Contraceptive advice from your Midwife in pregnancy.

(223 Posts)
missismac Sun 23-Feb-14 09:47:28

I'm just doing a project on this topic and struggling to get any info about womens views on this. I was wondering how you would feel about your Midwife raising the issue of postnatal contraception whilst you were still pregnant - say around your 36 week appointment? Is it something you would welcome, or do you feel maybe your head wouldn't be in the right place to take it in? Should it even be a part of the midwife's role, or is it for the GP/ clinic nurse to advise you on?

missismac Sat 01-Mar-14 22:03:57

Hi everyone, I've just popped back to say 'Thankyou' to everyone who's posted on this lively thread - even Gobolino. I stopped posting because it was getting a bit pantomime - 'oh no I didn't', 'Oh yes you did' between me and Gob and I felt it was unfair on those who had an interest in the topic to continue our bickering on the thread. However you've all given me a lot to think about. Thankyou for sharing your views so generously, and be assured I will never knowingly make the mistake of confusing a regulation, or a law with a recommendation again. ;)

HarderToKidnap Fri 28-Feb-14 17:42:37

People incredibly experienced in dealing with DV have written the guidelines and decided midwives need to ask the question. This is because it's a pregnancy problem (a third of DV starts in pregnancy) and also because it opens a door. No, I don't expect women to disclose DV to me when we first meet, and in fact only one ever has. A couple more have disclosed further along in the pregnancy. But by asking, you let the woman know that unacceptable, that HCPs are aware it happens and that support is there. It sows a seed, that perhaps it's not OK. That's the theory.

The one woman who did disclose was desperate for me to ask. She was just waiting for someone to ask. She literally grabbed the rope I threw and clung on, sort of realised this might be her last chance and took it. She was referred to SS and received in depth support and counselling from our DV liaison team. She was assigned a WA worker and given one of those special police codes that meant police would attend her house quickly. She left him before she had the baby and was happy in a hostel when we discharged her. I'm an experienced midwife, I have been working in the community for five years on and off and have seen thousands of women, and she's the only one who has disclosed initially and it changed her life. That one woman is worth upsetting a million people like higgle.

BoffinMum Fri 28-Feb-14 16:06:22

Harder, speaking as a victim of DV in a precious relationship, I can't imagine I would have told anyone because I didn't realise I was experiencing it, thanks to my mind having been fucked around with.

And in actual fact, what is anyone going to do about it anyway? Pull the victim out of an emotionally/physically abusive but comparatively cosy home, and dump someone on benefits in a hostel, just when they are about to give birth? And that's if there are hostel places, which a lot of the time there aren't. Clearly when someone might be murdered intervening is a no-brainer, but a lot of the time it's nasty but sub-critical, what goes on.

The harsh reality is that a lot of people put up being knocked about a bit because frankly the alternative is stigma, poverty, insecurity and greater anxiety. That's why it's such a problem. And you can't write a prescription for that.

higgle Fri 28-Feb-14 15:25:31

I'm reluctant to comment on this one because my views seem to be so controversial, I think that in part my negative feelings would arise because it would feel like an implication that my DH would be a "suspect" because he is male, and partly because I have very strong views about privacy and interference. I would certainly opt out of the present NHS data gathering exercise and refused to see Health Visitors when DS 1& 2 were little because of central storage of information from red books. I think that the word "Domestic" in relation to violence trivialises it a bit, (e.g. references to "a bit of a domestic" really, it is just straightforward nasty illegality in the same way that a street mugging is. The penalties might be higher if the word was dropped.

HarderToKidnap Fri 28-Feb-14 13:45:10

Higgle, I'm a midwife and I'm supposed to ask about DV at booking and at 28 weeks. Can you tell me how I can tell who is a victim of DV just by looking? That would be really useful.

Mignonette Fri 28-Feb-14 11:50:36

I am going by what you have said on here and you didn't present particularly empathetic and understanding view on DV. That is all we can go on seeing as it is anonymous n all.

Other posters clearly think so too.

Maybe instead of trying to defend your comments about DV, you should drop the defensiveness and give some time as to why others find them unappealing and why they fly in the face of the way you clearly see yourself.

I cannot make it any clearer than that but we'll have to agree to differ before our fingerprints wear away smile.

higgle Fri 28-Feb-14 11:35:42

So, now you know better than the people I support how good I am at my job? I despair. I'd like to give you their names and addresses to visit and listen to what they have to say about how I tirelessly stand up for their rights, but obviously I can't. Oh well, back to my thread on weddings. I'm clearly not good for anything else.

Mignonette Fri 28-Feb-14 11:19:32

Trouble is you expressed derogatory and judgemental views about a whole section of society- if you hold opinions such as that privately yet claim to espouse the opposite in your profesisonal life, that makes you appear unauthentic. And clients- certainly the clients I encounter- would be able to tell.

You weren't expressing views on your own health care- you made negative and derogatory comments based upon your perceptions of the kind of women who experience DV and don't immediately kick the person responsible out.

RE personalised health care we are actually singing from the same song sheet, arguing against tick boxes and generic comfort titles!

You can have accolades from your peers showered upon you but sadly that is not the same as being respected by your clients/patients. Some of the lousiest direct care givers in nursing are the best managers and are feted accordingly sad.

What I am saying is that you present in an incongruous manner. You do not sound very caring or empathetic in your own words and that is all I have because ultimately both you and I could be Walter Mitty's on an anonymous forum (although obviously people on MN knowing me IRL reduces the likelihood of that).

higgle Fri 28-Feb-14 11:11:27

So, if I express my personal views on matters pertaining to my own healthcare you feel able to judge me.

if I point out there is empirical evidence of my professional achievements you say you know better. It is always very odd when one poster seems to think they know better than the assessors at my professional institute, my CQC inspector and my service users who rate me very highly, but of course you always know best. A bit of a David Southall perspective really.

Mignonette Fri 28-Feb-14 10:53:39

And you do not demonstrate person centred care and your very own views evidence that.

Mignonette Fri 28-Feb-14 10:52:29

You are very slippery Higgle. i don't care about your clumsy self aggrandising.

I am addressing your derogatory comments about people who have experienced DV. As have many other posters yet you still cannot see it.

You clearly have no insight or ability to self reflect.

higgle Fri 28-Feb-14 10:49:03

Oh, Mignonette, once again when someone brings an evidence based response to your single track views you fail to respond. I don't need you to analyse my professional competence, I've plenty of formal proof that I've made a real difference to peoples lives.

I feel your personal history and the difficulties you encountered in trying to do the right thing has coloured your views, and before you descend down the route you have on other threads when people don't agree with post I'll make it very clear that I think that whether we pay for it or not we should receive good, person centred care. I deliver it and I expect it.

(puts on hard hat and waits to be told to "wind my neck in")

Mignonette Fri 28-Feb-14 09:59:51


You made disparaging assumptions about people who experience DV.

Your claim to offer tailor made 'care' rings a little hollow when your posts on here are so far from demonstrating any compassion and empathy whatsoever- victim blaming non?

And the old 'culture of dependency' argument you put forward as some kind of defence of your attitude is a load of old cobblers.

higgle Fri 28-Feb-14 09:54:14

Quite right, LittleBearPad, for the last 7 years I've managed a service for a Charity for older people, that CQC and our local authority rate very highly. I've run two pilot schemes on person centred care and been involved in a project to take the best practice from Health and Social Care and health Service management training into an accredited manager qualification. I'm also the chair of a national charity for older people with specific minority requirements. I practiced as a Solicitor for 20 years and also lectured in law part time.

My service provides funded ( and some private) care on a completely tailor made basis, you can have it for free if you qualify for support on the usual assessments. I don't provide one size fits all for my service users and I don't expect it for myself. Sometimes we have to send care staff into hospitals with service users to ensure their needs are met so I am well placed to judge the quality of services.

It saddens me to hear "inevitability" used as an excuse for inadequacy.
it also saddens me to see that instead of encouraging empowerment and creating role models of strong women who can make their own choices and be assertive there are those for whom a culture of dependency is tolerated, and that is no reflection of the individuals that society is not equipping to cope. It doesn't cost money or take much time to look at people as individuals, it doesn't mean being worried about being a whistleblower to say to your manager or commissioner "had on a minute, we can do this better". There are all sorts of organisations such as Healthwatch where individuals can raise these concerns and demand better, but no it is far easier just to put up with it and have a good old moan.

LittleBearPad Fri 28-Feb-14 08:53:03

And you choose to pay for your personalisation Higgle. Not everyone can do this or wishes to. I certainly didn't want to give birth in a private hospital - I didn't trust them as much as the NHS.
Given the wide range of people the NHS sees inevitably there is a standardised approach. Its patients have massive differences in education, life experience and understanding.

LittleBearPad Fri 28-Feb-14 08:44:52

I must confess that years ago as a young solicitor

Yes. I have read your posts. Solicitors have clients. Perhaps you are no longer a solicitor.

HolidayArmadillo Fri 28-Feb-14 08:24:42

The facts speak for themselves, 30% of domestic violence starts in pregnancy. That means a huge amount of women who have never suffered abuse before, will start to do so, by virtue of the fact they are pregnant. Pregnancy can cause vulnerability, financial and housing issues, additional stressors that they have also not experienced, so when abuse starts it is very very easy to become a statistic when it's piled on top of those other worries.pregnant women are vulnerable, or at least they can be, yeah it's a sex thing, because men can't get pregnant. When they can I'll start asking them the same questions.

higgle Fri 28-Feb-14 07:35:57

I don't have "clients" have you not read my posts?

I am asking for the values of personalisation, unique care planning and the acceptance of risks which are the lodestone of good Social Care practice to apply in the health service. I'm not happy that my health care should be provided on the basis that my answers and requirements need to fit into pre written boxes. My own GP is very comfortable with this and knows that I'll come in with some up to date inforamtion on whatever issues I face and want to discuss this with her. I am not happy that people who do not know me make assumptions about me because of my sex. It is the system that implies people may be weak and lacking in self esteem, not me.

LittleBearPad Fri 28-Feb-14 00:14:29

Higgle I hope that you display mire empathy for your clients than is apparent on this thread.

Mignonette Thu 27-Feb-14 23:24:06

I'd mind because the implication would be that I could be the sort of person who would put up with this, and that I needed someone else to help me. It would imply that I was too stupid, weak or lacking in self esteem to pick up the phone and report it

You do judge Higgle. it is there in black and bold.

higgle Thu 27-Feb-14 22:22:54

And you seek to judge me! Quite openly, I haven,t judged you, just put forward what I wasn't from healthcare professionals who deal with me. I don't want a social worker or victim liaison officer I want a highly skilled polite person who does their job well and no more.

Mignonette Thu 27-Feb-14 20:28:16

But you did talk about and judge other people. And you cannot even see it.

higgle Thu 27-Feb-14 19:20:44

"I was wondering how you would feel about"

I think that was the invitation for this thread, and "pretty annoyed" is my response. I'm not here to talk about other people on this thread, only me. If i want to engage in disussion about public policy and matters in the round I'll find another question to answer, thank you.

VivaLeBeaver Thu 27-Feb-14 17:08:12

Ah, I'd not heard the expression before.

Mignonette Thu 27-Feb-14 17:07:33

But you were talking about the lives of others because you extrapolated personality, will to change and ability to change things to all people in DV situations.

We all find it repugnant to feel we are not able to defend our own rights. But not everybody has the ability to extricate themselves so slickly and human relationships are complicated things. The will and self direction we possess at the start of a relationship may not be there at the end and we can only make choices if we feel we have them. And they have to be realistic.

Lincoln lawyers have a mainstream defn of lawyer whose private practice is doing so poorly that he goes to extremes to cut costs (such as running his office out of his car. However it can be stretched to cover people who 'practise' online on forums such as this with no guarantees as to quality of recourse.

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