Theresa's story

Community Maternity Units – a necessity not a luxury
As well as being allocated to maternity units within the NHS Trust where they are training, midwifery students have the chance to travel elsewhere for what is called an elective placement. Here Theresa reflects on her reasons for choosing Montrose and the impact the experience has had on her view of freestanding midwife-led units.

When I considered my choice for an elective placement I was limited to the UK due to childcare issues but wanted a different experience to the obstetric led unit where I had trained.  An elective placement should be a time of reflection and new experiences. Much as I had enjoyed my time in the obstetric unit, it was a midwifery philosophy that had retained my passion through a demanding 3 years of training. I felt the need to challenge myself and get a feel for a midwife’s role in a midwifery-led unit.

My first knowledge of Montrose Community Maternity Unit was when a family member stayed there after the birth of her baby. She was enthusiastic about her care and impressed at the arrangements for visiting relatives who were able to come and go freely yet the staff were able to ensure some rest time for mums. The breastfeeding support she received and the overall warm and caring environment at the unit helped her and her husband’s transition to parenthood enormously. I then noticed in the Royal College of Midwives magazine that the Montrose midwives were running a student study day and had won two awards (RCM 2005 “Promoting Normality” and British Journal of Midwifery “Best team” 2006).

I was intrigued. Despite having just finished my midwifery emergencies exam module, I was beginning to realise that I wanted to be grounded firmly in normality. With my mother agreeing to baby-sit my four young children, I contacted Phyllis Winters at Montrose and Judith Angus at Dundee University. Both were kind enough to welcome me to join the team.

Enthusiasm and passion
I am extremely grateful to all the midwives at Montrose for the chance to experience midwifery led care in a true sense. I had attended waterbirths before in my training, as my unit are keen to promote them too. However the enthusiasm and passion of the midwives at Montrose blew me away. I was able to talk about midwifery at length and the midwives were keen to hear my thoughts and experiences and were gentle and encouraging in my quest to gain experience in being ‘with woman’.

My first waterbirth was truly delightful. The couple had limited English as an Additional Language yet we were able to communicate what we needed to. The midwives at Montrose stepped back and let me take the lead role in the woman’s care. I very quickly felt secure in my knowledge and experience and, when the baby was born with intact membranes under water  (I had never seen this), Phyllis’s calm demeanour and guidance without interruption in my role was a real boost to my confidence. As the labour was clearly progressing normally, no-one required to know how many cm dilated the woman was and I did not feel any need to perform invasive examinations. The only time I put my hands on the woman was to monitor contractions and the baby’s heart. The only time I touched the baby was to pass him through mum’s legs to her after birth. Bliss……

Births like this happen all the time at Montrose (80 per cent pool births). However when women do need more input during pregnancy, labour or the postnatal period the links with the local obstetric unit 40 miles away are excellent and good communication between the midwives and the doctors is evident daily.

The women of Montrose and surrounding areas are fortunate to have this service. Hopefully the success of this unit and others like it can cause a ripple effect and show that midwifery-led units are a necessity not a luxury. Women and dedicated midwives throughout the UK deserve to have a unit like this in every town. If Changing Childbirth (1994) and Maternity Matters (1998) are to fulfil their recommendations of women’s choice and promotion of normality, then it is time these kind of units were extended and invested in by the NHS.