I am sure that if I had had any one of my wonderful community midwives with me during my labour I would have felt properly supported and more able to cope and my labour may possibly have had a different outcome or at least not been so traumatic in my mind. My community midwifes were phenomenal- seriously incredibly lovely lovely women. Their antenatal support was fab (one midwife would even cut short her Lunch so she could squeeze me in for an appointment). I wrote to them after the birth to express my gratitude and now 18months later I have just written them another letter as certain things they did to support me postnatally I feel really helped minimise the PTSD I now experience.
Some hospitals do try to do caseload midwifery where your community midwife team is also the team that delivers your baby- this is excellent for the woman but incredibly stressful and difficult for the midwives (my friend who is a midwife was at near breaking point in her trust because of it). If you want a homebirth it is easier to get this type of support but for those in hospitals you often just have the labour midwifes who in my experience were a very different kettle of fish to community midwives (they probably get fed up of hearing women scream all day long!). I have recently written to the clinical director of my new hospitals delivery suite to see if there is any possibility of me having a caseload midwife because of my previous experiences and PTSD- apparently my trust are trying to move over to this way of working so hopefully it will be agreed but I will keep you posted.
I do think have proper support in labour from a familiar face you trust will make all the difference to your labour and even if there are unexpected negative outcomes in labour- having a supportive person will dramatically reduce the psychological impact of such events.
Anyhow below I post the letter I just wrote to my community midwives as I wanted my praise of them to also be public. They deserve public recognition for the wonderful job they did and are still doing.
Dear W team,
I had to write to you gain to say thank you from the bottom of my heart for your pre and postnatal treatment of me and my daughter.
My daughter was born at the W Hospital in Feb 2010- unfortunately it was a very traumatic birth and she ended up in NICU with Grade 1 HIE. Although we are now 18months past the event and she is thriving (a completely mental toddler but a lot of fun and meeting all her milestones) unfortunately I am still suffering a bit from flashbacks etc. and have recently been diagnosed with PTSD- this is also exacerbated by being pregnant again (and due in January). At the minute I am down to have an elective C-section but I am also exploring the possibility of trying again for a successful vaginal birth. My PTSD isn’t too severe, and I think had it just been a traumatic birth I may have coped more but it was also the fact that my daughter was so ill as a result of her birth that I struggle with. My new hospital (we moved out of London) have been supportive and mostly agreed the ELCS and referred me for CBT which I should start soon.
I genuinely think my PTSD would be so so much worse had it not been for my top quality care from the W team supporting me postnatally. Specifically there were several things you did and said that made all the difference to my mental health during that time and I thought it might be helpful for me to document those so you could have evidence to continue this best practice for mothers who have had similar experiences especially in light of any attempted cuts to your essential services.
Firstly midwifes from the team visiting me in hospital and just coming to give me a hug and support- this made the world of difference. I was feeling incredibly isolated and not roomed in with my baby and having a friendly face to talk to really helped. Also A standing up for me on the post-natal ward and getting me moved from a shared room with another mum and baby to my own room as I would not have coped sharing when I wasn’t with my baby. G coming to the rescue when I rang up in tears from my hospital room when the three day blues hit and when I told her that I was feeling so so guilty for “giving up on my daughter and stopping pushing and wanting to die during the labour” she was wonderful in supporting me and telling me that many women feel like that and I wasn’t alone in this experience and she was so lovely and reassuring without marginalising my experience and it really helped.
E ensuring I got a post traumatic birth debrief with my consultant as well as referring me for psychological support was invaluable as well. My debrief with my consultant was very helpful where I learned I would not have been able to get my daughter out by myself and this helped reduce the guilt I felt about that. Also my sessions with the psychologist were very helpful just to have a safe space to talk about what had happened to me and how I was feeling. Again had I not had access to both of these I think my PTSD would be significantly worse.
Finally the fact that all you wonderful W team kept me on your books for 6weeks postnatally. Although I know you are supposed to only keep us for an average of 10days as we were in hospital for 8 of those days, A said you were going to count the day we got home as day one and you were round very often in the early weeks to support me and when baby wasn’t gaining weight properly your support helped me continue with the breastfeeding and top up regime the hospital had put us on. In fact I’m very pleased to say that I breastfed my daughter until she self weaned at 13months and there was no way I could have done that without your support (and that of community breastfeeding support team). My baby also got diagnosed with tongue tie at 7weeks and I had infected nipple cracks that wouldn’t heal so it really was one hurdle after another with breastfeeding and a miracle we managed to keep going!
I just had to write again and thank you because actually although the whole time was a horrible shock for us you honestly made such a difference and made it so much more bearable and I will never forget how incredibly important and valuable your support was too me. I sincerely hope that you continue to be able to provide such high quality support and that your services are not affected by any cuts.