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What women and midwives want
Our lives and future in your hands
Belinda Phipps NCT
The Importance of Birth
“It ranks as number 1 in my great moments”
“The way a woman gives birth can affect the whole of the rest of her life - how can that
not matter - unless the woman herself doesn’t matter”
“It’s something you never forget and it does mark a huge transition in your life”
“Incredibly important”
“Nothing can compare to the experience of giving birth and holding your child for the first time. It definitely altered my relationship with
my partner - for the better”
“Life changing - more meaningful than all other experiences”
“Birth experiences strike at the very heart and soul of you, they touch new emotions not
experienced before and bring a whole new perspective to life”
The Potential of Birth
• Empowering• Affirming• Identity changing• Courage giving• Advocate creating• Healing
Post-traumatic stress disorder
• ‘feeling in control during the labour and delivery and knowing what to expect were important protective factors against the development of PTSD’ (Lyon, 1998)
• Czarnocka and Slade (2000) found that ‘women with symptoms of PTSD were more likely to feel that they had little control during the labour, to have higher ratings of trait anxiety, and greater fear during the labour’
Safety is …
• A midwife you know and trust• An NHS you trust • Being listened to and taken seriously • Good teamwork• Feeling consulted and involved and supported to decide • Affirmation • Explanation • A comfortable and comforting and clean place to be• Being and feeling cared about and cared for • Confidence you can cope
Safety is not…
• Being left alone in labour or other times when frightened
• Being told off or threatened• Professionals arguing with each other and
contradicting each other • Being told your baby will die unless.. • Being unable to ask any question you want
without feeling silly
The ‘patient experience’
• 1. Patients are treated with dignity, kindness, compassion, courtesy, respect, understanding and honesty.
• 2. … staff …have demonstrated competency in communication skills.• 6. Patients are actively involved in shared decision making and supported to make
fully informed choices about investigations, treatment and care • 7. Patients are made aware that they have the right to choose, accept or decline
treatment and these decisions are respected and supported.• 11. Patients experience continuity of care delivered, whenever possible, by the
same healthcare professional or team throughout an episode of care.• 12. Patients experience co-ordinated care with clear and accurate information
exchange between relevant health … professionals.• 14. Patients are made aware of who to contact, how to contact them and when
to make contact about their ongoing healthcare needs.
NICE guideline QS15. Quality standard for patient experience in adult NHS services. NICE 2012.
Care Quality Commission Maternity Survey 2007/2010
Question 2007 2010
Women who got the pain relief they wanted 64% 65%
Women with confidence and trust in the staff caring for them 68% 73%
Women whose birth partner was made welcome by the staff? (not asked) 84%
Women left alone by midwives or doctors at a time when it worried them? 26% 22%
Women who were spoken to in a way they could understand during labour 82% 84%
Women involved in decisions about their care during labour? 70% 71%
Women with legs in stirrups at the birth
27% 30%
Fulfilment is …
• A midwife you know and trust• An NHS you trust • Being listened to and taken seriously • Good teamwork• Feeling consulted and involved and supported to decide • Affirmation • Explanation • A comfortable and comforting and clean place to be• Being and feeling cared about and cared for • Confidence you can cope
Fulfilment is not…
• Being left alone in labour or other times when frightened
• Being told off or threatened• Professionals arguing with each other and
contradicting each other • Being told your baby will die unless.. • Being unable to ask any question you want
without feeling silly
safety
fulfilment
To be a good parent
Less common
Main stream
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Midwifery 2020
“Women and their partners want a safe transition to parenthood and they want the experience to be positive and life enhancing. Quality maternity services should be defined by the ability to do both.”
“Midwives should have a visible place in a community setting where women can choose to access them as the first point of contact.”
“There are two key roles for midwives that are important if we are to achieve our vision: one is that midwives are the lead professional for women with no complications, and the other is as the coordinator of care for all women.”
“Each woman and her partner need a midwife they know and trust to coordinate their physical and emotional care through pregnancy and until the end of the postnatal period.”
Provide high quality care
Provide some care to many
people
Provide the best care for
everyone
Spend some time with everyone
Focus on one person
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action
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need
aim
In order to have this
I must have this
I must
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In order to have this
I must do this
I must do this
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B
Time
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She came to me and calmly said we were just going to chill out together, she asked why I was scared of hospitals and was the only person who actually listened to my fears. She actually 'said' very little but her whole presence spoke volumes, if that makes sense?. She advocated for me and truly.
Who wants to solve these dilemmas?
