Would you have used a service like this in pregnancy/postnatal period?

[Tiddlerslate1987]

I’m a desperately unhappy healthcare worker. I feel crushed under the stress of litigation and frustration at not being able to provide the quality of care I’d like to. I’m looking at ways to get some job satisfaction but still use my qualifications. I would be qualified to offer the following services, but I was hoping I could get some feedback on whether it’s a service people would find useful and pay for? Friends tell me it’s a great idea, but they’re my friends so I guess they would say that.

I would offer home visits to do any of the following -

1:1 antenatal ‘classes’
Previous birth debriefs
Birth plan/preferences
General discussions of expectations around pregnancy/labour/postnatal period
Hospital bag prep
Coping with baby with colic
Safe co-sleeping advice
Reassurance re: feeding methods and normal newborn feeding behaviours

It’s all a bit vague at the minute but I’d be so appreciative of any feedback on whether it would be a success or if I need to go back to the drawing board.

Sure there are services like this already so must be feasible to run as a business. Could you start to offer services whilst you continue your main job initially to build up a reputation cause I'd say it would rely on recommendations.

So a doula? I think it may depend were you live.

OP - what do you mean by the stress of litigation?

Yes I’d have to do this due to finances @ContadoraExplorer. I live in quite an affluent area where I imagine this kind of thing would be of value and so hope a reputation could be built. I just don’t have the confidence that I would get a good reputation yet

It would be marketed quite differently to doula services. I certainly wouldn’t be able to offer labour support whilst still practising within the NHS and I’d hope that my profession would give me a more unique selling point with antenatal classes and debriefs, for example. I did NCT classes for my husband’s benefit and was quite shocked at how out of touch it was with the reality of labour (sadly). You’ve really got me thinking about the crossover with doula services though

@Blue4YOU I’m struggling in my current role because of the constant threat of litigation. I feel unable to provide the care I want to because my time is consumed with relentless paperwork to cover my own and the Trust’s back. It’s taken the magic out of a job that I loved and instead I’m a nervous wreck at work

During the hideous early months, I would have bitten your hand off for a 'WTF is wrong with my baby' class. I'm not just being flippant. Someone to sit with us during the bad times (i.e. evenings), observe, and offer some unclouded advice, support and reassurance.

Previous Birth Debriefs, definitely! I've had two traumatic births, 15 months apart and it was only when my obstetrician offered a 'debrief' about Dd1 (I didn't even know such a thing existed) when I was pregnant with Dd2 that I was made aware of the monumental fuck ups that were made, things left off notes....I can't go into too much detail it's difficult to write.

I haven't been able to do the same with Dd2 yet (I had a grade 4 placenta previa, a really terrible experience with an EMCS) but I know I need to.

I need some clarity with what happened throughout both their births, if there was a service that could support me in it I would jump at that, I try not to think about it right now if I'm honest.

Hi OP. Im a nurse and have also had a traumatic birth. How would you offer a comprehensive debrief if you dont have access to medical notes? You cant just go off what the women tell you.

Id have loved support post natally. Id have paid for that. Just someone to trouble shoot with.

Previous birth debriefs would be impossible surely, unless you were there.

Scrap birth plan writing. Don't lull women into any illusions that their plan will happen. Just set out realistic expectations.

Post natal stuff would be more appreciated imo. With antenatal stuff, no one knows what they are 'missing' whereas a post birth 'WTF do I do now?' service would be ace.

Would you have the correct insurances to provide these services?

Thinking about it further - unless you were there and have access to medical notes, you cant ethically offer debriefs.

Previous birth debriefs would be impossible surely, unless you were there

My obstetrician wasn't present at birth, but she asked me to tell her what had happened, had my notes so told me what she had read, then when I added the 'missing information' which correlated some circumstances she asked me for more details and looked very concerned. Unfortunately I wasn't able to follow this up with her as I became quite ill (this was whilst I was pregnant with Dd2) so my priorities were with my LO.

What I would have liked is someone qualified (and impartial) to talk to about my birth experience, someone to attend the debrief with the obstetrician and much more qualified than me to understand the information on the notes (that I as a patient would ask for to give access), and then to follow up with some answers to alot of questions that I have.

Really those should all be provided by midwife and health visitor - mine were though I appreciate there have been cutbacks in the ten years since I had my youngest and with covid it may not be face to face. But the new birth and six week check from the health visitor will cover all this

@frazzledd the fact that your OB had your notes is key there.

Yes some of the services are offered post-natally by HVs and midwives, but that doesnt mean OP cant market her skills and sell them. The NHS offer antenatal sessions but people buy NCT, for example. Go for it OP!

I would have loved something like that. Post natal. I felt so bad and didn’t feel I could tell people. So I would’ve paid for it.

I agree that postnatal services is probably the bigger market and arguably more helpful- the antenatal stuff is all geared up to birth and then once it's done it's done, kind of thing (and most of us find during the process that what we've done antenatally was vaguely useful at best) whereas postnatal could cover all sorts. I was happy with my postnatal midwifery care but obviously that's only a few days.

You'd basically be offering what the HV service should in an ideal world, look how popular sleep consultants have become for people who really want support to the extent that they will chuck money at it and even those of us that didn't actually spend money on support will have considered it at some horrible point!

An evening service from weeks 2-13 weeks ish would be ideal to help troubleshoot.

Car seat safety advice is sadly lacking in all maternity/post natal support and is just as important as safe sleep advice

@Letsallscreamatthesistene absolutely, what is also notable is when she spotted the discrepancies made by her staff she took more details but I wasn't informed of any further details. Obviously my priorities were elsewhere at the time but I would have jumped at an 'independent debrief service' to attend alongside me, to ask the right questions and get me the right answers I still need. X2!!

You can request a copy of your maternity notes if you want. I have a copy of mine, would never have a debrief with the hospital in question because their care was shocking and I know full well it won’t make a shred of difference - but I would completely pay a fee to a private midwife or similar for an independent debrief.

I would have jumped at an 'independent debrief service' to attend alongside me, to ask the right questions and get me the right answers I still need

Yeah this is a good way to go about it. Depending on the OPs quals.

@Letsallscreamatthesistene

I would have jumped at an 'independent debrief service' to attend alongside me, to ask the right questions and get me the right answers I still need

Yeah this is a good way to go about it. Depending on the OPs quals.

I'm just saying this is a service I would use, I seriously doubt anyone would be allowed to offer this unless registered and qualified!

Thank you. I’m reading all of these and finding it so useful.

Yes I would certainly need indemnity insurance to cover all of this.

Re: debriefs - I could offer debriefs for women wanting to talk through a traumatic event. I could comment on why things may have happened that they hadn’t considered before or been aware of. But more importantly I could listen, and sometimes that’s all someone needs to feel more validated and at peace with an experience. This might not be the kind of debrief that some women would want, in which case they’d be better accessing a debrief through the hospital they delivered at. Anyone is able to request access to their medical notes, and so I would be able to comment more on what actually happened with this. However, there’s no way on earth my Trust would have me making money debriefing women on my colleagues’s etc care.

@PerpetualStudent

You can request a copy of your maternity notes if you want. I have a copy of mine, would never have a debrief with the hospital in question because their care was shocking and I know full well it won’t make a shred of difference - but I would completely pay a fee to a private midwife or similar for an independent debrief.

I did have the debrief (1 anyway) with the hospital and your absolutely right, it made no difference whatsoever.

I'm with you, I would pay for this service, I still want and need answers.

I'm finding this upsetting to write so going to stop, but I think far too many women go through traumatic births and are given no insight into what happened and live with the 'what ifs'. Its not healthy and I've now got a horrible feeling this is going to bite me in the arse if I don't talk to someone about it and get some answers.

Exactly why I think calling it a 'debrief' is tricky. Theres defo a call for the service, im not sure you can call it a debrief though.

Pp mentioned attending a debrief with a patient. I think thats a good idea.