To ask you to carry your pregnancy notes with you?

[NC4T]

I am a triage midwife. One of the biggest frustrations of the job is women turning up without their notes. I have some very basic information on the computer but I have no scan reports, no record of any of your antenatal appointments or admissions or consultant plans or anything!

Obviously when women know they are coming in they bring their notes, so I am talking about the unexpected admissions - the falls, RTAs, bleeding at work, fainting, unexpected waters breaking etc etc. Which is exactly when we most need the information! It’s also a huge problem as we are close to lots of centres of employment so every day have women being admitted who are not booked here, but haven’t taken their notes into work and we are the closest hospital for their emergency. Then we have not even the most basic information.

Just now I have taken a routine phone call and have referred her to a page in her notes, to be told “oh no, I haven’t got them, I am at work in x city”. Well why haven’t you?

So please, I know they are bulky, I know it’s a faff but carry your notes with you wherever you go. You just don’t know when you might need to go to the nearest maternity unit!

I did with my first pregnancy, however this time around it's all electronic and I don't have a folder of notes - apparently it's all in the system!

I don't drive and my notes were in an A4 folder and wouldn't fit in my bag. Took them with me if I was going away overnight or longer, but didn't take them to work with me as I've left too many shopping bags on trains to risk it!

I rarely have a bag with me so this would be quite difficult. But maybe photos of them on a phone would be sufficient? If they are so important it seems crazy that the NHS doesn't have a good way of making them accessible to those who need them when they need them. Carrying them around with you is a bit of a data protection nightmare.

I guess every hospital is different.

Where I work it’s not really an issue because although the women have their handheld notes we also have their main hospital notes which has all their scans in, all hospital appt dates plus summary of any hospital visits, any consultant plans, all blood tests, etc. Only stuff it doesn’t have is anything the community midwife may have written.

I looked after a woman last week who was on holiday in the area, she arrived in early labour and I asked her where her notes were. She didn’t have any as where she is they’re all electronic. She did have an app on her phone which she could access so when I was asking her if she knew her blood group, etc she was looking it all up. But it took ages, she was in pain and struggling, I don’t like relying on information being relayed second hand like that whereas at least if I can look at a set of notes even from another hospital it’s one less step of Chinese whispers but I didn’t feel I could take her phone off her to look myself.

I carried mine around with me from the moment I got them. But now, where I am, pregnant women don't have notes to carry. It's all computerised.

I'm 17 weeks, and my midwife told me to take the notes with me if going out, even if it's just to the neighbouring town for a bit of shopping.
She said that there are quite a few stories of missing notes causing an issue for pregnant women.

I work from home, and generally don't go far from home on a daily basis, so I leave the notes at home most days, including when I take the dog to the park, but if going out for more than 30 minutes or so, I do have the notes with me.

I would honestly find it far more helpful if the folder was smaller (I don't usually have massive bags with me, and with all of the personal information, I am not too comfortable leaving it in the car in case of theft - and is the information stored elsewhere in case the notes are lost?) or if it was possible to have it in a digital format, but I get why that also could cause issues (and the NHS would probably spend billions on that).

And yes it’s true we never really trust information from another hospital anyway, so would always redo blood tests for our own lab and often scans as well!

Some women are a little bit odd and will tell you all sorts of stuff. I know someone who’d got hold of a blank set of national pregnancy notes and turned up saying she was in labour. With 7 months worth of notes filled out and she wasn’t pregnant. She’d written in the notes herself!

I've had 4 children and never once have I carried my notes around with me, I think because I was never told too it never occurred to me to do it.

When I was in the second half of pregnancy, I had a hour and a half commute on train and tube, at the time when Southern were really playing silly buggers. The trains were crammed and I had two sets of notes due to moving house at 20 weeks; it was also baking hot and I really didn't need any extra load (DD was a monster baby and I'm only 5'2). It just wasn't feasible for me to carry my notes with me.

I understand why midwives ask this as there isn't currently a better system, but a move to electronic notes should be prioritised by the NHS.

My midwife was like CARRY THIS WITH YOU EVERYWHERE. I BOUGHT THESE YELLOW FOLDERS MYSELF. I EXPECT YOU TO SLEEP WITH IT. We got the message. But also, I've had to get medical records printed off from the NHS before and knowing what an almighty faff that is I wasn't in the slightest bit surprised that not everything was available to everyone.

Which notes? All of them? I'd need a wheelbarrow!

I forgot to take my notes into hospital when I went into labour with my first.

The hospital staff did not even try to hide how pissed off they were about this

I can only claim shock at going into labour early, not realising I was actually in labour for hours, and having to rush to the hospital in a lot of pain. I just forgot them.

There was talk of DH going back for them - but they didn't want to risk him missing the birth, as I was 8cm dilated by the time I got to hospital.

I still feel guilty about it tbh.

It's really shitty from a data protection standpoint, if they got lost someone could clone my entire identity. I have no idea why the NHS can't use the same system they use for everything else. If I tell my GP something and then go to A&E a month later they can see the information, why is the antenatal side any different? Its ridiculous.

Well, not just lost, if some scumbag decided to nick my handbag or my car.

It did say on the front of mine,carry these notes with you at all times.

I kept mine in the car, so mostly had them - but didn't take them when I went into London for work once a week. Which was stupid, but mine were huge due to endless scans and CTGs (one of the midwives looked at them and said 'gosh, this is turning into a novel, isn't it?') and I'd have had to carry a bigger bag especially - I was also a bit worried about a) losing them, since there seemed to be absolutely no remedy if I did and b) having them on display and someone I knew picking up and flicking through a book that begun almost every entry by saying I'd had multiple previous miscarriages and had been referred to the antenatal mental health team due to my history of depression.

Ours are all electronic now even though other trusts aren't. Was really unhelpful when travelling to the FMC for treatment as they were still on paper notes.

yabu
nhs should change their recordkeeping to more modern ones.

obviously that's long term... until then carry your notes with you... and photocopy it so you keep a copy before it gets 'lost' on the maternity ward

When I go on holiday at about 28 weeks I’m going to make a printout of what paltry information there is in there and take that but it won’t help them much!

I'm also in Scotland and had digital notes with dd. I asked the midwife whether they would work everywhere, got told no and to ask for a proper print out if I was planning on going anywhere later in the pregnancy.

There were definite teething issues though. My consultant asked me to make a birth plan, I did and added it on the bit which said "add birth plan here" (the only bit I could edit). Next consultant appointment...I get a lecture about how can they make this birth better than last time if I won't tell them what I want/don't want. I point out I did...we spent the next 10 minutes randomly pressing buttons on her screen and still couldn't find it. I had to log in on my phone and let her read it that way.

I think a lot of people don't realise how archaic the NHS medical records system is. They probably think you have their data on file.

This^ my midwife never told me to carry mine around so possibly more training along with an IT upgrade is needed I know, there's no money.

MrSpock snap!!

I think it's a fair majority assumption that the NHS have your maternity notes on electronic record. Ridiculous that they dont.

If that can't be changed, wouldn't it be common sense to make the notes A5 to fit in a handbag? Don't saddle women with a massive bloody A4 filofax and be surprised when nobody lugs the thing around with them.

And yes, if you don't have a handbag, where are you supposed to put the notes?

I actually found nearly every mw I met expected me to know how their system worked and each one was different.
So I was chastised for not bringing a urine sample to my first appointment (erm I wasn't told to), told I was being silly for coming in with reduced movements and not to believe everything I read on the internet (erm the Nhs website??) amongst other things.
So this notes thing is probably much the same, some mws will say you don't need them and others say you do but it's the patient who's being silly for not being a mind reader

I drive so could keep them in the boot of my car but they were massive in my first pregnancy so I am not sure that would have been logistically possible if I didn’t drive. I actually never felt comfortable leaving such sensitive info in my car but would have felt less happy taking it into work or shopping.

The NHS needs a massive injection of training and money to lessen the necessity of these notes. The hospital I gave birth at had two electronic files on me by accident which explained why sometimes sonographers seemed not to have all my history. Also materity medical history and general medical history is never in the same place. It all seems such a shambles.