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, as far as I can see you have not mentioned where you live. to me this would have a huge bearing on my decision. Are you rural or urban? how far from your nearest hospital able to deal with neonatal emergency are you? how long would it take for an ambulance to transfer you and a possibly distressed baby in an emergency?

doula has no medical knowledge at all and is basically just support in labour

The OP wasn't comparing a midwife and a doula she was comparing the contradictory advice of two experienced midwives (or at least that is how I read it).

I would give weight to the fact that one midwife also has direct personal knowledge of the pregnancy to add to statistical information.

The lack of professionalism on the part of the midwife who was working straight from guidelines without the patient knowledge would also weigh with me. It doesn't inspire confidence.

So basically OP has to choose between the midwife she trusts and who has cared for her or the midwife she didn't trust. Ideally another informed viewpoint might help be that the obstetrician or other qualified person. `The lack of an intermediate options such as MLU makes it even more difficult.

Cathf your posts are ghastly and ill informed. Maternity services have been under funded for over a decade.
It's not the time for women to be rolling over and accepting dangerous care at all.
The biggest cost to maternity is from life long pay outs to children damaged in child birth. That's not including women who need medical treatment and women who need counselling from the birth trauma mental and physical.

You can be as fit as you like but regrettanly that makes no difference to the fact that your placenta reflects chronological age.

The greentop guideline uothread has the stats - 40wk age 40+ has the same risk of stillbirth as 42wks in 20s yr olds (who are offered induction for stillbirth risk)

I would give weight to the fact that one midwife also has direct personal knowledge of the pregnancy to add to statistical information

As I said earlier this personal knowledge is irrelevant in this situation. Community midwife has no crystal ball.

Community midwife has no crystal ball

Well no one has a crystal ball. However if you have two experienced medical professionals, both with the population stats but one has the additional insights of your personal situation that one is going to be in a stronger position to help make the risk assessment.

Otherwise we might just as well run all the numbers, send out the orders and forget the actual consultation part. It is quite possible to do this, it is already done in a number of areas of medicine.
The OP certainly didn't feel she had attended a consultation.

10 minutes away is precisely 10 minutes, plus getting you to the car/ambulance waiting time/traffic issues/walking issues between contractions if no other transport fornyou ... 10
Mins may take more like 30 or more

Placentae DO fail in older mums, stillborn babies are more common, yes you might be fine, but you're more likely not to be, statistically speaking - how is that worth a gamble? Also don't forget I'd you die you'll be leaving your family without a mum too - I'd be listening carefully to to obstetrics consultant (I don't do midwives for medical advice .... and certainly not doula!)

Listen to the professionals - they do usually know best.

The midwife sounds a bit potty but I think she is right. I wanted a home birth with my first, and my dad insisted it was a terrible idea. He was right. I’m glad I listened to him - even though he wasn’t a medical professional - just someone wise and concerned for me health in case anything went wrong. I was induced in every way possible (unsuccessfully), then on a drip, had an epidural and ended being in labour for 9 hours before having an emergency c-section for my daughter in distress. She was huge - 11lb5.5oz, she would never have come out of me naturally i’m sure, and neither of us would have prob survived.

Not scaremongering at all, just giving you my story. Had I insisted on my way and a home birth, i’d have regretted it big time.

Good luck in whatever you decide to do.

I wanted a home birth with my first, and my dad insisted it was a terrible idea. He was right

What your dad thought had no bearing on the outcome of your birth.
I know that sounds rude but it isn't meant to be. I am just really fed up of any thread about non hospital births being full of anecdotes from women who had difficult hospital births as if they are proof that no-one should have a HB.

Why does your birth story mean more than mine in this context? I had four uncomplicated births. That doesn't prove that the OP should stay at home does it?

I agree that the OP should consider what the experienced professionals have said to her. I don't think she should necessarily discount any option.

.

OP - in my view the role of the professionals is to give you all the information you need to make a choice. I think the midwife consultant has done this, so you need to weigh it all up and make a decision.

Personally I can't imagine being so determined to have a home birth that it would be worth running the higher risks associated with your age etc (unfortunately I know from experience that a stillbirth is not something you ever get over). Out of interest, why are you so set on it?

I can understand wanting a natural birth if possible, however sometimes the circumstances just aren't right. 5/8 of my NCT group ended up with an emergency section - not what anyone wanted, but necessary (and crash sections in a couple of cases).

I wish you a smooth and safe delivery, whatever you choose.

However if you have two experienced medical professionals, both with the population stats but one has the additional insights of your personal situation that one is going to be in a stronger position to help make the risk assessment.

But they're not equally experienced - one is much more senior, and that's the one OP wants to ignore. By that logic cancer patients shouldn't bother seeing oncologists because their own GP will know them better.

You also make it sound like the midwife consultant has no information about OP but her age. I'm sure she reviewed her notes, too, in which case they had the same information.

Why does your birth story mean more than mine in this context? I had four uncomplicated births. That doesn't prove that the OP should stay at home does it?

It means more because of the stakes. The two situations aren't equal. If the OP has her baby in hospital and all goes fine, as it did for you, then she's had a birth experience that is not quite what she wanted. If she has the baby at home and something goes wrong, as it has for other women posting here, then the potential outcome is dead baby and even dead mother.

@NooNooHead I planned a home birth against medical advice for my second (for reasons which were all the result of having my first labour induced in hospital) and transferred in during labour.

DS was 11lb 7oz and badly positioned, and was born with forceps which caused temporary nerve damage to his face. I had a PPH.

Do I regret attempting a home birth? Not for a single second. I came out of it far less mentally and physically damaged than the first one.

What bearing does this have on OP's situation? The same as yours - none.

But they're not equally experienced - one is much more senior

We don't actually know how experienced the hospital midwife is. We can assume she has a certain amount of experience to be in that position but we don't know what it is. The OP's regular midwife has extensive experience in practical delivery and as a community midwife has to have both home and hospital experience.

By that logic cancer patients shouldn't bother seeing oncologists because their own GP will know them better.

I don't think that is the best comparison. A better one would be between say, a consultant and a senior reg (in old naming). The only reason I'm alive is because my DM took advice from a good registrar who looked in detail at her pregnancy over that of a consultant who was not as informed about her.

Summary notes are not the same as as the ongoing consultations and relationship which come from the regular care.

The fact is we don't know what the hospital midwife based her decision on or what credence she gave to history because the consultation was a bit of a pigs ear. Its very difficult to take advice from someone who behaves unprofessionally and seems not to be listening to you.

Blanket advice to induce at 38 weeks for a healthy pregnancy rather than close monitoring and induction if there are contra indication is out of line with local policy, and that of a number of other posters' areas. It would make me want an alternate view.

Potplant both are meaningless.
Neither relate to the OP.
They are separate and personal
Its just that difficult birth stories are the ones used to emotionally blackmail mothers.

In fact rereading the OP it looks like at least two different experienced midwives disagree with the hospital midwife - that would definitely make me want to get the hospital view from another advisor.

Jackie Your post is excellent but for this one line which disturbs me:

'I suggest you consider (a) At what point you would be happy to consent to Induction'

Language is important. The way this is phrased suggests that there is a point when induction will be consented to. For some of us, it doesn't feature as an option ever.

The population risk of stillbirth if you are over 40 in the last weeks of pregnancy is 1 in 500. Even with your pregnancy being so far a healthy one the stats won't change much. Most stillbirths are high risk babies ( not known high risk till after the event) in low risk women. You have to make the decision based on that.

'The UK has a higher stillbirth rate than most of Europe.'

And most of those happen in a hospital.

I agree that anecdotal advice is not going to have a bearing on the success of the OP’s labour and birth or her decision, but it is at least something to bear in mind. I’m sure she will decide what’s best for her and her circumstances while taking into account the risks involved of a home birth etc.

Equally through, you could also say that those saying ‘my home birth went wonderfully - ignore those who give their bad experiences and accounts’ could be more risky to listen to, as the OP could have a home birth and it could also go wrong and have complications. No birth or pregnancy is the same.

Most stillbirths happen in hospital because of the birth being induced after the baby has already died.

@Flisspass - of course, i’m not saying our experiences will have any bearing on the OP’s birth in any way. I’m just giving a cautionary tale based on my experience. I’m sure the OP and others will choose to ignore this as they see fit.

'I worked on maternity for 10 years and some doulas truly believe they are the font of all knowledge with regards childbirth !'

I can see why doulas might be annoying, - but I think it is worth considering what it is about current maternity service provision that makes mothers feel they need doulas!?

spikey Perhaps - but how many of those still births in hospital AFTER the baby has already died, were homebirths originally?

And - crucially, how does the UK rate of still birth compare to the rates of still birth in countries with much higher percentages of homebirths?

I had a home birth with my 3rd despite being advised not to due to a PPH with my first.

This is because I believed with all my heart that the PPH with my first was caused by the hospital. I felt safer therefore, at home.