Bad Mum 2B

Bad Mum 2B

Tuesday 13 February 2018

What to expect from the Midwife and your antenatal appointments




Having a baby is one of the most exciting things that you as a family will do. However is can be filled with anxiety and some confusion wondering what’s for the best, and what advice and research to trust. Women have been having babies for thousands of years, and unfortunately this makes everyone think they are an expert. The one person you will be able to trust is the midwife.

My name is Charlotte, I am a qualified nurse and have worked in accident and emergency and on a busy surgical ward. I topped up my training and became a midwife in 2011. Since then I have worked in a very busy referral unit dealing with extremely high risk pregnancies before going back to my training trust and working as a midwife on delivery suite and the antenatal/postnatal ward. 

Around 5 years ago I started working on the community midwifery team and have worked in a range of areas, including those of mass social deprivation and in very rural locations. Last year I took a very big step and left working for the NHS fulltime and bought a franchise of a world renowned company ‘Baby Sensory’ although I still am a midwife and still actively involved within the midwifery world.

The term midwife means ‘with woman’ and is a role that can be undertaken by both men and women. Families are often a bit put off by the idea of a male midwife but really don’t be. They are no different to a gynaecologist or a male nurse.  The role of the midwife is the same regardless what area we work or what our own beliefs are. Midwives are governed by a wide range of policies and procedures that are at both a national and local level, along with our registration which is governed by the Nursing, Midwifery Council and renewed each year and validated every three. So you can be safe in the knowledge that all the midwives looking after your care are trained at the highest level.

Midwives work at a completely autonomous and independent level, meaning that if you are a healthy, well woman with no other risk factors you may only ever see the midwife during your pregnancy. You should get to know the midwife well over the course of the next 10 months (yes 10 not 9). In an ideal world you should have the same midwife throughout your antenatal care and this is considered best practice, obviously sometimes it can be hard with staffing issues within hospital trusts but we hope that in most cases this is so.

Telling the midwife you are pregnant and being booked in for your initial appointment.

Below I’ve outlined the appointments you can expect and what happens during each of them.

Booking appointment* Medical history, family history, BMI, Blood pressure, blood tests, urine tests. This is normally where the midwife will decide whether you need to be referred to see a consultant or whether you can stay midwifery led, whether you might need a glucose test to see if you could be diabetic (this is often dependant on your BMI at booking, family history and ethnic origin).

*how you schedule your booking appointment will depend on where you live, give your GP a call and they can advise how to do so

11+1-13+6  - Dating scan, to see how many babies are there, and what date we expect your baby to be due. People often refer to this as the 12 week scan but it doesn’t always happen at 12 weeks. It’s at this point that you will be offered combined screening which hopefully will have been discussed with you at your booking appointment. This blood test along with the results from your scan are sent to be analysed and this can give you a likelihood of your child having any of the conditions tested for. This test is not definitive but if you were to come back high risk you would be offered further testing.

16weeks General appointment with the midwife. We can arrange further appointments now we know your due date, such as an appointment to check for gestational diabetes, and appointments to see the consultant at a specific point in your pregnancy. We also do a routine antenatal examination. Blood Pressure, urine check, and most excitingly for you we may well try to listen to baby’s heartbeat. Now this isn’t always the case and will be dependent on your hospital policy.

20weeks Anomaly scan, this is not to check your baby’s sex and in some trusts they will not tell you even when asked. This scan measures your baby, checks for any abnormalities of the vital organs and checks the volumes of water surrounding baby. Think of it as a baby MOT.

25 weeks Routine Antenatal- we can also give you your maternity certificate which is proof for your employer that you are pregnant and what day your baby is due (this can also be useful for paternity leave, benefits and housing) and we may try to listen to baby’s heartbeat

28 weeks Routine Antenatal and Blood Tests-The blood test is to check your iron level and make sure your body is coping well with the pregnancy It is also at this point that we will start measuring your tummy to see how well baby is growing, and using a chart specific to you we can assess the growth of baby. If your baby is growing nicely this will show on the graph. If baby goes suddenly very large we can do testing to see if there is a reason, and if baby isn’t growing well or suddenly drops in size we can also evaluate why this is happening. As a whole midwives are very experienced at this and if the same midwife is seeing you each week it’s much easier to detect abnormalities quickly. We may try to listen to baby’s heartbeat

31 weeks -Routine Antenatal - Blood Pressure, urine check, and we may try to listen to baby’s heartbeat

34 weeks- Routine Antenatal - Blood Pressure, urine check, and we may try to listen to baby’s heartbeat

36 weeks- Routine Antenatal and Bloods-  Not done in all trusts but a way to check you are well enough for delivery and that your iron is high enough.

38weeks Routine antenatal - Blood Pressure, urine check, and we may try to listen to baby’s heartbeat

40weeks - ooh exciting day (your friends will drive you mad asking if the baby is here yet, tell them only 10% arrive on that day and why it’s called expected due date not a definite one). We won’t do much with you except a normal antenatal check and make sure you are all ready.

41 weeks- dependent on the policy in your hospital trust and also dependant on how your pregnancy is going you might be offered a ‘membrane sweep’ at this point. This is an internal examination where the midwife or sometimes Dr. will try to reach your cervix using their fingers and once through the softening cervix will sweep the membranes over babies head. I don’t think anyone would ever say this a nice experience but it shouldn’t hurt. Although I tell my ladies that if I’m just going to tickle them with a feather I might as well not bother. So I’ll always do a good job to make it worth it, I do pride myself on a good sweep with very good results on the whole. I’ve had my fair share of babies born within a few hours of a sweep.

42 weeks - if you have a stubborn little thing that just likes being in there too much you may require induction of labour. The guidelines state this should be done prior to 42 weeks as this is believed to be when the placenta stops being as efficient at fuelling baby. Although that being said that is just a guideline and sometimes induction needs to be done before, or if a lady declines induction we can wait, but careful monitoring is advised.

So what is the role of the midwife in different areas?

The role of the midwife is so diverse it’s hard to explain everything that is covered by the midwife in day to day roles. There are many specialities within midwifery:

There are specialist midwives for drug and alcohol dependency, diabetes, chronic illness and high risk midwives, teenage pregnancy, screening, nurse consultants, safeguarding midwives, breastfeeding coordinators. Clinical midwives who work within antenatal clinic organising the drs, midwives who work on neonatal unit (not all babies on neonatal are little tiny preemies). Then we have midwives that train the midwives making sure we meet the standards set out by the NMC or RCOG.

As a community midwife my job dips in and out of many of these roles. Our job within the community it to build a strong relationship, not just with mums to be but with partners and the wider family and friends that live within your community. One of my favourite jobs in community is getting to know future big brothers and sisters. Having a new baby in the house can be hard for little ones so I enjoy engaging children as much as possible when they come to antenatal checks. Whether that be getting them to help with jobs like measuring tummies, listening to baby’s heart beat or just helping me get equipment.
We want to build a foundation of trust where you and your family members can tell us anything and use us to give advice and reassurance where we can. Our other job in community is to monitor ‘deviations from the norm’, if you attend your appointments regularly we can assess you closely and look for any minor changed that could be the start of something more serious. That gives us the chance to get you reviewed by a doctor or seen quickly and hopefully before a condition worsens.

Where to birth your baby:
In the U.K there are 3 main options for where you choose to deliver your baby, and these options are often open for negotiation and discussion.

Homebirth-my favourite. I’m lucky enough to live in an area where homebirth is quite popular which means as a community midwife I have been to my fair share of planned births. I’ve also been to an awful lot of unplanned homebirth-foot well of the car, in a corridor, in the back of an ambulance, in a house where the electric had gone out, down the side of the toilet, on the toilet, in the shower and bath…the list goes on (everyone was fine, even the shocked mummies laughed about them later). If you are a healthy lady who has been well throughout her pregnancy with a well-baby you should be offered a homebirth. There is a lot of research about the benefits of homebirth for healthy women and these should not be ignored. We give you a basic list of things to buy, an old shower curtain, old towels, any prescribed pain relief that you may require and we bring the emergency equipment, the gas and air, and the official equipment needed. Plus it’s not as mucky as everyone likes to pretend…my guess is these people have never actually witnessed a homebirth.

Midwife led unit/birthing centre - If a homebirth is not for you, the most common option is to have a hospital birth but in a midwifery led birth centre. There are often fixed pools, at a homebirth blow up pools can be hired. Midwives run the unit offering everything you can have at home such as aromatherapy, massage, physiological third stage of labour, but with the option of transferring to an obstetric unit if something isn’t quite going to plan or you want increased pain relief. Families often like this option as its low risk but with the added benefit of having the hospital on hand.

Obstetric Unit - Then there is the final option which is to have baby in an obstetric unit. Now in reality you should know in advance if you will be starting your labour journey here as you or baby may have a medical condition or there may be certain aspects of your birth that may have complications. Otherwise women should start in a midwifery led unit. The obstetric unit is normally run by very experienced high risk midwives who are used to dealing with emergencies, giving drugs and using monitors. These midwives will often also work in theatre scrubbing for C/Section and ‘taking baby’ at c/section where they care for baby and make sure it is well following delivery. The baby very rarely is ‘taken away’ it’s usually dried a bit so it doesn’t get cold and put in skin to skin with mum, but whilst being looked after by the midwife for safety. Sometimes on the delivery suite there may be families who are not in labour but require treatment. The midwives here, are used to difficult situations and will give you and your family the best care and attention.

We do an awful lot of training to become midwives and have to witness and deliver babies, then witness instrumental and surgical deliveries. Once we are qualified our training does not stop there. To keep ourselves up to date we have to undertake practice scenarios every year and are tested on our skills and knowledge.

So what can you do to help us during your pregnancy?


We want you to become the expert on yourself. We want you to pay attention to your body, get to know your baby and its movements, as this is the best indication of how well your baby is coping. Remember your baby should move in a pattern every day right up to the end of your pregnancy, and if this pattern alters you should see a professional without delay. We want you to attend antenatal classes, yoga, Pilates, aqua natal, hypnobirthing, meditation, talks on diet and lifestyle because these make for healthy pregnancies. We want you to do your research, come in and question us. If we don’t know the answer we will try our very hardest to find out for you, or at least point you in the right direction. Most importantly we want you to talk to us, be truthful and let us know what you are thinking. You might not always like what we have to say back but we will be truthful with you are help you the best we can. Our job is to look after you and protect you and your families, your job is to let us.

Charlotte can be found on insta @babysensoryburnley 
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