"Experience of community midwifery in South Birmingham"

Early booking and medical support for mums-to-be is seen as a key part of the maternity care pathway and so I thought it might be worth sharing my own varied experience of community midwifery in Birmingham. I'm almost 30 weeks pregnant and so have now had a few midwife appointments. My first was at home with my designated community midwife, others have been at my GP surgery and a couple have been at a local Children's Centre.

When I had my first community midwife appointment I was 10/11 weeks pregnant. I'd worried that I might have problems after some early spotting and I was feeling something of a walking pregnancy cliche with pregnancy rhinitis, extreme tiredness, sore boobs etc - the works! I was instantly reassured on meeting my designated community midwife - who completed the first stage of my Green Notes with diligence yet balanced this with a dry sense of humour at the extensive range of questions. She noted my gynae history (that had involved surgery) and my concerns about the impact that delivery complications could have on this. My midwife not only took the time to phone colleagues to ask which consultant would have the best gynae background to refer me to but gave me very clear advice about questions to ask said consultant to inform my birth plan preferences.

I heard her advise a father-to-be over the phone, again using gentle humour, to persuade him that he really did need to take his partner to the delivery unit asap otherwise he'd be "...looking for some marigolds to deliver the baby..." himself. I quickly felt at ease enough to ask her all kinds of questions ranging from vitamin supplements to the impact that being overweight would have on birth options and she answered them thoroughly and confidently using her own personal and professional experience. I really liked that she just didn't 'parrot' Department of Health guidance but gave her own view alongside it. As a result I felt treated like an individual and an equal.

At a subsequent appointment she gave me more advice on hospital processes following an initial and somewhat brusque hospital consultation with a senior registrar. Again I felt reassured and confident that with support from someone like her I could have a successful delivery with minimal trauma.

I've had a couple of appointments with midwives who have been perfectly pleasant but rushed and not really wanting to answer specific questions. They've very much deferred to DH guidance as a set response which is fine and understandable but sometimes you want to hear a view based on experience rather just than one-size-fits-all statements.

My last appointment, at 27.5 weeks at Anderton Park Children's Centre was really quite alienating and upsetting. I had to wait over 75 minutes for my appointment - which I'd expected from previous experience of what seemed to me as the slightly lacksadaisy approach at the children's centre but was unpleasant on a very hot day. The midwife told me how bad my veins were when taking a blood sample then criticised her colleagues for not having referred me to a dietician because of my BMI. I assured her I'd raised the subject of my BMI with my midwife myself, as I'd been concerned about potentially increased risk, but she ignored what I said and talked over me to insist on the referral.

When checking my stomach to establish a fundal measurement she was very rough and then practically shouted that the measurement correlated with a baby that was 28 weeks old and tutted while relaying this to her colleague. I replied that this would correlate with my own understanding of dates (going on conception which I was more certain of rather than last period dates) but again she ignored what I said. Her colleague, registering the look of panic on my face said direct to me it wasn't anything to worry about and that measurements were approximate but the midwife still didn't change her tone.

The midwife then lectured me on breastfeeding, despite me volunteering that I did want to breastfeed if I could and made a big deal about seeing me again at 41 weeks (ie after my due date) with no recognition that this wasn't necessarily a given. She rounded up the session by telling me *three* times to "Have a nice day" while not even looking up from completing my notes.

While lots of boxes were clearly ticked (the midwife wrote that she had 'discussed breastfeeding' with me on my notes) I came away from the children's centre feeling talked down to and wondering what the point of the appointment had been - it was neither quick and efficient nor reassuring. It might've been that the midwife, who didn't seem to speak English as a first language, didn't realise just how off-putting her manner was. But it wasn't just a question of rudeness - I couldn't help wondering what kind of experience the three mums-to-be waiting in front of me who didn't speak English as a first language but clearly a different language to the midwife had.

I called PALS after my appointment to advise that I didn't want to make a complaint just to make sure that I didn't have to see that midwife again if I did end up having to take up the 41 week appointment date.

They advised me to speak direct to my designated midwife about it which I will do at my next appointment next week.