With care and constant attention

Ok, so I went away and checked out the Independent Midwives (IM) Association and found the details of some IMs in our area. Things didn't start too well when the first one I contacted was fully booked and told me another was fully booked also. She did, however, recommend the final IM on my list and said it was worth contacting her as she thought she might have some capacity. We dropped the IM an email and she confirmed that yes, she did have a vacancy, as sadly someone previously booked with her had lost a baby - eeek.

So M_, the midwife, and I arranged an initial meeting for me and F_ to meet with her, talk about her services and see if we clicked and wanted to go forward with her providing our care.

She came round the next evening and we spent about 90 minutes chatting. This represented more time than all the antenatal care I had had in the preceeding 29 weeks put together! She seemed very nice.

The success of the meeting left me with a major problem - how we would ever finance this enterprise. Having recently moved we are still recovering from the financial strain of the move and have to pay off our furniture in October. I couldn't see how we could go ahead and felt despondent. The next day however, lady luck intervened and some unexpected money came my way meaning that we only had a modest portion of the total to find ourselves and so I went ahead and emailed M_ to book her.

Word cannot describe how I feel a great weight has been taken from my shoulders. I hadn't realised just how much stress I had built up over the whole issue of my midwifery care until the issue was taken away. I now feel that I can have the personalised care that I need to have a happy pregnancy, birth and postnatal period. The stubborn part of me does think that I should have been able to have this care on the NHS, as I did in Essex, but I will do what it takes to have the care that makes me feel safe. I will, however, be writing to the Superintendent of Midwives to express my disappointment with the NHS service I have been offered.

Born Free but Scared to Be

I went to see the midwife on Thursday. I was going to talk to her about my concerns that I feel like I don't know her from Adam and worry about who will actually attend at my labour. Everything is so different this time around, not just because it is a second baby but also because of the care that is offered where we now live. When I was pregnant with Olivia we had a team of two community midwives who provided all my care. Every one of the antenatal appointments was carried out by one or other of them, the appointments were much more numerous and we also had the opportunity of 8 antenatal classes to get to know them further. By the time it came to having Olivia we had spent many hours in their company and built up a relationship.

The NHS guidelines on appointments have changed since we had Olivia and for those expecting anything after the first baby you get appointments at 16, 18, 34, 36 and 38 weeks. Randomly they don't seem to see you after 38 weeks until you have the baby....can this be right??? There is a gaping hole in the middle of the pregnancy where you don't have anything apart from a scan for 16 weeks. So very little time to build up a bond with a midwife.

We are registered to have care with a midwife who is associated with our GP practice. Unfortunately when we had our booking visit the midwife was on holiday but we were not told this at the time. As the boooking visit, a lengthy home visit, is one of the best opportunities to actually spend some time getting to know the midwife we would have recheduled this visit if it had been made clear that the person coming was just some random person who was on duty that day and not our normal midwife. Having not had this booking visit with the usual midwife it meant that when I went for the 16 week visit it was just 10 minutes with a stranger and I left feeling like I still didn't know her and she certainly didn't know me and probably wouldn't recognise me in the street let alone know my name. Left alone for 16 weeks I began to fret...

I couldn't help but think back to the excellent continuity of care we had with Olivia, how lovely the midwives were and how safe I had felt. What wasn't clear with the care this time was what would happen if this named midwife was either away or attending someone else at the time of my labour. It seemed likely that, as there was no named second midwife in the team, it would be that, as happened with my sister when she had her last baby, a random stranger from the hospital would turn up.

So, having had some weeks to ferment my discontent, I went along to the 28 week appointment. When I went to check in with the receptionist I noticed that there was a lady in a nurse style uniform standing on the patient side of the desk but as I don't know all the surgery staff I didn't think anything of it. When I gave my name to the receptionist and said I was there for the midwife the lady turned round and said 'Hi, you are with me today'.

She conducted the antenatal appointment as well as you can when you have no idea of the patients medical history other than the scant details in the antenatal notes. When it came to trying to take blood she was apparently unable to get a vein to come up and so asked me to go to the hospital to have my blood taken at the blood lab, thus making a 10 minute visit to the clinic into a bit more of an epic. Good job I wasn't expected back at work anytime soon. That was it apart from the fact that she asked me to come back in 3 weeks - not sure why unless she got confused as to whether it was my first pregnancy as first timers get an additional appointment at 31 weeks.

After the appointment I had to call my little sister, who I knew was off work that day and in town, to ask her if she would mind taking me up to the hospital as it is quite a way away and I don't drive or have access to the car in the daytime even if I did. She kindly agreed and luckily after a 5 minute wait in the queue for the blood technician I spent about 90 second having the blood taken and then left. The technician was so good that I wasn't even sure when she had put the needle in and so broke my golden rule and actually looked at the blood being taken - yuk! So, it turns out I do have veins after all...who would have thought it?

....So.. back to me fretting...At no point had the midwife explained why I was with her rather than the practice midwife. It was only when I asked her directly where the other midwife was that she explained that sadly the other midwife had recently lost her husband and was on compassionate leave. I wouldn't wish that on anyone and obviously have every sympathy with the poor woman. Unfortunately, I wasn't given any indication of how long her absence might be and what alternative arrangements had been made for patient care in the meantime.

Unfortunately this all hasn't done anything to allay my fears about a stranger turning up to delivery the baby. The more I think about it the more worried I get. I don't know when the usual midwife might return (and who could blame her for having an extended period off after such an unhappy event) and just wish we were still in Essex with our old midwives.

I have decided to start investigating what we can do about the situation. The working practices of the NHS midwives in our area just don't seem like they will give me the continuity and frequency of care that I want and feel I need and so I am now looking into the options for private care.