Mothers alcohol use shown on medical records

'@BehindtheBump it might be mentioned if it became relevant.'

It doesn't work like that. Things are recorded on records or they aren't.

Unless you're saying that something happens down the line after the child is born, and the mothers records are opened and info dumped into the computerised shared notes of the child?

I really, honestly can't imagine a situation where the fact I had three miscarriages before him was medically relevant to DS. I do think it's quite weird they included that in the birth record for his notes but not, for instance, the fact I took aspirin and progesterone while pregnant with him, which I can see the relevance of. Personally I'm not that concerned if he can see that information, but I can see why other women would very much be and I think they have a right to privacy.

'Part of it is arse covering by the professionals. If you read significant case reviews where children have died due to parental actions or neglect then they always examine maternity records. Did mum attend appointments?'

This is not about maternity records! It is about information about the mother like previous pregnancies being recorded on the child's medical records as part of the first entry when they are opened.

FlorenceNightshade apologies, I am not clear, could I check please if when you say "in my country" are you referring to a country outside of the UK?

The issues affect women worldwide, but in the context of this specific story about alcohol, NICE guidelines only apply to England and Wales - although Scotland and NI also tend to follow them closely.

Regarding the integration of maternal notes into child health records, is anyone able to clarify if this is the current situation within the countries of the UK? If so I am very much in favour of shouting from the rooftops about it.

Thanks.

'. If a women attends an appointment and expresses that she’s not coping as she already has children at home the the number of siblings is relevant.'

This justification for including detail of pregnancy history in the records of one or more of her children is nonsensical.

She is the patient.

'I’m sorry but that’s just not true in all cases. If a women has had multiple pregnancies that ended in stillbirth or miscarriage then that’s relevant.

To the medical records of the child once it is born? How?

If a women attends an appointment and expresses that she’s not coping as she already has children at home the the number of siblings is relevant.'

Then mother is attending and it will say in her record how many children she has. Or, the GP can simply ask. Which they would normally do rather than trawling back through the notes (of the child??!!)

The phrasing 'case closed' certainly makes it sound like mothers are automatically investigated and have to prove they are not doing/ have not done anything 'wrong'.

I'm sure it wasn't intended that way but for someone involved in this it's an interesting choice of words.

@Clymene I’m sorry but that’s just not true in all cases. If a women has had multiple pregnancies that ended in stillbirth or miscarriage then that’s relevant. If a women attends an appointment and expresses that she’s not coping as she already has children at home the the number of siblings is relevant.

In a situation where there are no pre/post natal concerns then yes the information feels intrusive and irrelevant but it has to be gathered “just in case”. I appreciate that won’t sit right with everyone

@BehindtheBump it might be mentioned if it became relevant. Not engaging or appearing to be dishonest would raise a red flag but sometimes nothing comes of it, pregnancy progresses well, baby thrives, no further concerns “case closed” so to speak.

But if a mother failed to engage, missed appointments and then was found to be using drugs, or there was DV for example then yes the circumstances would likely be recorded in child’s notes.

Part of it is arse covering by the professionals. If you read significant case reviews where children have died due to parental actions or neglect then they always examine maternity records. Did mum attend appointments? If not, was it actioned etc. Of course that’s an extreme example but I hope it gives an insight into why professionals record seemingly irrelevant or private information. It’s about creating a big picture (if there is one) not breaching a parents confidentiality

[quote FlorenceNightshade]@Clymene from a risk assessment point of view the number of pregnancies/number of siblings question may be relevant. Likewise any complications may be relevant to new baby. That’s why it’s included.[/quote]
They are relevant to my pregnancy. They are of no relevance to the child once its been born.

Woman who don’t engage or who aren’t honest flag up anyway

That wouldn't make it into the child's medical history though, would it? 'Suspect mother might have consumed alcohol this pregnancy as she looks a bit shifty and my Spidey sense is tingling.'

@Hardbackwriter yes your physical antenatal notes would go in your hospital file but the first entry in a child’s record (usually the electronic gp one) is nearly always the birth summary. In a pregnancy with no concerns that’s usually all that’s there but if there were additional risks etc then these can be added to child’s record.

In my country a lot of the information that’s on the online system accessed in hospital that relates to parents is things like referral letters to other services and then the initial assessments.

We still don't have electronic antenatal records in my trust. Which in some ways I think is bonkers - if you forget to bring your notes they just have no information on you - but I guess that means most of it isn't in DS's notes unless someone has diligently copied it over? The original book is definitely in my file, not his, because I remember the nurse commenting on the extraordinary size of it (I had loads of extra scans and monitoring, all of which got paper-clipped in) when she was looking at my hospital file when I had a pre-operation assessment for something entirely unrelated to maternity.

@Clymene from a risk assessment point of view the number of pregnancies/number of siblings question may be relevant. Likewise any complications may be relevant to new baby. That’s why it’s included.

[quote FlorenceNightshade]@NiceGerbil I’ve already tried to explain what information about fathers is held but I’m happy to try again.

Any medical issues disclosed to midwives etc specifically relating to the father would be recorded such as hereditary conditions in his family and any significant health conditions he has that are disclosed including BBVs, MH etc.

Things like drug/alcohol use, info the police hold such as DV concerns etc would be recorded as social history. Social history information is usually gathered in detail when there are concerns raised.

In a pregnancy with no concerns and where a baby then thrives etc there is likely to be very little if any of this type of information recorded. That goes for the mother’s information too.[/quote]
'Likely to be' isn't really good enough. And what relevance are a mother's previous pregnancies to her children? Why are they part of a child's medical records?

Any and all info provided by the woman around her pregnancy is recorded on the child's records.

So
History of pregnancies with dates
Contraceptive choices
History of alcohol/ drugs and current consumption
Any DV or issues with the partner
Employment status
Any mental health issues by the mother including treatments and history of eg self harm or suicide attempts
Any other medication she's on
Any history of referral to SS etc
Then onto
Detail of the birth

I've been told my mum took drugs during pregnancy and there were MH issues. We are NC since I was 17 and didn't live with her, just visited. I wish this info about my mum was recorded on my records!!

I'm confused about how they would know if you had a glass of wine before you even knew you were pregnant? Does this not rely on the mother's telling the truth at their appointments?

Although, I know of a mum who smoked a few joints of weed before she knew she was pregnant, and admitted it at the appointment, they tested her and she came back positive, and they drug tested her each time she went after that. Seems a bit u fair that she would have that recorded and be tested, but other mums can drink and it doesn't?

Just not sure how it would work

I agree there needs to be clarification on this.

It might be easier to start with asking individual NHS trusts if they have a policy and what it is.

@NiceGerbil I’ve already tried to explain what information about fathers is held but I’m happy to try again.

Any medical issues disclosed to midwives etc specifically relating to the father would be recorded such as hereditary conditions in his family and any significant health conditions he has that are disclosed including BBVs, MH etc.

Things like drug/alcohol use, info the police hold such as DV concerns etc would be recorded as social history. Social history information is usually gathered in detail when there are concerns raised.

In a pregnancy with no concerns and where a baby then thrives etc there is likely to be very little if any of this type of information recorded. That goes for the mother’s information too.

This is genuinely awful - and women need to know about it

Totally agree with recent posters. I'm an HCP and was a V senior NHS manager prior to 2012. Admittedly my specialities never covered maternity or paeds but I'm still shocked by this if true.

I actually don''t think electronic integration could have happened as far back as 2000, other than as a specific pilot, as electronic records weren't widely used. That isn't the case now though.

I'd write to Matt Hancock if I didn't think his comlete blindness to the downsides of digital technology would make that a waste of time.

Perhaps Kier Starmer / John Ashworth?

Women need to know this.

Those from certain groups could be exposed to serious risk as a result of this.

Apparently that's just

I really really would like to see s policy or NHS info piece about this. I still find it unbelievable (although multiple posters who work in this area confirm it's happening).

Who would I write to, to confirm the policy on this in the NHS as a whole?

Although s PP has said there is no policy as it's just normal practice.

But there MUST be one as it's considered sensitive data.

No I had no idea either.

And Google gives nothing. Nothing at all.

Considering the highly sensitive nature of the data I'm shocked it's available to children and that this is not mentioned as far as I can see on the NHS site, I've found no discussion, news, anything, anything at all on Google.

I definitely was not advised this for either of my children at any point.

I work in an industry that handles sensitive data and the rules around it are VERY strict.

And this is just about as sensitive as it gets.

The point that there could be massive real life consequences for families and definitely risk of harm including physical to the mother as a result of this has apparently never occurred to anyone who knows this happens.

My question about what info of the fathers is recorded on the child's notes has not been answered which is telling.

The other point is that if this already happening then the original article makes no sense. As info on disclosed alcohol use by the mother is already on the child's notes.