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?

How is it precious to expect a professional to do their job? This isn't an optional top-up... keeping proper records is basic stuff! If TSHTF medical notes can be used in court.

What Health Board do you come under? Some are in the process of moving to an electronic system.

My DS is 6 months old and when I was 36 weeks pregnant I moved so had a different midwife. She was amazing and wrote down EVERYTHING although not in an excessive way IYSWIM but her recording was meticulous. She said that the point was to help doctors if I collapsed in the street or something (obviously my notes were on me all the time... ) or even if I went into labour and was rushed in or something. They can see st a glance how my pregnancy had progressed and if there were any concerns. She was also astounded at the lack of adequate records the previous MW had taken, and she gave me a double appointment in the end to try and catch up with my history!

My point is that all the blood tests, urine dips,measurements etc should be recorded during each visit! My MW even asked how I was feeling and made a note of that.

I refused to see the midwife at my GP practice when I was pregnant with my second.
I went to see her first when I was 9 weeks pregnant, she didn't look up from her notes and said " And you thought I would be interested because..?

That was my first and last appointment with her.

The maternity exception certificate you need to chase up if youve filled in the form and not heard back. The notes, im sorry but as a nhs worker if its not written down it hasnt happened. This is basic and she can be strike off if its not done. She needs to fill your notes in ideally at the time every single time, no excuses.. If its on the computer why hasnt she put it in your book as it certainly was each time i went in. I had a purple cover, pink notes. (Dd 4 months so recent)

You need to have full confidence in your midwife, otherwise you will not have a good pregnancy experience, your hospital will have a supervisor of midwives, ring and speak to her, she will arrange for you to have a different midwife, which should improve your care.

Please do not listen to anyone saying you're being precious. Of course, the NHS is overstretched, understaffed, everyone's stressed, etc - but that is not your fault, and does not change your entitlement to decent care.

I speak as someone who suffered a full term stillbirth 2 years ago, after a pregnancy in which the midwives I saw (never the same one twice) were much as you describe. BP etc was never recorded in my maternity notes, and a couple of occasions there wasn't a functioning BP cuff available so they just didn't bother taking it, on the grounds that I had a normal BMI and was probably fine.

Looking back over my maternity notes after by dd's death, I discovered there had been no growth after 36 weeks (I had extra growth scans at 32, 36 & 38 weeks - I don't know why, and neither did my midwife or the sonographer - and when I queried at the time that she seemed not to be getting bigger, and they rolled their eyes and told me she was still perfectly average and not to get my knickers in a twist). All sorts of things were not picked up because there was a total lack of joined-up care and no overall record of what had happened. People were looking for what was 'average' and not looking at how things might have changed from one week to another.

I can't tell you the distress it caused me, after it all went wrong, to have had so much not communicated to me, or not bothered with, and not to have any reliable record of what might have gone wrong.

It may seem like a small concern in the grand scheme of things if all goes as it should (which is the assumption everyone makes - it'll be fine! Trust them to do their jobs!), but it is very hard to forgive yourself for not standing up for yourself and your baby if something ends up going wrong.

Yes, I agree with PP, you're not being precious. The urine dipstick that's done in your presence is particularly important and is often the first indication of issues such as gestational diabetes and preeclampsia.
It's also important that you're able to carry your notes as IT is notoriously unreliable and if you needed help from a healthcare professional who couldn't access basic details about your pregnancy, that could be problematic.
Posters who say you're being precious have no idea how vital it is for healthcare professionals to record keep properly.
If you speak to the supervisor of midwife and you find protocol in your area is to note test results by hand in the blue book you carry I would suggest this is a matter serious enough to report to the NMC.

Can't you ask there and then about BP and urine? I'm very a bit anxious during pregnancy and I always ask midwife there and then if bp is ok, if urine is clear. I'm probably a bit annoying but at least I know for sure. If there was anything out of the ordinary she would mention it as soon as tested, esp for urine and bp. Maybe you need to speak up more in your appts.

I'm currently pregnant but in England so have green notes.

Bp & urine checked for protein every time i see midwife + fundal height & baby's heartbeat. All written down in notes. Everyone asks for these so they're still important here.

I got maternity exemption form from midwife by asking and then had it signed by gp.

Had urine test for uti with gp this week and got antibiotics. Midwife/consultant/hospital weren't testing for uti so I sorted it with gp.

You need to be confident they're doing their job right. Ask why she's not writing stuff down!

Even if your notes are being computerised (mine are, in East Anglia) you should receive a print out of them in the post a few days/a week after each appointment.

Like others have said, if they're not being put into your folder somehow, either by hand our print out, then why are we told to take the notes to every appointment with us? Computers fail sometimes, so a hard copy is invaluable.

Sounds normal to me. I'm on 3rd pregnancy, 31 weeks and only seen m.w a hand full of times. Very little recorded in my book. I see 2 m.w one said I was measuring big next said I was behind and sent for a scan baby is on larger side. Both told me baby was breech scan says head down.

There are some really nasty comments on this thread. The NHS is free at point of use and paid for via taxation. The fact that it is stretched and underfunded and being broken up and privatised piece by piece is not the OP's fault.

The midwife has a duty of care and a responsibility to do her job. If part of that job is to ensure that urine is tested, results are shared and details are noted down in the records, then she needs to do so - and if that's not happening then OP is absolutely right to be concerned.

I could tell you some horror stories about the midwife st my gp surgery including that she found sugar in my urine, but didn't record it because when she questioned me about what I'd eaten I said I'd had popcorn the night before. Turns out I had gestational diabetes, but went weeks without anyone knowing until I was admitted to hospital for a bleed and I mentioned it. They were quite concerned as there was nothing in my notes. She put some info into Trak, but her printer never worked so nothing was in my blue folder. There were lots of other things she did/didn't do and I felt very uncomfortable with her.
During my next pregnancy I had consultant led care at the local hospital due to complications during the first one. Everything was explained clearly, put in Trak and then printed out. Nothing was too much trouble and I felt like I could ask them anything.
A lot of the things that went wrong in my first pregnancy were down to her not noticing the red flags. I beg you to ask her to clarify or ask for another midwife.

She should definitely be testing the urine while you are there btw, please chase this up. If she tests it once you are gone and finds loads of protein meaning you need to go to hospital what's she going to when your no longer there?

I think it is worth being a bit proactive, reading up a bit and asking a few questions. They are very busy, so mistakes could get made and politely questioning things isn't bad, or rude, or saying that you don't trust their clinical judgement.
I had placenta praevia and was admitted with a third trimester bleed. The junior doctor on duty was pretty insistent that she should do an internal exam, because that was apparently protocol. Luckily I was pretty clued up and just said not until she had run it by her registrar/ consultant first just to check please, as I believed that internals were a bit of a no no in the situation. I was right.

She sounds incredibly lax. She should dipstick your urine while there and should record your BP and all other stats. Some will also have a little listen at the fetal heartbeat. It's terribly remiss of her not to record your BP which may be needed for comparison later on. I'd bring it up in a non confrontational manner and just say because of previous issues you are anxious that all stats be noted at every visit. She sounds like a lazy cow tbh.

plug

That is a truly hideous post, It concerns me that someone who doesn't want to make a fuss reads a comment like that - and doesn't take responsibility for their own care ie - keeping on top of these things and a potentially life threatening issue is missed. Because there are many of them, believe me.

Op talk to MW and say you want to see these things.

Luckily I was pretty clued up and just said not until she had run it by her registrar/ consultant first just to check please, as I believed that internals were a bit of a no no in the situation. I was right

We should all learn about our conditions as much as we can.

I refused to see the midwife at my GP practice when I was pregnant with my second. I went to see her first when I was 9 weeks pregnant, she didn't look up from her notes and said " And you thought I would be interested because..?

Fucking hell! Excellent choice, sacking her.

"And you thought I would be interested because" - that's absolutely disgusting. Because it's your fucking job maybe!!
Don't blame you never seeing her again. She should have been struck off.

Ps. I don't think you are being precious OP. Don't listen to the arses that say you are!!

Question anything you are unsure of! Ask for a new mw if you don't want the hassle. I asked for a new obstetrician when I saw who I had been given simply cos she had overseen my last preg in which our baby was not ok- nothing to do with her, I just wanted a fresh start.

I went to see her first when I was 9 weeks pregnant, she didn't look up from her notes and said " And you thought I would be interested because..?

Aye sure that happened as you say 🙄.

She spund sworringly lax about your notes. At each visit your bp and urine should be noted. If urine needs further testing this should be noted as well at the time. My mw is fab everything is noted down (not in major detail just what we have discussed and the results etc). Downs syndrome results were posted from GP so not mw. I am consultant led this time and my notes are jam packed. The consultant and mw are thorough with their notes in case I need to go in as an emergency everything is written down and the progress and complications of the pregnancy can be seen. This is a badic part of their job and in your shoes I would be taking this further. There is enough time in your appointment for effective notes to be written otherwise what the heck is the point of having notes in the first place?!