Pay For An Independent Midwife Or Not?

Mum_of_many_4

Hi
This is my first post in here, sorry if its a bit long and rambly but I just dont know what to do. Hoping fellow savers can help.
I am currently pregnant with my 6th baby (23 weeks) my first 3 pregnancies were all uncomplicated with overdue babies. #4 my waters broke at 36+3 and I had a 3 day induction (horrible) baby was born at 36+6 and spent 2 days in special care on iv antibiotics (precaution in case of infection, which there never was)#5 my waters went at 32 weeks then resealed and went again 34 +1, another long unpleasant induction this time baby was in special care for 13 days(first week in intensive care on a ventilator and lots of other probs) With all of this in mind I have looked at having a independent midwife for this pregnancy, one has been out to visit and we both (dh and I ) really like her. However the cost for this is £3000 and it would have to be paid in full by the time I am 36 weeks(if I make it that far) which only gives us 13 weeks to save. Also there is obviously a high chance of me having a premature delivery so birth wouldnt be at home/ in a birth centre which I would like but rather in a hospital, although my midwife would still be with me to support me. I am worried about how we might get the money together in time and really cant seem to make up my mind what to do. I am not planing on having any more babies so would like this pregnancy/delivery to be a nice positive experience rather than the unpleasant traumatic experience I have had the last 2 times, for this I think an independent midwife would be truly valuable. Obviously its just the money that concerns me.
Any advice, opinions experiences welcome. Thanks in advance

Eels100

OK, firstly I haven't had any children (20wks pregnant with first) so I can't speak from experience!

I think you need to ask yourself a few questions, mainly whether having an independent midwife will actually change what's going to happen to you. If you previous experiences were unpleasant because you felt unsupported, or that you weren't given enough information or assistance then an independent midwife would be a great idea. If they were unpleasant because of your physical problems with the waters breaking early, I don't expect a different midwife will be able to stop that happening again.

If you feel that you need extra support, maybe it would be a good idea to talk to one of your community midwives about this issue before committing to the independent one. I have been amazed by the encouragement and support my community midwives have offered me throughout the first stages of my (so far normal) first pregnancy - and they're keen to make sure I know I can call on them with even the slightest of worries. Is it possible that they've assumed that as a mum of 5 you feel OK with the whole process, and don't want/need any help? Maybe by explaining your concerns they'll arrange to offer you extra reassurance and encouragement.

If you still feel unsupported then by all means arrange to see the independent midwife but so far I have found the help I need is there, if I ask for it. Your local area might be different, but you might be pleasantly surprised by the great service community midwives are willing to offer.

I really hope this birth is everything you want it to be - good luck! :cool:

Jo_R_2

Oooh *rubs hands in glee* one of my favourite topics - giving birth!

I think given the history with the last two pgs, then I don't blame you for wanting to hire an indie midwife. I researched the same when I was pg with #2 but struck lucky with an excellent NHS midwife during my pg and another lovely one when I was induced.

The research I did for my area (East Mids) showed that some midwives will allow you to pay on a monthly basis, basically tailoring how you pay dependent on yr income. Have you spoken to anyone else or just this one? I would definitely research some more and see if you can find anyone who will let you pay like this.

Another option is a doula. They can be your birth support throughout pg and at birth, and you can get postnatal doulas as well. If you know you are likely to need a hospital birth then a doula is another option and not as pricey as a midwive, but offers loads of woman-to-woman support.

One more thing I will say is have you read through your maternity notes? I'm not sure if you know exactly what happened to cause premature labour in your last two babies after three term births? It would definitely be a good idea if you haven't to arrange to read through yr maternity notes so you know wat happened, when and why so you can pre-empt anything at all and be prepared for all eventualities. This way if you do decide to go NHS then you can plan the birth you want as far as you can given the circumstances and knowing all the facts.

I had a 41+1 natural birth with DD1 then a 43 week birth with DD2 so I know all about induction! I fought it to the bitter end but had to have an induction because she simply wouldn't come out! Do you know much about the stages of induction - having your waters broken (not that you would need that), prostin, then oxytocin drip? And the effects each stage has on your body and also on the baby? I just really believe in knowing exactly what you are choosing and what effect it will have - it helps you 'shape' your experience as much as you can if you do give birth in hospital.

Sorry went o/t a bit but as I said, I love this topic of conversation!

Justie

again I've not had a baby yet but am looking at all our birthing options and have considered a doula. An independent midwife would have more medical knowledge than a doula and if it got to the stage of hospital intervention may be able to speak up for you better in the hospital than a doula but if you'd discussed all options beforehand then a doula may well be able to do the same job anyway. If you have a healthy birth with little intervention then you would have your NHS midwife present anyway and I'm not sure how much more an independent midwife can offer. My thinking on an IM is that if you're likely to end up on a busy maternity ward where you're not guaranteed one to one attention then it's well worth the money but if you're likely to be in a small unit or at home with plenty of NHS help available then it's probably not necessary.

It all depends what you want the support for. If it's more medical then a midwife is probably better. If it's emotional support and some easing of pain etc then a doula may be a better and cheaper option.

I'd also talk through any options with your midwife beforehand I don't think any hospital would refuse you having an IM at your birth but they should be able to tell you what she would and wouldn't be able to do.

Also if you're going to employ either a doula or an IM and there's a possibility you could go into early labour check what would happen - would she attend? woudl you get your money back etc. Work out how long it will take her to get to you in the worst traffic conditions and check that she has no other bookings for the period you're likely to give birth (one of my friends had an IM abroad and when she went into labour the IM was with another client and sent a deputy who had no training and the whole birthing experience went downhill from there on in).

It is a lot of money and it may be the best £3k you'll ever spend or it may be a waste of money but you'll never really know beforehand. I would first speak to your midwife etc and see what extra support you may be able to get from them.

Good luck!

Mum_of_many_4

Eels 100- My main reason is the lack of support from my midwives to be honest. I never see the same one more than once and have only ever been delivered by a midwife from my "team" once. I appreciate that having a independent midwife can not change whether my baby is prem or not. Good luck with your pregnancy.

Jo R- I had an appointment last week at the hospital where I met with a registrar to discuss my care for this pregnancy. He said that they can find no reason for my premature labours and that he feels its just a fluke and that it probably wont happen again, something I am a bit sceptical about as they said that last time.The other thing we found out at this appointment is that I am group b strep positive (not sure if you have heard of this) basically it means I will need antibiotics during labour which the hospital recommend to be given intravenously (indie mw said it can be done with oral antibiotic therapy) they also want me to have a cannula (just in case) as I have had 5 previous births (apparently am more at risk of post partum hemmorage). They are not willing to give me any extra care apart form a reasurance scan at 28 weeks. I only know the basics of induction (had 4 inductions now) have experienced all 3 methods and didnt like any! lol. To be honest I dont feel I have had anything explained properly to me by the hospital or been given any alternatives, another reason I would like to avoid them if poss.

Cato

Mum of Many - congrats on your pregnancy. My wife wanted an independent midwife to ensure continuity of care and a home birth (if she'd had to go into hospital then the IM would have been an excellent advocate for her to ensure the best possible outcomes for mum and baby). It was the best 3 and a half grand we've EVER spent, the ante natal care, the labour, the post natal care - independent midwives are worth their weight in gold. We're not in debt and don't generally 'do' debt but decided to put savings towards it plus a £1000 loan which we've just paid off in 8 months. We cut back to the bone on other things (no holidays for last year or this) but don't feel the pinch as the result of hiring indie midwives was just great. I've got a broad smile on my face just thinking about my daughter's birth.
By the way, lucky you're expecting your last baby as independent midwives may not be available for much longer due to new government legislation, see
https://www.saveindependentmidwifery.org

Mum_of_many_4

Justie- We x posted. My main reason is the medical knowledge and also 1 to 1 care something I havent had in my last 2 births. Also if I could avoid hospital that would be great and (hopefully) an IM would be with you throughout the birth. At our local hospital if a mw isnt available then you have to go in, they are often short staffed so not many people actually get the homebirth they want plus I am group b strep positive so the hospital wont support me with a homebirth but the IM would. We have already discussed the possibilty of a prem delivery with her and she is happy to attend, also she isnt booked in to deal with anyone else at that time.Have had a meeting last week with the hospital and they are basically not going to offer me any extra support apart from 1 scan at 28 weeks as reassurance.

cloz

Hello, just wanted to add my support and say that i had an Independent midwife with my son in 2004 and it made the whole experience wonderful. I REALLY did not want to go to hospital and she gave me the confidence to have the home birth i wanted (had a water birth) and was nothing other that supportive all the way through the pregnancy. The aftercare she offered was also priceless as we had a few problems with feeding lo. Yes it is alot of money but would definetly consider using her again, I am still in contact with her now almost three years later!

Justie

Mum_of_many wrote: »

Justie- We x posted. My main reason is the medical knowledge and also 1 to 1 care something I havent had in my last 2 births. Also if I could avoid hospital that would be great and (hopefully) an IM would be with you throughout the birth. At our local hospital if a mw isnt available then you have to go in, they are often short staffed so not many people actually get the homebirth they want plus I am group b strep positive so the hospital wont support me with a homebirth but the IM would. We have already discussed the possibilty of a prem delivery with her and she is happy to attend, also she isnt booked in to deal with anyone else at that time.Have had a meeting last week with the hospital and they are basically not going to offer me any extra support apart from 1 scan at 28 weeks as reassurance.

it sounds like you would benefit then whether it's a home birth or in the hospital and that you need an IM rather than a doula. It's worth meeting a couple of other IMs if you can as going with the first one is never an informed choice. I'd also check with your GP about the strep B antibiotics orally and don't use the IM instead of the NHS but to support you through the NHS process...

not sure if it's any help but I've just been reading up on other pregnancy things and have come across something that says that orgasm should be avoided if there's any history of premature labour... just to cheer you up :rotfl:

Mum_of_many_4

Cato and Cloz Thank you for such lovely positive replies . I was certainly hoping to hear some good stories. We would certainly have to cut back a lot to pay for it and I guess my main worry is making everyone else suffer for something I want.

lipidicman

I heard on the radio the other day (Woman's Hour) that independent midwives are practicing without insurance! Worrying thought!