March 23, 2019
Meet Our Members: Meg Miskin
Meg has been an independent midwife for 14 years. She worked in the NHS, mostly as a community midwife with a special interest in homebirth and moved into Independent Practice in January 2005. She has cared for over 150 women as an IM; initially as a lone IM and then with two midwives, Liz Nightingale and Sarah Ifill, under the name of Oxfordshire Midwifery Practice (OMP). Although Liz has recently retired from the midwifery register, she continues to support OMP in a non-clinical role as Nightingale Birth Friend.
WHY DID YOU BECOME A MIDWIFE?
By accident! During my nursing training I was interested in travelling and working in third world countries. I was advised that midwifery would be a very useful additional qualification for this. I was offered a place in Bath within a year of qualifying as a nurse and within the first 6 months of training I knew I would never return to nursing – I was already a midwife in my heart and soul. Shortly before qualifying as a midwife I found myself “doing the practical”- I was pregnant with my first child, now nearly 30, so after qualifying I returned to my hometown of Oxford to plan my homebirth and work in the local hospital. Still haven’t quite made it to work in the third world…time yet?
WHY DID YOU CHOOSE INDEPENDENT MIDWIFERY?
I was only ever really interested in continuity of care and I loved homebirth. I was so lucky to work for a while as a Team Midwife – with a relatively small caseload and an emphasis on continuity of carer. We cared for the women in our caseload wherever they birthed, but a significant number chose homebirth. After I had my second child in 1996 I returned to work and everything had changed. Team midwifery had gone. My caseload was huge. I couldn’t even remember all their names, let alone give continuity.
“A chance conversation with an Independent Midwife in 2004 resulted in me attending a “Make the Move” workshop and I knew I wanted to work that way.”
I tried to ensure I attended all the homebirths of the women in my caseload, but the “system” made that increasingly difficult. Working without continuity and feeling I was unable to be do a good job had a very adverse and stressful effect on me and I had time off work with depression.
A chance conversation with an Independent Midwife in 2004 resulted in me attending a “Make the Move” workshop and I knew I wanted to work that way. As the main income earner with two school aged children it still took some months to make the decision. In January 2005 I took my first client, but kept on my NHS work, by May 2005 I had too many clients to continue with NHS job and made the complete jump. With no other IMs nearby I was alone…except for the then IMA which subsequently became IMUK. Wonderful, smart, supportive, opinionated, brilliant IMs. (I was a bit in awe).
DO YOU EVER FEEL ISOLATED IN YOUR WORK?
Not any more. The beginning was tough. Other Independent Midwives were lovely and supportive but not geographically close. When two local midwives started up together as IMs I watched them enviously for a while before going and asking outright if I could join them. (Second) best move I ever made! In addition IMA eventually became IMUK. Something was lost of the original spontaneity and informality but, for me, much was gained. An appreciation of; the need for IMs to become so much more politically aware: the importance of being able to demonstrate, as well as perform, good practice: an awareness of how important our image is when persuading the establishment to embrace our model of care: so much more than that – including that I had “found my tribe”. A safe place to explore and enhance my knowledge and practice. Now I am never alone. “Always someone awake in the IM world”.
WHERE IS YOUR ‘PATCH’?
I’m based in Oxford. Generally, I will travel up to an hour from my home, most of Oxfordshire and into Berkshire, Buckinghamshire and Gloucestershire. I have occasionally been tempted further afield by lovely persuasive women – Northamptonshire and Wiltshire! Not something I want to do too often as a long drive to a woman in labour can be a bit stressful.
WHAT ARE THE BEST PART(S) OF BEING AN INDEPENDENT MIDWIFE?
I walk beside a woman on her journey. Helping her work out how she “can” never telling her she “can not”.
How to sum that up? It is the whole thing. It’s the getting to know a woman and her family. Having time to work through issues and concerns. Involving the whole family. I love receiving pictures of older siblings with stethoscopes “playing Meg”. I get so much joy from watching women step into their power, often having such beautiful and empowering births after difficult previous experiences. As an IM I walk beside a woman on her journey. Helping her work out how she “can” never telling her she “can not”.
WHAT IS YOUR PHILOSOPHY AROUND PREGNANCY AND BIRTH?
Pregnancy and birth are a normal part of a woman’s reproductive cycle. It works well if it’s given a chance. It helps women to understand why certain changes take place and how they can help themselves to stay healthy and manage the challenges that sometimes present. I work in collaboration, primarily with women, but also with other birth workers (both inside and outside of the NHS) when necessary and appropriate. A woman’s autonomy is paramount. Women are able to make good and sensible decisions about their bodies, their pregnancies, their births etc. if they are given good information and support. They are entitled to receive this information in as unbiased and un-emotive way as possible. They are entitled to incorporate this information into their own values, life experience and situation and make their own decisions. My job is to facilitate this and support their choices to the best of my ability, while giving the best care I can to keep mother and baby safe. My role is collaborative, the women and I rely on each other to stay aware of any changes so that we can react and plan appropriately.
HOW DO YOU SEE YOUR ROLE DURING A BABY’S BIRTH?
* I am there to support women. Holding their space.
* Make a woman both feel safe and keeping her safe.
* Having knowledge I hope not to have to use!
* To try to do as little as possible to disrupt the birth hormones: that tricky line between doing and not doing.
* Observing a mother and her baby without disrupting her.
* Women are amazing and I am so lucky to be able to play a supporting role in their birth.
ONE THING YOU WISH SOMEONE TOLD YOU BEFORE YOU BECOME AN INDEPENDENT MIDWIFE?
You are never alone! There is so much support for each other within IMUK. Never be afraid to reach out and ask.
WHAT HAS BEEN THE MOST CHALLENGING PART OF BEING A BUSINESS OWNER?
Valuing myself and what I do. I still find myself apologising for and justifying the cost of what I do. I try to remember to heed my own advice to mothers. “Value yourself and look after yourself or you cannot give the best care to your child”…in my case “client”
THE MOST UNUSUAL SITUATION YOU HAVE FOUND YOURSELF IN AS AN INDEPENDENT MIDWIFE?
That’s a difficult one! Every birth is so unique and different. Probably at the birth of my grandson, at the moment I realised I couldn’t step back & let someone else take the midwife role. To be mother, midwife and grandmother, helping my daughter birth her baby in the home where I had hoped she would be born. I expect it will be a once in a lifetime event & you can’t get more unusual than that! Bringing a lump to my throat just thinking about it. PS my daughter was and is AMAZING
TELL US SOMETHING WE DON’T KNOW ABOUT YOU.
I had a life before midwifery. Amongst other things, I worked in Woolworth’s, as a kitchen assistant, in an insurance brokers and as a care assistant on a specialist old people’s ward before training as a nurse and then a midwife. I also travelled a lot in Africa and Europe. Eventually, in my retirement, I hope to do lots more travelling.
DO YOU HAVE A MESSAGE FOR BIRTHING WOMEN?
* Believe in yourself. This is your journey, so take along the people you want to travel with.
* Don’t trust advice that makes you feel guilty if you don’t follow it, instead ask for information that makes you feel empowered.
* Ultimately you are going to have to make many more important decisions on behalf of your child(ren) so pregnancy is a good place to start.
Meg has been an independent midwife for 14 years. She worked in the NHS, mostly as a community midwife with a special interest in homebirth and moved into Independent Practice in January 2005. She has cared for over 150 women as an IM; initially as a lone IM and then with two midwives, Liz Nightingale […]