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Midwife communication...long !!!

(69 Posts)
steakchipsandfriedeggs Fri 21-Jun-13 10:46:32

I went to what should have been my 34 week midwife appointment this week. Unfortunately I was a week late as they were so booked up the week before. Nonetheless, at the appointment before, the midwife told me we would be going through birth plan, place of labour, basically all things that the NHS website explained would be discussed, as well as the guide to appointments in my mat notes. As I am extremely anxious about labour, I had really given myself a good talking to, and had a list of questions that are weighing heavily on my mind, hoping I could be reassured at the appointment.
I went in to my appointment and explained that I had forgotten to do a urine sample and could I quickly nip to the loo now (previous midwives have ok'd this) she said I probably wouldn't need to give one if my bp was fine, plus I hadn't had an issue before with protein in urine etc. I was a bit skeptical about this, but as she is the professional, I didn't query. She then gave me my blood results from 2 appointments ago, which we had already gone through, despite me explaining this. She then measured me and checked heartbeat. At no point did she tell me my measurement and I had to read this from my notes after the appointment. It seems I'm measuring a week smaller, although I'm not sure if I should be concerned as at my last appointment I was measuring a week larger. I just would have thought she would have explained what this might potentially mean?!? Anyway, I keep telling myself that if it was anything to be concerned about she would have said. She then asked if I had been experiencing any back pain, to which I replied not really, only if on my feet for long periods of time (work in retail, can't avoid at times). She then told me to try swimming as an exercise as I was carrying the baby in my back and this might help bring him forward. She also mentioned this at my last appointment as I was concerned that I was appearing 'small' for how far along I was. She said this was because I was tall (5ft11) and was carrying him further back. There was no mention of issues with positioning, she even told me that he was head down, although not yet engaged. I assumed everything was fine and normal.
She then insisted that I attend an 'early pregnancy antenatal class' that evening, it would be beneficial to me, although didn't explain why. I thought she may have mixed her words slightly, and perhaps meant early labour class and what to expect etc. She then ended the appointment briskly and said she didn't need to see me until 3rd July. I felt confused that we hadn't discussed birth plan, labour etc, but also like i was being rushed out of the door, so didn't protest. I wish I had, but i just left feeling rather deflated! When I got home and rang to confirm my attendance to the class my midwife had insisted I go to, the lady on the phone asked how far along I was, I said 35 weeks and she laughed. The class was for ladies in very early stages and how to cope with first/second/third trimesters, all of which I'm a bit late for. I was baffled by this.
To add to this, I have been reading through my notes, and have had to resort to the Internet to decipher what she has written, and it turns out my baby is back to back. I am terrified by this. The pain I can take, but I have severe anxiety issues about giving birth and privacy and going by everything I have seen so far on the Internet in terms of NHS, it seems that doctors prefer to intervene with forceps much of the time. This is not what I wanted, I really can't handle the thought of being on my back, legs in the air with forceps being used. I wanted privacy, to be active and to have at least a shred of dignity to be left intact after all this. I feel my midwife has failed to explain to me my options or at the very least what to expect with a back to back baby. Am I wrong to feel that my appointment was rushed and insufficient? And if she doesn't want to see me until the 3rd of July when my baby is due on 23rd, does this leave things a bit late? What if he turns up before then? I'm so worried that I'm just going to have to do what everyone else wants me to do, and I feel so let down that as this is my 1st child, I'm not being kept very well informed of what is going on? I know the midwives are stretched and I'm not the only woman giving birth, but I've never had any of this happen to me before, and I feel so alone with it all.

Sorry it's so long, but I relying on advice and the experiences of strangers at the moment, instead of from my midwife. Any support/advice would be welcome!

Thank you xxx

BraveLilBear Fri 21-Jun-13 14:15:19

Hi Steak I'm in a similar boat to you - 35 weeks and very anxious about examinations and lack of privacy during birth, for similar reasons to you, it seems.

This is not something that can be easily 'sucked up' and 'brushed away'. I did get some advice on here about getting DH to help by, for example, doing a special hand massage if you need to be examined and that might be a way he can support you and make you feel safer.

You can also decline internal examinations if you want - and a back-to-back baby doesn't mean flat on your back with forceps - in fact, most people who labour like this are encouraged to be more active these days in order to avoid that.

I'm sorry your midwife wasn't very helpful, I have my next appt on Monday and worry that I'll get the old telly-offy midwife and not the younger much more sympathetic one as I really need to raise this issue with them myself.

In the meantime, I bought myself Birth Skills by JuJu Sundin - worth every penny so far. I still have anxieties about being made to feel vulnerable, but I am slightly less anxious about the rest of the process, knowing there are ways I can practically control the pain etc and at least take back some control.

It also includes a very helpful chapter about back-to-back labours - and has a general attitude that if you need pain relief, that's fine, you're not a bad person for wanting or needing it which I find to be very novel and refreshing.

I strongly recommend you ring up the midwives and ask for an extra appt and explain why - anxiety falls under mental health, and most areas now have dedicated people trained to help women in pregnancy and nearing childbirth.

Good luck x

steakchipsandfriedeggs Fri 21-Jun-13 14:17:22

So not being told that baby was back to back is fine is it? If that is the case then ok, I just wanted to know if it was normal to have notes written up in code for me to decipher at home? I know midwives are not psychic, but neither am I! I don't know what half of anything she wrote meant, and my only means of finding out was the Internet, which unfortunately threw up some nasty stories hence the anxiety. I've never had a baby before, so I'm anxious, I'm anxious that he is healthy, measuring right, in the right position etc I wasn't told any of this. Thank you to those who have told me their own experiences re back to back, rushed appointments etc. I didn't want it to seem that I had this crazy expectation of my mw appts, I just really have no clue what to expect other that what my mat notes and NHS say.

And as for my 'other' anxiety issues, I touched on this briefly in my original post, which is what some posters seem to have homed in on. I really wanted advice on whether my appointment seemed rushed, or whether I should be concerned about not being explained certain aspects as well as the midwife not following the NHS guidelines or maternity notes in terms of what should be discussed, which is kind of what she is being paid for right? I'm sorry if I gave people an alternative impression. I'm just a first time mum who came out of an appointment feeling a bit deflated, confused and let down. Silly me for thinking that MN would be a gentle and reassuring way to diffuse my concerns. I don't mean to offend anyone who has been genuinely lovely and helpful because i really appreciate any help where i can get it. It just seems that some posters on here really get off on making others concerns and worries seem inadequate, just because they don't share the same views or have had the same experiences. Not just on my post, I see it every day hmm

And finally, looking back on this thread, yes I suppose I have been fairly assertive on here today, I've actually surprised myself! Shame that the Internet and reality aren't quite the same though, is it?!?

Ps, I have made another midwife appointment for next week (earliest I could get) OH wants to come too as he has questions. I will write down everything I want to say/ask and hopefully with OH support we won't leave until they are answered.

Thanks again xxx

scoutfinch1 Fri 21-Jun-13 14:27:29

I'm due on the 23rd also steak so have just had a similar midwife appointment. Firstly, as others have said don't worry about measuring slightly small. After my first fundal height measure I looked at my notes at home and saw that bump was under 10% and midwife hadn't mentioned it. I was very concerned about this. Checked at next midwife appointment and was told was fine. The next appointment after that (with different midwife) bump was measuring way above the curve. I questioned the midwife about this and she told me to not pay too much attention to the chart. What the midwifes are concerned about is that the measurements are going up week by week. I think that your midwife didn't explain about your measurements because they are nothing to worry about and a week out either way is not significant. So don't worry about that. I was very worried too but found that the best way to stop this is to make sure you check the measurement before you leave the room and question the midwife if you are not happy.

Also, like you I have been told baby is slightly back to back. So again, I got the questions about back pain as the baby's position can cause this. I was also told by the midwife that although some babies are born back to back, the majority that are positioned like that do move. Again, I suspect this is why a big deal was not made about this as there is plenty of chance for the baby to move. At your next appointment just ask the midwife if the baby is still back to back and explain that you have concerns about the effect this may have on your labour.

If you don't get a call back about the parentcraft classes you could try just turning up. Or ring one of the midwife numbers you should have been given and explain that you are really keen to go. I really think they could help. In my area we had a hospital tour which may help to relieve your anxiety towards the birth somewhat or at least help you to feel more prepared. Also, I found that these classes were a great opportunity to ask questions (there were only two couples in mine.

With regard to your birth plan it may be that this wasn't discussed as the midwife realised that you hadn't been to these classes and it would be easier for you to think about this after the classes and tour. At my appointment I was also surprised that this wasn't spoken about, my midwife asked if I had been to the parentcraft classes, what I thought about them and if I had any questions. Like other posters have suggested, write a birth plan (loads of templates online) and take it to your next appointment. Also, I would suggest writing a list of things you would like to discuss. My experience is that the midwifes have been happy to answer questions and discuss things when asked but if you don't ask them you end up with a very short appointment and things don't get mentioned.

Also, the timing of your next appointment is fine and is the same as mine.

With your anxiety it might be worth trying a hypnotherapy CD as other's have suggested. I am finding that it is keeping me very relaxed about the birth. I understand that due to your past your have some issues surrounding the birth and it would do you good to get some help about this. Is there anyone you could talk to. I hope this doesn't sound patronising but it is your own anxiety that you need to work through and there is nothing that the midwives can do to guarantee that you will get the labour you want. You need to find someway to get your self into a place of mind where you can cope with whatever comes along during labour and not to get too tied up in trying to control the type of birth you have. Without knowing your past and specific anxieties I can't tell you how to do this but options could be things like hypnotherapy, relaxations, talking to someone close or seeking professional help. I hope this has been useful and has stopped you worrying about some of the things. Good luck.

steakchipsandfriedeggs Fri 21-Jun-13 14:33:23

Thanks scoutfinch, I appreciate your comment. I have started on a birth plan this afternoon, made a midwife appt for next week(only Gp receptionist can make this) and am going to try the direct midwife number again to book classes which mean it should start on 4th July (if I can get in!)
X

PrincessScrumpy Fri 21-Jun-13 14:37:00

I haven't read the whole thread but wanted to add my experience. I have had 2pgs and 3dds. It shouldn't be the case but in my experience you have to stand up for yourself and make sure you get what you need. I used to walk in with a piece of paper with a list if questions and take a pen so I could write the answers for each. The mw could see the list and me writing so had to go at my speed.
As for the birth, everyone had a different experience and I would say, do your research but don't get scared. The aim is to get baby out safely - I didn't know dd was back to back until after her birth and was it more painful? No idea as i've not had a birth that wasn't back to back.2nd pg was emcs and 2 prem dds.
My approach was to have an idea of the birth id like but know it may not happen, however I had a list of things I didn't want and I wanted a cs over forceps - never became an issue. Most important was for dh to know what I did and didn't want as I wasn't in a position to argue whilst in labour so Dh was my voice. In my experience this was vital.
Good luck and congratulations on your pg xx

steakchipsandfriedeggs Fri 21-Jun-13 14:38:11

Bravelilbear, I remember your post about your own anxieties. I'm glad some of the suggestions given to you have worked, I'll def look into the books. Thanks for the advice smile

steakchipsandfriedeggs Fri 21-Jun-13 14:42:20

Thanks princess. Please don't think that I have some wild unrealistic expectation of my birth. I only want to be covered as much as possible and to have a water birth if possible or be as active as possible as I've heard that many back to back births end up on the back with forceps. Thankfully many people on here have said that it may not be the case so am feeling a little more optimistic about the whole event.

Thank you!

RugBugs Fri 21-Jun-13 14:45:06

It's policy in my area to not write Baby's position on notes before 36weeks (I had to ask more than once for confirmation at 30wks that baby was breech and it doesn't appear on my notes) because they still move about, I know that at 32wks baby here is still rolling around and moving from breech to head down a lot. It may well be the same where you are?

I'm in the same position as you re half a day a week when I can see a mw and appts are always 30-40mins late and very rushed. I've been offered an appointment with my trusts consultant midwife to go through all of my concerns about labour/delivery after a bit of a palava with my first pregnancy. It might be worth seeing if your trust has one too?

Back to back is ok - plenty of women (including myself!) do it with no forceps. That position doesn't automatically mean lots of intervention. He was not back to back at 38+4 days, but was at 39 weeks (the day he was born). I spent loads of time in the pool, using only gas and air, and only had morphine right at the very end, 20 minutes before he crowned.

Also, there is plenty of time to 'move' the baby round. Get on your knees and scrub the floor is common advice to help get the baby into a better position.

steakchipsandfriedeggs Fri 21-Jun-13 14:54:48

Visualise, so they let you have a water birth despite being b2b? That's what I would ideally like to have. X

You do need to be quite forthright during your appointments. As she is writing in your notes, ask her to explain what she is writing, or what has been written in the past. I never left an appointment till I understood exactly what all those notes mean. The notes are more for the staff (as and when you do go into labour) than you as a patient, so don't worry if you don't understand the codes!

Yes. I did plan on giving birth in the water, but changed my mind! I spent about 3 hours in there (went in at midday, got out after an hour, got back in for another couple of hours, got out about 3pm, baby born at 4pm). I got out because I was exhausted and wanted to lie down!! I ended up on my side on the bed, having a morphine injection, and baby was born about 20 minutes later.

There was no question about using the pool at all! It's not about 'letting' - you decide what you want!

onceipopicantstop Fri 21-Jun-13 15:03:20

Hi
ds was back to back and I was advised to do some exercises to try and move him. 3 years later I can't remember what they were (!) but found this link which you might find helpful:

www.babycentre.co.uk/a544493/getting-your-baby-into-position-for-birth

Also just wanted to say that if you have significant anxiety relating to your labour, and you don't feel as though you're getting anywhere with your mw, it might be worth asking if there is a specialist mw. I suffer with severe ocd relating mainly to a fear of contamination from blood etc so I was very anxious about going into hospital. I only found out about the specialist mw by chance but she was brilliant. We met and discussed my anxieties and the best way to manage them, and she wrote a very clear plan in my notes so that whichever mw cared for me knew what to do without me having to go through it all again. It made going into hospital a lot easier to manage.

CatInWellies Fri 21-Jun-13 15:21:18

I think what people are trying to point out, OP,is that if you get yourself into a state, focusing on forceps, no water birth etc, then if things don't go "to plan" (which they don't, babies have ideas of their own!) you will freak yourself out even more. You also mentioned you only want your husband and one midwife in the room. I totally understand this and there's nothing wrong with having an idea of how you would like it to go. But it might not, for all sorts of reasons. It's far better to get yourself into the mindset that you are going to give birth, and people are going to see you.It's horrible having anxiety issues and I'm pretty sure everyone understands that even if they haven't experienced it themselves.

It sounds like your midwife was a little abrupt and disorganised, but like you said, if there was anything for you to worry about she would have discussed it with you. Babies move about all the time, there's loads of time for the little one to get him/herself out of the back to back position

You will do absolutely fine, and you will have a beautiful snuggly baby at the end. I'm almost jealous!

Repeatedlydoingthetwist Fri 21-Jun-13 15:25:08

OP I do feel for you, I am pregnant with DC 1 too so I know how anxious you must be. I just wanted to raise a point though, and hope that you take it in the spirit which it is intended as I am certainly not trying to upset you or cause offence... Looking at your first post, I am just wondering why you didn't question any of these things with the MW there and then? The reason I ask is that my midwife is similar in that she will ask me things or write in my notes without explaining, and as appointments are so tight I'm sure she would shove me out of the door in five minutes if she could! However, I always always ask her what she means as we go along. A lot of the time she hasn't explained because it is a minor issue which she doesn't feel needs to be explained (and in fairness to her I am the world's worst worrier so she's right - I freaked out about what the word ceph meant in terms of presentation blush), but as I know I will worry if I don't know everything I make a point of asking her to explain, and I won't leave until I am comfortable with the answers.
I had a similar issue with regards to my birth plan too. It wasn't discussed the week I was told it would be, so I made sure that it was the first thing that I mentioned to her when I arrived for my next appointment. If you don't feel like you can be that assertive do you have someone you can take with you? And you can make sure that they know what you want to discuss so that if you don't feel like you can say or you feel rushed they can do it for you?

Just a thought, again I do really see why you are anxious, good luck.

adagio Fri 21-Jun-13 15:25:21

Apologies not had time to read all the replies but has anyone suggested the spinning babies website?

Also I did Daisy Birthing classes which were excellent (if available in your area?) Alternatively ante natal yoga - both Daisy and Yoga have moves and positions to help encourage baby to get to the right place.

Neither of these help with your midwife situation I am afraid but they might help you avoid back to back labour! I think your plan to see her again with OH (moral support) and a written list of Q's is a great idea.

I took along a list to one of my appointments, I don't think its unusual. I also felt somewhat left to it in the last weeks - Midwife was nice enough but the appointments didnt really match my expectation from the notes (e.g., I saw her at 40 weeks and she said she would see me again at 42 if the baby didn't arrive before then!)

PoppyAmex Fri 21-Jun-13 15:48:31

"Silly me for thinking that MN would be a gentle and reassuring way to diffuse my concerns. I don't mean to offend anyone who has been genuinely lovely and helpful because i really appreciate any help where i can get it. It just seems that some posters on here really get off on making others concerns and worries seem inadequate, just because they don't share the same views or have had the same experiences. Not just on my post, I see it every day"

OP I think you're being unfair to people who took their time to post on your thread.

You asked for any advice/support and I think you got plenty of both; you didn't specify that you only wanted to hear from people who reinforced your point of view about the midwife's behaviour.

I didn't see anyone "making your worries seem inadequate", I think people were just trying to gently point out that you need to take some responsibility for your own care. To be honest, in her position I'd assume you didn't have any questions because you didn't ask.

Anyway, hopefully you're feeling a bit better and more reassured about your baby's current presentation - it's still early days, so plenty of time for that to change.

Also, great idea to write all the questions down.

Good luck.

MummyTheresAfireBeeOnYourHead Fri 21-Jun-13 16:01:46

I've had two babies back to back and no forceps were involved and no tears etc but legs were indeed akimbo and it's a messy noisey wonderful process, painful and exciting etc. I think you just need to speak to a midwife again and get your questions answered so you feel more in control maybe! Birth isn't something you can control however so go with the flow and know you are in charge of finding answers to your questions and not letting yourself get rushed out the door or fobbed off, maybe the midw was really busy and unless you ask she may not realise your concerns, particularly if physically everything is going ok. I hope you get sorted. X

MummyTheresAfireBeeOnYourHead Fri 21-Jun-13 16:07:59

Sorry op just re read sme of the thread and I hope I didn't come across as harsh re not letting yourself get fobbed off! Honestly it's easier said than done, I have to try hard and make myself get the answers I require at times at writing it down is the idea solution t that. By the way both mine were water births. The first was longer but quick for a first labour and the second was very quick, I think she turned well as I was in the water, but by that point if I had had to get out and be on a bed or have other intervention I would have cared a stuff as long as babies were ok, it doesn't matter how they arrive. Birth is just the beginning and a very small part of being a mum to your babies/children. Good luck and relax!

steakchipsandfriedeggs Fri 21-Jun-13 16:10:23

Ok, so back to the negativity Poppy. I did thank everyone who had given me relevant, kind and genuine help. Those people know who they are, I don't need to point out who. However, the second post I got was pretty harsh, blunt and had a 'matter of fact' attitude about it. This upset me, as I'm sure it would anyone who was had asked questions relating to my situation. I then got another similar post which was equally as upsetting and also missed the point of my OP entirely. I made my feelings known about those posters as they did about me and my (valid) issues. If I'm allowed to be criticised for my point of view, then they (and you) must be prepared for my response. These posters have not fully read my post, if they had I think their opinions may have been different. 99% of responses I have had have been from people who have read, absorbed and tried to understand where I am coming from, and to those people I am grateful.

I guess I hold the belief of 'if you can't think of anything nice to say, don't say anything at all'. I'm not asking for everything to be sugar coated, I am asking for a bit of compassion though. So can we stop with the bashing? If you don't want to help then just ignore me.hmm

VivaLeBeaver Fri 21-Jun-13 16:17:28

Ok, to try and get baby to move from a back to back position. Stop sitting on the sofa as much as possible. Best thing to do would be to get a birthing ball and sit on that to watch TV. Not quite as good but better than a sofa would be to sit on a dining room chair.

It is normal for midwives to write in code and unfortunately not always explain everything very well. Been back to back at this stage isn't unusual. Hopefully if it had been anything to be concerned about from her POV she'd have explained better. But I can understand why you want to make sure that baby isn't B2b further down the line. She's quite probably of the mindset that baby will turn by itself, and in all possibility it probably will. But no harm in doing what you can to help.

Next apt - at the beginning tell the m/w that you'd like things explaining a bit more clearly as you want to know what's happening. They won't mind. And do put in your birth plan that you have concerns over examinations/privacy, etc. Midwives should try and help women to maintain their dignity and get consent for stuff anyway. But if you give them a heads up then they can make extra sure that you're happy with what's happening.

madamginger Fri 21-Jun-13 16:21:58

I had a home birth with a b2b baby. He turned when I was in labour, yes it was painful but not much more than my other 2 labours.

Repeatedlydoingthetwist Fri 21-Jun-13 16:25:34

I don't see how Poppy was being negative......?

PoppyAmex Fri 21-Jun-13 16:28:31

OP I added my initial comment in the best possible spirit and genuinely thought everyone was being helpful (albeit clearly not in the way you wanted them to).

There has been no "bashing" and no one was "ripping you to shreds".

Frankly, I find your reaction very odd, so I'll leave your thread now wishing you as much luck as I hope for my own pregnancy.

steakchipsandfriedeggs Fri 21-Jun-13 16:29:44

Thanks Viva, I actually ordered a birthing ball last night once I had realised what her notes meant. Hopefully that will do something. I've booked an earlier appt for next week to discuss my concerns. I'm also going to book in for the hospital tour this weekend so I can actually see what the ward is like, as right now I have no idea what to expect.

Madame, that's reassuring. I'm under no delusions that this is going to hurt like hell, but as long as he is healthy I can take the pain. Just glad that there are stories of natural births out there for b2b babies x

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