Mental health and wellbeing, Pregnancy after loss

Why midwives matter

This week it was officially announced that my midwife Michelle (yes, that is quite confusing!) is the London regional winner of The Royal College of Midwives Mum’s Midwife of the Year.  I nominated Michelle back in the summer last year when we were away on our fundraising adventure and then promptly completely forgot about it until I got a message from her in December saying that she had won.  Cue lots of tears from both of us!  Michelle is wonderful woman and midwife; she is kind, compassionate, dedicated and passionate about her work.  She has gone above and beyond in her duty to look after myself and Andy and I feel that we have a bond that will last forever.  I am so honoured to have Michelle as my midwife and incredibly proud that she has won this award.  She thoroughly deserves it and anyone who has the opportunity to have her as their midwife is very lucky indeed.


Michelle is a caseloading community midwife.  This means that she runs a team of midwives who have a small caseload of women who they see all the way through pregnancy, birth and up to a month afterwards.  This provides women like me with:

  • Continuity of care. I don’t need to explain who I am, what I need or what my journey to motherhood has been thus far at every appointment.  Michelle will always follow up on any questions or concerns I may have, and there is a sense of progression at each appointment – that together we are moving towards bringing our baby into the world.
  • An empowering and close relationship. When I was pregnant with Orla, I saw Michelle for almost every antenatal appointment.  I felt like she knew me and I knew her.  I looked forward to my appointments and to telling Michelle what had been going on in between: yoga, hypnobirthing, stubborn baby continuing to headbutt my ribs in a breech position!  On the few occasions that she was on leave, I saw another midwife from the team, but since they work as a close unit, I was confident that she also knew who I was and what my care had been.  I had the opportunity to meet the whole team in the weeks leading up to Orla’s birth, so that if Michelle was away at the time I gave birth, I would know the face that would be greeting me at home or in hospital.
  • Choices.  I had the option of a home birth, the midwife led birthing centre or hospital, and I would still have Michelle with me whichever option I chose.  I had hoped for a home water birth and felt confident and empowered in coming to that decision, whilst also knowing that at any point, I could change my mind and negotiate a different plan.  The options were person centred and holistic.  We discussed the hypnobirthing and yoga that I practiced religiously and considered all pain relief options, including aromatherapy as well as more traditional medical interventions.
  • Confidence.  As a first-time mum, I felt confident (and dare I say it, even excited!), to give birth.  Having a relationship that I had built with Michelle over time meant that I could make fully informed decisions that were based on discussions and me being able to ask questions and express concerns.  For someone who grew up fearing that childbirth was something I would not be able to cope with, this was really important to me.

During my first pregnancy, I knew that all of this was important, and that I had completely lucked out by being allocated to Michelle and her team.  But little did I know that this was something that would save me from the hardest and most traumatic experience of my life.

We found out that Orla had died on a Sunday evening.  I hadn’t been feeling right and had noticed reduced movements.  I called the midwife team pager and they advised popping in to the maternity unit for a quick check on the machines.  But sadly a quick check delivered the most devastating news.  The still ultrasound screen that was switched off before the doctor placed her hand gently on my leg and said “I’m sorry”.

We went home, packed a bag and came back to our side room on the labour ward to begin the induction process late Sunday night.  I called the midwife pager and informed the midwife on call.  And within minutes, Michelle had called me back.  She was calm, soothing and kind.  She told me she would be there first thing in the morning and that she would be by our sides throughout.  And she was.

Induced labour at 37 weeks to deliver your first baby, who you know will be born still, is emotionally and physically exhausting.  Michelle stayed with us throughout; we talked, cried and even laughed together.  We shared the most intimate of journeys and I felt safe, contained and supported throughout.  I still had choices and was empowered to make them.  I was still a mother, giving birth to our first child and this was a precious and special time despite the overwhelming heartache.  I trusted Michelle completely and she gave me the strength to keep going, even when I felt like I couldn’t.

Other members of the team popped in at various points to sit with us.  Not only was that good for Andy and I, it helped us to see how a caseloading team provide support to each other.  I didn’t need to worry about Michelle because I could see how she was being looked after by her team.  And I imagine that it is this support that enables midwives to provide the best care to couples like Andy and I in both the best and most tragic circumstances.

When Orla was born, Michelle was the first person to hold her.  She told us that Orla was a girl.  She took the only photos that exist of Andy, Orla and I as a family.  And she made sure that we had and did everything we could to make as many memories as possible.  Michelle encouraged us to look at the whole of Orla – her whole, perfectly formed body – and to take photos.  These are the ones I return to over and over again, since they show me that Orla was real: an actual fully grown baby with long legs and feet, that I had grown and birthed.  Sometimes, when I fear that she will become a figment of my imagination, this is the photo that I go back to.  Orla was real, she existed and I am so proud of her.

Michelle stayed with us to complete all of the relevant paperwork.  She ensured that we had Orla’s hand and footprints, that we had clippings of her hair and hospital tags with Orla’s chosen name.  She didn’t leave until we were transferred down to the postnatal ward and had handed our care over to the midwife on shift.  Michelle visited us at home numerous times in the weeks following our return home.  She came to Orla’s funeral and was always at the end of the phone if we had any questions.  And throughout all of these things, Michelle showed us respect, compassion and kindness.  She allowed us to feel whatever we were feeling without judgement and could sit with us without trying to change or fix things.

But something else that Michelle gave us throughout was hope.  Hope that one day we would have a baby that we could take home.  A baby that would never replace Orla, but one that would help us to heal and parent in the way that we had always hoped.  Michelle has held the hope for us when we have been unable to. It is hope that is tentative and respects our pain and loss.  And never, ever diminishes Orla’s existence.

When I fell pregnant again, Michelle was the first person that we told.  We were away in the States and very early into our three-month trip.  She immediately allocated me to her caseload, booked me in remotely and scheduled our first scan for the day after we arrived home.  She has coordinated my care throughout this emotionally difficult pregnancy and has seen me as and when I have needed.

At a time when I often feel paralysed with fear, Michelle is doing everything she can to help us navigate the gauntlet of pregnancy after loss with as few obstacles as possible.  Where there are bumps in the road, she is by our side.  She listens to my fears and validates them without immediately trying to fix them.  She normalises what I think and feel.  She provides choices and helps me to think them through.  Again and again.  At a time when I feel completely overwhelmed and terrified, I still have a sense of empowerment that I can, and I am, doing this.

In a political climate where cuts and cost savings are rife in the NHS, I feel so lucky to have been allocated to Michelle.  The bereavement care at my hospital is limited due to cuts; there is only one part time dedicated midwife and no bereavement suite.  This feels so wrong, since the care that you get at this critical time is make or break in terms of your grief journey.  And not everyone else has a Michelle.  It fills me with absolute horror that someone would have to go through the loss of their baby without some form of consistent support, but I know that this is often the situation.

Midwives do so much more than deliver babies.  They empower women and help them to achieve their hopes and dreams of having a family.  But they also support families when they are at their most vulnerable, when things don’t go to plan and sadly the worst happens.  They are at the frontline of supporting the mental health and wellbeing of parents when tragedy strikes.  They are counsellors, care coordinators, advocates, coaches and cheerleaders.  They become like a member of your family, are your guardian angel and your beacon of light and hope.

And this is why midwives matter.


Some local press coverage of Michelle’s award:


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1 Comment

  • Reply LanaSalt February 4, 2017 at 11:27 am

    This is wonderful! I am so pleased for you that you’ve had such excellent care and that link between someone who knew Orla so well and will know her little sibling. It’s amazing! So lovely for Michelle to get the recognition she deserves too.
    I’m retrospectively jealous as our NHS care really wasn’t great with Isobel and after some early failings in care in my rainbow pregnancy we ended up deciding to go privately in my second pregnancy. We had amazing care from then but the £4000 we had to pay for it was money we really couldn’t afford and I know if we had another pregnancy we definitely couldn’t stretch to it again which scares me!
    Hope your pregnancy is going well and you are coping as best you can xx

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