From NHS Midwife, to Neighbourhood Midwife to Independent Midwife – My lessons in continuity

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 a block in my writing skills of late, probably down to the whirlwind of emotions and riding this ride, dealing with the closure and continuing to support families for months after, moving house, overcoming personal challenges, setting up a business and just finding my place again… that has all required all of my attention in ways that haven’t permitted time to just sit, to just sit and be, to let thoughts flow into written words like I used to. Ever since being a student midwife, I have found solitude in reflection, in my writing and sharing of experiences, but for some reason I held back doing this for the last 7 months.

NM fam

I firstly want to share a little about the magic I experienced on the sad day that we were told that we were closing and all losing our jobs, as I think it demonstrates just how powerful it is to have a real connection as a work family. There were tears, lots and lots of tears, but we all sat together, we hugged and cried together, we held space for each other on that day and our priorities for all of us were supporting families and each other through this. There was no anger, not one bit at all and the way everyone reacted was a huge testament to the loving working family held together by our matriarch, Annie, and our support team, Tina, Eleanor, Cathy, Jill and Sharon. Having been a part of this family, we all knew how much had gone into Neighbourhood Midwives and knew that every single thing that could have been done would have been done. The most magical memory I have with them is on that day, when we had an impromptu sing together of The Beatles ‘Let It Be’, it was so beautiful.

I found it hard to decide what to do next, I wondered about finding a caseload job as an NHS midwife, but I felt a draw to Independent Midwifery. I did a huge pro’s and con’s list with the help of 2 of my colleagues Leonie & Tess and both options looked amazing… But stepping back to look at it I realised it felt like most of the ‘sensible’ reasons that came from my head (financial, reliable pay, potential future study, pension etc) came under the NHS, whereas the things that felt they came from my heart such as about my values, my personal and professional growth and my work/life balance all came under being Independent. I think one of the biggest things for me was that I wanted to be completely free to give care in the way I wanted, I absolutely did not want to go back to working set days or set shifts either. To some that sounds bizarre, but having worked shifts in the NHS before, then working how I did with NM, I felt like the next step was to try being an IM. It felt more like a forward step for me,  I always knew I’d be an IM one day, and although this was at an unexpected time, I knew I had to make the leap.

All Right Reserved

Since then I have personally supported 20 families in various different ways either as their midwife or as a back up providing care, I’ve been at 10 births, 5 who were families who had booked under Neighbourhood Midwives (those of us who had decided to be IM’s volunteered to keep caring for these women so that they continued getting the care they had paid for).

I’ve had the joy of caring for women in the way they need, in the places they need to be, with the total freedom for them to decide what and where that is at the time, rather than having to decide in advance.

I have had the absolute honour of being able to support women as they learn to trust themselves, their instincts and are in control of their choices, holding space for families to have positive birthing experiences in all sorts of situations.

I have advocated for women in ways that led to a doula friend Natalie compare me to Al Pacino in the film Serpico (you only need to read the description of the film to understand this haha).

All Right Reserved

I have been met with open arms (and often hugs… I encourage this) by my NHS colleagues, I have had Consultant Midwives and Obstetricians treat me with nothing but kindness and respect and include me in the planning (as it should be). On a very small number of occasions, I have been met with rudeness and disrespect and I have learnt a lot about how kindness generally wins, that reacting with kindness helps move it to a positive relationship and reminds them I am not the enemy, all I am doing is supporting a woman in the way she has asked me to.   

I have connected with so many new midwives and gone through a bit of a journey in terms of figuring out who my ‘tribe’ is. I am very lucky to have some incredible midwives in my life and in the IM community. When working this way you really need people you trust with your everything, who support you without judgement, who you can completely rely on to be there when you need backup or a chat, who are honest and who will understand if you need to call them at 3am for advice, a 2nd opinion or if you need support. I have also connected with a number of student midwives and had the absolute pleasure of having Marina, a student midwife from Germany come and spend a few weeks with me, not only did we enjoy some lovely visits together but we also explored London, something I hadn’t done for some time.

Nonatus House

The 6 hospital births I’ve been at have been at 6 different London trusts, which has taught me a lot about the variety of care that women experience in trusts across London. Some amazing, some shocking, but it is a very big reminder of why continuity matters so so much in the NHS.

I experienced a 2 week period where I worked around 145 hours. I’ve also had weeks where I’ve had 2 appointments all week. I’ve had a month with 3 new bookings, followed by 2 months without any. I’ve had a month with 4 births and some with only 1. In one week I looked after a woman who went into labour at 37 weeks and a few days later a woman who was 42 weeks. I’ve cared for women at home who have been told their babies are ‘too small’ or ‘too big’ who have gone on to have positive homebirths with perfectly healthy babies. I have provided care for women who have planned homebirth but circumstances led to an abdominal birth. I have walked alongside a woman planning a VBAC, from being at home, to trying out the birth centre, to the calm and positive decision to have an abdominal birth. I have supported women who opt for an induction and those who prefer to wait for labour to start after waters have gone. I have cared for women who have made the informed choice to decline intervention offered who have later decided to change their mind because instincts tell them to. I have cared for women whose most positive environment for birth is the labour ward and couldn’t imagine giving birth at home and others who didn’t want to leave their home… I’ve supported women at home who never imagined they would want to be there at any point in labour and I’ve supported women in hospital whose plan was to be at home.

A big lesson in this which is very relevant for NHS caseload midwives is that I have seen that it doesn’t matter where a woman is or if her labour follows her plan exactly when she has her named midwife with her. That is powerful stuff. I have seen women come away from experiences that could be potentially very difficult to recover from, feeling powerful, strong and positive. That their bodies, regardless of how their baby was born, what kind of feeding journey they had or if they had difficulties during pregnancy, they come away being able to reflect back and see it all as a hugely positive experience. Looking after women with love, respect, kindness and absolute adoration is our best investment into our future generations and for this, continuity really does matter!!!

3 thoughts on “From NHS Midwife, to Neighbourhood Midwife to Independent Midwife – My lessons in continuity

  1. Rachhuk says:

    So lovely to hear ! I’m a case loading midwife and have been since I qualified 2 years ago for One to One midwives. I can’t see any other way of working.. I can’t imagine not providing individualised care, and promoting normality. The relationships I have with families are immense, nothing like I experienced in training. Good luck in your new venture. Each and every woman is lucky to have you as their midwife 💕

    Liked by 3 people

  2. Carolyn Hastie says:

    I really enjoyed reading your thoughts about your experiences. Thank you for sharing them. Your words will help those who don’t understand what it is like to work with women and their families in this way. Women emerging from the birth of their babies feeling strong, positive and powerful, no matter how the births unfolded, is an essential ingredient to confident parenting, successful breastfeeding and robust mental health. The ability to give individualised care to each woman as you have put it “looking after women with love, respect, kindness and absolute adoration is our best investment into our future generations” – an ever-increasing pile of research and experience agree with you.

    Liked by 3 people

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