Would you hire an independent midwife?

Coco's thread about birth experience got me thinking... how many of you would hire an independent midwife next time?

I had a fairly dismal birth experience that I won't go into, but part of it was definitely the NHS professionals who I feel (and know for a fact now) let me down tremendously. The thought of having to put any future pregnancy of mine in their hands again fills me with horror.

The alternative seems to be an independent midwife, who would provide a continuity of care that seems to be non-existent in Miton Keynes and who would attend the birth. Depending on pregnancy and health, it seems an IM would also attend a home birth without making the usual excuses that some mums are up against.

It seems to cost around ??3K for full care throughout pregnancy, birth and after, which is a lot of money - certainly for my family! So my question is: would you feel that ??3000 is justified for the peace of mind, or is it money better spent on family/investing in children's future/etc.?
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  • If I had ??3k spare I would definitely hire one, but I wouldn't make sacrifices to be able to afford it.

    B x
  • No, having had the birth i had and how i will be high risk next time i wouldnt want 1 midwife doing my whole care i would want all the services provided by the hospital, if my birth had been straightforward then maybe my feelings would be different,
  • If I had the money I would. Both my births were spoilt by what was imo inadequate and inconsistant care by the mw team. So much so after the first time that I had planned a home birth for my second, unfortunately it didn't happen due to meconium in my waters and again in hospital it was just not a nice experience. Neither were a traumatic birth in the fact that they were both born naturally and no foreceps or anything involved but they were major parts of the whole experience that could and should have been handled much better. It's a shame as I know that a big contributor to the general lack of care and professionalism is down to budget cuts and being short staffed. Particularly when I hadn't seen anybody at all for about 6hrs after the birth and I had to go and find someone to ask if I could go home and they said no as lo had to be monitored to check that she hadn't inhaled any of the meconium, when I pointed out that no-one had monitored her at all in the last 6 hrs they said that as she was my 2nd baby then I should know if anything was wrong with her breathing.

    I would definately consider an independant mw or a doula if I were to do it again.
  • Hi hon

    As you know I had 2 for my last pregnancy (they cost ??4k but a friend who hired 2 others negotiated her cost down from this by choosing to take out some of the visits). I had a great experience and the continuity of care was fantastic. Because I had a great home birth with them, I can say that every penny was worth it because I built complete trust in them over the months and was able to just get on with the birth without any anxiety.
    Had circumstances been different and Id ended up going in to hospital, I would only have been allowed to have 1 of them in the delivery room with me (or else hubby would not have been allowed in if Id have had both in there) and the mw(s) would have had to acted as a doula because they cant legally assist (hands on) with the birth in a hospital they arent insured in.

    Overall though I think they are definately worth it. Now that Im not working, we've scraped the money together to pay for another this time round as it's so important to me to be at home and I wouldnt feel that I could do that without having an independent mw. It's not only the care before and during the birth that is invaluable, but the care and support you receive afterwards.
  • piggypops - the IM is there alongside the hospital staff, a bit like an extra birth partner. The way I read the info I have is that the hospital still deliver the baby, and the IM is there at the birth to assist and reinforce the continuity and deal with any medical stuff that might need explaining. I think she also goes along to consultant appointments and things as support for you if you need it.
  • In a heartbeat!

    The aftercare of both my births was horrendous and during my second birth was horrendous too... my poor little ds had the cord wrapped around his neck twice and his heart beat was dropping dramatically for hours yet a dr never came when the midwife promised he would.. thankfully ds decided to get the hell out of there fast so he was fine but we where left that much that the midwife had no idea i was about to have him and was there just in time to pull my leggings off with the help of hubby.

    As for aftercare well just completely overstaffed, i was left for 2 hours with bloody sheets (i kept leaking through) as no one was there to find me new ones, breastfeeding help was non existent and i even supplied my own pain relief as no one bothered to ask if i needed any.. i could go on and on! I didn't even get a discharge letter for my dr or bounty packs.

    So yes i definitely would if i could! xx
  • Hi EmilyB, I had a fairly mixed experience with my care in pregnancy, I gave birth in MK General on 1st July but from 37 weeks I was admitted a couple of times due to high BP and queried pre-eclampsia so spent a bit of time there!

    My community care was in my home town run by midwives based at the Luton hosp but I chose MK to deliver as we used to live in Bletchley and knew the area and knew it would only take us 20 mins to get there. As it happened I went into hospital at midnight so it was a clear run! I had a midwife the duration of my labour which was just over 4 hours in hospital ( I wasn't allowed a water birth due to the high BP issue and risk of fitting??) and then still on the labour ward but recovering I had another couple of midwives and it wasn't until I was on the postnatal ward where the care sort of diminished. I was shoved in the corner bay which had 4 beds, there was one window and it was in someone else's bit and she kept the curtains closed. Considering I gave birth before 5am I was on the ward around 9 but had no paediatric check and I was so hot and exhausted I asked to go home that night after I had help with BF. It took about 4 hours for them to decide if I could go! I also had a MW come round and ask if I would talk to the media as they were doing coverage about the maternity services, ah yes, I'd love to be on camera 5 hours after having given birth without a proper shower - mental!

    Once I was home the community care was much better, as I was having BF problems the team sent over their student who was just about to qualify, she was just fab and visited me 3 days in a row off her own back.

    I don't know if I would be high risk in my next pg as they decided I had pregnancy induced hypertension and was consultant care for my last 3 weeks but the individual care independents offer is very enticing, especially for a first time mum. If I had the money I probably would, but not in place of more long term things.

    Sorry to hear some of you had a rough time with your birth experiences, mine could have been better and it wasn't what I wanted but I think as my birth was fairly straightforward ( although they strapped me to that bloody monitor round my bump the whole time) I didn't have too bad a time, plus the hospital were under a serious review and still are. You can really see where they are understaffed as they just don't have the time for everyone but all it takes sometimes is one complete star of a midwife who just explains things to you to give you a more positive experience.

    May have been complete waffle but just wanted to share, I have not spoken to anyone else who has been to MK, I think the independents do have their place.
  • If I knew at the outset that I would be in the hospital for my birth I think I would opt to have a doula, seeing as though the IM would pretty much have to act as one anyway (in the hospital). Doulas are generally not as expensive as IMs. You can also choose what level of care you require (ie before, during and/or after the birth). Maybe you could look into that as an alternative option too?

    http://www.doula.org.uk/utilities/userServices/search.asp

    x

    [Modified by: mummabear on September 06, 2010 01:48 PM]

  • but they cant actaully do anything in the hospiatl for insurance reasons so its a lot of money for a coach,
  • I think it's the care before birth that would interest me a lot too, I had atrocious antenatal appointments, they were, quite frankly, a joke. And aftercare was awful too - if I ever see my named midwife again I may have to stab her following the "I told you so" comment - yeah, an episiotomy is totally what I deserved for wanting to have a homebirth!
    Doulas look amazing... that's definitely a good option too!
  • I used one because I got seen by the midwife at 5 weeks pregnant and she wouldn't book me in for another appointment until I was 24-26 weeks pregnant. I did have 2 scans in that time (1 private, 1 NHS) but they were just scans, no time to discuss anything.

    I paid ??3k and even though we ended up with a ECS, it was still money well spent IMO. She guided me through every stage, when I didn't have a clue to what to expect. I still kept my NHS appointments and there was no problem using them both together. She was present at the birth, even though it was a CS and was such a help afterwards too. The care ended when my LO was 6 weeks old.

    I looked into the doula service but generally these are people who are only there for the birth. A much cheaper (generally only ??100's) option if that it what you are looking for.

    If there's anything in particular that you'd like to know, feel free to ask xx
  • Also just to respond to piggypops comment - my IM was on the books of the local hospitals as "pool" staff and did work the occasional shift there. Due to this, she was given permission to deliver my baby in hospital under their insurance. I understand this is common practice, as it's a way they keep up to date with things that are going on in the NHS.

    I actually didn't want her to deliver my baby, I wanted her there as my support, my voice if things got difficult and someone who knew exactly how I wanted my labour to go, who was only thinking about me and not what was best/cheapest option. Still was nice to know she could have done it, had I wanted her to. HTH xx
  • No I wouldn't. That 3k could be used in a million more tangible ways. But this is easy for me to say, as I was lucky enough to have excellent ante- and post-natal care with both my babies, and fantastic caring staff when I laboured and delivered.
  • I probably wouldn't personally, because they become a bit redundant if you end up in hospital (considering how much money we're talking about). If you were set on having a home birth then I would only use an IM that was personally recommended by someone I trust who has used their services - there are some bad IMs out there just as there are in the public sector.
  • I would.

    I have a very bad view of NHS maternity following the birth of my dd3 - and I don't want to offend anyone here, but this is purely my opinion based on what I have been through.

    I think that when women have good birth experiences in nhs hospitals it is despite the nhs maternity services, not because of it. The birth of my 3rd baby was such a bad experience that it stayed with me for long time afterwards, caused flashbacks, and destroyed my sex life for a good while to boot! Baby stopped breathing at a minute old, (was thankfully revived) and I haemorraged - the amount of support I got through this? Precisely zero! Any kind words of comfort? Nope. Any explanations at all? Nope - doctors just marched into the room and started injecting me, without saying a word to me or hubby! ffs!

    I really really believe that it would have been a different experience if I had had a doula or similar - purely to support me.

    I always consider my second birth really good - as it was so quick. But in reality I v nearly gave birth in the corridor because a mw tried to send me home, saying I wouldn't be having bubs that night!

    Sorry for the rant - I feel sorry for midwives being so chronically understaffed and overworked that it is like this. I think the mw-led birth units are probably a better bet?

  • i would if i had the money as i felt a bit let down with my hospital both times, we are ttc number 3 at the moment and im hoping for a home water birth if there are no problems.
  • I think that when women have good birth experiences in nhs hospitals it is despite the nhs maternity services, not because of it.

    Sorry but this is a preposterous thing to claim based on just on one bad experience! Why do people insist on tarring all NHS staff and trusts with the same brush after a negative experience? (I don't work for them btw).

    Like you and usually enjoy reading your posts, Totty - but can't agree with you here.
  • Hi PTB, I agree it is a sweeping statement - and I don't mind anyone disagreeing at all - but it wasn't based on just 1 experience. I have had 3 bad birth experiences (in 2 separate hospitals) and heard of countless. Both on BE and among family and friends. My opinion has also been influenced by various articles on maternity I have read, and documentaries on the UK maternity services.

    My opinion is that, on the whole, women are not treated as individuals and are not supported in their birth choices. Any requests I made were completely ignored - eg, wanting to give birth kneeling - No not allowed! And for no reason - except it seemed they wanted a 'managed' labour.

    One article I read - which was supporting a channel 4 documentary - had an investigative journalist looking into the state of our maternity hosps. She formed the opinion that maternity was onto a winner since the vast majority of women come out with what they went in for - with a live infant - and so will generally forgive a bad birth experience. She also said (which made me smile) that 99% of women would come out with a live infant if they gave birth on their own under a hedge!

    This same journalist said that when she took her info/article/film etc to her boss - they said it surely can't be that bad? She said it was.

    Anyhow - I'm sure that there are plenty of people that have had wonderful experiences - and I'm happy for them. But my experiences have left me scarred.

    I think there are some very good midwives in the nhs - dedicated and caring - but they are so overstretched they cannot do their job as they would like.

    Stories of women being turned away from hospitals, and being left on their own for hours on end, and no aftercare are so so common. But a lot of people just put it down to experience, move on and enjoy their baby. And quite right too.

    xx

    Just modified to add that yes, this is the way I see maternity services - which is why I think having a doula or something to be there to support and advise you would be a good thing if you can comfortably afford it. The hospital mw's are just always so rushed off their feet! I think that whilst they wouldn't necessarily change the outcome of a birth - ie, if you're going to end up with an emergency cs, then they wouldn't be able to change that.... BUT what they can do is make sure you understand what's going on, feel supported and in control. They can help out with pain-relief, birth positions, massage, breathing etc - which may actually prevent the need for an epidural. If anyone has had anyone in an NHS hospital able to give the time for all this to one patient - well, I think you are very lucky indeed.

    I think plenty of women do have good birth experiences on the nhs - what I was trying to say is that I don't think the way our maternity hospitals are run - target led etc - do anything to enhance a woman's birth experience. I just remember overwhelming feelings of being out of control.

    If I was to have another baby (which I won't) I would opt for a water-birth at home or in a birth unit. with a doula - or even go private. Wish I had had the courage to do it before!

    xx



    [Modified by: ~ Tottie ~ on September 07, 2010 11:57 AM]

  • Absolutely if i had the money. And definately a doula. I am in the process of researching becoming a doula myself image

    Unfortunately IM's could soon be a lost art. There are very real plans to ban them. Independent Midwives operate without insurance as there is none available to them. The government is planning to make it illegal for midwives to work without insurance therefore making independent midwifery illegal image

    Sad Sad world.
  • My only negative experience with having my daughter was that I didn't get any help really breastfeeding, and waiting so long to get to go home, so based on my experience an IM would be a waste of money for me

    It's a real shame that so many women suffer because the NHS is so stretched- the government needs to spend more money on university places for student midwives and not be wasting money on this stupid HS2 idea! Do we need another train service from London to Birmingham? No. Do we need more midwives in our hospitals? Yes. I don't know why they find this so difficult to comprehend. Maybe it's because they are mainly male

    Another upside to there being more student midwives is that once registered they will be more open to what may be considered "radical" by the older midwives, such as birthing positions, VBAC, physiological 3rd stage etc. This would hopefully make more women have a much better experience all round

    xx
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