King's midwives vs Lanes??

[mirabelle]

Hi all,

I'm expecting my first baby at the end of July and have been looked after by a King's midwife since the beginning of my pregnancy. I was assigned to this midwife after going through the dulwich medical centre on crystal palace road - apparently the Lanes midwives already had a full caseload. My midwife has been great so far, I have no complaints, but she did mention at my first appointment that I would be put on a waiting list for a place with the Lanes, but we haven't really discussed it since and I've been wondering if it would actually be a good thing to switch over to a different midwife halfway through my pregnancy?? (I'm now 21 weeks)

My understanding is that the main difference between a Lanes midwife and one from King's is that the Lanes will follow you throughout your pregnancy AND be present at the birth, whether a King's midwife most likely won't be present when you go into labour.

Have I understood this correctly? Does anybody have any advice or views about the pros & cons of one system vs the other? should I enquire about the waiting list?

Thanks!

[mrs f]

If you get the chance I'd jump at being with the lanes, you will have a dedicated midwife who will follow your pregnancy, birth & post natal care. I've met 4 of the 6 midwives on the lanes team (through meet the midwives session) & they are all lovely. Mainly though having a community midwife is a huge benefit through the continuity of care you receive. Also if you are interested in a home birth, the lanes are set up to deal with that (as well as hospital births)

I feel so lucky to have a lanes midwife & am totally at ease about going into labour as I know my midwife knows exactly what type of birth I want & knows me so it will be brilliant having her 'on side' when the time comes.

Good luck & definatly go for it if you get the chance

[simonethebeaver]

I'm with Oakwood, which is the same system as The Lanes, unless I've got it completely wrong, and from the reactions of others to hearing about the service I'm getting (service seems almost a rude word but I can't think of a better!), Oakwood are far and away better than the Kings' midwives.

Oakwood:

- have done all my appointments at home, and pretty much to time

- have given me a named midwife, and introduced me to the two others in the group - I'm having a home birth (fingers crossed) so two of them will be there with me and I'll already know them

- have spent as much time with me as I've needed at each appointment

- will come to hospital with me if needed, so I'll have continuity of care throughout labour and delivery, which can make you far less fearful and relaxed

- are completely supportive and understanding of hypnobirthing, which we're planning to do

- are planning a two hour visit with me and my partner at 36 weeks to go through the birth plan thoroughly with us, and will help us put it together

- say they'll visit every day for the first 12 days after the baby is born, including coming to the hospital if I'm in there.

I can't say exactly how this compares to Kings' as I've never been with them, but quite a few people I know are with Kings and don't seem to have had this sort of stuff. However, if you're happy with your midwife, then she may be the best person to stick with. Lots of people do have their babies happily with Kings. I'm sure you'll be fine whatever happens.

[Smiler]

The Lanes were great for me. Continuity of care after the birth is really important, in those difficult early days is v nice to see a familiar face.

The Lanes also do appointments at home - not sure if Kings do this.

[Kes]

Do the lanes/Oakwood only deal with home births? After lots of problems and an emergency cs last time home probably wouldn't be an option if I had another but sounds like you get much better care with caseload midwives.

[Sally81]

i was with the lanes and did not get the continuity of care at all...someimes that system jut does not work. I wasn't as impressed with them as I was hoping to be. My advice about them is make sure you're very clear about anything you do/don't want in labour and write it in your notes. Many people have great things to say about them though, i think i was just unlucky.

[lenster]

Mirabelle, I'm also due in July and am with a Kings midwife after going through DMC. I was told the same thing about the Lanes waiting list.

I considered chasing it up a few weeks ago, but decided not to bother. I'm not planning a home birth though - if I was, then I'd probably be looking to switch.

[Beagle]

I had a fantastic experience with The Lanes, but the midwives I saw at Nightingale in Kings when I was in labour were fantastic too.

Just one thing Mirabelle, you mention a Lanes midwife being with you when you go into labour. They will come out and assess you or refer you to Kings and assess you there, but no one is likely to stay with you if you are in the early stages of labour, (for some women in can be a slow labour) so don't change midwives on this basis.

Yes, Lanes attend Kings as well as homebirths.

all the best

[mrs f]

Good point Beagle, the lanes will come to your house, whether you have a home or hospital birth & they will assess you & only send you into hospital when you are ready (4cm?) so there is no chance of you getting sent home & having to come back.

Sorry you didn't have a great experience Sally, I've ended up with my midwife changing over the course of my pregnancy however I still feel very lucky to be with them, & friends I've spoken to from outside the area are stunned at the service I have available as they have nothing of the sorts, especially not on the nhs.

I think they are very busy though as we all keep breeding in this area !-)

[srisky]

I had a great experience with the Lanes.

I had the same midwife for all my antenatal appt, which were conducted in my living room! However, I went into labour when she was on leave and another midwife (whom I had met at 'meet the midwives') from the practice attended to me. They provide telephone consultations during the early stages of labour but will come to see you if you or they have any concerns.

Once I was contracting every 5mins the midwife came to me enabling me to labour in my own home for 8 hours until I was 8-9cm. This meant I couldn't have an epidural, which I was glad about, but may have asked for (and got) one if I had been in hospital. Nothing wrong with that at all (I would never judge someone for taking all the pain relief available!) it was just my personal preference.

As things were going well she gave me the option to deliver at home but I prefered to go into King's, so she called the labour ward, got me a room and delivered my daughter. The King's midwives did not get involved in my care at any point (as there was no need) and I was in and out of hospital within 4 hours.

The main advantage during labour was being able to stay at home for as long as possible, without to-ing and fro-ing to King's, work through the pain without medication and still having the option to deliver either at home or at hospital.

The midwives (not always the same one but all very nice) then visited me almost every day for 2 weeks.

I hope you have a fantastic birthing experience, whichever option you choose. The main thing is to keep an open mind about your birth plan and pack some bendy straws and a fully charged camera with plenty of space in the memory card!

(sorry for the long post)

[mirabelle]

Thank you all for your great feedback and advice!

I'm still not sure what to do!... :-S but I think I'll give the DMC a call to at least find out if I'm still on the waiting list and then take it from there. The care you get from the Lanes does sound great, and I particularly like the fact that your midwife will come round and take care of you in your own home during the early stages of labour.

At the same time my current midwife is really lovely, spends as much time as I need during my appointments, and my last appointment was in the MAU at King's (easier for me than the DMC as it's on my way to work) so as she had scanning equipment on hand she gave me an impromptu scan so my hubby and I got to see the baby again, which was great!

Although I like the idea of giving birth at home I'd also like to have a water birth but our flat isn't really big enough to accommodate a birthing pool, so I think I'll opt for a water birth at King's. We'll see, my mind isn't set yet!

Decisions decisions! Still, I feel very lucky to have all these options, even if I don't get a Lanes midwife - I'm from France and the antenatal care there is completely different and very medicalised - all obstetrician/gynecologist led and water births are practically unheard of, let alone home births!! My friends back home who have had babies have all had very different experiences to my UK friends - not necessarily bad, just very different (epidurals and given almost automatically so you have to opt out if you don't want one, they seem to always monitor the baby's heart rate even if everything is going well so you're pretty much strapped to the bed and don't have the freedom to move around or try different positions, etc etc)

Anyway, I'm rambling now, sorry! good luck to those of you who are also expecting, I hope you have a great birthing experience!

[srisky]

I hope this doesn't confuse you anymore.....I also wanted a water birth at King's, which I put in my birth plan, so my midwife called King's and requested a pool room when I was 8cm and we got one. However, you are not guaranteed a pool room regardless of whether you are with the Lanes or King's, as for obvious reasons you can not book in advance.

Re: appt at MAU, the Lanes carry out you appt at your own home, which is of course v.convenient, but there's no scanner only the hand held Doppler probe to hear the fetal heart.

Good luck!

[jollybaby]

Am I the only one to think that having a midwife visit you at home in the early stages of pregnancy is an unnecessary luxury? Whilst it may be more relaxing and convenient for the mother it seems to me to be a completely inefficient use of the midwife's time.

[Mellors]

They only come out once in the early stages (for your booking appointment), after that you see nobody will you are about 6 months.

Agree you could do it at the docs though.

[srisky]

Yes, I was suprised when they said they would conduct the consultation at my home. However, the Lanes operate from a single-room portacabin on the grounds of the DMC and as such only have space to see on woman at a time and all the other midwives would have to wait outside whilst this was happening! Therefore, by going to the patient's home several consultations can be carried out simultaneously.

[sillywoman]

mirabelle Wrote:

-------------------------------------------------------

> I'm from France and the antenatal

> care there is completely different and very

> medicalised - all obstetrician/gynecologist led

> and water births are practically unheard of, let

> alone home births!! My friends back home who have

> had babies have all had very different experiences

> to my UK friends - not necessarily bad, just very

> different (epidurals and given almost

> automatically so you have to opt out if you don't

> want one, they seem to always monitor the baby's

> heart rate even if everything is going well so

> you're pretty much strapped to the bed and don't

> have the freedom to move around or try different

> positions, etc etc)

Not in Pithiviers hospital near Paris - check it out along with the work of Michel Odent who was their lead Obs there. :))

[BellendenBear]

jollybaby Wrote:

-------------------------------------------------------

> Am I the only one to think that having a midwife

> visit you at home in the early stages of pregnancy

> is an unnecessary luxury? Whilst it may be more

> relaxing and convenient for the mother it seems to

> me to be a completely inefficient use of the

> midwife's time.

I agree JB. I also don't understand how there can be such an inequality in the level of service you can expect to receive from different midwives all linked to the same hospital. I am feeling very lucky to currently be receiving care from the Brierly team, but I feel that it is unfair that others in different parts of the Borough or who weren't aware of these teams and how to get on their books as early as possible won't get the same continuity and follow up.

[Kes]

From what was said it seems sensible that the lanes come out to you, but I totally agree with the BellendenBear about the different levels of service. When I was pregnant I lived in a different, mostly very deprived area, and only heard about case load midwives at my NCT class. The teacher urged us all to claim we wanted home births to help us move to caseload practices and told us by doing so we'd get much better care and could just pretend to have changed our minds and want to go to hospital at that last minute.

I was horrified, having never been told about the options before, that this seemed to be a way for the few people in the area wealthy enough to afford NCT classes to snap up much better care than those whose circumstances probably meant they needed it more. With hindsight I wish I'd done it as the extra care would have been great but I just couldn't bring myself to at the time.

That's not to criticise anyone who uses these services though. If I'm ever pregnant again I will be on the phone to all these practices as soon as I see that little pink line! I just think it seems wrong that there are great services on the NHS but you have to be in the know to access them.

K

[ClareC]

I'm with the Lanes and only had one appointment at home. I've gone to the portacabin for appointments. Not sure how they work it but would appreciate appointments at home given only 6 weeks to go, a baby that seems to tap dance on my bladder whenever I walk and a 14 mth old who gets very fed up and grumpy strapped in a buggy that isn't moving! Don't really feel I get to pay much attention to the new baby's appointments. The one at home was fantastic, toddler could play with her toys so was happy, I could concentrate on new baby's appointment so happy :-)

[jollybaby]

Don't get me wrong I didn't mean to criticise the women who have had home visits from their midwives (you're hardly going to say -no I'd rather visit you in your portacabin if that's ok). It was more of a comment on the model of care and whether it is the best use if the currently available resources. I just don't think it is fair that there are women who are unable to even see their midwife in the latter stages of their pregnancy and so instead have to book in with their GP, whilst other women in the same borough are having home visits (which may last over an hour according to my NCT friends).

[srisky]

Re: resources - from what I understand it is more resourceful for the midwives to see patient's in their homes, as the practice covers the catchment area of DMC and they can, therefore, travel by foot, pushbike or in their own cars.

It would be much more costly to construct a building with however many consultation rooms, a reception + staff, offices, toliet etc not to mention finding a suitable piece of land and the costs of running the place. The portacabin is on the DMC site but not run by or under the auspices of the DMC so they do not use their reception, staff or rooms (only the loo!). The portacabin is used as an office/occassional consultation room with much lower running costs.

ClareC - were the appts at the portcabin the more 'routine' ones i.e check bp, urine not much else? I had a couple of those there but the remainder were all at home. I can definitely empathise with the tap dancing baby!

[ClareC]

I've only had routine appts so far, my last one at the portacabin we did the usual BP, urine, Doppler, measuring and discussing birth options. My next appt is there too, am assuming same things will be checked only no more birth option discussions.

The tap dancing is a nightmare?!?! Didn't get it last time but this time round it's every time I walk any distance ie anything other than wandering around house!! It's embarrassing!! Dreading my next appt as not sure whetherthe toilet facilities at DMC are large enough to take ta toddler.

[Mellors]

Clare - it seems to depend on which allocated midwife you have as to where your appts. are held. I am due at the same time as a friend of mine under the Lanes - I've had all my appts at home, and hers have been at DMC? The toilet is big enough btw - I've squeezed in me, baby and toddler before now!

[ClareC]

Thanks Mellors, that's good to know! I walked down there the other day and only got half way before the dreaded tap dancing started! It's not even far!!