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Midwife communication...long !!!(69 Posts)
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
FWIW, I'm one of the weird minority who love being in labour. I could do it every day of the week if I had to! You don't hear many positive stories, IME, but we are out there!
That said, I was petrified before my first, so I completely understand your anxiety.
The thing I found most useful of all was reading a book called Stand And Deliver - it consists of nothing but positive birth stories (from EMCS through to planned home births - the only common theme is that the women all found them positive, life affirming experiences) and tips for writing birth plans. Get hold of a copy if youp possibly can.
My comment about negativity was because I felt I was (finally) getting away from the point of my anxiety which was genuinely not the reason for my OP, only to have it brought up again. I've been trying to get away from it throughout this whole thread.
I'm kinda astounded by SOME of the reactions I've had, not all but some. Maybe I didn't make my point clear in the first place, maybe I don't take criticism very well regarding my own situation (although as it is MY situation, only I know how it feels) and maybe some (not all) of the comments have really touched a very raw and painful nerve, and that these people are stronger than me at being assertive in life. Perhaps it's all 3. Anyway all I know is I'm done with talking and crying about it now, so I'm off. I'll take the advice I've been given today and use proactively and hopefully it will be ok. Thanks everyone, I really do appreciate the help
steak I'm sorry some of the posts have upset you but your (understandable) anxiety is pretty clear from your first post so it is difficult to give advice without mentioning it.
That aside, yes it is normal for the midwife to write notes in code, the notes aren't really for your benefit. They are like your doctors notes - the only reason you "hold" them is that antenatal care is shared between different locations. It is just shorthand for the midwives convenience. She should have explained it better though.
At 34/35 weeks the position of the baby is not really that important as there is (usually) plenty of time and room for things to change.
I agree with the others, try to get another appt to talk to the midwife about your birth plan if it will reassure you (I wrote mine at home and the midwife checked it), but the chances of you going into labour before your next scheduled appt will be pretty slim anyway.
My last pregnancy was high risk and I had to go back and forwards to the hospital and midwife several times a week, be reassured that the reason they are being so "relaxed" about your antenatal care is because they are assessing your pregnancy to be progressing well with no issues.
I would recommend juju sundin birth skills for getting yourself informed, and second the
Are you able to book yourself on a local birth workshop, maybe with NCT or I did one through my active birth yoga classes, have a google.
However, I have heard the NHS classes are excellent and really cover the birth stuff that the MWs don't get time to cover, so hopefully questions will be answered then for you.
"I've been trying to get away from it throughout this whole thread."
Why mention it then?
If what you wanted to know was info about rushed midwife appointments you could have asked that. Or asked a straightforward question about back to back.
Your first post mentioned your anxiety several times and so of course posters picked up on this, I'm not sure how your separate the two unless you just don't mention anxiety.
I don't think bar a couple of unhelpful suck it up posts anyone was critical of you. Why are you astounded? I'm astounded how arsey you have been in the face of continued help and support.
I've not found on MN that people get off on making others concerns and worries seem inadequate but then I don't respond to people who offer advice which I feel misses the mark for me in the way you have.
Like Poppy I wish you all the best for your pregnancy and birth.
So my posting has obviously annoyed a fair few people, for this I apologise. I honestly thought that I had been genuinely grateful to all who have helped me with advice and comments. As I said, a good 99% of those who commented were genuinely lovely and I have taken all advice on board and tried to turn my sad day yesterday into a much more positive one by using that advice. I really don't know how much more I could have thanked people.
All I did was react (maybe badly, maybe rightfully, only I know) to a couple of comments that I feel could have been better worded, and I feel that these were fairly obvious, there really were only a couple of comments, but there was a lot of comments jumping to their defence. I had to stick up for myself as i felt i had been misunderstood, but i don't think I had been arsey, i just had a differing point of view, which i am entitled to, as is everyone else. Call me over sensitive, but I could never comment on anyone's post by saying "no your vag is nothing new" or "more exciting things happened last night", because I don't know that OP, I don't know what they are going through, and so I would only offer advice that I feel would be helpful to that person. I guess the 'shock tactic' approach doesn't work on me. My criticism of MN was more a criticism of the Internet in general I suppose. Whilst I am fully aware that there are plenty of well meaning, helpful lovely people on here, there are others who don't quite get where others are coming from but still put their own 2 cents in all the same. I'm not entirely convinced that if we had been in a room together discussing my issues that these people would have had the same approach, just the same as I may have found a better way of dealing with things. The Internet is a faceless machine and a tool to be as brutal as anyone wants.
And Parttimer79, for what it's worth, I found your advice helpful, you were certainly not one of the posters I took offence to. I realised I hadn't pointed that out clearly and for that I am sorry. I can understand why you felt a bit defensive yourself if you feel your advice hasn't been appreciated. I think I have been massively misunderstood by this post, no ones fault but still frustrating all the same. I'll try to seek other ways of getting through this all in the future.
Again, thank you!
Just to reassure you, I've had 4 kids back-to-back, one came out back-to-back and one required me being moved to help a stuck shoulder, but no one ever mentioned any forceps nor was it considered an option (with stuck one, they discussed a c-section when I became quite distressed but only reluctantly with a lengthy deadline as I kept coming in and out of the pushing stage due to his position).
Sadly, in my four pregnancies, I've had a lot of rush jobs and midwives spending more time trying to convince me that they and their colleges were right rather than being concerned about my fears. What worked best for me, was just creating a birth plan that listed my concerns and how I wanted to handle it as well as a couple of my main desires and handed it over directly (My birth plan for DC4 basically said please be nice as I'm really scared and will remember this, I have a bad history in hospitals so don't ask my partner to leave, with anesthetic so I can't have spinals or pethedine, only G&A or full going under, with placenta problems so I want to delay the injection until the placenta comes out, and give me my baby as soon as possible and care for baby in my sight where possible. And that DP didn't want to cut the cord). If you don't know how you want to handle it, say you really want to discuss before you progress too far to make decision making easier. Be kind but blunt and bold. I hope the best for you and an easy delivery for you.
Good god you're going to need a thicker skin before you become a parent if you call this being 'ripped to shreds'. And I don't care if I get flamed for not being nice to you.
People have taken the time to post advice for you and anyone who doesn't entirely agree with your viewpoint, however gently they have put it, has been shot down and accused of 'bashing' you.
You have been bloody rude.
I had a back-to back delivery with DS1, or "face to pubes" as it's delightfully known. He was undiagnosed and it wasn't till his head started to appear that they realised. For me, giving birth on my side with a leg in the air was the most comfortable. Midwife was lovely and coached me through it. I had no pain relief.
The main thing is to keep calm and try to relax as much as possible. Try to sort of ride each pain wave and remember every contraction is one nearer to a beautiful baby.
My dd was back to back and it was extremely painful but still managed to deliver with no forceps. I'd never heard about back to back until I was in labour!
I think in regards to midwives, I tend to think of them like cabin crew, when I'm on the plane going through turbulence thinking I'm going to die, I look at them, and if they're carrying on like everything is normal then it means everything is okay.
I never got talked through a birth plan with dd and to be honest never asked, I think they take their cue from you a lot of the time so if you seem all care free and relaxed they'll feel no need to mention anything (as I think above) but if you tell them your anxieties and ask lots if questions they are normally ime very good.
Hi OP. I haven't read the whole of the thread so may be echoing what others have suggested.
Back to Back is not an ideal position simply because the baby will come out face up. Sometimes in this position they get their chin or shoulder stuck and need help but this is not always the case. It can also mean a longer labour and more painful but this is also not always the case.
I have had two B2B labours, The first was long and painful and I needed vontouse help. The second, all of the pain was in the back and in many way this was easier than my two front labours.
There is still plenty of time for baby to move but you can also try and encourage a good labour position by sitting in straight backed chairs with your legs slightly apart. (try not to slouch).
It is probably a good idea to prepare yourself for the prospect of additional pain relief should you feel unable to cope with pain. Although a MW can talk through your birth plan, these often go out of the window during labour and so if there is something you really feel you do not want/or done in a certain way, then talk it though with your birthing partner and asked them to be your voice so that you can concentrate on labour.
Re the anxiety. I also suffer from this but I promise you, during labour your body does something really special and anxiety really takes a back seat. I actually had a full blown cold and sickness when I went into labour with my DS. The minute I went into labour, it disappeared only to return once I had given birth.
If you have any questions or concerns, it might help to phone the Cow and Gate Careline on 0800 977 8880. The team is made up of midwives, and other professionals and you can talk 24/7 to them and ask for advice on most things.
Hi OP, I was also worried about labour (although for different reasons) and knew I would not get the detailed explanations I prefer, on the NHS, because they are just too busy, so I had an independent midwife and she was brilliant. (Obviously I did go to NHS appointments too but I was able to ask her anything I didn't understand and also she helped me decide what I really wanted when HCPs were recommending all sorts of different things and disagreeing with each other!)
One thing she did was a 'birth talk' at our house a few weeks before the due date -- she talked us through how it worked in detail, she had pictures to show us and we could ask all the questions we needed and not feel silly.
It might be possible to get an independent midwife to do a visit like that as a one-off, to put your mind at rest and avoid the whole 'battle' feeling you can get when trying to get individual service from the NHS.
Also, I don't know if you're anything like me but when I get anxious I ask lots of questions and I think I come over as questioning the HCP's judgement when I just want them to explain clearly. I find it sometimes makes it hard for me to get a decent service from HCPs as they think I'm having a go...it's definitely an anxiety thing as when I need to speak to HCPs for work I don't have that problem at all!
I do hope things look up for you.
At this stage there is plenty of time for the baby to turn round so don't fret that there's no chance the baby won't turn. DD wasn't back to back at my 36 week appointment. At 38 weeks when I was in labour she was. There are lots of things you can do. The main thing is to keep active - perhaps go swimming as your midwife advised.
It seems that you aren't asking questions when you don't understand things hence the googling afterwards. It may be that the midwife saying you we're carrying the baby in your back meant it was back to back. HCPs speak in a lot of jargon and sometimes forget their patients don't understand. They aren't being mean just not thinking. If your midwife says something you don't understand then its absolutely ok to ask. It's also ok to say what you want to discuss i.e. birth plans etc.
Phineyj-unfortunately I'm the other way round. I've had a couple of doctors visits in the past that made me feel like a massive time waster and a hospital visit that nearly made me boycott ever setting foot in one ever again, so my approach now is only bother if absolutely necessary. If I'm nervous as well, all questions tend to fall right out of my head. But I'm working on writing a list of questions so I'm prepared better and ill have OH there for support or in case i forget anything. It's just a shame that the MW earlier in my pregnancy was really forthcoming and explained everything to me. I know everyone is different though. Thanks for the advice!
Again, thank you to everyone for the insightful, personal supportive advice. I'm feeling much stronger and more confident today to tackle this thing. Reading back through the thread, I really don't feel I have been rude (just defensive regarding a couple of posts, when needed) but I know others may have a different opinion of me. I'm really not a bad, rude person, I just needed some help which the vast majority have given me. Too many of you to thank individually, which may be why there's been some crossed wires.
Thank you xx
OP - dont worry about the baby being back to back at this stage at weeks 34-36 mine was back to back and at the last appointment (37 weeks) he had turned round.
All midwife appointments I've had have been very quick as well and I have felt shoved out the door. If there's anything to worry about though they will tell you but perhaps you could ask for a longer appointment next time to talk through your fears?
The list is an excellent idea. Hope your appointment goes well.
I'm glad you were feeling stronger yesterday and hope today is another good day.
I have my own difficulties with these issues and you must remember that the emotions and fears you feel are real, valid and not your fault. (Not always easy, I know).
I have found that clinicians try to be understanding and sympathetic if you disclose your fears, but every woman is different and to get the help you need (rather than me, or the clinician's stereotype of someone with your history) you need to be quite blunt and straightforward in spelling out what your triggers are, what has helped you in the past, things you would like to try. I find it easier to write down my history and these pointers and hand it to the clinician so I don't have to talk about it if I don't want to.
There is a book called
"when survivors give birth" by Penny Simkin which might give you some ideas. There is also a booklet online titled sensitive practice guide at www.sstaffs.gov.UK/pdf/SPG1.PDF which is mainly about treating adult survivors of childhood sexual abuse but contains much that is relevant for anyone with something in their past which makes some types of medical treatment especially hard.
Good luck for your next appointment.
Wanted to add two quick things - firstly, I have also just had a totally underwhelming mw appt (36 wks) with little information given about baby's positioning etc and notes not properly filled in (ie presentation, fetal heartrate, engaged or not all not filled in).
Also, my baby 'might be a bit back-to-back' at the moment. I'm not worried about this though - there's a long time to go and some good advice above.
I also mustered up the guts to say that I have anxieties about intimate examinations. The response I got was akin to 'well there's not much we can do about that, we try to maintain dignity but there's no other way to do things. Maybe hypnosis might help.' Wasn't very happy about this.
Ceara that leaflet is great - my specific 'issues' are different to that, but the advice to health care practitioners is exactly how I'd like to be treated. I'm seriously considering printing out some of the relevant pages...
Hope things are well OP.
Hi Brave, that's awful! I'm so sorry you've had such a disappointing visit. I have my next appointment on weds and I'm taking OH with me because I'm worried i'll just clam up and not ask anything. I understand how upsetting it can be to feel your worries and concerns are not being taken seriously.
I've also heard back from my community midwife team regarding antenatal classes, apparently they are on a drop in basis so hopefully these will help calm any nerves. It also seems that the midwife I have been seeing is a temp to the team and I have a neighbour who is also not terribly impressed with the standard of care she is being given by her, so whilst its frustrating that this is happening, it is reassuring to know that I wasn't just driving myself mad :s
Hope you're ok, I'm sure we can both get through this x