WIBU to put a formal complaint in to GP practice?

[PeapodBurgundy]

Had a traumatic labour and birth with DS. I've been through the channels and said my piece on that, several aspects were mishandled, and the communication between each other, and with myself and DP was abysmal. (To add context, the services have since been branded inadequate for the exact reasons I flagged up, so I'm not the only woman to have been treated this way).
We decided we would like another child, but I was quite frankly petrified of a repeat performance. I booked an appointment with the GP who supported me through the situation so knew the ins and outs to discuss my concerns. I asked if it would be possible to have my care managed through a different hospital, but still try for a home birth. He looked into it, and confirmed that yes it was possible for me to do this with a GP referral under the circumstances.

After lengthy discussions, we decided to try for number 2, and I'm currently pregnant. Now that it's too late, the hospital have refused to let me book with them unless I agree to a hospital birth. We've been left in the position of having to choose to be manages by the team who caused all of the problems last time, or to agree to a hospital birth.

Is it unreasonable of me to write a complaint to the GP surgery regarding the misinformation? If I'd known this was the situation, we would not have chosen to have another baby, and I briefly even considered a termination, but decided that would be much worse. I'm not taking a big ranty effort, but to flag up how let down I feel by being poorly informed? I'm finding it hard to judge as I'm very emotional at the moment. I can't really discuss it with family as my Nana just passed away, so I don't want to be selfish and pile more onto them.

What are the reasons the hospital is insisting on a hospital birth?

Because it's out of area. They'll happily manage my care, but won't attend a home birth (which is frustrating, because in average traffic, I'm a 30min drive away. The opposite side of the patch they cover is potentially over an hour away).

I'm slightly confused. Your GP has made the referral and made a case for you having a home birth with hospital number 2 but they're refusing to let you have a home birth? Hospital 1 will let you have home birth but you had a bad experience there last time?

I don't know if your GP is at fault. The initial inquiries he made were before you even got pregnant so there could be a particular reason hospital 2 are refusing a home birth that wasn't clear before they saw your file.

Ah, sorry. Crosspost.

If you are labouring at home I didn't think they were allowed to refuse to attend you. Or maybe that's just if you are in their catchment area.

I think you're justified in flagging this up - it doesn't even have to be a complaint. The GP was right in a way that they can refer you to whichever hospital you want for maternity care, but it would always be the hospital's decision as to whether they would formally support you in a plan to deliver at home - the GP should have known that, told you that, and could potentially have referred you for a discussion at the hospital before you became pregnant.

Furthermore, community midwives from one area do not cover home births when they occur 'out of area' - it would generally be the local community team that would support that regardless of which hospital you booked at. Did you plan a home birth last time? If so then you will end up with the same community team, though not necessarily the same individuals. Again, your GP should have known this.

Now that you're in this position, if you do want to go ahead with a home birth, then I'd suggest that you ask to speak with the head of midwifery to discuss what your concerns are. You may feel more reassured if they acknowledge your previous concerns and put concrete plans in place to make sure that they don't happen again? If you can take control of the situation it might take some of the anxiety away.

Sorry to hear about your Nana, you're having a very stressful time

The GP has given you the information in good faith by the sounds of it so surely it is the hospital team you need to complain to and not the GP?

I'm not sure I entirely follow.

However I have had terrible experience trying to arrange a HB in a straight forward pg.

It was suggested I get in touch with AIMS with their support got in touch with right person at hospital and suddenly there had never been an issue.

Can't remember which forum I got in touch with them on - but there were very helpful. Might be worth a try.

Don’t know if this is financially viable but what about a private midwife for Home birth if they don’t cover your area? Or a doula for hospital who can advocate for you when you’re in labour?

I’m sorry you’re facing this, I had a traumatic birth with DD so fully understand how scared and how much you don’t want to go back to the other team.

If we manage to conceive again I’ll be getting a doula to come with me to hospital because I was off my face on gas and air and DH bless him is just not the confident on speaking up!

A GP should know how maternity services work and that community midwives from one Trust won't support home birth out of the area that their Trust covers - it's really basic knowledge about how maternity services work. If the GP had listened properly to the concerns the OP had then they would have realised that her concern was about who would be attending her in labour - and that was always going to be the same community team as last time.

Direct your complaint and request to the hospital. GPs have almost no control over this.

Okay I've re-read:

So to stop under hospital 2 care you have to give birth there.

Or transfer back to hospital 1 where you gave birth with major problem but under community MW presumably for HB but run risk if you need a transfer in during labour of ending up back at hospital 1.

I'd still get in touch with AIMS - just to be sure those are your only options - but yea I'd do a polite letter to GP practise manager to let them know this is an issue and could be for others as well.

Can you not just book with them, agree to a hospital birth, and then still request a home birth on the day.

When you are in labour if you tell them you are staying home, they will send someone. If you decide to go to hospital, equally you will be on their records, and they won't turn a labouring woman away.

I think maybe you need to change your mindset, they aren't in control of this.

Is it possible that things have changed between the time you talked to the GP and now?
Is it possible that it’s the hospital that is being difficult, aka they prefer to have you in hospital rather than at home knowing that last time things didn’t go well and you did complain about it?

Perhaps they changed their policy or the person who responded to the initial GP enquiry wasn't actually in a position to say and then after referral it went to someone senior

TBH if you had such problems in your last pregnancy you might not be low risk enough for them to advise a home birth anyway?
Either way not the GPs fault, the hospital have made the decision here.

I agree @BoywithApple - I actually had a traumatic and mishandled hospital birth with my first and so organised a meeting with the head of midwifery at - in fact a different - hospital (although it could have been the same one, but I had such horrible experiences there I didnt want to go again). I came in for a 'Care Plan' meeting to make sure that nothing as bad happened this time again. As she was so experienced and knowledgeable she was even able to 'overwrite' certain red flags such as a health condition I have which she knew not to be a problem in labour, but which a lesser midwife would have red flagged, meaning I wouldnt be able to birth at the birth centre etc. It was extremely valuable. You have to remember you have a VOICE, fight for your rights to be heard. It's International Women's Day so put in that call today!

groups.yahoo.com/neo/groups/homebirthUK/info
www.homebirth.org.uk/homebirthlinks2.htm

You have the control here.

It's not the GP's fault. What are you hoping to accomplish? they went above and beyond to look into it for you, most GPs (myself included) would just refer to your choice of hospital and get you to do any research you want. If you complain, your GP will think - great - the one patient I went above and beyond for has complained. I won't be doing that again.

@Namechangemum100 - that's terrible and potentially dangerous advice, home births are safest when they're planned. It also won't alter the fact that the team who will be sent out to attend OP in such a circumstance will be the team she has an issue with, OP has no control over that, the community team from hospital 2 won't come out to her, she's not on their patch (in the same way that I, as a resident of Newcastle, can't ring for an ambulance and request that I get one from a neighbouring city's Trust rather than my own).

@boywithapple so the alternative is that she goes into the hospital she is unhappy with and feels unsafe in, rather than having the baby in her own home?

As long as she is deemed low risk it is perfectly safe to have a home birth, and plenty of prep that op can do before hand.

Having a last minute home birth is not unsafe for low risk women, as much as the media, consultants and plenty of other mum's would have you believe.

I don't think you should complain about the doctor either. He referred you according to the guidelines and information he had. It was the hospital who rejected the referral, possibly for medical/clinical reasons. Your battle is with them.

Just wanted to offer you my sympathy. I had a similar scenario. The birth of my DS was badly managed and lots of problems came out later regarding the hospital. With my second I opted for a different hospital which was further away. They wouldn't consider a home birth for me or the birth centre because of the previous complications. Initially I was very upset about this, but I was under a fantastic consultant who gave me a lot of say in the decision making about how the birth would be managed. Even though I was considered a high risk, they kept the birth as low intervention as possible and even trialled going against usual hospital policy. It all worked out really well. The staff were wonderful and I felt safe and looked after and respected. Totally unlike my first experience. They ended up asking me to speak at a conference about the experience (low intervention for high risk patient) which I was really happy to do.
My advice would be rather than to put in a complaint, look at how you can make the best of this situation. I would be really clear about the level of upset you are feeling and make sure that it is addressed. This is not something that can be fixed with a few reassuring words. You jointly with the hospital/ midwife/ GP/ consultant/ whoever need to come up with a workable plan that may need a little compromise on both sides, but that you are all confident in.
Also consider a doula to help support you through the birth. I didn't use one in the end as I felt confident in the hospital and my DH to advocate for me should things start going wrong again!
There is no reason why you should have a repeat experience! Good luck to you!