Tell me about the midwives and the, your experience of being cared for by the midwives?

Yeah, like I say, they, they were brilliant. They were really good, they gave me all the information that I needed and they you know, told, told you everything you needed to know and it’s just nice to go in for your check-ups and know you were going in for your check-ups to, so they could tell you everything was in the right place and, you know, everything was going fine and theres nothing wrong with you. Because you can become quite paranoid about things being wrong and but no, they really put my mind at ease and they, they were very good.

Did you get paranoid occasionally?

Yes [laughing].

Tell me what you got paranoid about?

Just, you just think, oh it’s not moving today or, you know, there must be something wrong or just general, just generally that, actually, the, the movement thing, when they start moving at, what is it? 5 months or whatever, 4 or 5 months, that was when I started to become more paranoid because, you know, oh, hes not moving today, what’s wrong? Blah, blah, blah, and I was waiting for my midwife appointments so I, you know, so they could confirm the heartbeat and, you know, everything was fine but no, they, they were good. And I think they should, shouldn’t, because I heard that they were trying to stop, trying to not to have so many midwife appointments in, in the future. I don’t know if that’s still going on but I don’t think they should do that, definitely not.

Is there any advice that you would offer to health professionals, midwives or GPs or whomever, about how to be, you know, about what pregnant women need that they may not be getting?

No, not, I mean, like I say, they need to, to definitely, to see their midwives as often as, as they can, really, I think that’s, that’s very important. And you know, probably more often than, than you do actually go in the, in the beginning. Because in the beginning you’re only going every, once every 2 months to see, for your midwife check-up and I think you should be able to go when you like, really. That would be good.

How did you feel in between appointments?

I just felt that I wanted to go more often just to make, just to make sure everything’s okay and I think especially with your first baby. I think when you’ve had a baby and you know, you’ve been through the experience and you know what’s going to happen to you, you need, you know, you know what all these feelings and stuff that are going on. But yeah, like I say, especially with your first pregnancy, I think you need extra midwife attention. With the second one or third one or whatever, you’re a bit of an old hat at it so I don’t think you need it so much.

Were you able to ring up your midwife in between appointments?

You could do, yeah, yeah you could do.

Did you ever do that?

I didn’t, no.

Why not?

Because I just, I feel that all the people that work on, on the NHS, for the NHS, are very, very busy and I just, you know, nothing was wrong with me, nothing was wrong with me ever. So I didn’t feel the, the urge to, to, to ring her and, you know, for no reason, so.

Were there ever times when there was just something that was bothering you and you would have quite liked to be able to speak to somebody? Or just be reassured?

Yeah, yeah, there was, there was times, like I say, if I’d had a couple of days of no movement or, you know, a day of no movement and you’re supposed to have 10 movements a day and I’d only had 6 that day or something, [laughing] I’d think, ah. But it’s just something that, you know, you, you are more paranoid about, about things and, like I say, especially with your first baby.

Well, in my doctor’s surgery they have a midwife come round once a week, comes in and does the clinic there. On the whole it was fine. I mean, the only times was, there was quite a lot of women having babies around the same time as me, so when we got to the 32nd week and you’re supposed to go in every week for a sc-, to be checked, that she was booked up with people to see. And that happened even like quite, quite close to the end, like even when I was 38 and 39 weeks. I think there was one of those weeks I didn’t manage to get to see the doctor, see the midwife. And obviously I did feel a little bit anx- – well, not really anxious, but it’s sort of like, that’s definitely the sort of time I think you definitely need to go and see someone a lot, whereas in the earlier stages you can perhaps miss an appointment and, you know, feel relatively relaxed.

So that was the only thing for me, do you know what I mean? I felt maybe they hadn’t prioritised well enough who they were going to see. Even though they were quite busy maybe they should put people who were at the end of pregnancy as a priority to be seen, rather than people who were just in the very middle of their pregnancy or something who can perhaps, do you know what I mean, miss an appointment or something like that. So that was the only thing if, if there wasn’t enough, there wasn’t enough health professionals in my, in my surgery to sort of – or they didn’t have enough time to see all the women in the area, you know, which made you – I don’t know. Yeah, I did feel a little bit [laughs] – how can I say? Yeah, it did make me feel a little bit – not neglected, but I did feel a little bit sort of like, Oh, maybe she doesn’t want, I’m not sure if she liked me very much. It sounds sort of a funny thing to say, but she was nice, she was a nice woman [laughs].

You said that your relationship with the midwife was sort of spoiled by her assuming that you’d want to have a termination because you were young and single and pregnant. Can you describe to me what it was like having to be cared for by her, given that situation?

Well, it, it was difficult. After, after my midwife had done this assumption of having the termination and asked if I needed a social worker, you know, I’m a very competent, capable Mum, well I think I am, anyway [laughing]. And to, for her to be assuming like that, because I was on my own and young, made it difficult for her care of me the rest of the pregnancy because, like I say, I didn’t feel comfortable. I didn’t feel comfortable with her because I felt like shed, shed judged me and I wanted to be confident and happy in my pregnancy and, you know, it just, it just meant that I couldn’t really open up to her. If I had difficulties, I feel if I was, I was finding, finding difficulties, I didn’t want to go to her because I’d, you know, I didn’t want to reinforce what shed thought, that I was perhaps, discovered to be struggling because I was in my situation.

Was there anybody else that you could go to for advice and support?

I’ve got lots of friends and family that have been fantastic so in, in one respect, to be honest with you, second, second time round, this pregnancy, I wasn’t too bothered, actually, by the whole health care thing because my family and friends were fantastic, so. And the, towards the end of the pregnancy I was taken, my care was taken over by a consultant because of the problems I had at the end of the pregnancy so I didn’t see that much of her in the end so it was okay.

Didn’st get the information you wanted, what would have made your experience much better do you think?

Just not being treated like a disabled person because I just felt I was being treated like a disabled person, like, you know, because most women, they can go in and have a talk with the midwife and that but, even though the midwife was really nice and supportive, in a way, she didn’st really talk much to me about things. It’s like when like she checks to see if the baby is okay, she just goes, Yep, the baby is fine. And then that’s it. She didn’st like explain anything, so in a way, it’s put me off being pregnant again in in case, you know, just same same treatment.

[mm]

Because I just didn’st enjoy it at all. I couldn’st wait for it to finish.

I feel extremely fortunate in the midwife that I had. She was my key anchor person through the whole of my antenatal care and she was first class. And I think for me to say, for me to say that [laugh] means that she was really excellent, because I do tend to be quite discerning, I think, and possibly overcritical sometimes in the way that, that professionals interact with me. She, she has responsibility for training other midwives as part of her job , and so shes very much up to speed with the latest in thinking, clinical practice, and shes also sort of underta-, I know that shes undertaking a degree at the moment and shes clearly continuing to develop herself as a midwife clinically.

She, but apart from her as a clinician, her as a person did make a big difference. She, she very much respected my need to express my own views about my pregnancy. The pregnancy went on beyond the due date and my little boy ended up being 11 days late and that, that was an example of, of her sort of collaboration with me I suppose in terms of how to proceed with my care, and it always felt that I was in control, which is very important to me. I suppose I was fairly well informed as a patient, as it were, and she said a couple of times to me, ‘That’s not the sort of thing most people ask me. Or, she did say to me, ‘You are very well informed, you know, and gave me that feedback.

You didn’t always get the same midwife, you had all different ones. Some of them were, some of them were nice. Some of them were a bit funny with you. They’d just like, ‘Lie on the bed. Check the baby’s heartbeat. Oh, yeah, that’s fine. Urine. That’s fine. Okay, see you in three weeks, or see you whenever’ do you know? Other ones they’d sit there and talk to you and ask you if you’d got any problems and things like that. It’s like, my midwife actually that I went to first when I found out I had my SPD [symphysis pubis disorder, pelvic joint pain] and my midwife like explained everything to me. Because when I asked the hospital the hospital just said, ‘Oh, it’s this and… The way the hospital talk it was like all medical terms and I didn’t really understand what they were going on about, because it was all dead long words and things like that.

So I went and asked my midwife, made an appointment and asked my midwife, and my midwife explained what everything was for me. And it was like, it was better for me really because it was the midwife that I used to get on with. She was really nice. She explained that, what to do and things like that and that. To wear my back brace. And she was always checking the baby to make sure the baby was in the right position. But other than that she was just fine, she was lovely.

When I came to the UK, in order to hook into the system I had to register myself with a GP immediately on arrival. That got me into the NHS system. But actually we were hoping to have a home birth with an independent midwife, and so I needed to hook into another system as well, which is the Independent Midwives Association system. They have a website which allows you to search by region for an independent midwife, which I had done before I had left the country I was living in previously. And I had been trying to do as much research about the options open to me as possible before I arrived so that I could click straight into the system instead of having much of a delay. Obviously at seven months theres potentially not much time to waste. And so I had been in touch with a few different independent midwives and come up with a shortlist of people I would like to speak to. And I did only one interview with an independent midwife in this country before I found someone I thought was highly suitable, and went with her.

Okay, so you were, I take it then you were planning to interview a few and pick the one you liked the best?

Yes.

Right, so what were your criteria, what, what did you want your midwife to be like?

Well, I placed a high priority when selecting a midwife on, an independent midwife, on the way that our personalities related to one another, because I think that giving birth is a highly personal experience, highly private experience and you need someone who is going to mesh with you in that, in that way. You need someone that you can trust. And that was definitely one of the factors in choosing to have an independent midwife as opposed to giving birth within the NHS, because I wanted that continuity of care, that was really important to me, that I would know the person who was going to help me give birth. Also she had to be experienced [laugh] and, and up to date in all her training obviously, I think that goes without saying.

I think one sort of thing that surprised me was how important exactly what people say to you is, and I don’t think I had cottoned on to that before. That somebody can say something which they probably only mean as a throwaway line but when you’re the patient you, it has enormous importance for you and you go home and you think about that particular phrase and the words that they used and wonder, you know, did that have any special meaning? Was there a- more of an implication than they said?

So I think I’ve become much more aware of that. The other thing was I think I was surprised at how I felt about seeing a different doctor every time I went to the antenatal clinic and I hadn’t really thought that that would be that important to me but in fact it was. And I saw somebody different every time I went which wasn’t entirely satisfactory. This was at the antenatal clinic rather than the IVF clinic;

At the IVF clinic I, I suppose because I was there longer, spending longer there you build up a good relationship with one or two people and that was I think very important, really, because they supported you through that stressful time. And I know that the antenatal clinic is different because they’re busy and they’re only seeing you for a short time. But I think that I, I was surprised at how important it seemed to me to see the same person at the clinic when I went.

Did it- I mean how did it make you feel that you weren’t able to see the same person every time?

I think I was slightly disappointed that I didn’t see the same person every time. And also because I got slightly conflicting messages from two different doctors that I saw at one appointment and then one that I saw four weeks later. So I felt that maybe there wasn’t much continuity- much communication within the team, which surprised me a bit. And it disappointed me a bit as well.

Did you point this out to them?

I pointed it out later on to the consultant because the fact that- on the same day that I had seen one doctor I saw the consultant later and I told her that two members of her team had given me different advice and, you know, she was very nice about it and said, you know, that maybe we wouldn’t in retrospect have given you the advice last time that we gave you if wed, you know, if wed thought about it. So yes I did point it out to her and she took it on board I think.

And what kind of care did you have, was it midwife led, GP led or..?

Midwife-led both times. First time, first pregnancy it was a midwife team. I can’t remember the name of it. It’s a midwife team and they basically are in the community and in the hospital, and they follow you within it, which is supposed to be quite good because it’s consistent, maintains the personal contact, history etc, and that, I can really see the advantages. However, if you get a duff midwife they follow you everywhere and you can’t get away from them, and you can’t get any other opinions, and they’re scuppering it all. So not so good for me.

Tell me a bit more about what the issues were with her and why you felt that way?

There were a few different issues. Basically she was a very nice lady, very chatty, affable. I think she genuinely wanted to help and meant well. Her personal skills, her interaction skills were good. I just think it was basically a lack of knowledge, a lack of, either a lack of training or a lack of ability to retrain, retain the information and training that she had had. So that was an incompetence area, really.

What sort of things?

She, also I think she was too, she didn’t really stick up for you enough. She was too easily swayed by if a doctor said, ‘I want to do this, then her role is really to support the woman, and she didn’t really. She sort of tried to persuade the woman to do what the doctor said, because she felt very subdued by the doctor. I don’t think she was very confident within her role.