to complain about midwife (internal/assault)

[Hensinthehedgerow]

I'm sorry if this is in the wrong section. I'm in search of some opinions. This may not sound like much to complain about to some people. But this has really affected me and my marriage and I can't seem to move on.

In summary, I had a birth plan, it said no internal examinations and everything done needs to be explained to me. I thought she was doing an external examination, but instead did an internal which was very painful and basically in public view after my husband had been sent out of the room. I wish I had kicked her in the head and screamed and called the police, but I was holding my newborn baby and didn't I want to cry, I can't sleep.

I raised these issues with the som who said it shouldn't have happened an that she would speak to the midwives. Then emailed me to say the midwives agreed more communication would have been helpful to me wft

I have no idea if making a formal complaint will help. But can't let this go. Aibu to complain. The midwives were horrible and essentially bullied my husband. I guess it's wwyd? Sorry for the ramble.

But if a patient states no internals during labour, then how likely is it she wants one after?

OP, sorry you're feeling so low, you poor thing

My Dh was sent out of the operating theatre after I'd delivered my son as she joked that it was far too undignified patching me up for Dh to see. Do you think that might be why the mid wife sent your Dh out?

The other thing is you say you were examined in public view, do you mean there were other people in your room?

You don't have to answer those questions if you don't want to x

"I am not comparing the examples (both Nurses and mine) to OP's situation which if you re-read what I said in the context of a comment on the responses to Nurses earlier posts, that should be perfectly clear."

So why go into them on this thread?

The OP is clearly talking about a very different situation to any of those you have referred to or Nurse may have been referring to.

So why bring them into it to muddy the waters when what happened to the OP is clearly different.

She was not unable to consent, she was not confused or combative. She just wasn't asked properly, her notes weren't read and any consent she gave was uninformed because it wasn't properly explained to her what the midwife in this case intended to do.

Yes poor communication and it needs addressing but what support is OP getting in RL? Why won't your GP be supportive? Can you see a different one? What about your HV?

How is your mood generally? Is this becoming such a preoccupation that it is overshadowing what should be a happy time? If so then you need to gain RL support from people/groups as well as NRL.

Sorry for the questioning but there is a danger that something like this can become so preoccupying that it cancels out all that is good and memorable. It doesn't have to be this way. Consider all avenues of support because going through the complaints process is not something you should do feeling alone.

OP you are being so brave to be complaint and talking about it on here

Please ignore anyone, no matter how well meaning, who tells you to 'get over ir' and just concentrate on your baby. I felt I should be doing just that after a incredibly traumatic stay in the post natal ward, and it weighed me down adding to the guilt and shame of being traumatized.

I think good councelling might help you try and process what happened and help you to put it in the past where it belongs - but really you can only do that when you've put alot of effort and expertise into this journey of healing. Not just 'shutting up and putting up'!

I had flash backs and was really really shakey and traumatized for months, and people get 'stuck' in that state if you can't process it and come to terms with it. Its awful. It was actually talking about it on mumsnet that helped me realise quite how bad it had been and that it was ok to be feeling so bad. That was a huge deal for me, as rl people, (& myself), had been minimising it all and pretending everything was fine... Which made it do much worse.

That's why it's so important to get help, and also try and get back control by complaining and getting people to admit what they did wrong and maybe even learn from it?!

I wish I'd followed up my complaints formally, as it doesn't matter how busy / stressed / overworked people are, there is never an excuse for treating women like animals.

Anormalone - in my situation you couldn't have had both. You either would have had the damage or the internal.

I don't think we should tie women down and examine them - of course. That goes without saying.

But there has to be a limit on how difficult we make peoples jobs (and how much we complain about the care we get given that it is the best/safest it has ever been) and there are ways of doing a good job and making sure all is well, and of doing a partial job. You wouldn't go to the dentist and refuse to let him/her put an instrument inside your mouth and request that he just look from the outside - this would be akin with that. What is the point. You may as well not employ the dentist in the first place and just get a friend to check the teeth.

I am trying to understand - I just can't as all I see is that it is part of completing the job and doing a good job, and as unpleasant as it is it can be a life saver - literally.

Perhaps my experiences bias me.

Not muddying the waters. The over the top, all or nothing responses to what Nurse said deserved a response.

Since when did discussion need to be linear?

Agree with bues comment completely

But I absolutely do agree that you should be told what is happening and in that way give consent - but I think there was a miscommunication. I think from what the op says, the mw did think she had consented.

I categorically do not agree that any hcp can simply go there without telling you.

And there was an element of 'why do HCP's not feel the need to seek consent' which kind of does bring it into the conversation....

nurse you have my respect please sleep well and continue to do a great job. Thank you. OP report it and see what happens Id love to know the outcome. You may want to consider going private if the nhs terrifies you. I hope your little one isn't at sick kids hospital as much as mine, I don't know what I'd do without them. Good luck with motherhood and congratulations on a healthy baby.

Hoorah for mignonette someone who understands and doesn't think I need suing or sacking for providing emergency care that my dying patients haven't consented too!

And I quite rightly haven't gone in detail due to patient confidentiality! I'd get another flaming :-)

Blimey. I know I am not being helpful here and I can't start a thread about a thread, but all I can think of is how grateful I was to receive all the brilliant care that I did when I gave birth.

If I had (I am sure I did but I cant really remember) I was confident that it was for the good of myself and my baby.

I had wanted a home birth but thankfully decided to go into hospital, I ended up with an emergency CS. In all honesty, I could not have cared less about any examination by the midwife or doctor.

I am sorry though that you feel that way and I hope that you can get past it and enjoy your baby.

mignonette, nurse didn't explain she was an A&E nurse until one of her later posts. Most of the responses seem to be to her earlier posts, excusing the midwife for not gaining consent because the OP was bonding with her baby.

I agree with Sarah, you are muddying the waters. The situations you describe have no relevance to the OP here. Using them to explain away someone elses comments (when they themselves have seemingly drip fed about their own situation) is unhelpful. The element of "why do HCP's not feel the need to gain consent" has been quite clearly applied by most, to situations when informed consent is entirely possible, such as the OPs experience.

Op I would have held you down if you were ill and were at risk of harming yourself/me/other patients!

There's no comparison with ED nursing to midwifery!

I find it so sad that were living in such a blame culture, virtually everyone gets a CT scan these days if they come in with a headache because our doctors are frightened of getting sued! Then the patients have the audacity to complain that the results take an hour to come back!

Try living in a country where NHS care isn't available, go have your babies and see how much it would cost you!

I'm glad we live in a culture where (most) people do not think it's ok for HCPs to assault women.

Responses along the lines of 'you should be sacked' were after her professional disclosure (which was pretty clear to me)....

I totally agree and believe that HCPs need to change their views and approach regarding getting consent before doing anything to another person (including explaining what they are actually going to do).

However, I also think there needs to be some form of protection/more protection for HCPs against complaints when there are bad consequences as a result.

At the moment, its a bit like they're between a rock and a hard place. And whilst I don't agree that anything gives them the right to override consent, they are certainly highly pressured to achieve good outcomes, as well as facing lawsuits/loss of career if something does go wrong.

I wonder if having a form to sign, similar to the 'self-discharge against advice' form would help. Not just to protect HCPs but also to make them more consciously aware that actually, the patient's choice is central, and not their own targets.

In fifteen years time it is highly likely that MW's won't even exist any more in sufficient numbers. Babies will be delivered in the main by medics.

We can have a linear discussion about that one day too .

So because her health care was free she has to be grateful for the bad treatment she got? She wasn't in any danger, baby was fine and surely when working in an a maternity ward/unit it doesn't take much to realise these women are exhausted vulnerable and in alot of pain and that perhaps a few mins of explaining and an attempt to be a bit gentle wouldn't go amiss???

You can't compare emergency situations with one where the mum was there and able to consent.

I never said I condoned assaulting patients nor the non seeking of explicit consent.I have to be very careful and explicit with my clients because of the field i work in and the nature of my clients problems.

I don't condone an intention or thought of violence towards a HCP either.

I'm glad we live in a culture where HCPs generally are still prepared to do what they need to do. As the blame culture gets worse this will stop and care will get worse. There will be more back covering than caring and nobody will want to step in and do something a little risky in case they get complained about or sued.

I feel sad that the op is sad and understand that for some people it is more important that things are explained. I can understand the op a little as I struggle to go to the dentist due to circumstances that made the mouth a no go area for me. However, I do still go and bear it even though I need a drink before hand and I do like to get the low down on everything they are going to do. But they don't explain everything prior to doing it. Last time they cleaned my teeth without telling me they were going to and I was almost sick with fear. However, I wouldn't complain or think of it as assault even though for me the mouth is far more personal than anywhere else. I have to tell myself that they are doing it for me.

There was another thread recently where a poster wondered why women allow themselves to be assaulted in labour/postnatally - "why don't they just kick the HCP in the face?"

Exactly Frog

Anticipating many crossed posts, but still...

OP, congratulations on your baby, I'm so sorry that the happy event has been overshadowed in this way. I do hope you're taking care of yourself and will seek RL help if you feel you need it. Does your husband understand how you're feeling?

I am absolutely disgusted by some of the responses on this thread, both as a woman and an HCP.

Consent is vital. What the OP describes is assault. She has been very clear that this was not an emergency situation and she was competent to make her decision. The MW may well have felt that she obtained consent - so at the very least making a complaint should result in some specific retraining in what taking informed consent actually entails. I am very clear about what I am asking a woman's consent to do - and even in an emergency situation (perhaps, especially in an emergency situation) it is important to do so - it's not time consuming to state that you want to examine internally FGS!

Yes, to properly check for tears one does need to examine a woman internally (there can be vaginal/cervical trauma without external tears). If this had been properly explained she could have chosen not to consent, or to consent to a limited exam and the MW (again, not acting in isolation) should have respected and documented this. She would have had nothing to worry about had anything have "gone wrong" in the future.

I wonder if the responses would have been the same if the HCP had been a doctor? A male one? If a complaint like this was upheld by the GMC what do you imagine the outcome would be??

In an emergency situation, yes, it may be necessary to go against a patients wishes - but that is not one person acting unilaterally in an otherwise empty room. Making a best interests decision to act without consent involves senior members of the team -not just one individual- and I hope this is what Nurse is describing. This is obviously right and defensible. Perhaps the MW did feel she was protecting dignity by sending DH out of the room - but it wasn't her decision to make - it was the OPs.

And fwiw, relatives connot give consent on behalf of a patient except with enduring power of attorney etc. If a patient doesn't have capacity to make a particular decision then it's up to the healthcare team do act in their best interests.