The Birth I Want

With my new job as a case loading midwife looming, I came across this campaign via Facebook which really struck a cord with me.  It’s been set up by Vicky Garner, a busy Mum to 3 boys who strongly believes that all pregnant women deserved one-to-one midwifery care throughout their pregnancy, birth and postnatal period.  I was lucky enough to speak to Vicky and find out more about the campaign.

Tell me about the campaign

It’s a campaign for mums, by mums.  We’ve set up now because for years successive governments have promised changes in maternity services – changes that would put the wants and needs of the mother-to-be at the centre of care, where she should be.  Yet we are still not at that point.  Back in May 2012 the current government pledged to reform maternity services and we want to encourage them to deliver on those pledges – to ensure that every mother is given one-to-one care with a midwife/midwives they know through pregnancy, birth and beyond and also given the option of having their baby in a hospital, a birth centre or at home.  Since maternity services should reflect what mums want and need, our campaign is based on the thoughts and experiences mums have of birth and maternity care.  We aim to take the collective voice of mums to policy makers.

What made you want to start it?

After my second baby was born at home under the care of community midwives I was surprised when pregnant with my third to be told that there was a possibility that the same group of midwives might not be able to send out a midwife to my home(if the birth centre was busy) and should that happen, I would have to go into the birth centre to have my baby.  I knew that I wanted a home birth and I also knew that I didn’t want to be worried about whether or not I had to go into the birth centre, so we took on an Independent Midwife.  This brought two things to my attention.  One, that independent midwifery is under threat and we need to do something about it and two, that women across the country are not being given choice over where they have their baby and many are also not getting continuity of care from midwives that they know.  I decided to put my experience as an environmental campaigner to use and set up The Birth I Want.

How important do you think one-to-one midwifery care is for women?

One-to-one midwifery care, before, during and after birth is, in my mind the single most important factor in a positive birth experience for mum, baby and family.  It makes complete sense to me that getting to know your midwife and your midwife getting to know you is an essential ingredient in having the birth you want (even if things don’t go to plan).   And of course, the benefits of one to one care in terms of reducing interventions, reducing c-sections and increasing breastfeeding rates are well known.   And I don’t think one to one care should just be for those mums who are having babies at home or in a birth centre. Mums who chose to birth in hospital or who are high risk so have no choice should be able to be accompanied by their midwife.  It may sound like pie in the sky but it would make such a difference to the birth experiences of so many women.  That’s what mums are telling us too, so we want to try and make it happen.

Do you think the lack of case loading midwifery encourages women to choose an independent midwife?

I think the lack of case loading midwifery certainly does drive those women who understand the importance of a close relationship with their midwives, to Independent Midwifery.  I also think that not being given choice of place of birth is doing that too.  What those women will do come Sept 2013 if the insurance issue hasn’t been sorted I don’t know.  The fact is that we could deliver a case loading system far more widely without many more than the promised 3500 more midwives if those in the driving seats were able to think in new ways.  I’m pretty sure too that if we went down the route of more case loading, we would see less Postnatal Depression and Post Traumatic Stress Disorder, because mothers-to-be who feel supported throughout their pregnancy and birth experience are less likely to have an experience that leaves them feeling out of control and disempowered.

What can be done?

We need to let policy makers know that mothers (and their families) want change. We are the ones who have the experience of maternity services, we need to have a say about the shape of them. We have various ways that you can take action via our website and there has never been a better time! 

3 thoughts on “The Birth I Want

  1. I am all for ensuring women receive the best care in all aspects of their pregnancy, during labour and postnatally. What I question is whether anyone ever asks what the midwife wants?
    Most find case loading midwifery just too much. It means being on call 4-5 times a week with working hours sometimes in excess of 24 hours .. All this with a family of their own.
    Most of the research suggests that although continuity of carer is the most important thing for women in labour, infact that carer could be the birth partner or friend and not necessarily the midwife.
    Just things to consider

    • It’s a really good point Laura and I’m not sure what the happy medium is. I think we have a good compromise for our midwives at Kings with the range of midwifery care we offer. Vicky felt that maternity services range so much throughout the uK, a postcode lottery of care. Having worked within another London NHS trust, it makes me realise how good our community midwifery is at Kings. Only time will tell how case loading will work for me and my family.

      • I think caseloading is completely sustainable but the model needs to be tweaked and on the surface that would look really costly. Essentially midwives near to be able to drive the model more i.e. maybe I’ll do my 36 births over 7 months of the year or maybe I’ll take a smaller caseload etc…let midwives truly be in control of their diaries maybe it suits me if I have small children to start everyday after I’ve taken my children to school or finish in time to collect them and then perhaps work an evening or two….this flexibility along with flexible size caseloads with midwives working in pairs, three or slightly bigger teams I believe would make caseloading a more viable and sustainable option.

        There is absolutely no doubt in my mind that it the ‘gold standard’ of care and we need to start being inventive about how we might make it more attractive to midwives. I believe all women who desire it should be able to access a caseload model of care. I truly believe that while it may look more costly initially the reduction in LSCS rates, less PND, increased breastfeeding, higher homebirth rates etc mean that in terms of both short and long-term outcomes caseloading is both sustainable and offers good value for money.

        Caseload Midwife

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