PERSPECTIVE : Is It a Shift Too Far to Expect One Midwife; A Birmingham Midwife Is to Launch a Report Today Calling for Radical Changes in the Way in Which Women Are Cared for during Pregnancy, Childbirth and beyond. Jo Ind Reports

Article excerpt

Byline: Jo Ind

Given the choice, what do you imagine a woman who is having a baby would prefer?

Would she rather go into labour knowing the midwife will stay with her until the baby is born, or would she prefer a stranger to take over should she be in the process of giving birth during a change of shift?

Would a mother rather experience childbirth with midwives who have got to know her or would she prefer to be seen by midwives who barely know her name?

Would she rather have a midwife allocated to care for her from the start of her pregnancy, through birth and learning to breast-feed, or would she prefer to be dealt with by whoever happens to be on the shift at the time?

You might have to phone a friend to answer that one.

The fact is that midwifery services in the West Midlands, as in most of Britain, are organised in such a way that it is not unusual for a woman to see as many as 15different midwives from the start of her pregnancy through to the checks once the baby is born.

Jo Hindley, a midwife at Birmingham Women's Hospital, argues that this is not the most satisfactory way of caring for women.

Today she is launching a report called Having a Baby in Balsall Heath which investigates the effects that having many midwives has on mothers.

When she did the research, as part of her masters degree with the University of Central England, she was a midwife with the Balsall Heath Sure Start programme, so she invited 20 women from the area, three-quarters of whom were not white, to talk about their experiences in focus groups.

The results were quite shocking.

'I go down to the labour ward at 6.40 and he was born at 7.23 with no midwife in the room. They'd gone out,' says one of the women.

'I gave birth by myself. I was like 'Oh I want to push!' and I was like 'Help, help!' and I was like 'You'd better come out then!' 'Because I've got hypertension I was supposed to have all these monitors on. They'd just brought me down and the midwife was 'Oh I'm going to go and get this and get all the little things.' 'I can't even remember the midwife because all she was worried about was going off shift at 7.30. I would have liked somebody there to deliver me. He could have fallen off the bed or anything.'

Jo found it was very common for women to receive inadequate attention at the time midwives were changing shift.

And that is not the only problem with the shift-method of providing midwifery care.

In another report, Why Mothers Die, by the Confidential Enquiry into Maternal and Child Health, the authors cited poor communication between the midwife and the mother as a contributory factor to the death of a mother while having a baby.

Yet a recurring motif in Jo's research was that women find it much easier to communicate with midwives when they have had the opportunity to build up a relationship with them than they do if they are having to start all over again with strangers every time.

'I was very upset during my labour as I had three different midwives,' says another of the women.

'I didn't know them. I felt uncomfortable asking questions, talking about my fears, whereas if I had already known the midwife, I would have felt less stressed and scared.

'This was my first baby and the experience was spoilt. I felt unwanted and not bothered for.

'It would have been a big load off my mind that the midwife I built a trusting relationship with was to be there for me.'

Another advantage of women having the opportunity to know their midwives was that it lessened the effects of racism.

Many women said they felt they were not heard or believed by their midwives, but this was particularly true of the Black and Asian participants in the study.

When midwives have the opportunity to get to know the Black and Asian women over a period of time there is much less ignorance and stereotyping. …