I first heard of Viv Gray, and her partner Andy Parker (the Maya Midwives, who have since been joined by Alison Shaloe who is also a midwife, with a breastfeeding and tongue-tie speciality) through a friend of mine who had them at her beautiful home birth. After watching the video of her son’s birth, I could see how they worked as a team, and I was amazed by their skill and calm in dealing with and sorting out an unexpected event which occurred. I began referring clients to them, and when we eventually met we did so in my back garden, on a sunny day in August many years ago now.
My overriding memory of this event is of Andy making an inadvertent joke, and of us roaring with laughter!
It was therefore a no-brainer that when it came time for decisions to be made about my own pregnancy and birth, I called them. I’ve had people ask why, since I am a Doula, I opted for the care of an Independent Midwifery (IM) team, rather than the support of a Doula. My answer to this is that doulas and IM’s provide different things. Doulas are not medical; we provide support of all and unstinting kinds. I was fortunate enough to have this in spades already with my husband and family. What I didn’t have was the specialist knowledge that IM’s bring to bear, which fitted right in with my intention to birth at home, and would be there just in case an emergency situation arose.
How did you meet Andy and Alison?
I met Andy when she came to work at the NHS Hospital that I was leaving to set up an independent practice. I was working on the homebirth team and had popped in to labour ward to dispose of a placenta. The place was heaving, and the coordinator asked me to support Andy, who was on one of her first shifts on labour ward. She had been sent to care for a woman who was about to give birth and had been put in a curtained area of the high dependency recovery room because all the other rooms were full, and all the core labour ward staff were busy. I was immediately struck by Andy’s kindness and compassion to the woman and her partner, and how she helped them to labour despite the less than ideal circumstances. We managed to get into a room just before the baby was born. When I asked Andy if she wanted me to get syntometrine, and she asked me ‘what for’. I knew right then we could work together.
I first met Alison when we volunteered for the NCT. I have never met anyone who can listen like Alison, who is able to hear people compassionately, and meet them where they are. Our paths crossed again when I began working as a midwife. She was working part time after the birth of her first baby, and struggling with the demands of NHS midwifery, especially the medicalisation of birth on the labour ward. She left the NHS to work as a breastfeeding supporter while maintaining her midwifery registration, and had some more of her own babies. I have been waiting for years for Alison to be ready for independent practice, and am so happy that she has come to work with us.
Why did you form your partnership?
Independent midwifery practice is incredibly rewarding, but it can be very demanding. I had tried before to set up an independent practice on my own but found it impossible. Working with someone else who you really trust means you can take turns. So when one is down, one of the others is usually able to be up, whether that is physically, emotionally, or practically.
How did you develop your ethos and working relationship?
We have evolved our working relationship over time by communicating honestly about our needs; what we like, for example, and what we find difficult about working together. We have listened to what our clients tell us, and their feedback after we finish working together, and are constantly looking for ways to improve what we do. We are aware that different clients will have different needs, and accommodating these is our first focus. We have needed to swallow our egos, open our hearts and pay careful attention. Our ethos has evolved from this process. It reflects who we are as individuals, committed to working together to serve women and babies. It has been the most rewarding time of my professional life.
How do you juggle your work and your lives?
Maya Midwives provide antenatal, birth and postnatal care to a caseload of around 25 families a year. We also offer a postnatal care only package, individual consultations and one off appointments. We have a weekly drop in coffee morning that is open to anyone and we speak to student midwives at local colleges about independent practice.
Working in independent practice has much less impact on my life than NHS practice. I have more control over my day to day activities, and although I am on call almost all the time, I work less hours, with more control over when I work those hours.
I am likely to be out at a birth 3 times a month, any time of the day or night. I enjoy working most when work really needs to be done, and so it really suits me to have the urgency of calls to births. Also, of course, by the time a woman has her baby with us, we have developed a relationship and it is really exciting to get that call and go and be with her while she has her baby. I love the ‘dance’ of birth, responding to the changing unpredictable situation, finding out what helps, and what doesn’t, watching how a couple work together.
We take on 3 or 4 women a month between the 3 of us, and make sure we take a break every year to allow us to fully relax, travel, turn off our phones and be completely irresponsible.
Each woman works with a pair of midwives.We try to split the work about 50:50 across our whole caseload, and we usually find that’s how it works out. Sometimes a woman has a real connection with one of us, or a need that one of us is particularly able to meet, and we try to respond to that need. Of course, we all have our own personal lives, and sometimes we need to ask one of our partners to help us by taking on a little more of the work while we deal with our own stuff. Midwifery is a tough job to fake, so when you are ill or under stress it is important to be able to recognise this in yourself, ask for help from your colleagues, and to hear and give that help when your colleagues ask.
What are advantages to the mother of having an independent midwife?
There are so many! When I began working with pregnant women, before I was a midwife, I was interested to note that women who chose an independent midwife had more normal births, and even those who had interventions during their births felt OK about their experiences. Here are a few of specific advantages:
- Continuity of carer is one of the few interventions which has been shown to improve outcomes during birth, and the NHS is just not able to provide this service.
- Independent midwifery is a personalised service. We are able to help a woman find out what is important to her, and figure out how to help her achieve this.
- We have more time to spend with each of our clients, and feel that we serve the whole family, so we support Dads, siblings, and members of the extended family too.
- We provide our care at a time and in a place that is convenient to our clients.
- We offer additional services, like acupuncture, hypnotherapy, craniosacral therapy, and frenulotomy.
- We are able to work with women with a higher level of need, whether this is due to their medical or obstetric history, social circumstances or strong preferences about the sort of birth they want.
- We strongly believe in women being in charge of their own care. We provide information, and make recommendations, but we support women in the decisions they make.
Where do you most like to attend a birth?
Home! Of course, some births need to be in hospital, and it is also rewarding to help a woman who has chosen a hospital birth, or needs to be in hospital. And birth is always beautiful. But there is nothing like being up all night at a home birth, tidying up, turning on the washing machine, tucking a new mother and baby up in their own bed, and leaving a newly formed family behind as I roar off into the sunrise on my motorcycle to sleep all day.
How do you help a woman decide which hospital is best for them in an emergency? Indeed, what sort of training do you have which helps you in an emergency?
We attend regular training in dealing with emergencies, and also practise dealing with emergencies during our team meetings. Some women choose a hospital to work with during their pregnancies, others prefer to choose a hospital only if the need becomes apparent. Our knowledge of the policies of many of the London hospitals helps us to advise people of the right choice for them. We are also able to change plans if necessary, for example if a hospital is particularly busy or has a policy which particularly suits a situation which has arisen.
Looking at your birth statistics in your own practice, does anything interesting stand out to you?
Because we look after so few families, it is difficult to do any proper statistical analysis of our outcomes, although we do keep track of them and they are remarkable consistent, with a normal birth rate of 70-80%, and a caesarean rate of about 15%. The thing that always surprises me is that it is impossible to say who is going to have a straightforward birth, and who will need some help. Almost all of our client say they would ask for us to care for them in future pregnancies, and we I believe that this is one of the most significant indicators that we are doing something right.
Do you have any tips for new mums?
One of the most interesting things in my practice is watching how each family works out what is right for their own particular needs. Although families usually have an idea of how they would like to be as parents, babies also come with their own needs and wants. So my biggest tip to new parents is to be open to changing their preconceived notions, and to have confidence in their ability to respond to their baby’s needs.
What sort of things are you planning for the future?
We have updated our website and are really excited about this. We are integrating our new skills in hypnotherapy and craniosacral therapy into our practice. We are relieved about the resolution of the insurance issue for midwives working outside the NHS, and looking forward to continuing to help familes to have the best possible experience of pregnancy, birth and parenting. We helped our first family to have a twin homebirth this year. We are particularly enjoying working with families for their second or even third babies with our practice, and considering offering free care for any family who has used our services four times for their fifth birth with us!
Thank you Viv, for taking the time to share your passion!
Personally and professionally, I highly recommend the Maya Midwives who can be found by clicking on their highlighted name in this sentence.
Happy birthing ladies!
Tags: acupuncture, Alison Shaloe, Andy Parker, birth, chinese herbal medicine, Fertility Support Company, homebirth, hospital, Independent Midwife, Maya Midwives, Naava Carman, NICE, pregnancy, twin, Viv Gray