After the shock…

I am still in the fog of trying to decide what I am going to do in regards to my Maternity care. I have no idea what is going on with it all. I have called the local hospital to be allocated a community midwife. Obviously with such a huge number of people booking in and me not being priority I might have a while yet to wait. Being on nobody’s “books” is causing me some anxiety as I don’t really have anyone to contact directly if something should go wrong or I get concerned about anything. I have been told to call triage but again, they are going to be very bus at the moment too. Anyway I am trying to keep positive and calm about the whole thing. I am hoping that when I do get allocated a new midwife that I get someone who is positive about homebirth. I am worried that I will have a fight on my hands. I think my age might be a factor, my BMI possibly but hopefully the fact that Evan’s birth was at home will count in my favour and that this is baby number 4. I am also slightly worried that Dylan being “small” might come back to haunt me and maybe Eilys too, who knows! I am trying to keep positive but also trying to think about all eventualities so I am well prepared. I know that at the end of the day I am an informed woman and I know what my rights are. I know to question things, I know that ultimately it is my body and my baby and that I decide what happens.

This was all so unexpected. I am still so heartbroken by it all and now also quite angry. From what I can gather from reading articles about the One to One closure it was to do with them being charged increasingly more and more money for services that they had to refer their women to the nhs for. You would think that with all those homebirths (one to one had a 33%+ homebirth rate) and with one to one having lower transfer to hospital rates and lower medical intervention rates than the national average that having a service like One to One would be saving the NHS money but apparently that doesn’t count for much. And neither does the satisfaction of the women under One to One’s care.

I just wanted to put my experiences regarding standard NHS maternity care and the care I received at One to One midwives into a blog post. I am in no way saying that I received substandard care in the NHS, far from it, but I think that One to One did a lot of things a lot better than the NHS did. With my first pregnancy I had a community midwife from the NHS and I had all my appointments at a Children’s Centre that was about a 35min walk from my house at the time (and I was coming from work so it usually took me about an hour to walk from the station unless I go the bus – I didn’t drive at the time). I saw a number of midwives during my antenatal appointments but I did see my named midwife on about 3 occasions. I had scans and we attended classes at Leighton hospital and had the tour of the ward. My waters broke when I was 39w and 3 days and I was induced 2 days later. After I was induced we were left to it and were checked on every hour or so.  I was hooked up to a monitor and told to stay in bed, totally against everything that I had read about how I could make birth easier for myself. The monitor kept losing connection and bleeping. We were told that my husband should push the monitor into my stomach to help with the connection. This caused me a lot of pain and discomfort as my contractions were becoming a lot stronger. The connection was still terrible and after a while I told my husband to stop pushing it into my stomach as it was too painful. I took the monitor off and it started to bleep a lot but no one came to check. No one checked on us for over an hour. At that point my contractions were becoming very regular and very strong. The midwife who came in was very rude and told me off for taking the monitor off and then said that there was no way this baby was coming today as I was not having contractions as the machine said I wasn’t. She didn’t listen to me when I said I was in a lot of pain.I really really wanted a water birth but as I was induced so I requested a bath. After a while of begging for a bath they finally relented. But before I went for the bath the midwife told Joe that afterwards he would have to think about going home as Dad’s weren’t allowed on the ward over night. I was getting myself into a right panic. I felt like non of the staff were listening to me or taking my pain seriously and now they wanted to send Joe home!. Anyway I got in the bath…It was the worst bath ever and I went into the transition stage of labour, I didn’t realise that was what it was as the birth class didn’t really explain the stages of labour very well so I was really scared and in a lot of pain. I was so out of control and freaked out that this wasn’t real labour that I was in a total panic. It was so scary. I couldn’t walk very well and was in so much pain that I rang the emergency cord and a midwife rescued me from the bath. She examined me internally as the pessary had fallen out and she needed to put it back in. And then the mood changed. Buzzers were pushed and people were running around as I was 8cm dilated. I was wheeled around to delivery and my son was born 20mins later. The whole experience made me feel so out of control and like I had to ask for permission at every single corner. We had a lot of issues with breastfeeding too in the early days but the emphasis was put on baby gaining weight and now the issues behind the lack of weight gain. I was told to combifeed and left to it on my own after the allotted 2 weeks of after care.

When I found that I was pregnant again I was informed at a very early appointment that this pregnancy needed to be monitored more closely as Dylan was “small” (he was 6lb 12) and so I would have extra scans and the Midwife led unit would yet again be off limits to me. At every single one of my appointments at my Doctors surgery they were running 45mins+ late and waiting with a toddler in a Doctors surgery waiting room for that long was not very fun. Appointments always felt rushed and I often felt like I was putting my midwife out by having my son with me. My last additional scan was at 38 weeks and then I was told that my baby had lost weight, quite a lot of weight so I needed to be induced asap. I tried to advocate for myself but was told that if I wasn’t induced that I would increase the rate of my baby being stillborn. I was booked in for the day after. My consultant said that I wouldn’t need to be monitored all the time and that I would be able to walk around during the induction. When I got to Leighton I was told that in my notes it said that I needed to be monitored constantly. This time after I got very upset they offered me a portable monitor and given a birth ball to use.But I really had to fight for these. After a few hours of monitoring I tried to negotiate and they midwives said that I was able to go for walks between monitoring. Nothing was happening with the induction and the following day I was given the drip. This time the birth itself was a lot better. I felt more in control and had the same 2 midwives with me until their shift changed during the final 20 mins of my labour. Trying to push a baby out as a handover takes place isn’t very fun. After the birth I wanted to get out of hospital as fast as possible but I was told that I had to produce a certain amount of urine before I could go. It felt a little like being held hostage. Yet again after the birth I had feeding issues and this time baby had a tongue tie too. But after my 2 weeks I was passed to the Health Visitors team.

As you all know Eilys had spinal muscular atrophy and died shortly after her first birthday so when we found out that we were pregnant again I knew that I was going to need a lot of additional emotional support. I didn’t want to have to explain the situation again and again. I had heard of One to One from a friend who was also a service user so I called them to see what the deal was. I instantly felt like I had made the right choice. My midwife offered to go to the CVS procedure with me (as we needed to have the baby tested for SMA to see if we wanted to continue with the pregnancy). After we got the all clear and my appointments with my midwife started properly the difference in care models became so obvious. My midwife spend a long time with me for each appointment, she involved our son in everything at the appointments and she made me feel cared for and supported. She fully explained every step to me and talked me through all options with me. I felt listened to. All my scans were at the One to One “shop” in town. We didn’t have to pay for parking or for scan photos which was amazing. The appointments were always on time unlike in the NHS where we were often left for an hour waiting for a scan, which is fine but with my second pregnancy I had 8 scans so that is a lot of time for my husband to be away from work and for me to find childcare for Dylan. I opted for a home birth this time and I felt like I was completely in control at all times. Although my named midwife left One to One to relocate 2 weeks before Evan was born the handover to my new midwife was handled really well and I felt at ease with it. My birth was exactly what I wanted and my midwife was absolutely amazing throughout. Instead of being left feeling like I had endured labour in order to get the baby I felt empowered by it. The after care of both me and baby meant that even thought the same feeding issues occurred (I have Insufficient glandular tissues so I physically cannot make a full supply of milk and therefore have to combifeed) but this time I felt fully supported with both my midwife and the MAMA from One to One and this continued for 6 weeks after he was born.

I am currently 28 weeks pregnant and chose one to one again. I had the same midwife allocated to me which was great as we had formed a really lovely bond. Yet again, having appointments at my home and having my children involved with those appointments was so lovely. I am so gutted that One to One have gone into administration. I am now so anxious and worried about my maternity care. I had wanted to have another home birth but I feel as if my choice will be taken away from me again. Since the closure of One to One has been announced I have been in contact with the local hospital to arrange the transfer of my care and I already feel as if I am out of control. I explained my situation and gave my basic details and then was asked if I wanted a home birth, to which I said yes and was told they would “look at my history and make a decision and get back to me”. I really hope this was a flippant comment. I understand the strain that the NHS is under and that they are stretched but after having such exemplary care I am so nervous and worried that the care that I am being transferred to will be lacking. I don’t in anyway mean that the care offered by NHS Midwives is substandard because for the most part it is ok but I have definitely been spoilt by One to One and know how fantastic care could be under the same model. I think more women should be getting this level of care, not less. It isn’t even the appointment side of things that I am worried about, I am worried about the birth itself. For starters, I had such a wonderful experience with Evan’s birth and I really want the same or similar again. I don’t feel as if I should moan about Dylan or Eilys’ births because despite being induced both times nothing actually “went wrong” and nothing overly traumatic happened but also, I don’t think I should have to downplay the affect of not being listened to, the affects of being told one thing when actually something else was in my notes, the feelings of being out of control and not being part of any decisions has had on me. I think I suffered a degree of birth trauma from both experiences (which makes me feel a bit embarrassed but it is true). I am a little worried about seeing a different midwife for each of my appointments again and potentially having to explain about Eilys each time. I really hope that I am wrong and I really hope that everything goes smoothly.

The One to One model of care was absolutely amazing and empowering for women. I know a lot of One to One Mothers and they all say similar things that they were listened to, that they felt supported and cared for throughout and that they all felt like they had the best care from their midwife. I am so sad that other people won’t be able to experience this amazing service, it is an absolute disgrace that this has been allowed to happen. When a woman sees the same midwife throughout their pregnancy (and during their birth if they have a home birth) and for 6 weeks after birth allows a really strong and trusting relationship to grow. It allows the midwife to get to know the woman and their family. The midwife is in a really good position to see any warning signs in regard to the woman or families wellbeing and mental health and flag this earlier and get them the help they need. Looking at the outcomes that One to One have achieved alone tells the story. They have amazing home birth rates and they have very low intervention rates, their breastfeeding rates are very high too. In offering a rigid framework of support throughout pregnancy and beyond really helps women enter motherhood in the best health possible. I really hope that the voices of the services users are heard and that something is done to change the system. Hopefully all these One to One midwives who are having to take jobs within the NHS will help to shake up the system and hopefully all the women who are affected by the closure will shake the system up a bit too.

I am just so gutted for everyone involved by this. All the families and all the staff. It is a great loss to the local area. I should hopefully hear back from my local community midwife today and get the ball rolling in regards to my care. I am trying to remain positive about it all but also overthinking everything because that is what I do best. Thanks to One to One I am more knowledgeable about birth and my rights, I know what questions to ask and that I don’t have to agree to anything that I don’t want to do. And at the end of the day, no one can force me to go to hospital. Free birthing is always an option too (I am kidding).

Thanks for reading

xx

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