One to One

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The NHS is a wonderful thing, but it’s well reported that there’s a shortage of 2300 midwives nationally. And with this coinciding with an 18% increase in birth rate it’s a recipe for disaster.

Frustrated by the budget cuts and not being able to provide the care they want to, many midwives say they’re thinking of leaving the profession, and there’s a sad irony that some of then are going to private midwife services such as One to One midwives, available to patients via the NHS.

Yup, private midwives, funded by the NHS. I’m no expert but surely that doesn’t help the budget cuts?

Switch to patient mode, however, and this seems to me to be the most fantastic thing to happen to maternity care since, well, tea and toast post labour.

I’ve never had a bad experience with the NHS, but the benefits were obvious – one to one care (hence the name) with a named midwife who’s available on the end of the phone for any concerns you might have, and who does your appointments at your home at a time convenient to you. And it wouldn’t cost me a penny.

One to One operate on a ‘case load’ model which essentially means each midwife has a certain number of women to provide full care for during their pregnancy – this is the ‘gold standard’ of midwifery care and I have recommended it to every pregnant friend I’ve seen since!

Having appointments at home after work was the clincher for me. As a working mum in a demanding job, not having to trudge home and back for appointments in the middle of the day would prove to be a godsend. And this was underlined when I had to have a Glucose Tolerance Test (GTT) to check for diabetes – instead of at least half a day sitting round in a hospital, my midwife came to my home in the morning to take the first blood test, and I was able to work from home until it was time for the second. Perfect.

And speaking of my midwife, Lisa was an absolute star. I never once felt rushed at appointments, and I was able to chat freely about anything that was bothering me. Because she showed a genuine interest in my life, I felt comfortable talking about pretty much anything however minor it may have seemed, meaning I felt more relaxed and confident about the pregnancy and labour. A stark contrast to other appointments I’d had, where with the best will in the world a person you only see for maybe 10 minutes isn’t going to be able to get you to open up about the things that are bothering you deep down. Even my older daughter loved it when Lisa came round, and Lisa showed endless patience when G wanted to show her what she’s done at school, or help her check on baby.

If you have a straightforward pregnancy – and particularly if you want a home birth – then a service like One to One is a no brainer if it’s available. Your named midwife will be the one with you throughout your labour, birth, and for after care up to when baby is 6 weeks old.

For hospital / birth centre births or if you have any complications in your pregnancy, there are a few niggles, but these are more ‘wouldn’t it be nice if’ rather than being problems in their own right.

For example, your One to One midwife can’t be with you at your hospital/birth centre birth, you’re over to the hospital for that. However if your labour starts at home your midwife can come out to check on you during early labour, to avoid the risk of rocking up at hospital too early only to be sent home which can be incredibly demoralising.

I ended up being induced with C and this was the thing I was most terrified of, so would have loved Lisa to be able to support me through this. And during my labour with C I was reminded of the NHS midwife shortage when a room on the labour ward wasn’t free for me until more than half way through active labour, and a labour ward midwife wasn’t available until around the last hour. That and the fact that it took me having a mini hormonal melt down in the corridors, 2 days into what was starting to look like an unsuccessful induction, for a midwife to actually look at my birth plan which told them about my fear of hospitals and my anxiety if I don’t know what’s going on.

It’s also slightly frustrating that if you need any prescriptions or referrals (eg for physio) during your pregnancy you have to book a doctors appointment to request it. With an NHS midwife my experience is that they write out the script and pop next door to a doctor to authorise it there and then. Going from the convenience of at home midwife care to the scrum for doctors appointments in the morning was a slight frustration and perhaps a sign that private midwife care hasn’t been fully accepted into the NHS just yet.

Speaking of which, I never quite figured out if the NHS staff I saw were a bit put out by me using One to One, or if they were simply curious as it’s quite new. There were certainly a few blank faces when I explained I didn’t see the local community midwife team, a few sideways glances as they nonchalantly asked “so, why did you choose to go with them?”, and a couple of outright refusals to look at my One to One notes and look instead just at the few early pregnancy notes written in the green NHS folder.

But these are minor niggles, and having had this experience I wouldn’t do it any other way. I would love the NHS to be able to adopt this model themselves, but in the meantime I can’t recommend a service such as One to One enough.

One to One operate in areas of the north west and are expanding into new areas all the time. To use them you self refer by contacting One to One yourself. This post is all my own views based on the care I received, I’ve been given no incentives to write about One to One, I just think they’re fab!

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