Call the Midwife – or call a midwife you know and trust?

I enjoyed reading Sarah Johnson’s recent blog post on call the midwife.  I LOVE call the midwife and read the books when I was student; how I dreamed of working in that way – a local midwife, on her local patch, working with the local women, caring for them in their own homes.   

For most midwives, this way of working is a million miles away from the reality of midwifery care within the NHS; birth at home is no longer the ‘norm’, midwives work in large centralised units, women are very unlikely to be cared for by a midwife they have ever met, normal birth rates are incredibly low and the use of analgesia and the associated risks and side effects high.  Sarah suggests that birth stools are ‘standardised equipment’ in units, and women birth in up-right positions: statistics suggest otherwise, with the NCT citing in their research that less than 40% of women are encouraged to be mobile, upright and off the bed and their backs.  I myself have visited units where birth stools may be quietly gathering dust in the corner, where huge, shiney new units are built with just one ‘token gesture’  birth pool (despite NICE guidance stating that birth pools should be available to all women as an effective form of pain relief) and where one-to-one care is not always achieved for women in labour.   The NHS offers the best it can on a shrinking budget, with a hard working yet disillusioned work force, with a growing population, and with women presenting with more and more complicated pregnancies. 

My dream of practising as a 1950’s midwife might not quite have come to fruition, but I am honoured to have carved a way of working which comes as close as possible: I care for the same woman throughout her pregnancy, birth and postnatal period; I care for women and families in their own home; I attend home births (and follow the woman into hospital if plans change).  I may not have a bike (and am about to invest in a 4x4 to make work life easier), but I do carry my own equipment and have a big ‘Midwife on Call’ sign to hang on my dashboard when I am with a woman in labour! 

When a woman in my care goes into labour, they can call a midwife – they can call a midwife they know and they trust, who will be by their side until their baby is tucked up safely in their arms, who knows all about them and what is important to them.  That is Independent Midwifery – the recognised gold standard of care, a choice for women outside of the NHS.  And it is under threat.  Just as that 1950’s midwife is no longer recognisable, so too, might be Independent Midwives; EU directives, insurance issues, and a government failing to deliver on its promise to really offer choice are seeing to that.

So, women, mothers, midwives, fathers, grandparents – if you LOVE Call the Midwife like me, if you LOVE the idea of calling a midwife you know, if you LOVE the idea of care in the home being the norm, then make sure you make a call to your local MP and tell them that!

You can find out more about this issue by visiting www.northsurreymidwives.co.uk

Even a future Queen to be is still ‘just’ a Mother to Be.

The exciting news was announced that The Duke and Duchess of Cambridge are expecting their first baby; whilst the Duchess recovered from Hyperemesis Gravidarum (a debilitating acute from of morning sickness) and amidst all the excitement and media hype, was the devastating outcome of the ‘prank call’ and the everlasting ripples from the fall-out:  not the most positive start to a pregnancy for any couple, yet alone a couple who are prominently held in the public eye.

So what next for the Royal Couple? Well, just like any other new parents-to-be, before any of the screening, bloods, ultrasound, place of birth, type of birth choices they make, they might like to consider who they invite to care for them; they may choose to have their care with a private obstetrician, or they may choose to use their local NHS system, or they may seek a known midwife to support them in their pregnancy; but they do have a choice over all of these.   Essentially, having someone to talk to might make negotiating all those choices a little easier!

If I was Kate’s midwife (as her midwife, I would call her Kate, and she may call me Angela), I would spend time with her talking through her options; in-between appointments (that would be in her own home, and at convenient times, with appointment times that William could also come to) I would encourage her to read widely; some books I might suggest to her would include ‘Ina May's Guide to Childbirth’, Childbirth without Fear: The Principles and Practice of Natural Childbirth ’ and ‘What Every Parent Needs to Know: The incredible effects of love, nurture and play on your child's development’, as well as giving her up to date information on nutrition, screening and normal pregnancy ailments.   (I did google pregnancy books for Royalty, but it just found the Royal Free in Hampshire!)  We would drink tea together, share concerns, and build a trusting relationship, and she would feel secure in knowing that she would be well supported in her choices, and that on the big-day, someone she knew would be at her side when her baby was born.

This type of midwifery care enables women to really make choices; we also know that they are more likely to have a normal healthy pregnancy, a  normal straightforward birth, more likely to establish breastfeeding, and less likely to experience postnatal depression.   Pretty compelling reasons as to why one-to-one midwifery care is so important, and why it is essential that women know that this is the care they should receive as the norm, that they should be shouting loudly for, and that shouldn’t only be open to those whose NHS trust is forward thinking, or those who can engage an Independent Midwife like myself, and whose way of working is under threat.

The hype around the beginning of The Duke and Duchess’s pregnancy will hopefully settle and they will be able to look forward to the next 8 months or so (albeit it being very much the talk of the nation).   Expecting a baby, is for most people, a joyful, exciting event;  but every woman, whether it’s her first, second or subsequent baby, may still have the same anxieties, the same pregnancy complaints’ and may have to make some of the same choices that other mothers will – even if she is a future Queen!