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Private midwives take strain

TWO hospital births convinced Kathy Smallwood that she wanted to have her third baby at home.

She had heard plenty from other mothers about the opposition she would face and about the risks she would run if something went wrong. Mrs Smallwood, a solicitor, was not deterred. She booked a private home delivery. Something did go wrong; Mrs Smallwood had a haemorrhage at 37 weeks. Nonetheless, four days later, 10 weeks ago, her daughter, Laura, was born without mishap, without doctors, but in hospital.

Despite the problems it was the happiest birth of the three. Her baby was delivered by her own midwives and she was home an hour later.

Her experiences describe very well what might happen when a home birth becomes an obstetric emergency. When she began to bleed and her waters broke she bleeped her midwife who was at her home in two minutes.

The midwife checked Mrs Smallwood and the baby, phoned the Chelsea and Westminster Hospital and took her there in a taxi. 'We were on the ward in less than half an hour from it all happening. A consultant wired me up to monitors. Everyone was convinced I would go into labour.'

When nothing happened, and assured that her baby was well, Mrs Smallwood went home. She decided to have an induced birth. 'It was totally my own choice. My midwife met me at the hospital. The hospital was aware of everything that was going on but left us to it.'

Both midwives who run the service delivered the baby. 'They told the consultant when I went into labour. They just left us to it. I went straight home after Laura was born and we had been cleaned up.'

Mrs Smallwood, who lives in Chiswick, west London, is well qualified to judge the system. Her first baby, Thomas, was born in 1990 in hospital. He was in the wrong position and she was in labour for two-and-a-half days. 'I was seen by 12 midwives and doctors. No one told me what was happening. They treated me like a first-time mother who was just in a panic.'

Her second baby, Benjamin, was born 13 months later. This was also in hospital but using the midwife-centred Domino scheme. 'The idea is that you get to know the midwives on the team and when you go into labour the same one stays with you in hospital. But it didn't really work.

'There were six midwives on the team, which is too many. I never saw any one of them more than two or three times . . . so there was no opportunity to get to know them.'

For her third pregnancy, Mrs Smallwood chose the Special Delivery midwifery practice, run by two midwives who take on a limited number of clients who all live in a defined geographical area. The full service costs about pounds 2,500 for about 50 hours of care.

Mrs Smallwood said: 'The advantages of having your own midwife are enormous. If something goes wrong she is with you all the time. It was very different to having a load of doctors treating you like a piece of meat.'