How to make a midwife listen to me? Appointment this afternoon.

[PrisonerZero]

I know my midwife is very busy and we only have 5 minute appointments. Since our local maternity ward closed all the women have been sent to another one in our area which means it is over crowed, staff are rushed off their feet and they simply don't have time to be in two places at once. I think the midwifes do a brilliant job and make the best of a bad situation but it does lead to rushed appointments, mistakes on notes and I generally feel that my thoughts and feelings are brushed aside.

I am 40 weeks pregnant and have an appointment this afternoon with my midwife, I have only seen her twice during my pregnancy and never seen any other midwife more than once, there is no continuity of care and information gets lost between appointments.

Early on in my antenatal care I explained to my midwife that if I went over 40 weeks pregnant (which I fully expected to as previous DCs were induced due to being late) then I would only have specific dates that induction can happen due to childcare. I am able to arrange childcare up until the 17th June which would make me 40+8 but after that I am basically screwed as I will have no one to take care of my DC should I go into labour naturally or medically. I am including neighbours and distant friends in this, we have new neighbours both sides that I don't know. The midwife at the time said this wouldn't be a problem as she was sure that something could be arranged and I would possibly be induced at 41 weeks.

The NICE guidelines state that induction should be between 41+0 and 42+0 and the dates I have child care fits into this. It also says that the mothers home circumstances and social issues should be taken into account.

I asked the midwife at my 38 week appointment if I would be given a sweep at my 40 week appointment (this afternoon) and she said no, and that it was normal to gie a sweep at 41 weeks - which is correct, but I could really do with being given a bit of help before then. I plan on asking her again today and also to try and arrange my induction date, partly for my own peace of mind and partly due to my childcare issues.

Recently, I have know a few people within my area and with the same midwife that have been given induction dates at 17/18 days over due - mainly due to the staff shortages and having no beds at the hospital. I want to avoid this if possible. I am not sleeping well because of the worry and have had anxiety issues in the past, including counselling and being signed off work for a few months. I have done so well to get past these and am very nervous about ending up with the severe PND I had after the birth of my last DC.

How can I make the midwife understand, given the lack of time I have and the fact that she doesn't know me or my history?

I do realise that the hospital are so busy - to busy infact to have given me an appointment with a consultant that I should have had months ago.

[CalmInsomniac]

I couldn't read and run. I don't know what to say except you can be very polite but also firm, and not leave until you get the reassurance you want. Politely repeating yourself again and again works, apparently. Quoting NICE guidelines would be very good. Also AIMS might be able to give you advice about tackling the fact your hospital is so over busy.
I know how helpless it can make you feel and you are absolutely right that the lack of control and anxiety is not helping you. So I want to send you some (unmumsnet) hugs x

[PrisonerZero]

Thank you, I really appreciate you taking the time to post.

I will have a google of AIMS as I haven't heard of it before.

Thanks again.

[diplodocus]

Just to say she's not being difficult about the sweep - if the cervix isn't favourable (and quite often even if it is!) a sweep won't work.
Hope you get something sorted out.

[CalmInsomniac]

Yeah do look up AIMS www.aims.org.uk/ as they have a helpline. Hopefully you can get through to someone and they will be helpful. I've heard good feedback about people who needed their help.
Good luck and let us know how you get on.

[mummysweeangel1]

PrisonerZero- i really really feel for you reading your post, i know i am more worried about my 2 year old son and arranging childcare for him other than anything else and its really stressing me out too.

I would have imagined that because your over 40 weeks now they should be prepared to get the "ball rolling" for you - so to speak - its not like your asking for the baby to born dangerously early- I know of various people who have been induced because of the same reasons as you so definetly make a stand today and put your case to them - my hat goes off to the midwifes - they are overstretched most days , and there really is a genuine need for more of them country wide but they also have a duty to listen and help aswell - my fingers are crossed for you today .

x

[LoveBeingAbleToNamechange]

I would ask her for sweep as soon as you go in and see what her reaction is to that and then say you would like an induction during the next week. If she asks why, looks like declines then state anxiety, circumstances and the fact you were told this wouldn't be a problem. Just be firm, not rude so it sound too much like a question.

[LoveBeingAbleToNamechange]

Btw my mw had said that at my 40 wk appt she would do a sweep automatically.

[PinkFondantFancy]

On top of what the others are suggesting, is it worth trying something like reflexology? I've heard quite a few anecdotes from women that swear by it getting things moving, and it's got the extra benefit of being lovely and relaxing too.

[PrisonerZero]

Thank you all.

I have found the number on the AIMS website and will be giving them a ring in the next few minutes.

I had sweeps both times with my previous DC but they didn't work so i'm not holding out much hope of it working this time, but it may help so I will ask her anyway.

I will have a google about reflexology, sounds like it will be very relaxing whether it works or not, and I could do with something to send me off to sleep at the moment.

I was such a state with PND after my last DC (years ago, it scarred me that much that I thought I would never have anymore DC, my marriage broke down, I lost my house etc - I was diagnosed by the counsellor as having PTSD, but have never mentioned it to anyone as I have been to ashamed)

I think I will try and get a doctors appointment for after the midwife appointment (if it goes badly) and appeal to him/her too, as they will have acess to all my notes on their computer so maybe it will make a difference. I lost my job in April last year as my anxiety came back and I recognise the warning signs now so hopefully want to avoid it this time.

[PrisonerZero]

Have left a message with someone at AIMS and they are hopefully going to call me back before I leave for my appointment in 20 minutes.

[eastegg]

FWIW I was offered a sweep at my overdue apptmt at hosp and that was at 40 +3, although it would have been a bit later had there not been a cancellation. But the MW who offered it must have thought there might be some merit in doing it. Can't say whether it worked as I declined it.

[runnyeggsareyummy]

It doesn't sound like your request would be unreasonable, as other posters have said be pilite but very firm - definitely don't be rude as it tends to have the wrong effect(cry by all means!).

The only other thing I would say is that you might need to think about what would happen if you are induced towards the end of the period when you have your childcare arranged. If by any chance you need a c-section or either you are baby are poorly after the birth you may need to stay in hospital longer than planned - anf obviously you would then need someone to take care of the older kids. Having already had children you should be fine but you never know.... worth taking into account.

Good luck.

[PrisonerZero]

Thank you for all your advice.

I have seen the midwife and she was fantastic. I can't fault her for listening and understanding what I was saying - I was in her office for an hour! She also offered and gave me a sweep straight away, I am 2cm and the head is well down so she says my cervix is favourable (another plus as they don't like to induce otherwise)

She took notes on what I was saying and rang the hospital, she spoke to the head midwife and was put on to the consultant. She really fought my corner, but the consultant said no, even though I would be 8 days over. The midwife did however insist that I was given an appointment with the consultant on Wednesday and told me to go in and stand my ground, also to take the notes I had written from the NICE site with me.

I was polite but firm with what I said, although didn't really need to be firm as she just accepted my reasons without question.

I now have to wait and discuss it with the consultant which i'm not looking forward too, I have a feeling that wont go well at all.

I don't know what I would do if I was kept in hospital, the lady from AIMS has given me some phone numbers to ring etc for advice, I couldn't speak to her for long as I was on my way out but she said she would ring me back later.

Going to go and run up the stairs a few times to see if that gets the sweep working!

Also made a doctors appointment for tomorrow as I would like the anxiety stuff written on my notes, the midwife also said the consultant will take advice more willingly from a doctor than a midwife so maybe if I can get him/her onside it may help.

Thank you for all your advice.

[WinterLover]

Im really pleased it went well, good luck for Wednesday..

Have a hot & Spicy curry tonight

[LoveBeingAbleToNamechange]

Fab news!

[PrisonerZero]

Thank you.

I have a doctors appointment at 10.30am, I am going to take my NICE guidlines with me and hope that I get a sympathetic and understanding doctor. I am trying to plan what I want to say

*That I have a long and documented history of anxiety, including counselling (organsied through the doctors) and being signed off work for 4 months last year with the reason 'anxiety' on my doctors note.

*That I understand the risks of induction - also having been induced twice previously, with no intervention or pain relief and very short labours I feel that I am able to cope with the procedure.

*I am over 40 weeks pregnant

*The NICE guidleines state that the womans needs and circumstances should be taken into account when setting an induction date - I only have childcare for a limited time and seeing the consultant on Wednesday would only give me 2 days - should she decide to go ahead with the induction - to have the baby and recover enough to take care of my other DC. Should she decide not to induce then I will be taking my DC to the hospital with me! Which is causing my main anxiety.

*My cervix is 2cm dilated, low and very favourable according to the midwife.

*I understand that during the day is the most busy time for the labour ward, I am able to come in early, or of an evening, or even to transfer to another hospital that may have more room.

*My midwife was encouraging of induction and actually recommended it going so far as to phone the consultant herself.

Is there anything else I should be saying? I don't know how much influence a doctor has over a consultant (who i've never met and doesn't know me or my medical history at all)

[KateeTheBump]

It sounds as though your consultant is being an arse!

What you've written here sounds good - what you could also mention is that anxiety will inhibit labour happening naturally - if the doc/consultant agree to you being able to be induced on Wednesday, today, then the relief would give you a better chance of labour being spontaneous in the mean time?

Good luck, stand firm!

[PrisonerZero]

Thank you - I will definately add that to my list.

My doctor will think I am a right pushy sod!

[CalmInsomniac]

I think the "if you want to induce me on x date that's fine but I will be bringing my other children with me as I have no access to childcare on that date" should bring the doc up short. They don't want children running round labour ward!
Sorry got to go. My DD is systematically throwing her cheese on toast pieces on the floor.

[DaisySteiner]

The thing is, if they're really busy as you say, then they will have to prioritise those who have medical reasons for being induced (like gestational diabetes, pre-eclampsia etc) and even then they may still be too busy to safely induce you. My SIL has been in hospital for the past 7 days waiting to be induced for hypertension. They keep having to stop the induction because they are too busy to continue, and that is with somebody who has really good medical reasons which mean she needs to be delivered for her and her baby's safety.

Whilst I hope you can get a date for induction when it fits in with your childcare arrangements, I think you also need to have a plan B in case it doesn't work out this way eg. you might need to pay for emergency childcare from an agency, find a doula who can look after them or find someone else to be with you so your dp can look after them.

Hope it works out.

[PrisonerZero]

Thank you both,

Daisy - your poor SIL I really hope she has her baby soon.

I saw the doctor this morning and she was very nice, she said she couldn't ring the consultant herself but would email a letter to her adding her support to my midwife. She gave me the number to ring to speak to the consultant and said I should give her a call this afternoon and see about bringing my appointment forward to Monday or Tuesday to give me more time to work things out with whatever the outcome of the meeting is.

I have called, but the consultants secretary said she doesn not take calls from patients as she is very busy - which I understand, but also said she does not return calls either. I left a message saying who I was and why I was calling and also mentioned the email she should be recieving so hopefully she should have a read of it this afternoon. Secretary said that the only time to see her would be on Wendnesday so I will just have to go along to that appointment and see if they can squeeze me in somewhere.

[DaisySteiner]

Fingers crossed for Wednesday then, or even better that you go into labour before then!

I am so MAD on my SIL's behalf, it is totally disgraceful IMO that they should have left her basically in early labour for a week after starting the induction off and then not continuing. Not to mention the cost of keeping somebody in hospital for a week!

[CalmInsomniac]

Good luck for today, prisoner zero x