Reminiscing about the publication of Changing Childbirth (Department of Health (DH), 1993) over a decade ago and looking forward to the outcome of the national maternity review, midwives continue to provide choice and continuity for women. Consultant midwife, Pauline Cooke shared an experience that shows midwifery care matters and shares one experience of one-to-one midwifery practice. Her story reminded me of the amazing contribution that midwives continue to make to the lives of women and their families.
‘During a spring holiday this year, I visited the beautiful gardens at Wisley with my sister. Around lunch time a woman approached me and asked if my name was Pauline and if I was a midwife. When I said yes, she exclaimed “you were my midwife 20 years ago!” I vaguely recognised her face but when she said her name, I knew immediately who she was, where she lived and remembered James, her then 3-year-old very bright little boy with a liking for toy Swiss army knives. Photos on Clare's phone were shown, mobile numbers exchanged and an invite issued for tea to meet Hannah (the “baby”), now 20, before she returned to university.
‘The next week I spent a delightful evening with Clare, Hannah and James. Over tea and cake, we recounted the events of 20 years ago, remembering Clare's nausea, the day she went into labour with my whispered instructions to her husband, Chris, to drive quickly! We laughed at the photo of Clare and me, taken just after the birth, which showed neither of us had changed that much. When Clare was pregnant in 1995, I had been working with the 0ne-to-0ne midwifery practice at Queen Charlottes and Hammersmith Hospitals. I was responsible for education and practice development but also carried my own caseload of about 15 women per year. Nine months after Hannah's birth, Clare wrote an article in the local National Childbirth Trust newsletter, part of which follows:
‘“All my routine antenatal care was carried out at home, at convenient times … On my midwife's first visit, I immediately felt at ease, as it was obvious she had researched the notes from my previous pregnancy and knew everything about me … Over the months, we built up a very good and quite close relationship and had many opportunities to discuss my experiences last time and what I hoped to achieve this time round … Having received weekly visits towards the end of my pregnancy and discussed my birth plan, we were very much in tune with each other and I felt 100% confident about the coming event … One Saturday morning at 39 weeks, I woke with a few slight twinges … by 3pm we were sitting in front of the fire watching the rugby and I started to have proper contractions at 10 minute intervals. We called the midwife to inform her labour had started and I felt very confident knowing she would come whenever I needed her … It was time for the warm bath and TENS machine, but the plan had already changed by the time I reached the top of the stairs. No bath, TENS machine on and ask the midwife to come over. She arrived in 10 minutes and having witnessed one contraction, advised that we leave for hospital immediately. Her parting shot to my husband (out of my earshot) was ‘put your foot down!’ A further 10 minutes and 22 speed humps later we arrived at Queen Charlotte's… During a very strong contraction in the lift, I was already wanting to push. I told Pauline this, expecting the usual ‘no not yet’… To my surprise she said ‘okay, let's just get into the room’. Once installed, I took up a standing position, leaning forward over the bed and 10 minutes and a few contractions later, a little girl was born, literally into my arms … Although the actual delivery was swift to say the least, the atmosphere was very relaxed. An hour passed in which we were able to get to know our new daughter. Pauline had prepared a lovely warm bath and waited to see us settled down on the ward. She was certainly in no rush to leave and we all sat chatting about the events of the evening like old friends…. Looking back, I can honestly say I received faultless care from start to finish, from a service which was tailor made to meet my individual needs …”’
This story is one of many examples of the unique and special relationship between a woman and a midwife. A relationship where the power to create and nurture is supported, a relationship where trust and confidence are pivotal to the facilitation of the power of birth, a relationship that knows no boundaries and is committed to personalised, continuity of carer; where choice, continuity and control are integral to the ethos of care.