Well what a wild ride this last year has been. I haven’t actually written a thing on here since my post 3 months in with Neighbourhood Midwives and, as you may well know, we closed on 31st January this year. I have often opened my laptop to start writing but have had a bit of … Continue reading From NHS Midwife, to Neighbourhood Midwife to Independent Midwife – My lessons in continuity
Hi, my name is Rachel. I am a mother of three ages 11,8,3. I qualified as a midwife in September 2018 and started work as a caseloading midwife the same month. There are many reasons I chose to work within this model, one of which was the flexibility it offers, this is achieved because I … Continue reading Rachel’s Story: Mother of 3 and Newly Qualified Midwife In A Caseload Model
Emma-jane Berridge talks about her journey into midwifery and how working as a caseload midwife gave her more time with family. ''As a full-time caseload midwife, however, I dropped my five-year-old to school every morning. I managed my own diary so that I saw my first client around 9.30, I was usually home for kids' teatime at 5.15, I was able to take my 10 year old to swimming three times a week, I put them both to bed every night, and sometimes I got a call in the evening or the early hours and went out to a home assessment and/or birth.''
3 months into my new job as a caseload midwife and I wanted to share more about the practicalities of this way of working. I have looked back on my diary over the last 2 months to provide a detailed idea of how many appointments are done, how many on calls we have and importantly how many of those we are actually called out. This post is also a reflection of my learning points in terms of self care, things I have picked up on which I am sure are common themes for caseload midwives.
A truly heart warming story of a midwives journey to becoming the midwife she really wanted to be. Tina talks about what influenced her throughout her life, in a journey that led to her becoming such a positive influence and role model herself.
A lovely birth story, baby Caspar born in the living room whilst his big sister slept along the corridor. For those who read my post about being an on call midwife, this birth got a little mention!
Flex Appeal is a campaign set up by the glorious Anna Whitehouse AKA Mother Pukka in response to her company not supporting flexible working. So what has this got to do with the Continuity Matters campaign I hear you ask? Well...
‘WELCOME HOME’... They were the words of a friend who understands my need to work in caseload midwifery in response to me sharing that I’d been to my 1st birth with my new team back in September. Those words sum it up perfectly because it so feels like home, where I can finally be the midwife I want to be!!! I thought after a month of being with Neighbourhood Midwives NHS team I would share a bit about my experience so far.
An anonymous insight into being newly qualified, challenging the perception that newly qualified midwives should work in obstetrics before working in the caseload model of care
On Saturday 10th March 18 I woke up at 6.45 am having a few niggly pains. I asked hubby to take the girls downstairs so I could have time alone to see what came of them. I was 40+8 and hour later I knew this was definitely labour. Hubby took kids to grandmas and I … Continue reading Hayley’s Story: The twin birth of Tobias and Maximus
Its meeting her for the first time and not having any preconceived ideas about what she should feel, what she should want or what her needs are. Its being quiet and listening, for as long as she needs, to allow her to speak and open up to her innermost fears, hopes and dreams that she … Continue reading Continuity – The Epitome of Being ‘with Woman’
Shauna shares her experience of being cared for by the wonderful Valley Midwives. She tells us how the care helped deal with anxieties, needle phobia, mental health worries as well as some health concerns in the final few days of pregnancy.
Lina Duncan, an internationally trained Midwife and Doula shares with us her experiences of providing continuity to extremely vulnerable women during her 18 years of working in various parts of Asia
Ali qualified as a midwife in the US, where she had her first baby and experienced receiving and providing continuity of care, before moving to the UK where she had her 2nd baby and is now retraining as a midwife.
My story of post traumatic stress triggered after a difficult day on placement, the subsequent difficulty of accessing the right help and diagnosis and finally the profound impact of the continuity of support received as a student from a team of caseload midwives. How love, support and encouragement from likeminded midwives aided my healing and made me the midwife I am today.
This is a plea for those who have successfully implemented continuity of carer to get in touch. We have all the literature, government and health policy and union support to start continuity, but how exactly can we start something ourselves? I think inspiration would be helpful from those who have done this already to help others see how achievable it is.
This story is one that sadly I am sure echo the stories of many women, every day, around the world. One which this amazing woman has offered to share and whose voice I believe every single person who comes into contact with women during labour and birth needs to listen to. A woman who believes that continuity of carer would have made a difference to her experience. You only have to look up the #metoointhebirthroom hashtag on Twitter to have a glimpse into the unacceptable treatment women are experiencing, but these stories only just scratch the surface.
It is a woman’s human right to make choices about her care (NMC, 2015, Birthrights, 2013) and women must be provided with the information they need to make an informed choice (NMC, 2009), including discussing risks and benefits of the options available to women, which is both the legal and professional responsibility of midwives and obstetricians (The Supreme Court, 2015). It is important to be aware that the way in which risk is discussed can exaggerate risks (Van Wagner, 2016) and that lack of adequate time and follow up when discussing risks with women during pregnancy can direct care towards interventions (Van Wagner, 2016). The provision of relational continuity can counteract this and is shown to improve outcomes for women with perceived risk factors (Sandall et al 2016).
Professor Lesley Page CBE is a visiting Professor at King’s College London and Adjunct Professor at UTS and Griffith University, Australia. She is one of the most (if not THE most) knowledgeable people around relational continuity in maternity, its implementation and its sustainability. Here she shares her infinite wisdom on the topic.
Chloe Mulholland - Midwife and Hypnobirthing Teacher tells us about her experience of pregnancy with the added insight of having also worked as a caseload midwife, so knowing how important this model of care is. She shares the anxieties she felt knowing this model of care wasn't offered at her local trust and then the impact that continuity had on her pregnancy and birth.
Dr Susan Crowther, Professor of Midwifery and advocate for caseload midwifery gives an insight into her experience. Susan has vast experience across all models of care provided in the UK and overseas, which gives a valuable insight into the caseload model of care - as she rightly puts it, the barriers to this way of working can be overcome with the support, desire and inspiration to succeed!!
The perception of what it would be like to be a caseload midwife is often that it involves working 24/7, lots of overtime, no work/life balance and the inability to spend any time with family, which admittedly does sound pretty awful. But you only have to speak to midwives working in this model to know it is far from the reality.
The evidence for the benefits of continuity of care during pregnancy, birth and during the postnatal period, for both women and midwives is strong (Sandall 2014, Sandall et al 2016a, 2016b, Forster 2016) and repeatedly highlighted in government publications both nationally (Department of Health [DoH] 1993, 2007, 2010, NMR 2016) and internationally (WHO, 2016), it is recommended by both midwifery (RCM 2016) and obstetric trade unions (RCOG 2011), and is within the recommended guidelines for maternity care (NICE 2016, 2017a, 2017b) yet it is still not available in the large majority of the UK.
What better way to start the Continuity Matters campaign than by sharing Michelle’s beautiful birth story. Having a midwife who she knew and trusted explicitly allowed her to let go, lose control and feel safe whilst doing so. Michelle said she felt safer than she ever did at any of her previous births because of her relationship with her midwife.
After two previous traumatic Caesarean sections, followed by a hospital vba2c, my home birth was everything I have learnt that birth can be.
It’s truly wonderful to end my birthing days with the most beautiful, empowering birth.
It was instinctive, intimate, undisturbed, empowering, peaceful and I was in control at every moment.
I didn’t have anyone tell me what position to be in.
I decided when It was time to get in the pool.
No one told me when I could push or not push.
No one knew the size of my cervix at any point.
My movements weren’t limited or hindered by machines or technology.
Time did not dictate my fate…
I had chosen not to have any vaginal examinations because I didn’t need someone to tell me what my body and my baby were doing. There was no medical indication to do so. Instinctively I knew that everything…
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