Is choosing or knowing your midwife really as important as the evidence says it is? We are informed by studies that knowing the midwife improves outcomes with all variables….you know, less caesarean sections, less babies in special care, more women achieving normal birth, less hospital stays, more breastfeeding, more satisfaction with the process……I am sure the list can go on but already it is clear to see a cost saving, and far less complaints maybe, if all these things were reduced? How much money could be saved by the implementation of continuity of care? The Government know it, the NHS knows it, the trusts know it, the mangers know it and the midwives know it. But do the women know it? Does it matter to women that they get to know the midwife who will be caring for them at the birth or is all they want is a knowledgeable, caring, kind midwife?
Currently Neighbourhood Midwives is trying to make changes to the way maternity services are delivered by setting up an employee-owned social enterprise organization. They state that their primary purpose is to provide an NHS commissioned caseload midwifery homebirth service, based in the local community, “wherever it is required”……
Wherever it is required? Surely the question should be; is it required?
In order to gain the relevant information to answer this exact question, a colleague who is working on the implementation of Neighbourhood Midwives asked this question on the Facebook page “One Born EveryMinute-The Truth”;
“Does it matter to you that you don't know the midwife who will look after you in labour? If not, why? If you could have a choice and choose a midwife whom you knew and who could care for you throughout your pregnancy, would you choose this option”?
As would be expected on a page that is primarily about evidence based midwifery practice, there were quite a few women raving about having the option of knowing ones midwife and continuity of care. To be fair there were also a lot of comments from women who had amazing experiences but who did not know their midwife and then some women were saying that it really doesn’t matter as long as the midwife is kind and caring.
I have been thinking about the final comment as I remember having the exact conversation with a mentor many years ago when I was a student midwife. The mentor told me that “all women want is a king caring midwife.” However this was also the same midwife who said “the important thing is a live healthy mother and baby,” when we were discussing birth plans. Well of course I do not think we could argue either of those points because both are important and any birth would be unbearable without either. But why does anything have to be sacrificed? Why can’t women have it all? Why can’t lots of things be equally important? Why can’t importance have parallels?
I love really using analogies so I will compare it to going to a restaurant and choosing a dessert…..
OK I really want a dessert the type of which I know is sold in another restaurant and which I absolutely adore. They do something similar here and I have tried it at this restaurant too but here it’s not quite the same. It is not a fancy dessert in fact it’s been around for years, including at this place but in the other restaurant it is so utterly special because it is with a fresh cherry on the top. The cherry makes it exquisite to taste. Lots of people want it with a cherry too but as it has never been available they settle for the dessert as it is served here. Despite asking for a cherry I am told by the waiter that sorry I cannot have a cherry. What he knows and everyone else knows is that the fresh cherry has loads of health benefits and is exquisite to taste but according to the restaurant owner they would have to install an expensive machine to de stone the cherries. Even though they know that people will come to the restaurant from far and wide and rave about it and that in the long run their takings will improve they think “oh well it’s been ok for most people for all this time so we will keep the dessert as it is”. There are some people that eat at the restaurant who love the dessert as it is, they say it is perfectly good enough and cannot for a second believe that a cherry would make any difference. Some diners say all that matters is that the dessert tastes nice and so let’s just leave it as it is………
But I know the truth, and all those other diners who have tried it at the other place, knows the truth, is that they have never experienced it with a cherry on top, that if only others would try it a different way they would widen their eyes and say “oh my oh my the other way was good I admit but oh how delightful how exquisite and how memorable is this desert with the cherry on the top……and healthy too…. wow we are having it all…..
Who wouldn’t want midwifery care with a cherry on the top?