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.

@Namechangemum100 But what would demanding a home birth on the day achieve other than the OP being attended at home by exactly the team she already has a problem with? If OP is fully informed and wants to have a home birth then of course she should have one - and, actually, it doesn't sound like anyone is trying to stop her from having one, it's just that she won't be able to access the community team at the new hospital and no amount of on the day refusals to go in will change that.

I agree that unplanned home births will generally have a good outcome for most women, but I'd also argue (based on evidence) that planned home births (planned by both the woman and the health service) are even safer. There's every reason to put a plan in place for OP and no benefit to just winging it on the day.

Do you live in a One To One area? It seems to be mainly NW (Wirral/Liverpool/Cheshire) and Essex.

I can't speak highly enough of them and would particularly recommend them to anyone with previous medical trauma to contend with.

A private midwife or doula would otherwise be a very good idea.

That's annoying that you have been told two different things. First it was possible and now it isn't. Was your first birth at home? And really if you've had problems I'm not surprised the hospital won't agree to a home birth. And I don't think it's the GP's fault at all.

Had there been a policy change since the initial enquiry by your GP or was your GP given the wrong information when they enquired. To be honest I am not sure it is your GP's fault.

If you are out of their area it may well be that they cannot attend your home for god reason, such as no insurance. You would be best to talk to the head of Midwifery and try and see if you can move forward positively, before launching into a complaint to your GP, it's possible that it is not their fault. I am so sorry to hear about the poor communication you were subjected to and can see why you wouldn't want to go back there. Have you been offered a proper debrief about what happened?

Sorry, I've been out all day. I should clarify, that the issues last time were caused by a massive breakdown in communication, which lead to an induction which wasn't necessary at that stage, and may never have been necessary. I was booked for a home birth last time too, but was asked to attend the hospital to create a 24 hour plan as my waters had broken, but my contractions has slowed and weakened to virtually nothing. For starters, the community midwives should have come out to so that with us unless it was out of hours. When I arrived at the hospital, they admitted me for induction automatically, despite me trying to explain that I was told I was there to do the 24 your plan then going back home to try the ball etc to move things along. Nothing about the induction process was explained, and I hadn't researched it as I wasn't overdue, so there were questions I didn't know to ask. Things went downhill from there, and I only avoided a section by pushing against their advice. If I'd gone with what they wanted, I'd have had a section without even trying to push (even with the drip my contractions weren't ever regular, and many were weak).
There is no medical reason for me not to have a home birth, I'm currently booked for a home birth under the same hospital as last time. I can't decide if I want to stay put, or to move and accept a hospital birth.
I should clarify , that I wouldn't be writing a rant to the surgery about me not getting my own way, I'd simply like to flag up yet another breakdown in communication. I suppose feedback would probably be a more accurate description. I've spoken at length with the other hospital, and was told they never accept out of area home births, so I should never have been told it was a possibility. I'm just frustrated to have been misinformed about such a major factor in our decision. I'm struggling with the guilt of being pregnant with a baby I currently wish I wasn't having.

I should add, I'm trying to find a doula who covers this area and is available (one will be on maternity leave herself when I'm due and the other has a lady due the same week).
Please somebody correct me on this, but I thought private midwives were illegal now?

Private midwives aren't illegal, they're just expensive because they need really good insurance now.

Thank you GummyGoddess. I'll look back into it. I briefly looked into it before we tried for number 2, and found a huge blog rant with links to various pieces of information about how choices are being limited/made difficult for women when giving birth. There was a link to some literature about how changes in the criteria to be a registered midwife and changed, and as such ruled out midwives working outside of an NHS trust. I shall renew my search 🙂

Yep, private midwifery isn't illegal and there are various options depending on where you live.

I'm really sorry you have had both these experiences. The GP should have known that home births will never be attended by out of area midwives.

PP not reading the thread - nobody is saying the OP can't have a homebirth, they're just saying that if she wants a homebirth she has to book with the hospital that covers her area.

OP I really feel for you; is it possible to book for homebirth with the original hospital and speak to the HoM about getting you caseloaded (if they do any kind of caseloading)? Or, if there is more than one community team, you being assigned to another team even though you don't live in their little patch? Or does the second hospital have a low risk birth centre that you could go to instead as a second option?

I'm in a similar situation because if I have a baby and want a homebirth I don't want to go to my catchment Trust because I've heard such horror stories, but my (slightly better) neighbouring Trust wouldn't come out to me with where I live. And where I work is too far away.

If a school is in special measures it has oodles of support. Is it the same in the NHS? You say the team has been judged to be inadequate so I wonder if measures have been put in place to supervise the team very closely - and things will be very different. Also, even if the team is the same name, are the people all the same? You could have very different people attending you.

What do you hope to achieve from the complaint? I’d say you’ll likely get an apology, perhaps the GP will explain they were unaware, and that they won’t do it again. This would no doubt be achieved by a normal conversation rather than the rigmarole of a formal complaint. But obviously it’s up to you, and you have the right to complain if you wish.

FWIW in the area where I work, there were changes made where patients were offered full midwifery care rather than the current shared care agreement between GP surgeries and the hospital. Were GP’s informed of this? No, they weren’t. Which no doubt has led to lots of pissed off pregnant women and embarrassed GP’s.

I think your ire would be better directed towards the team who mismanaged you in the first place

I've been thinking about this most of the evening. In my area we have a hospital with midwives and then we have dedicated home birth midwives, is that not the case for you? They say that if they are unable to send two home birth midwives then they will send one and a hospital midwife.

If that is the case for you, then the midwives that come to the house would be different ones to the ones that attended you in the hospital last time (I'm assuming your complaint is based on the way the hospital midwives handled your labour). Would that be good enough for you to consider the original hospital, or is the risk of transferring in too upsetting for you to consider it?

I would definitely contact AIMS and Birthrights and see if either can offer advice on your position, having had a traumatic birth experience the first time around with the Trust you are seeking to avoid... especially since your GP had told you it would be possible to home birth with another Trust.

• In many trusts, the home birth midwifery team is different from the hospital ones (and often better trained to be more woman-centred and seek informed consent properly, IMHO!). You also get two midwives coming out, so a good level of attention (vs being left alone or not informed about what is happened or given the chance to ask questions). Find out about their team. In light of your experience last time, could you ask to meet with the Head of Midwifery and get to know some of the community midwives who might come out?

• Do consider a private midwife. As a past poster says, they are still around after the struggles to find insurance. Then you would have the certainty of a home birth plus a known midwife and continuity of care (including if you had to transfer in to hospital).

• Research what would happen if you have to transfer in to hospital. Could you still transfer in to your preferred Trust? If it was an emergency and you were sent to the original hospital, what would you do? (Doula or private midwife sounds like a good idea).

• There is a Facebook group called MatExp that may be able to help answer your questions. Many maternity professionals as well as women with an interest in maternity experiences.

I had a wonderful home birth last year after a less-than-ideal first birth with my eldest when I had to transfer in to hospital and, like you, found aspects of the hospital experience difficult.

Best of luck, I hope your pregnancy and birth go really well.

The setup here is that a team on community midwives manage your antenatal care, then you go to hospital to birth (usually, home births in this area are extremely uncommon. I was told during my last pregnancy only 2 or 3 a year. I now wonder how many women book them, then are bullied into hospital like I was). At the hospital you could be attended by either a community midwife, or one of the midwives based on labour ward. I had three different ones last time. The 3rd who actually delivered my son was a community midwife, and her attitude was completely different. She found a mobile monitor so I could get up off the bed and move around, and loosened thee straps on thee monitor that I'd been asking them to do all night (back to back labour was bad enough without straps digging in too). She also let me have a proper drink and a glucose sweet, as it was 8.30 am on the Thursday and I'd not eaten anything since around noon on the Wednesday, and not been allowed more than sips of water since my admission at around 7pm he evening before. She was the one who questioned why a section was being recommended rather than trying to push first, but the consultant was having none of it (the monitor had been on DS all night, and there were no signs of distress in him).
There is a midwife led unit at the OOA hospital, but that's still in hospital, it's just a different side of the same corridor to labour ward, so it's no different as far as I can see. Plus we don't drive, so I'd have to take two busses on my own to get there in labour if I planned a birth there (no childcare for DS, so if I have a hospital birth, I'll be by myself wherever I go). The hospitals need you out, so they perform unnecessary interventions to rush you through, and I don't want that to happen again. Plus she didn't leave the room for the full labour, so DP and I couldn't even discuss what was going on. I was literally sat there in pain and in silence all night. It was awful.
I'm aware that if something went wrong with a home birth, I'd be transferred too the local hospital, which there's nothing I can do about.
I'd not hope to achieve anything for myself by flagging up my concerns, but the communication in the area regarding pregnancy and birth is so bad, it needs so much improvement, but if nobody ever complains about the issues, they're just going to get brushed under the carpet, and nothing will improve.

As for the PP who said I should direct my feelings at the people who mismanaged my birth last time; I've already been as far as I can with that. They've admitted they were in the wrong, and that the interventions performed were both without informed consent, and possibly completely unnecessary (certainly unnecessary at that point in time), but they basically don't give a shit. DS came out in one piece, so they're not at all bothered. The next step would be to sue for medical malpractice, which I would never do in these circumstances.
I have no idea what support, if any in in place in the hospital at the moment, I just know that all multiple births and high risk pregnancies are shared care with another hospital which is also OOA but still within the same trust. These women don't birth at the local hospital, jut have the majority of their antenatal care here. I'm not sure what happens post birth.
I've found one private midwife who covers my area, but she's several hours away (I'm JUST inside her patch). I've messaged her to make some enquiries, but I doubt we'll be able to come up with the funds given we've just had an offer accepted on our first house and it doesn't even have a fully functioning kitchen. A doula would be my best bet, but I don't think I'm going to be able to find one. As I said above, home births really aren't popular here, so I suppose it's a case of no demand, no supply.

Know one can be gauranteed a home birth. Anything can develop on pregnancy or labour that could prevent this being safe. Im sorry you feel in such a difficult position.

Please RTFT Seacow, that's not the issue here.

I'd definitely recommend getting a doula. I had one with DC2 after I felt pushed into a c section with DC1. She was fantastic, met me a couple of times and arranged for me to meet the supervisors of midwives, we had lots of FaceTime/email/text conversations and I felt supported and listened to throughout. She was very reasonably priced too- 3 figures rather than 4.

I went on the doula uk site to find mine- have you looked on there?

That's the site I found the 2 ladies I've contacted already. Home Birth just isn't popular here. I can speak up for myself better than I did last time, because I know slightly more, but I worry that last time will cloud my judgement. I'll be firmer this time about what I want, but I worry that I'll draw the line between refusing unnecessary intervention, and pig-headedly putting the baby at risk in the wrong place.

I would have a hospital birth at hospital 2. So many things can go wrong and if your in hospital then it can be sorted quickly.

I'm not planning a hospital birth. I've booked for a home birth with the same hospital as last time. I'm just feeling very apprehensive about it based on what happened last time.

Booking a hospital birth at hospital 2 means taking 2 buses, alone, in labour. I want to do as much as possible to ensure DP will be at the birth.

The GP should have known that 'out of area midwives' wouldn't be able to cover you for a homebirth. It will relate to commissioning of service's. Your local health commissioner's will have purchased their community midwives from a particular area. I work as a nurse on the Welsh border, this sort of issue crops up frequently.

Have you looked into employing a Doula who could be there with you during the birth and could advocate for you if you did need to go into hospital.

Sorry just seen you’ve looked into Doulas.