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)!