, if so, did you like it?

Oh and one more, did you ever hear of anyone getting a 'surprise' i.e. a black baby for a white couple or anything mad like that?

I'm A Midwife, AMA

cyning wrote: »

Would you prefer to see a movement towards birth centres and away from consultant led care?

What are your feelings on the Philomena Canning case? Do you believe that the gun was jumped so to speak considering there were no complaints etc?

Is there an increase in inductions and c sections around private patients and consultant holidays?

Do you recognise the problems that tongue and lip ties have at getting breastfeeding established: is there supports for getting tongue ties snipped in your hospital?

I think a move away from consultant led care would be fantastic, I'm a big believer in midwifery led care, public maternity care in particular. I think alongside birthing centres would be fantastic, the birth culture in Ireland is not quite ready for stand alone centres, in my opinion.

I feel that Philomena is a fantastic midwife, with a wealth of knowledge and experience and I feel that her case is little more than a witch hunt. She was coming close to establishing her won birth centre and I feel that may have something to do with it.
As I said in the above answer I don't think Ireland is ready for stand alone centres, the issue with self employed community midwives is that there is an us and them feeling both from them and the hospitals. While none of the SECMs would ever delay in transfer in it's a stressful process for the women, it's a shame there aren't more SECMs employed by the hospitals to make this easier, allow us to all work together to improve birth in Ireland.

Yes, I do.

If a tongue tie is picked up in the hospital the woman will be referred to relevant services, we don't have the facility to snip them in the hospital. They will be linked in with the lactation consultant as soon as a problem is spotted. Many women will contact the lactation consultants at around two weeks postnatal and a posterior tongue tie may be identified at that time, due to poor supply, baby not gaining weight etc, it takes two weeks for a posterior tongue tie to be identified due to these factors, often everything appears normal at first.

monkeysnapper

Will it feel weird when you go in to have your baby and the midwife asks you what do you do for a living and you tell him or her that your a mid wife ?

Are there any men doing mid wife in Ireland ?

Do you feel exhausted sometimes after a long drawn delivery , and is it hard to go and start another?

Eeden

I've come across a few theories and articles which say that reality shows (eg One Born Every Minute) and other TV shows (soaps, etc), which always show the trauma and drama sometimes associated with childbirth, could be causing more women to have a fear of pregnancy and childbirth. Any thoughts on this?

KKkitty

What's the biggest baby you've helped to deliver?

Lisha

Have you ever seen a mother to leave hospital abandoning her baby?

Do you see social services being involved often?

How common aand how identifiable is foetal alcohol syndrome or babies born drug addicted/damaged?

Do you ever pity a baby cos the parents are simply incapable of being good parents?

I'm A Midwife, AMA

Lisha wrote: »

I'm normally a very capable, can handle most things kinda gal
But oh my dear lord I coped so badly in labour. I went to pieces literally could not breathe. All I can describe is that every contraction was like being trapped under a giant wave and drowning. Then just as I revovered bam twas like bring hit by a bus. I was a mess could not breathe and I'm so lucky I got my daughter out safely.
MY waters went first and I never really got contractions for hours, following day o was grand them all of a sudden bam labour ended fast n furious. My gp reckons I just don't dilate properly and so that it's a hormone thing.my first was section following failed induction 24hrs+ after waters went.

Do my questions are do you yhink done women cope better in labour than others?

And are done physically not able to labour safely without section?

Are sections done too freely?

Thanks midwives fascinate me its a great job ye do for scaredy cats like me!!

Sounds like you had a pretty tough time, I wonder if your baby might have been looking up at the stars, rather than looking back (at your bum, so to speak). When the baby is looking up it often happens that waters go with no labour and labour can take longer to progress when contractions finally do start.

Some women definitely cope better than others in labour but it has a whole host of factors involved - previous experience with pain and coping techniques, support from partner, tiredness etc.

There is something called cephalo-pelvic disproportion which may be the cause for some emergency sections, the baby literally will not fit through, despite good contractions. There is no way of knowing this is the case until labour begins. If a woman is at the end of her pregnancy and the head is clearly not in the pelvis she may not be suitable for labour, equally if the baby is breech labour is not recommended. Women with certain medical conditions cannot labour for various physical reasons, though everything is assessed on an individual basis.

Are sections done too freely is a difficult question, there is always a reason, sometimes that reason happens to be maternal request. It can happen that midwives are requesting to go for section if we see something changing antenatally or in labour and doctors will sit on the woman for longer than we may like, other doctors will "bail out" very quickly.

Lisha

No she was not facing up. All I know is that both times my waters went and the for 24hrs no pain nothing. Then all of s sudden I wanted to push and then contractions came fast and furious. I suppose cos my waters went they did not wish to digitally examine me. But once pains started it possibly only took 1.5hrs for Her to be born.
On some usa websites they talk about a hormonal imbalance whicheabs dilation is off with some women. I dunno but I don't intend to have another one

After my first which was a section after failed induction I felt like s total failure. I really felt my body left me down.
Is it common to feel a failure after c section?


Thanks again

uck51js9zml2yt

We had 2 in the rotunda. Have to give credit were it was due, midwives were fantastic on each occasion.
One of them even remembered my wife when she came into the birthing room from 3 years earlier. Loved the Spanish accent when she said push

First time round the m/w told the doctors what to do and saved my son. 2nd times she picked up on breathing difficulties as he found it hard to transition.

I can understand the dad watching the suturing. I took a photo of the placenta in the dish on the first.
Second time, cup of tea, baby and wife are grand, now home to my other son.

I'm A Midwife, AMA

shalalala wrote: »

I was talking about female genital mutilation with a friend today and I was wondering if you have seen it be an issue within Ireland in certain cultures? It would be interesting to know if it is something that has spread to Ireland, knowing that it us fairly commonplace in England.

Are you trained to deal with such cases?

FGM is something we see, ranging from mild to severe. The law prevents women from being "sewn up" after they've had their baby so women who have required deinfibulation (opening) during labour must be sewn on either side, as opposed to across the front again, generally women are counseled during their pregnancy to deal with this, but I imagine it's very upsetting for them, to go home looking and feeling completely different than before the birth. While I obviously wholeheartedly disagree with the practice of FGM I am concerned for those women postnatally.

Raminahobbin wrote: »

Do any women request alternative forms of pain management/assistance during labour, such as acupuncture, or is this something that most hospitals don't allow?

I've seen youtube vids of women having 'orgasmic' births, where they turn the pain into pleasure...do you ever have anyone experiencing it this way??

Women practice acupressure in labour to help them cope and some bring homeopathic kits with them too. Unfortunately not enough midwives are trained in acupuncture, though many would like to be. There is an increase in popularity of hypnobirthing which is fantastic, it's a method of training ones brain to self hypnotise and cope with the surges throughout labour, and allowing women to give their baby the birth it needs.

I too have seen videos of orgasmic birth though I've not seen it first hand. I've heard of a good few stories of partners giving labouring women clitoral stimulation while the midwife is in the room, which I do not feel is completely appropriate to be honest. Yes, while at home, yes, when there is no one in the room, but maybe not in front of others, if we get the feeling that a couple needs space we will never crowd them, only do what we have to and leave again, if it were me I'd rather my partner wait until we had some space. I'm all for kissing and cuddling and a bit of boob touching during labour, it helps keep the oxytocin flowing and it's what got the baby in there in the first place!

I'm A Midwife, AMA

baby_pebble wrote: »

Have you ever seen an epidural go wrong as in didn't kick in or patient reacted?
What is the most common pain relief in birth for a first time mom?

Most common pain relief for first time mum in labour is an epidural.

Sometimes epidurals don't work, sometimes they only work on one side and sometimes the block comes up too high and women can't feel anything at all, which is not productive. We will get them re-sited if they're not working, the risk of that happening is always explained to the women before they have it done.

Omackeral wrote: »

Congratulations on your first pregnancy, lovely stuff.


Would you consider having someone you know deliver your baby... or will ya just do it yourself like?

Are there many male midwives? Are they called midhusbands?

Did you watch the movie Knocked Up and, if so, did you like it?

Oh and one more, did you ever hear of anyone getting a 'surprise' i.e. a black baby for a white couple or anything mad like that?

Thank you!

I would love to have someone I know attend my birth, hopefully one of my friends - of course I'll deliver the baby myself, as every other woman does, the women do all the work, the midwives are there to attend and conduct and catch!

There are a small number of male midwives. The term midwife means "with woman".

I don't remember particularly enjoying the movie Knocked Up, though I saw it in the cinema with my mother in law. I did enjoy What To Expect When You're Expecting!

I remember a woman quite some time ago who was unsure whether her baby would be black or white when it was born as what she might say to her partner. There was an episode of Call The Midwife about the same thing. I've heard of one set of surprise twins in the last ten years, with the massive increase in ultrasound it's less likely to happen now.

I'm A Midwife, AMA

monkeysnapper wrote: »

Will it feel weird when you go in to have your baby and the midwife asks you what do you do for a living and you tell him or her that your a mid wife ?

Are there any men doing mid wife in Ireland ?

Do you feel exhausted sometimes after a long drawn delivery , and is it hard to go and start another?

I'm attending my own place of work so I already know everyone and they know me!

Answered above.

Yes, sometimes if a birth has been particularly long and difficult and you're wrecked it's difficult to immediately perk up and go into the next room but it must be done!

Eeden wrote: »

I've come across a few theories and articles which say that reality shows (eg One Born Every Minute) and other TV shows (soaps, etc), which always show the trauma and drama sometimes associated with childbirth, could be causing more women to have a fear of pregnancy and childbirth. Any thoughts on this?

Totally agree, One Born can be very stressful, I'm not sure about any soap story lines so can't comment on them, I'm a big fan of Call The Midwife and while it can be stressful I think the fact that it's set in a very different time probably eases peoples minds somewhat.

KKkitty wrote: »

What's the biggest baby you've helped to deliver?

I once caught a baby that was 4.6kg (over 10lbs) and I had serious trouble lifting it up to the mums chest when it was all slippery! I have met a couple of babies around the 5.3kg mark (nearly 12lbs)!

I'm A Midwife, AMA

Lisha wrote: »

Have you ever seen a mother to leave hospital abandoning her baby?

Do you see social services being involved often?

How common aand how identifiable is foetal alcohol syndrome or babies born drug addicted/damaged?

Do you ever pity a baby cos the parents are simply incapable of being good parents?

Thankfully I've never seen a woman abandon a baby.

Yes, I see the involvement of social services a fair amount which is very reassuring. Like anyone they are pushed to the limit at the moment but they do a very difficult job very well from what I see.

Foetal alcohol syndrome is quite rare now, I've never seen it myself. I have looked after babies who are withdrawing from various substances - if a mum is known to be using a substance regularly then we will perform something called the Finnegan Score on the baby for at least the first five days of life, this assesses the level of withdrawl symptoms and will indicate when or if a baby will require transfer to the neonatal unit. Withdrawl is not dose dependent and to see a baby withdrawing is always upsetting for mothers. If a baby is showing signs of withdrawl but the mother is not known to be taking something regularly the baby will be reviewed frequently, again it's on a case by case basis. Babies can withdraw from coffee, coca cola, cigarettes and lots of other things, not just heroin etc.

Lisha wrote: »

No she was not facing up. All I know is that both times my waters went and the for 24hrs no pain nothing. Then all of s sudden I wanted to push and then contractions came fast and furious. I suppose cos my waters went they did not wish to digitally examine me. But once pains started it possibly only took 1.5hrs for Her to be born.
On some usa websites they talk about a hormonal imbalance whicheabs dilation is off with some women. I dunno but I don't intend to have another one

After my first which was a section after failed induction I felt like s total failure. I really felt my body left me down.
Is it common to feel a failure after c section?


Thanks again

That sounds like a really really tough time. It is common to feel like a failure after a section, though I think that if you remember that your baby needed that birth it can be of some comfort. Obviously if the feelings were going on and on for a long time I would always encourage women to go to their GP to talk about them or book an appointment with their hospital team to discuss the birth and the recovery from it, mentally and physically.

Marz66

What will your birth preferences be for your own labour and why?

How is the relationship generally between midwives and doctors / anaesthesiologists? Do you ever disagree with their assessment?

Can you predict when an induction is going to fail and end in c section? If so, do you still think it is worth trying induction?

Are Irish women well prepared for labour?

Are patients allowed read their own charts?

Do you judge patients for choice of feeding method, choice of pain relief etc. Professionally I'm sure you shouldn't but personally?

What is your role on post natal ward? To ensure mom heals ok and baby healthy? What about making sure mom looking after baby correctly?

Is it part of a midwifes role to ensure breastfeeding is established in each patient? Or is patient responsible for this?

gzoladz

How much are the birth practices in Ireland influenced by the catholicism, how it compares with 20 years ago and how do you see this evolving?

Lisha

What is your opinion on home births?

Is it, in your opinion, an unnecessary risk especially if the house is far away from the hospital?

A friend of mine had her 3rd girl recently. Long story short, all were by section and she had a very long journey to conception with a lot of intervention.
While waiting fur her section the midwives were saying 'surely its a boy' and then when it was a girl she was patted on the hand and told sure 'we'll see you hear again and better luck next time' .
She said thankfully she knew a 4th was out of the question and she has laughed it off but she feels another person could have been very upset by the careless comments.
Do other midwives old fashioned ways get under your skin at any time?

Thanks again for your time

clappyhappy

I have 2 very good friends who are mid wives, one is a manager. The stories they tell are sometimes priceless.

But as often said 90% of the time it is the best place to be, helping parents bring their new born into the world, but that other 10% is horrendous. Having to deliver a still birth or a baby incompatible with life etc. have you helped in a birth like that and do you find it difficult to remain “focused and without emotion?"

irish_goat

Have you had many teenage pregnancies to deal with? Are they particularly worse?

I'm A Midwife, AMA

Marz66 wrote: »

What will your birth preferences be for your own labour and why?

How is the relationship generally between midwives and doctors / anaesthesiologists? Do you ever disagree with their assessment?

Can you predict when an induction is going to fail and end in c section? If so, do you still think it is worth trying induction?

Are Irish women well prepared for labour?

Are patients allowed read their own charts?

Do you judge patients for choice of feeding method, choice of pain relief etc. Professionally I'm sure you shouldn't but personally?

What is your role on post natal ward? To ensure mom heals ok and baby healthy? What about making sure mom looking after baby correctly?

Is it part of a midwifes role to ensure breastfeeding is established in each patient? Or is patient responsible for this?

For my own birth I want to keep an open mind, ideally I would like to go into labour myself, though my mother had three inductions for being overdue, I will be employing hypnobirthing techniques and listening to my music as much as possible. I'd like to stay home as long as possible and remain upright and mobile. Ideally I would like to avoid an epidural, I hate the idea of someone putting a massive needle into my spine and having to sit super still while in pain to allow them to do it, though if I'm tired and I'm not coping then I'll absolutely get one. All going well I'd like to have the cord left intact for 2-4minutes and keep baby skin to skin for as long as possible. I'm happy for my baby to have vitamin K injection and I'm going to breastfeed.

Generally relationships between midwives and doctors are good, we respect each others roles, though there will always be personalities that don't get on. If we are unhappy with an assessment we will speak to them about it and occasionally go over a doctors head to their senior, we spend more time with the women than they do and can see changes that they may not pick up on right away.

We can predict when an induction will not work but I do think it's still worth giving it a shot most of the time. The odd time I really don't agree with making an attempt, having someone uncomfortable or in pain and have nothing productive occur at the end of it.

Many Irish women are not well prepared for labour, they know the word epidural and don't want to consider much else. I find many often don't want to "feel" anything at all, while pain and discomfort and hard work is a very normal part of labour, women want to be numb from the waist down and have nothing to do with it. I think not enough women go to antenatal classes, I've had some say to me "why would I go to them they're full of aul wans".

Women can read their own charts any time they want, guidelines tell us to write legibly and in a manor that can be understood easily, not to use medical jargon etc.

I never judge women for their feeding choice, it makes no difference to me what they do. Personally I think breastfeeding is the normal way to feed a baby, it's what I grew up seeing, I think to put a bottle of artificial milk into a babys mouth is grossly abnormal. I equally understand that women who grow up surrounded by bottle fed babies feel that placing a body part into a babys mouth is abnormal too. While I understand that women feel guilt around feeding choice it makes my job difficult when I spend a lot of time supporting someone to establish breastfeeding and on day three they decide to stop, despite all going well, because they "just wanted to try it" or they "didn't get enough help" or they're tired - this goes back to lack of preparation too, breastfeeding is a learned skill for both mum and baby but many wont give it a proper go.

The midwives role on the postnatal ward is to support new families in learning skills they will need to care for their new born baby, support feeding choices, observe mother and baby interaction, support mums mental health and well being, we perform basic observations and make sure the women are not in pain. In our changing population we are caring for more and more high risk women too, women with extremely high BMI or previous medical conditions etc.

Not really sure what you mean by is it part of the midwives role to ensure each patient establishes breastfeeding. If a woman wants to breastfeed she will receive all the support she asks for, we make sure that a few feeds at least are observed, assist with latch if necessary, make sure women know feeding queues, how to know baby is getting enough, different positions and how to hand express prior to discharge home. As I say above, there should be some onus on women themselves to prepare for breastfeeding, though very few do any preparation, from what I've seen.

I'm A Midwife, AMA

gzoladz wrote: »

How much are the birth practices in Ireland influenced by the catholicism, how it compares with 20 years ago and how do you see this evolving?

I'm not sure I can accurately answer your question, having not worked in the services for quite that long. I can say that in the units I've worked in there are no nuns any more and while some will continue to offer mass on a Sunday.

clappyhappy wrote: »

I have 2 very good friends who are mid wives, one is a manager. The stories they tell are sometimes priceless.

But as often said 90% of the time it is the best place to be, helping parents bring their new born into the world, but that other 10% is horrendous. Having to deliver a still birth or a baby incompatible with life etc. have you helped in a birth like that and do you find it difficult to remain “focused and without emotion?"

I have never attended the birth of a still born baby, though I have "discovered" a baby who has passed i.e listened to the heartbeat to find the baby has passed unexpectedly, I've looked after families before and after the birth of a stillborn and it is always shocking and very upsetting. I've also looked after families where babies are going to be sick after birth and babies who are critical or receiving palliative care in the neonatal unit. I don't think it's necessary to remain without emotion, if you form a bond with someone it's ok to become emotional and for them to see a tear in your eye, it's never ok for you to make the situation about you.

irish_goat wrote: »

Have you had many teenage pregnancies to deal with? Are they particularly worse?

I've dealt with a number of teenage pregnancies and like any other women they have their own personalities and ideas about what is right. Some will get on with things like absolutely natural born mothers and some will take some serious coaxing to do the basic things. Some will behave like absolute brats but as I say, that's not unlike any other women that we meet every day.

I'm A Midwife, AMA

Lisha wrote: »

What is your opinion on home births?

Is it, in your opinion, an unnecessary risk especially if the house is far away from the hospital?

A friend of mine had her 3rd girl recently. Long story short, all were by section and she had a very long journey to conception with a lot of intervention.
While waiting fur her section the midwives were saying 'surely its a boy' and then when it was a girl she was patted on the hand and told sure 'we'll see you hear again and better luck next time' .
She said thankfully she knew a 4th was out of the question and she has laughed it off but she feels another person could have been very upset by the careless comments.
Do other midwives old fashioned ways get under your skin at any time?

Thanks again for your time

I think that for low risk women who's partners fully support them home birth is a fantastic option, though as I said in an earlier post there is a culture of us and them, coming from both the "institutions" and the self employed community midwives, making the process of finding a midwife and attending both the hospital and the midwife during the pregnancy potentially stressful. As I also said in the above post if more hospitals and units had midwifery led units and homebirth schemes it would offer more choice to women, something scarily lacking in Ireland.

There are less and less of these sorts of old fashioned opinions where I work, thankfully. I would be horrified to hear such a thing.

cyning

I had an induction on my first: 5 rounds of gel: I've never read or heard of anyone receiving 5 rounds of gel: is it something you've ever seen? I did not cope with the pain at all on my first despite pethidine, gas and air and an epidural. My second another induction was a pretty perfect labour: despite only having a TENS and some has and air. Much less painful! In your experience do people cope much better on a second birth?

Also are you seeing any increase in people breastfeeding when pregnant? If never heard of it before it had my first and I fed until I was 16weeks pregnant: I'm probably a total hippy at heart though I had a midwife ask me how I got pregnant when breastfeeding... Try explaining that one!!

Marz66

Thanks so much - your answers are really interesting and informative.

seventeen sheep

I'm A Midwife, AMA wrote: »

For my own birth I want to keep an open mind, ideally I would like to go into labour myself, though my mother had three inductions for being overdue, I will be employing hypnobirthing techniques and listening to my music as much as possible. I'd like to stay home as long as possible and remain upright and mobile. Ideally I would like to avoid an epidural, I hate the idea of someone putting a massive needle into my spine and having to sit super still while in pain to allow them to do it, though if I'm tired and I'm not coping then I'll absolutely get one. All going well I'd like to have the cord left intact for 2-4minutes and keep baby skin to skin for as long as possible. I'm happy for my baby to have vitamin K injection and I'm going to breastfeed.

That all sounds perfect! It must be great seeing close up exactly what works best and what doesn't work so well for other women giving birth. I was one of those women with the epidural late on in labour, and it was absolute hell trying to remain still through several close contractions while he was trying to put it in.

Have you had the experience yet of being midwife for one of your colleagues (or anyone you knew)? Is it strange or uncomfortable at all, or does it make the whole experience even more special?

At what point (if any) does medical necessity override the wishes of the mother or next-of-kin? Example - say if you have a mother in labour at or close to full-term, who absolutely explicitly refuses a C Section no matter what, and the baby's father backs her up, and the Section is urgently required to save the baby's life. Maybe this has never happened in your experience, but what do you think would happen if it did, and if the parents weren't budging? Assuming the decision urgently had to be made there and then.

If you weren't a midwife, what would your alternative career choices have been?

I'm sure that these days, in the case of any birth defects etc, problems are usually identified early in the pregnancy. But have you ever had cases where a problem only becomes apparent at birth? If so, would it be your responsibility to inform the parents or the doctors' responsibility? And would the parents be told there and then in the delivery room?

Do you find your role any more difficult now that you're pregnant yourself? As it's a physical job, I'm sure being pregnant will make it more difficult that way, but I'm thinking moreso from an emotional point of view. For example, does it make it harder for you to deal with pregnant smokers or addicts, or others who you know are damaging the baby through their lifestyle choices? I imagine it must make it harder to remain objective and supportive, but maybe not!

Thanks for all the answers - very informative!

gzoladz

I'm A Midwife, AMA wrote: »

I'm not sure I can accurately answer your question, having not worked in the services for quite that long. I can say that in the units I've worked in there are no nuns any more and while some will continue to offer mass on a Sunday.

Thanks. I supposed the question was more oriented towards how religion influences decisions in critical situations, etc

I'm A Midwife, AMA

cyning wrote: »

I had an induction on my first: 5 rounds of gel: I've never read or heard of anyone receiving 5 rounds of gel: is it something you've ever seen? I did not cope with the pain at all on my first despite pethidine, gas and air and an epidural. My second another induction was a pretty perfect labour: despite only having a TENS and some has and air. Much less painful! In your experience do people cope much better on a second birth?

Also are you seeing any increase in people breastfeeding when pregnant? If never heard of it before it had my first and I fed until I was 16weeks pregnant: I'm probably a total hippy at heart though I had a midwife ask me how I got pregnant when breastfeeding... Try explaining that one!!

Five rounds of gel is a long induction but yes, I've looked after women in that position, I'm glad to hear that you got to have a vaginal birth after it all. I imagine a big factor in your pain the first time was that 1. induction pain is very different form spontaneous labour, more intense and 2. you will have been wrecked from all that gel, your uterus irritated etc.

People cope differently every time, depends on what position baby is in, how tired they are, if they've been eating of vomiting the entire time. Generally speaking the second comes quicker so this helps massively.

If you've had a period when breastfeeding you can get pregnant, you're only considered "covered" while you remain amenorrheac and even then it's not a guarantee. Plenty of women breastfeed while pregnant around the world, fewer here in Ireland. If you were to continue feeding throughout your pregnancy and after your second baby was born your body would produce one type of milk for your newborn and another for your older child, it's incredible.

Dingle_berry

What do you think of elective sections? Should a section be performed when there is no medical indication? Do you think that tocophobia is becoming more common? If yes, why and how should it be dealt with?

How dependant is your practise on allied health care services like radiology and pathology? Do you ever find yourself stalled waiting for a test result? Would you prefer more bed-side testing or the central lab?

Do people ask and if they do, how do you explain, the difference between a Midwife and a Nurse?

I'm A Midwife, AMA

seventeen sheep wrote: »

Have you had the experience yet of being midwife for one of your colleagues (or anyone you knew)? Is it strange or uncomfortable at all, or does it make the whole experience even more special?

At what point (if any) does medical necessity override the wishes of the mother or next-of-kin? Example - say if you have a mother in labour at or close to full-term, who absolutely explicitly refuses a C Section no matter what, and the baby's father backs her up, and the Section is urgently required to save the baby's life. Maybe this has never happened in your experience, but what do you think would happen if it did, and if the parents weren't budging? Assuming the decision urgently had to be made there and then.

If you weren't a midwife, what would your alternative career choices have been?

I'm sure that these days, in the case of any birth defects etc, problems are usually identified early in the pregnancy. But have you ever had cases where a problem only becomes apparent at birth? If so, would it be your responsibility to inform the parents or the doctors' responsibility? And would the parents be told there and then in the delivery room?

Do you find your role any more difficult now that you're pregnant yourself? As it's a physical job, I'm sure being pregnant will make it more difficult that way, but I'm thinking moreso from an emotional point of view. For example, does it make it harder for you to deal with pregnant smokers or addicts, or others who you know are damaging the baby through their lifestyle choices? I imagine it must make it harder to remain objective and supportive, but maybe not!

Thanks for all the answers - very informative!

It's lovely to be a midwife for someone you know, provided you know them well - you don't want to look after someone you half know, that's just awkward. I'm really looking forward to being looked after by my colleagues and I'm really hoping it will be my best friend with me in labour. It's not like we're judging anyone's bits and pieces, it's all body parts. I have a close friend that does my bikini waxing too, some people find it a bit strange but I don't have an issue with it.

If something like a section is urgently required to save a babies life and the parents outright refuse then under our current constitution (which states the baby has equal right to life as the mother) a judge can be phoned and a section sanctioned over the phone, awarding the baby a ward of state in order to do so. It's not something that I know has ever definitely happened but I know it has certainly come close in a couple of cases. It has also happened that parents of babies in the NICU refuse treatment for their baby and the courts get involved, when life is at risk, as the baby is going to survive with reasonable quality of life. In the UK if a mother refuses section there is nothing that can be done about it, once she fully understands the risks to her babys life.

If I wasn't a midwife I'd love to be a baker, running my own cafe come gallery - it's all about buns in ovens!

Yes, while most birth defects are identified in advance there will always be one or two that slip through the net, we can never fully rely on technology. I've not been at the delivery of a baby with birth defects but no one jumps to any conclusions unless there is something very visible (cleft lip, for example), if we feel a baby has "dysmorphic features" we will ask the parents if the baby looks like anyone, getting a good look at the dad usually helps too and the baby will be examined over the following few hours and days for any other telltale signs of abnormality. If there is anything really suspected then the parents will be counseled and blood tests taken for genetics, these take some time to come back.

Physically it is challenging, it's harder to stretch to do certain things and the tiredness is a big factor. I don't find myself more emotional when it comes to things like smoking etc, the women I look after are all big girls and they know what they're doing can harm their baby but they have their reasons for doing it anyway. Moreso than addicts I find women not understanding the consequences of having really high blood sugar or ignoring the fact that they are diabetic in pregnancy very stressful, it's a serious thing but I'd never make anyone feel guilty for what they're doing, my role is as an educator and support person.

Hope those answer your questions!

I'm A Midwife, AMA

gzoladz wrote: »

Thanks. I supposed the question was more oriented towards how religion influences decisions in critical situations, etc

The only religion I've seen affect care situations in the last few years are women who are Jehovah's Witnesses. Some of these women will not accept blood products, even in life threatening situations. Most of the women will be taking iron therapy throughout pregnancy and have their iron level monitored closely so that if they haemorrhage they are at lower risk of requiring blood transfusion. The women discuss what they will and will not accept in the out patient department antenatally, informing us what they will and will not take.
I have heard of cases over the years where parents will refuse blood transfusion for their baby in the unit, causing their baby to become a ward of state for the duration of the treatment. Ethically a very difficult situation to be in.

Redser87

Thanks so much for your answers, it's fascinating, and congratulations on your own pregnancy!
Did you always want to be a midwife or did you consider other career paths such as nursing or becoming a doctor?

I'm A Midwife, AMA

Dingle_berry wrote: »

What do you think of elective sections? Should a section be performed when there is no medical indication? Do you think that tocophobia is becoming more common? If yes, why and how should it be dealt with?

How dependant is your practise on allied health care services like radiology and pathology? Do you ever find yourself stalled waiting for a test result? Would you prefer more bed-side testing or the central lab?

Do people ask and if they do, how do you explain, the difference between a Midwife and a Nurse?

There is a time and a place for elective sections. Do I think sections should be performed without medical reason - no, it makes me sad to see a woman have a scar on her uterus with no good reason, making her higher risk both in her recovery and future pregnancies. There can always be a reason found for a section, on a first time mum we rarely hear "section for maternal request", though this may be the case for repeat sections, if women do not want VBAC.
Perhaps tocophobia is becoming more common, perhaps years ago women didn't have choice or felt they couldn't speak about things, just got on with it - I'm not saying that's better. It's hard to know how to deal with it, apart from counseling throughout pregnancy (once it's identified) and try to do some preparation for birth. I've only met two or three women with true tocophobia requiring section.

I work in a big maternity hospital so much of our testing is done on site, sometimes we have to send women to the local general hospital for tests not done in ours but this doesn't usually take more than a couple of hours, in the day time.

People rarely ask me that and refer to me as "nurse" constantly, which I say little about but find irritating. A midwife is someone who can practice autonomously as the lead carer for low risk women and their families from conception through to birth and throughout the postnatal period, meaning we need to guidance from doctors when it comes to the normal.
I know very little about the role of a nurse to be honest, because I have never trained as one, I would be of very little use in a general hospital!

I'm A Midwife, AMA

Redser87 wrote: »

Thanks so much for your answers, it's fascinating, and congratulations on your own pregnancy!
Did you always want to be a midwife or did you consider other career paths such as nursing or becoming a doctor?

Midwifery wasn't something I always wanted to do. After leaving school, doing some travelling, working in retail and then returning home I took a job as an auxilliary nurse in the maternity hospital, did my care assistant training and gained a real interest in the role of the midwife. I undertook my training as a mature student and it's the best thing I've ever done, don't know where I'd be now if I weren't a midwife!

No interest in nursing, the wonderful thing about midwifery is how well the majority of my women are! I would not like to be a doctor, it's a long, hard slog to establish yourself at all, the hours are rubbish and the work is not nice either - as a midwife I'm an expert in the normal, doctors are only concerned with the abnormal.