[AutumnAir]

I thought I'd ask here to see if I was way off-base with my expectations. I had a traumatic HB - hospital transfer, and a lot of the problems stemmed IMO from my having totally different expectations of my midwife and what she would and wouldn't do than she had of herself.

So, what do you mamas expect of your midwife?

 

[dogmom327]

Broadly speaking, I expect her to play lifeguard. Essentially to observe the process, offer helpful suggestions and intervene if things go badly.

 

[Peony]

First off, I'm not an easy client, I don't go along with anything just because someone said so. My MW selection process can be interesting because the MW I choose needs to be ok with what I want and don't want. Many are not, and that's fine, but it wouldn't work for us to have a relationship.

I hire a MW for just in case. I don't do any testing, this pg I choose not to do any prenatals, my MW is basically just available if I want her to be which can be a tricky relationship for legal reasons. I do throughly line out what my expectations are and what my MW's are. During DD2's pg, after a couple of appointments, it became apparent that the MW I was seeing then had different expectations then I did regarding the birth, I had no qualms about switching to a provider, we were all happier then and it worked out for the best.

 

[hikingmommy]

Quote:

Originally Posted by dogmom327 Broadly speaking, I expect her to play lifeguard. Essentially to observe the process, offer helpful suggestions and intervene if things go badly.

I like your analogy. I'd add a bit to that, as my last birth was induced and ended w/ a c-section, so I haven't gone into labor spontaneously, nor have I given birth. I expect her to back off when I want her to and jump in when I want her to, but also to recognize when/if I should be doing something different and intervene regardless of what I say I want.

 

[alegna]

Quote:

Originally Posted by dogmom327 Broadly speaking, I expect her to play lifeguard. Essentially to observe the process, offer helpful suggestions and intervene if things go badly.

Very good way to put it. And on top of that- I don't want a micro-managing lifeguard

Quote:

Originally Posted by Peony First off, I'm not an easy client, I don't go along with anything just because someone said so. My MW selection process can be interesting because the MW I choose needs to be ok with what I want and don't want. Many are not, and that's fine, but it wouldn't work for us to have a relationship. I hire a MW for just in case. I don't do any testing, this pg I choose not to do any prenatals, my MW is basically just available if I want her to be which can be a tricky relationship for legal reasons. I do throughly line out what my expectations are and what my MW's are. During DD2's pg, after a couple of appointments, it became apparent that the MW I was seeing then had different expectations then I did regarding the birth, I had no qualms about switching to a provider, we were all happier then and it worked out for the best.

: In pregnancy I want my midwife to be a partner in the process, but a lesser partner. A resource. A go-to. Not a boss. Not a mommy.

In labor I want her to sit back unless needed.

-Angela

 

[Amber Lion]

As an aspiring/student midwife, a CBE, and a doula, I needed someone who could help me find balance between KNOWING so much and still doing it all for the first time. She needed to respect the knowledge I already brought to the table and help fill in the gaps. She needed to accept the first-timer fears and questions even when I already knew the answers and make me comfortable enough to express them when I knew I should already have known the answers.

She needed to be ok with what I said I wanted or didn't want at my birth and to know that if she said I needed to do something different, I would do it b/c that was what I was hiring her for, so not to take advantage of that - meaning, when in labor she said she needed to use the doppler even though we'd waited to listen to the FHR with a fetescope until I was 19 wks along b/c I wanted to avoid all ultrasound use I knew she *really* needed to hear the heartbeat and didn't argue the point, and again when she said I needed a shot of pit to stop my bleeding I *knew* it was necessary and didn't argue. I knew she would not have used these things needlessly.

I guess all that's to say I expected a level of trust between us that left us both completely comfortable with each other and anything that might have arisen. I got that trust and it was an amazing birth.

 

[Jilian]

I like the lifeguard analogy too. I expect my MW to use her knowledge to keep me and my baby safe (which she did and does perfectly). I also expect her to discuss things with me to allow me to make an informed decision every step of the way. We talk a lot prenatally about various situations that may arise and how they will be handled so I have a good feel of how she reacts ahead of time. I trust and respect her and I expect her to trust and respect me.

 

[munkeesmama]

Quote:

Originally Posted by dogmom327 Broadly speaking, I expect her to play lifeguard. Essentially to observe the process, offer helpful suggestions and intervene if things go badly.

Ditto this exactly. I would add that I also expected that she would offer emotional comfort/reassurance if needed/wanted.

 

[Overthemoon]

I just want my midwife there for guidance since this is my first homebirth and first natural birth. If I feel pain and feel I won't be able to go on, I want her to talk me down and help me to make it through. But I don't want her to be too involved, like if I want to labor with just dh and I, I want that respected. But I do want her here to deliver the baby. Everything I've gone over with her seems like we have a good meeting of the minds as she is comfortable just doing what I prefer.

 

[sunflowergirll]

I am not sure what I want my midwives to do. My first birth was hospital all-the-way. Induction/epidural etc. I thought that was what I wanted at the time.

This time, I am still scared of pain. I'd like my midwives to be involved. To be there constantly, help me (massage, etc) and give me tons of encouragement. My husband is very supportive, but I don't think he'll know how to support me in labor without specific direction.

I'll let you know what how it went in a few weeks

 

[Carmelturtle]

In the beginning of this pregnancy I still had reservations and was harboring some feelings about having a HBAC. I thought I wanted an experienced midwife and that's all that mattered. Then slowly I became more educated and passionate about homebirth. Then my expectations changed of my midwife. I realized that even though the one I was seeing had been doing VBACs for decades, was not right for me. She was more "hands-on" and to be quite honest, a little arrogant. I switched recently and love my new midwife. I would say she is an Ina May incarnate. She's very mothering and nurturing - but at the same time VERY hands off. Like the pp said about the life-guard (love that) she will be there to observe and only "jump in" if I need her to

 

[JamieCatheryn]

I expect my midwife to reassure us that everything's within the range of normal as things are going on (which we'd already know normally, but as it's happening a voice of more experience helps). I expect her to be reachable to consult about early labor on the phone, and come over and do some knitting in the corner or other room when things progress. She should help to watch out for problems large and small, check baby with a Doppler intermittently while she's here, and tell us if she sees something happening (I'm familiar with complications, medical shorthand would do even) and suggest in a quick dialog with us just what we can do about it in case we panic and can't think straight in response. She should help correct minor things like malpositioning or keeping me recharged that would get in the way if they didn't get fixed. She should help in sudden emergency situations like shoulder dyscotia, an infant needing resuscitation, or hemorrhage.

I feel very confident this is what I'll get from her, both by her attitude as we've met with her through pregnancy, her approach to prenatal care, and by her discussion of her role at a birth.

 

[Talula Fairie]

I want her to hold my hand when things get really intense, talk me down if I start whining I want to drive to the hospital for my epidural, keep me and baby safe by having all the equipment, medications, ect. I expect her to make the judgment call in time if we have to transfer for a medical reason (highly unlikely, but possible). I would like help cleaning up, postpartum and newborn care. And of course, prenatal care.

I love my midwife, she's been great so far

 

[HippieWannaBe]

Quote:

Originally Posted by dogmom327 Broadly speaking, I expect her to play lifeguard. Essentially to observe the process, offer helpful suggestions and intervene if things go badly.

Yeah that!

 

[rixafreeze]

I UC'd my first, so I am coming from a place where I know I just need to be left alone. So, for this birth, I am seeing a midwife and told her "basically I am paying you to do nothing, unless I ask for it or unless an emergency situation arises." I don't want emotional support, coaching, help with breathing, massage, suggestions, perineal support/massage, etc. I just want her to stay out of my way and just be there if I need/want something. There were one or two things we worked out between our comfort levels:
- She will check heart tones but otherwise leave me alone during labor
- She would like to be present as the baby's being born but is happy to sit in a corner and just quietly do nothing (I might actually ask her to take pictures, which is a great way of making sure she can't *do* other stuff! LOL), including in the postpartum period. So no hats, blankets, bulb suctioning, etc. She'll stay out of my line of sight and, unless there are warning signs of something funky going on, observe silently.

These two things were big ones for me to compromise on, but I also understand that if I invite a midwife to the birth, they would like to have their own way of knowing the baby is doing okay.

 

[AutumnAir]

(OP here) Sounds like I'm not totally weird then.

I too wanted my MW to be pretty hands off, but I did expect her to be able to identify potential problems and to be able to deal with most of them at home. I expected her to be respectful and supportive of me, and to have faith in my body.

Unfortunately that's not what I got. DD was malpositioned (she turned posterior during labour and was possibly also asynclitic - I figured all this out later by myself). Her bad position led to me experiencing labour as one never-ending contraction, through which I couldn't talk and had a really hard time doing anything other than just breathing and trying not to fall apart.

As soon as she walked in she started criticising how I was breathing. When she checked me ( I had agreed to one VE on her arrival, and one when I felt like starting pushing) I was already 7-8 cm. But she just turned and made a comment to my DH about how this was going to take a long time. I'm guessing she realised that DD was malpositioned then, but didn't bother to tell me or to suggest anything to try to correct it.

She also commented about how I was getting dehydrated, but didn't offer me anything to drink. I was totally beyond being able to get up and go to the fridge, pour and drink something and nobody seemed to care that I hadn't had anything to drink for about 12 hours by now (though really that was supposed to be my DH's job).

After a couple of hours went by she insisted on doing another VE, even though I had no urge to push. She declared that I was 10 but with a lip. In my head I was frantically trying to remember what I'd read about dealing with cervical lips. I could remember something about arnica, using ice to unswell it maybe, but I couldn't *say* anything. Yet again no suggestions for dealing with this. From this point on either she or her assistant were constantly holding the doppler on me, and freaking every time the baby moved and they lost the heartbeat. Another couple of hours later and she said I needed an enema. Really not something I wanted but I was just incapable of speaking up for myself - incapable of speaking full-stop. So I had an enema, in my never-ending transition, with back-labour and nonstop contractions. Certainly not a pleasant experience.

Finally about 3-4 hours after she had checked me and I was at 10 with a lip she stated that we were going to the hospital or she was leaving. I *really* wish I'd just told her to get the he!! out of there, but I wasn't prepared to UC and because I trusted her I believed that there really was a problem that wasn't 'dealable with' at home. She promised that she would come with us to the hospital and act as a doula there (also as a translator, since we live abroad and don't speak the language very well).

Well, she drove us to the hospital but then abandoned us there. I ended up being birth-raped by the doctors as 'punishment' for having tried to homebirth (this is a very anti-homebirth country).

It's been over 15 months and I still can't figure out why a midwife would act like this. She's one of only a few in the whole country but is quite well-known and speaks out frequently on the need for more birth-choices for women. She is trying to establish the first birthing centre in the country. She interviewed really well, was lovely during the prenatal visits... I just feel betrayed.

Plus the reading that I've done since has turned up heaps of things we could have done/tried at home, from simply changing positions more often ( I would have needed physical help and encouragement to do this) to manual dilation of my cervix as a last resort, which is what they did in the hospital anyway. Now, if I as a layperson, with no other birth experience can find all this information (and could even remember some of it in the middle of labour, though I couldn't communicate it) why on earth wouldn't a midwife know these things. That *is* their job isn't it?

Yes, most births progress just fine without any intervention. But most women do appreciate some support and encouragement in labour, along with maybe a glass of water. And a midwife should be able to identify and correct most malpositions themselves. If we'd tried a whole bunch of things - positions, rebozo, ice/arnica, manual dilation etc. and still had no progress then maybe I would have felt a bit better about the 'need' to go to the hospital. Where she should have stayed with us to keep an eye on the doctors and what they were doing and maybe warned me in time.

Wow - sorry that got so long. I've just been wondering for the last 15 months whether my expectations of what a midwife does and doesn't do were totally off. Seems like my expectations were pretty similar to most people's here. So maybe I got my MW on a *really* bad day, or maybe she talks the talk but doesn't walk the walk..

 

[Overthemoon]

Quote:

Originally Posted by AutumnAir (OP here) Sounds like I'm not totally weird then. I too wanted my MW to be pretty hands off, but I did expect her to be able to identify potential problems and to be able to deal with most of them at home. I expected her to be respectful and supportive of me, and to have faith in my body. Unfortunately that's not what I got. DD was malpositioned (she turned posterior during labour and was possibly also asynclitic - I figured all this out later by myself). Her bad position led to me experiencing labour as one never-ending contraction, through which I couldn't talk and had a really hard time doing anything other than just breathing and trying not to fall apart. As soon as she walked in she started criticising how I was breathing. When she checked me ( I had agreed to one VE on her arrival, and one when I felt like starting pushing) I was already 7-8 cm. But she just turned and made a comment to my DH about how this was going to take a long time. I'm guessing she realised that DD was malpositioned then, but didn't bother to tell me or to suggest anything to try to correct it. She also commented about how I was getting dehydrated, but didn't offer me anything to drink. I was totally beyond being able to get up and go to the fridge, pour and drink something and nobody seemed to care that I hadn't had anything to drink for about 12 hours by now (though really that was supposed to be my DH's job). After a couple of hours went by she insisted on doing another VE, even though I had no urge to push. She declared that I was 10 but with a lip. In my head I was frantically trying to remember what I'd read about dealing with cervical lips. I could remember something about arnica, using ice to unswell it maybe, but I couldn't *say* anything. Yet again no suggestions for dealing with this. From this point on either she or her assistant were constantly holding the doppler on me, and freaking every time the baby moved and they lost the heartbeat. Another couple of hours later and she said I needed an enema. Really not something I wanted but I was just incapable of speaking up for myself - incapable of speaking full-stop. So I had an enema, in my never-ending transition, with back-labour and nonstop contractions. Certainly not a pleasant experience. Finally about 3-4 hours after she had checked me and I was at 10 with a lip she stated that we were going to the hospital or she was leaving. I *really* wish I'd just told her to get the he!! out of there, but I wasn't prepared to UC and because I trusted her I believed that there really was a problem that wasn't 'dealable with' at home. She promised that she would come with us to the hospital and act as a doula there (also as a translator, since we live abroad and don't speak the language very well). Well, she drove us to the hospital but then abandoned us there. I ended up being birth-raped by the doctors as 'punishment' for having tried to homebirth (this is a very anti-homebirth country). It's been over 15 months and I still can't figure out why a midwife would act like this. She's one of only a few in the whole country but is quite well-known and speaks out frequently on the need for more birth-choices for women. She is trying to establish the first birthing centre in the country. She interviewed really well, was lovely during the prenatal visits... I just feel betrayed. Plus the reading that I've done since has turned up heaps of things we could have done/tried at home, from simply changing positions more often ( I would have needed physical help and encouragement to do this) to manual dilation of my cervix as a last resort, which is what they did in the hospital anyway. Now, if I as a layperson, with no other birth experience can find all this information (and could even remember some of it in the middle of labour, though I couldn't communicate it) why on earth wouldn't a midwife know these things. That *is* their job isn't it? Yes, most births progress just fine without any intervention. But most women do appreciate some support and encouragement in labour, along with maybe a glass of water. And a midwife should be able to identify and correct most malpositions themselves. If we'd tried a whole bunch of things - positions, rebozo, ice/arnica, manual dilation etc. and still had no progress then maybe I would have felt a bit better about the 'need' to go to the hospital. Where she should have stayed with us to keep an eye on the doctors and what they were doing and maybe warned me in time. Wow - sorry that got so long. I've just been wondering for the last 15 months whether my expectations of what a midwife does and doesn't do were totally off. Seems like my expectations were pretty similar to most people's here. So maybe I got my MW on a *really* bad day, or maybe she talks the talk but doesn't walk the walk..

Oh Lisa, I'm so sorry, my heart aches for you reading what you went through. It sounds like she was a sucky midwife. I'm sorry she took what should have been a great experience for you. Hugs to you.