Mothers alcohol use shown on medical records

To elaborate; "risk" in my profession is a catch all for many types of risk, inc risk of harm to all persons involved. In the context of this thread it would be weighing up harm to unborn child and harm to self, harm from others etc on the basis of the information available at that time and best practice guidance from the midwifery council, GMC and RCN.

'Risk always outweighs confidentiality.'

This is rubbish.

I can think of loads of examples where it doesn't.

Also, what of the risk to women of this info being available to their children?

Risk always outweighs confidentiality

Is there more to this principle, because that’s not true in a whole host of situations where men’s medical records are involved - genetic diseases that may be passed down, STDs that may be passed on, etc.

I hope no one minds, but I have started a discussion in legal to ask if anyone would like to input into this thread.

Can I ask for some legal brains to input on an issue about confidentiality? www.mumsnet.com/Talk/legal_matters/4027786-can-i-ask-for-some-legal-brains-to-input-on-an-issue-about-confidentiality

There is no evidence as to what would be a safe amount because it would be unethical to do the research. Because of this, women are advised to avoid alcohol completely.

To be clear, FAS doesn't happen to the children of women who had a small spritzer with their xmas dinner.

Risk always outweighs confidentiality.

It does, but only in very specific situations and then only on a case-by-case basis.

It's not my area of expertise, but from memory, when confidentiality is breached say for safeguarding purposes, the organisation has to record why they have breached GDPR and could be held to account for their decision.

Routinely transferring maternal information into child records is a very different scenario and we should not be blasé about it.

I'm still not clear from this discussion that it is definitely happening, but if it is, then an almighty stink needs to be kicked up.

I'll get my DMs ready.

Alcohol is the drug that kills the most people in the UK, hopitalises the most people in the UK, and is responsible for more ill than all of the rest of the drugs available combined. Only cigarettes are any kind of rival. I chose not to ingest alcohol throughout my pregnancy, because it is common knowledge that even ONE glass has the potential to harm unborn children. Doctor's and other care givers may need this information to protect both the mother and child.

Risk always outweighs confidentiality. Perinatal mental health services have to manage these dilemmas all the time. It would be interesting if any MH nurses working in perinatal shared their experience as I'm coming at it from the perspective of someone asked to help the potentially brain damaged middle aged adult children.

Nicegerbil we never really know if anyone is who they claim to be online do we? (I realise that also applies to me too).

I actually think most professionals would be concerned by this. They understand the consequences if patients can't trust their information is confidential.

Langdown thank you. The other HCPs on the thread have seen no issues. That really is troubling.

There's also no answer that I can see about the potential consequences of having this info on file to be read by the child.

No they won't be writing that.
But could use language that communicated that.
On the basis that a lack of personal care can be a sign of mental health problems.

And having unshaven legs is not in the same league as having previous pregnancies recorded or mental health history.

As for the unkempt hair and stuff, I've heard various HCPs talking about service users in a derogatory manner, stating things like, she could look prettier with some makeup on, unshaven legs, how slatternly is she. And other things.

Well that's human nature to an extent. But are they writing, 'slatternly unshaven legs' on my medical notes and passing those on to my kid?

Nice Gerbil, I'm an HCP and while I can see the information is useful, I am absolutely against merging medical records without full, informed consent of mothers.

And I'm pretty sure I won't be alone.

But it's not you who will have recorded the info on the child's record. Info about the mother gathered while she was pregnant and before the child existed.

If a woman has her meeting with midwife and they say what about drugs and the woman says no I used to do a lot but gave up 10 years ago it's up to that midwife to decide whether to add it to her summary report about the woman which could in turn form part of the child's notes when they are born.

None of the women on here were advised that any info they shared could be read by their child years later.

There seems to be no policy, no guidelines, no informed consent, no understanding of data protection law and no consideration of ramifications.

All the HCPs area just like oh well it's handy or would be handy so there you go.

This is extremely concerning to me and many of the other women who have posted.

It's not hard to imagine a woman being abused or killed over info that apparently is in there. No one has responded to that point.

Yes I totally appreciate the privacy concerns of the mother. It has to be significant and/or repeated consumption over a long time to be considered in my assessment.

I asked what info about the dad was recorded on the child's record. I think this is a huge point. Are how many children he has fathered and whether they were aborted added? The answer will be no on the basis it's not relevant for the pregnancy or the birth. I can see no reason why the info the mother gives on this is deemed relevant for the child. And it really bothers me that no one has considered the risks and consequences of children getting this info on their mother. I mean that just sums everything up really.

As someone who is involved in cognitive testing for adults presenting with neurological damage it would be really helpful to know how much the mother was drinking during pregnancy and BF. Often the patient themselves has no idea and may not even be aware that there were alcohol issues if they were raised in care (especially 20+ years ago when we may not have paper records still) or relatives who could give a history have died

But where does the information gathering stop?
How much and what info is passed on, is down to presumably an individual at that moment. Unless its everything and that would be worse than parsed info.
So an individual decides that the couple of pints a woman had right at the start before she even knew she was pregnant is useless info, and doesn't add it, another individual decides that any drinking even the half glass of champagne at a wedding is critical, your left no further forward.
And it still is all kinds of wrong.

As for the all relatives dead scenarios, it happens, I'm one of them. And each time I say I dont know, HCPs take it just fine. But there aren't that many cases where absolutely no one is around to ask, so adding birth mother private info is still not justified.
Also often people who drink will hide it from family, like gamblers will (curious is that also recorded)

My dad was a gp retired now and even back then they were aware not to write personal opinion which certainly happened before. There's loads of code.

Eg

Well informed means they have been googling and think they know it all and are a pita

Thread the other day, saying why do they put 'i meant this pleasant patient' = she's fine

Sure there is more but it goes on. Also stuff like being unkempt would be couched in professional sounding terms if they felt it was relevant for the notes eg looking after yourself is considered a thing when it comes to mental health I think.

This is all an aside because the point of this thread is it's not your records.

It would be your child reading that you were scruffy on X date. Although I think it's more summaries they transfer into the child's notes, I don't actually know though. The notes that are part of their record available across NHS and GP etc.

It's an interesting question@SafeInBed. I haven't ever seen my medical history. Not sure I want to, given that apparently they might have recorded that I looked a bit shifty or 'didn't engage'- whatever that means. What else do they record? Hair a bit unkempt, socks didn't match

I've seen my records, theres a huge lump missing for various reasons. A lot from childhood around birth to 5 years, and then other stuff from when we lived abroad. As it's all now online, or at least on a computer, there should be nothing missing since records went online. So for the children born after 2000, it should all be there, including apparently some parts of the mothers history.

As for the unkempt hair and stuff, I've heard various HCPs talking about service users in a derogatory manner, stating things like, she could look prettier with some makeup on, unshaven legs, how slatternly is she. And other things.

Which section on there flitting I scanned but it's a long doc.

Getting a medical history is not a problem why would it be.

This is about taking a woman's medical and lifestyle etc history during pregnancy and copying some/ lots of her history into her childs record which will then be available to GP and all other NHS providers as per the new electronic set up, and available to be read by the child from age 16 if they ask.

Oh sorry yes child records.

No they are lost in the mists of time!

In fact all my notes and x-rays from years of surgical procedures as a child have been lost when the hospital moved but that's another story

Well in future they will. Do you think that breaking such a fundamental of the handling of sensitive personal data of all sorts of stuff, without consent, is appropriate then? Because it might help, with something that might come up, decades later?

www.bps.org.uk/sites/bps.org.uk/files/Member%20Networks/Faculties/Intellectual%20Disabilities/Guidance%20on%20Neuropsychological%20Testing%20with%20Individuals%20who%20have%20Intellectual%20Disabilities.pdf

In case this is of interest, these are some of the aspects of an adult's history I would be required to ask about.

You will do or people in the future will.

And I'm sure people over 45 have NHS records! In fact really sure because I'm over 45 and I have seen mine at the GP!

The part about putting loads of information about someone else in (their mother) will come through from children born after 2000.

Alcohol in pregnancy related rather than their own use, can excessive alcohol use by a person impact their brain function, or do those people not go to you? Ditto for excessive drug use.

Also isn't it an assumption? Rather than a diagnosis? If you suspected brain damage due to mothers consumption in pregnancy and the notes on the child's records about the mothers habits and history etc say no alcohol, would you think oh it's not that then?

I work with people 45 years+ and we don't usually have child records for them.