Or is my midwife a bit shit?

[Heatherbell1978]

28 wks pregnant with DD1; I've moved house since having DS1 so a different mw and GP practice to last time and a few things are making me think my care has been a bit lacking especially as I'm a slightly older mum (39) (and obvs have last time to compare it to).
At my 8wk check mw spent 15 mins putting my blue folder together and gathering all the various Bounty and NHS packs before getting round to the questions which she raced through without asking how I was. I had no concerns so thought nothing of it at time.
4 weeks after 12wk scan it occurred to me I hadn't had my Downs test results and then when I chased she blamed the hospital but a few days later they arrived in the post with a post-it from GP reception apologising for not sending them earlier (they were dated 2 weeks prior).
Now my biggest worry is that she isn't putting a copy of my results in my blue folder. She's taking my blood pressure etc but I have no record of any of mine or baby's stats to look at in the folder. It just occurred to me last night that when I take my urine sample in I don't see what she then does with it and again, nothing in records. I had a urine infection with DS1 that went unnoticed by mw as she hadn't checked the test results properly but this time round I don't even know if she's sending them for testing!
It's also just occurred to me that I haven't received my certificate for free dental checks although that's least of my worries just now.

I feel fine but probably not quite as great as I did with DS1.

I have an appointment next week but before I go in all guns blazing, am I being precious about this and how would you tackle it?

Yanbu. Just state calmly that there are a number of things you've noticed, starting with no test results which is probably the most important - ask for a print out there and then. If she baulks at all then ask if they've been tested, and don't be afraid to take the complaint higher. You can request to see a different midwife I believe or they could do your appointments in the hospital. Good luck!

You are being precious. She checks BP, its fine, end of. same with urine. Can't you be happy that you have no real concerns? It's the NHS, they have time constraints for each patient too. If you want to be treated like a princess you had better pay for it and employ a private midwife.

Just on the maternity exception certificate point- you need to fill in a form for this. Has it not turned up despite you filling in the form? If so, then contact NHS BSA and ask if they have got the form (can take a while to process).

It's most likely a computerised system which most hospitals are switching to now so all your results are on the computer not your folder. Midwives also hate having to spend so long faffing with paperwork rather than spending time with women but when the trust marks your performance on that paperwork whilst giving you too short appointment times to do it all in midwives have little choice but to rush through the rest.

I thought the whole point of carrying around your notes was that there was a record of your pregnancy and the tests you had had? I would ask where the test results are noted, or that you could have a copy for your notes? When I had my last baby there were a few measurements/ results noted at each mw appointment. I do t think it's too much to expect and definitely think you should ask. If you aren't feeling confident you could call hospital where you are due to give birth and ask for appointments at the hospital?

That ^ is horse shit.

She should be noting down all these things because each person is different. You blood pressure may have risen but still be 'normal' for quite some time.

They don't write stuff down for the hell of it. Why else are you told to keep your notes with you?

Do question it. You're doing the right thing.

Id just go in and say my copy of my note isn't up to date can we sort that out today as I had issue with dc1 and want my own copy. No guns, no blazing just and adult to adult conversation.

The horse shit comment was not for yellow car! Sorry!! Didn't post quick enough!!

Plug trust me I'm no princess. My point about the urine is that she does nothing with it in the appointment, I pass it to her and then nothing. With DS1 she'd test it while I was there so I don't know if it's fine.
I have very low blood pressure and was borderline anaemic with DS1 which although I appreciate are pretty low risk issues compared to other potential issues I could have, I'd like to know if they're a problem this time around.

It isn't precious to expect your notes to include a record of your blood pressure and results of urine, my notes have always just had a few pages at the back for records of each appointment, with boxes for each thing that should be tested. Fair enough your bp is fine now, but if it's not recorded future midwives won't know what's normal for you so it's harder to detect an increase over time. Your urine would just be tested with a dipstick thing rather than sent off though.

Sounds odd. I had dd 17 months ago and everything, every test and blood pressure went into my hand held notes then.

Its the NHS midwives have up to 40 women or more to visit per day they can't be doing your paperwork and chasing up forms for you if your that concerned phone the hospital for yoir results or pay for your medical care and go private like the rest of us.

I have pink notes so not sure what your blue ones look like but in mine there is a space for each appointment for the midwife to note blood pressure, urine results, baby's heartbeat, baby's movements, fundal height and anything else we discuss. Are you saying she's not completing any of that? Because I would definitely be concerned about that. And all other test results are meant to be included too. Your notes are supposed to show the details which is why you're meant to take them everywhere with you.
By the way, my urine sample doesn't get sent off, she just does a dip test on it.

breathe yes that's it. My notes are blue it maybe that's a Scottish thing. All I have in my notes at the moment are blood test results which come from the hospital and my two scan results which again come from the hospital. Nothing relating to my regular checks. I did have them in my folder with DS1, mw would print them off each time and put them in my notes.

Are you sure your hospital isn't using computerised notes? Then she will be writing it all down but it will be online so you won't get a copy?
Ask her nicely at the next appointment! If they are not online and she isn't recording your notes (and no, that isn't too much to ask!) then it would be appropriate to write a letter of complaint to the supervisor of midwives.
(Am an obstetrician. Have never ever known even the busiest NHS midwife not record BP and urine and a sentence about how you are doing at each visit!)

I'm 28 weeks and my urine is tested with a strip test there and then at every appointment (even my consultant gets his hands dirty and does this!) it's then been sent to the lab a couple of times for full analysis. The strip results are written in my notes every time, as is my BP. I don't think you're being precious, it's important that there's a record of test results and your care, when I went to MAU last week they read all my previous notes to get an idea of my history. Maybe ask if it's recorded different in your area, on a central computer system?

Not being precious at all.

Hate this attitude of "it's the NHS suck it up". It's everywhere? Why be accepting of something that below par service? We pay for the NHS' existence.

I am guessing they are part computerised and part paper based - this was the case for me so the paper notes were blank in some cases.

Say it to her - she is there to mind your baby AND YOU over your pregnancy.

Hope you continue to feel well!

As pp, I would expect a note of your BP and urine dipstick somewhere in your notes. Can you go through and check very carefully?

In mine it was a single line they filled in each time, date, BP result, urine dipstick (clear or what found & next action) whether you're well, then signed. Oh also last Hb if they'd done one (filled in from the time before)
That's a pretty basic documentation, but if everything's fine, I wouldn't expect it to be more complicated.

I had printed copy of two blood results which were slotted in, but not of the more routine full blood count type. All these should be in the system, so a printed copy less essential.

A note was made of my flu jag, again just a one liner.
Notes don't have to be long, or complicated (unless you are long and complicated iyswim) but they should be there.

I wouldn't expect to have printed out urine results. Usually this is just a dipstick to check your urine for protein & glucose. They would then bin it. It's only sent away if a problem, and they'd probably ask for a fresh one.

I'm unclear whether it's your new midwife or the old one who the problem if with. Are you being referred to consultant due to your age?
At that point you may well see a hospital midwife & could raise it there.
Or is there another mw you can see at the practice? Otherwise an appointment with the practice manager may be appropriate.

There's some basic stuff not happening there by the sounds of it.

On the downs results, it is possible that she assumed that she hadn't seen them as they hadn't been sent, not realising that reception had them.

They should be recording your BP, urine and fetal heart rate in your patient held notes. So ask about that.
Surely you can file your downs screening results in your notes?
It's up to you to sort your exemption certificate, the midwife only gives the form. You fill it out and chase it up.

Just to add to super long post, and cross posted within every one. Grindelwald & plugugly are both wrong.
Documentation is super important.
It's possible it's computerised, but there should be something in your handheld or what's the point?
If no documentation is happening it would be an NMC issue, no joke.

coldhands it's my new mw. I lived in another area with DS1 and mw there was fine and used to update my notes but this one doesn't. Where I live the age is 42 to be referred to a consultant I think so just normal mw care for me.

Everything should be written in your hand held notes just in case you visit another area and need hospital admission. Being busy is not an excuse not to record BP, urine test results and blood results etc. If it's not written down, it didn't happen! Definitely ask your midwife to ensure they are up to date.

People saying you are being precious are dicks.

Your notes should be up to date and have test results, bp, measurements etc in so if you do need to go to hospital then they will have all your info to hand. Talk to your midwife about this, with mine it was both written in notes and on the computer. If you are not happy, it's your right to ask to be seen by someone else.

Good luck with your pregnancy

Even if they are recording it on the computer system they need to put it in your notes too- not all trusts use the computer system yet and if you are taken ill in a different trust area, they need the details if your pregnancy.

I'm in Scotland too with blue notes. My mw uses 'Track', which I assume is an online NHS monitoring system. Everything is recorded on there plus my next appt etc but then (if printer is working!) she'll print out the results and I get an A4 page with all my updated previous appt details (BP, urine, fundal height etc) stuck in the front of my notes.

I don't really like this computerised system as I feel that she looks at the screen rather than me for the whole appt, but it is all recorded and I get a copy.