Midwife Consultant bully!

[libertysilk]

Expecting my third child, and, as I'm 45, am monitored quite a lot. I have 3 weeks to go. I've had a complication free pregnancy. Scans and tests all normal and within expected parameters.
Due to my age, I've been refused the option of giving birth in my local birth centre as its not attached to a maternity ward. I challenged this, and was booked an appointment with a midwife consultant.
She wants me to be induced at 38 weeks, due to statistics of women my age having problems. She keeps saying I'll haemorrhage or have a still born. In a meeting on Wednesday she took my hand in hers, and placed it on her stomach. Said she wants the best for me and wished me well.
My midwife has ok'd me for a home birth, and disagrees with the consultant.
I feel I'm being scare mongered, and bullied.
I'm part of a group run by a midwife and doula with 38 years experience between them. They support me along with my midwife, and say I am healthy and fit and perfectly able to have baby at home. They've said the midwife consultant is behaving professionally and is bullying me, and I should report her.
I'm in two minds.
I'm not naive, and will not put my baby at risk, but, this is putting huge stress on my pregnancy, including confusing and upsetting the father too.
AIBU to be upset?

OP - while i think the hand on stomach thing is odd , i really dont think it warrants a complaint.
The midwife's job is to ensure that you are FULLY aware of the risks , in plain english, and there are risks involved in being an older mother.
She was giving you the hard facts, and giving her advice which is an induction and delivery in hospital.

You can decide yourself, no one can force you to do anything however you need to be sure you have all the correct facts and are not vulnerable to agendas from groups or the midwife consultant.

I am very surprised you have not seen an obstetrician - i would ask for an urgent appt to speak with the obstetric consultant.

Quite aside from the rest of your post, home birth is cheaper than hospital birth

If it all goes smoothly, yes.

Pengwynn, that's sort of my point. I don't think pregnant women should be able to make demands as they see fit.
Her decision? If she wants to go against medical advice, she picks up the bill, it's as simple as that, no choices.
The pp is already costing g the NHS extra with the additional monitoring, which is entirely correct.
But her 'challenging' the advice has cost consultant's time already, and the additional cost (and resources ) of a home birth, to say nothing of more costs if intervention is needed.
We all have a duty to save NHS money wherever we can, yet no-one seems to think it should apply to them.

Just out of interest what happens if everybody advises against a home birth and the woman insists, can you get midwives to come to a home birth if they are really against It?

Karmagician, I am all for the de-medicalisation of birth, but I don't think there is a hospital or midwife in the country that could have responsibly let you go past 38 weeks in an IVF twin pregnancy at 46 in the hopes of a "natural" delivery. IVF has higher risks, twins have higher risks (twins everywhere are considered full term at 36 weeks), being 46 when you give birth has higher risks, whether you like it or not, and no matter how "fit" you feel. The consultant didn't want your babies to end up dead before delivery - and making it about whether she has children herself is pretty low.

Er...
Doctors don't know everything and are not always right. They often give poor advice and waste resources on unnecessary tests and treatments, which may do more harm than good.
Op should listen to and consider advice and make own decision.

Yes, you can have a homebirth against advice and the midwives will still attend. Happens a lot.

Why would the midwife putting her hand on the OP's tummy mean that a second opinion should be asked?

I am confused by this.

Oh, am I not allowed to speak now either?

I had DCs 4 & 5 at home. I didn't do it on a whim and I didn't do it because I wanted candles and whale music.

Everyone was very supportive. Until one mw went a bit weird at about 36weeks with DC5.

She started insisting I was high risk despite there being nothing to say I was. She said I would have a PPH despite me having no history, that I was anemic because my HB was lowered (got it back up within a couple of weeks), said I was grand multipara despite this being my 4th birth child not my 6th.
She said if I agreed to transfer whilst in labour, give birth at unit and then come straight home she would be my MW even if she was off duty.
How that would be safer than a HB baffles me.

It was all very unsettling and confusing.
Turns out she had only seen on HB during her training and was clearly uncomfortable with them.

I understand your upset.
I am not someone who advocates HB under any circumstances. You shouldn't go against good, objective medical advice.
But people need to be aware that not all medical advice is objective.

Beaver
Thank you.

I would love to spend a day with you where you teach me lots of things as you are always there when I have a question on these threads.

Thank you, lovely.

From a midwife friend:

"Not aware hemorrhage increases but risk of stillbirth does with older women, same way as for diabetics. Placenta more likely to degrade. Often r offered induction early to avoid this"

At the end of the day it's your choice, however, I would not discount a professional opinion just because I disliked the way it was given.

The induction thing is worrying.
Is that what happens now?

I had baby number 3 at Home, age 42. I was under a consultant , said I wanted a Home birth and he was fine, not an issue or concern with him. I’d had 12 week scan , and 20 week scan all fine. No other intervention. He did warn me that if I was late they would want to induce. Luckily baby appeared 1 day before due date, Home birth, no issues and much more pleasant than in the hospital.
Only thing was apparently my placenta was yucky, grey looking and the midwife was surprised and asked if I was a heavy smoker! Nope, didn’t smoke. She said the placenta was at the end and baby wouldn’t have survived if inside much longer . Whether that was because I was older no idea. But baby was 100% healthy. I think that’s why the baby was ready to come out, as no goodness left in the placenta. I was about 20min away from nearest hospital if I’d needed to go in.

Cathf - because pregnancy and childbirth is not an illness or injury but a state of health, and the natural instincts of women as birthing animals are more than capable of producing healthy babies in the overwhelming majority of cases. Medical intervention when needed is a great thing, but if doctors aren't careful it can be given too early and with too little respect for the mother.

I spent four days on the labour ward of Chelsea Westminster in September (induction which set off a spiral of intervention which I wish I had refused) and lost count of the number of times I heard women saying to the doctors "I've done this before, I know how it feels, why aren't you listening to me?"

In your broken leg example a better parallel would be the doctor accompanying you in your daily life and saying no, don't take the stairs, walk an extra half mile round the hill instead, because statistically across the year there's a two percent chance you might slip on ice and break your leg. And I'm not taking into account that today is the middle of June".

It's a tough one. Your choice vs greater risks. One professional will value one over the other, hence the conflicting advice.

My grandmother gave birth to my mum at 45 in 1948. No scans and she gave birth at home. Like you she was extremely healthy and had a pregnancy free trouble. She did however had to go to hospital in the end and my mum was delivered with forceps. Still what would overall considered a straight forward delivery.

So the policy where I work is recommended Induction at 40 weeks due to your age. If you chose not to follow this recommendation, you would be advised to come in for daily monitoring until you went into labour OR consented to the IOL. You would be given written information about the risks, and citations for the evidence underpinning the recommendations and asked to read and sign it to say you understood those risks.

With regards to the Birth Centre it would be irresponsible of the hospital to allow those facilities to be used for high risk cases. They don't have the resources to correctly manage and monitor those types of labour - you all saw how the midwives at Morcombe Bay were roundly criticised for a "normal birth at all costs" mentality. All maternity units are under a massive amount of scrutiny and are very risk averse due to the huge cost (personal, emotional and financial) of claims when things do go wrong.

I am sorry to read that you feel unsupported in your birth choices. If you feel that the Consultant Midwife was bullying you, you should of course put in a complaint. However, you need to come up with a birth plan that you are happy with, that is clearly documented so that you get the care you want. I suggest you consider (a) At what point you would be happy to consent to Induction (b) that you understand you may need to transfer into hospital during your homebirth if the midwives caring for you identify any changes in labour that means it is no longer safe (c) You have read and understand the risks and you accept them.

Best of luck.

I don't agree with her placing your hand on her stomach that's very strange.

BUT

I do believe she's going off what she's been given to go off from guidelines and past experience. Any consultant midwives in this area are VERY experienced and have worked in midwifery for a long time so they do know what they're doing!

Saying that I also think every mum should be heard and not made to feel uneased or upset by those caring for us. I also don't think your midwife team should be saying these things about the consultant, if they have an issue they should contact and speak to the consultant and higher themselves. It's like you've been put in the middle of them OP and that's not fair!

Please sit and consider what the consultant says, every one of us wanted the best birth etc but not everyone gets that and these consultants know what they're doing. Even if you do decide to do the home birth at least you have considered the facts AND know the risks etc.

Good luck with whatever you choose OP and please don't let any of these professionals rush you into a decisions x

The NHS should be using the cheapest and most efficient was to deliver the baby safety for both mother and child.
Mother's wishes, sensibilities and demands should come a lot lower down on the list.
Do we all agree the NHS needs to save money?

Of course you must heed the voice of medical professionals. And as medicine isn't an exact science people will differ in their opinions of treatment. Ask to see somebody else if you're not happy. You shouldn't feel bullied though. But do remember they have your best interests at heart but the bullying is wrong.

The point at which we strip away bodily autonomy because the NHS is free at the point of use, is the point we know it is truly fucked IMO.

Ultimately the decision is yours, OP. But she is correct about the increased risks and the possible consequences. She has to present you with that information in order for you to make an informed decision. How she presents it might leave a little to be desired though.

Have your other midwives given you this information at all?

Risk management isn't only a matter of likelihood, though. If the consequence of the risk is devastating then it's reasonable to take stronger measures to avoid it happening even if that outcome is unlikely.

As I understand it the risk involved in home births is non-trivial for women carrying twins, who are older (no matter how fit) and with any other risk factors. The likelihood is that everything will still go OK, but if it doesn't the consequences will be devastating - dead or severely disabled baby and possibly dead or very seriously ill mother. Why risk it?

I can't understand those who say it's all natural, women have been doing this forever, in the vast majority of cases it's ok. Nature doesn't care about the individual and allows for a certain amount of natural wastage. Without modern obstetrics a certain proportion of babies, and a smaller proportion of mothers, would die who otherwise would be saved. Why risk being one of them?