Annoyed at Midwife

[whattodo202000]

I am not sure if I am being unreasonable but I am annoyed after my midwife appointment today. I have not seen her for about 9 weeks - I last saw her when I was 30 weeks pregnant (she has had a busy schedule which I appreciate) and I am now 39 weeks pregnant. I was hoping to use it as an opportunity to discuss my birth plan, get an idea on how I know if I am in labour, what happens if I go past my due date, etc.

Instead she told me to research these things online (I already have done so and thought that as a midwife she might be able to give me a bit more advice) and refused to go through a birth plan with me and told me I needed to write one up at home and take it with me to hospital. I am a first time mum so not sure what the procedure was but was hoping for a little bit of support. AIBU? I might be, I know there are lots of people in a worse position than me - I was just so disappointed and wonder why she wanted to see me. My appointment lasted about 10 minutes where my blood pressure, weight, and fetal heartbeat was monitored and that was it.

[jakeyboy1]

Hi
Sorry you are not having the experience you should be, I'm guessing all ante natal classes etc have gone out of the window too. Have you considered paying for a private ante natal class online where you may be able to get some more advice if it's within budget? Have a look at Rock Your Birth on Facebook/insta. It may just help reassure you a bit. Good luck!

[hammeringinmyhead]

It absolutely does help, just from a research angle. For example, when they offered me an epidural before my induction started, I knew to say yes! I didn't need it in the end as DS made a speedy exit with some encouragement from a propess. I think before you have a baby you think there are 2 types of birth, vaginal or C-section, and actually there are so many variables.

I always say mine was straightforward but I was PROM, then I was the 1 in 10 who doesn't start contracting within 24 hours, and then I had a 3 hour labour with gas and air and a haemorrhage at the end.

[UnderTheBus]

I think the process of making the birth plan is more important than the plan itself. Understanding what could happen and what your options are. How would you know to ask for an epidural or other pain relief, if you've never researched it or talked about it with a midwife?

[Muppetry76]

I toiled for hours formulating a birth plan for dc1. Perfect. When it came to it everything went out of the window and I got just about the opposite of anything anyone would want giving birth but fortunately a healthy baby at the end.

When I got to dc2 the hospital midwife chuckled at the birth plan page in my notes

'Have baby'

[bloodyhellsbellsx]

That’s really poor care, I would feel quite abandoned as a FTM! They can’t use covid as an excuse either, I work for the NHS as a specialist nurse and I am still running clinics and seeing patients. People can’t have their needs ignored just because of the virus. That said though, I found my community midwife very poor in comparison to the ones I met in hospital, my community one didn’t really answer any of my questions and told me minimal info, she was also useless at measuring growth and I had to have 3 growths scans as she kept saying my bump was getting any bigger (it clearly was!) The hospital midwifes were all fantastic tho!

For your question about students, I would imagine it’s in addition to a qualified midwife, good luck hope all goes well with the birth for you!

[UnderTheBus]

So if you hadnt phoned the MAU or the baby had been transverse but not painful - which can happen - then the position would not have been picked up until now at 39 weeks, if at all. Transverse lie can be life threatening for baby as more likely to have a cord prolapse. I think that is awful.

As @Gammeldragz said, Covid19 is dangerous but its not the only thing that can kill or harm a person. For most people, there are far worse things out there which currently arent being dealt with. I'm sure there have already been preventable deaths where people are scared to go to the hospital because of Covid or because they dont want to "overwhelm" the NHS. And In the next few years there will probably be as big increase in deaths from things like cancer because routine screenings arent taking place.

[AG1x]

@whattodo202000

Thankfully I have the contact number for the local maternity assessment unit so haven't been completely left without care. I did get seen at around 36 weeks when I called them as I was in terrible pain on the sides of my bump and it turned out my baby was lying transverse (which was causing the pain) and I had to go back at 37 weeks to have a ECV which fingers crossed has worked so far.

I have been looking into things and one question I had was if you say that you want to have student midwifes attend to you, is this instead of a qualified midwife or in addition to?

In addition too, student midwives should always be supervised by qualified midwives

[LouiseTrees]

You can write addition detail on questions like that, it’s highly unlikely your full birth plan will get read. I’m happy to fully talk you through a birth plan if it helps, each question and how overall it’s really for you to help advocate yourself in the hospital on what your preferred plan is rather than for them to read and follow as wrote. My daughter’s birth was induced and then ramped up so quickly that I actually changed my plan in hospital twice. That’s because I had almost ranked the options in my head and knew eg if that can’t happen at least I can ask to do x.NCT are doing online antenatal classes. I remembered BRAIN when changing my decisions to suit the situation.
B- benefits of taking a specific decision
R- risks of said decision
A - Alternatives to said decision
I- intuition- eg I knew that I would not be able to sit still for an epidural to be placed when I was offered one
N - what are the consequences of just waiting and doing nothing -ask this question

[whattodo202000]

Thankfully I have the contact number for the local maternity assessment unit so haven't been completely left without care. I did get seen at around 36 weeks when I called them as I was in terrible pain on the sides of my bump and it turned out my baby was lying transverse (which was causing the pain) and I had to go back at 37 weeks to have a ECV which fingers crossed has worked so far.

I have been looking into things and one question I had was if you say that you want to have student midwifes attend to you, is this instead of a qualified midwife or in addition to?

[AWryGiraffe]

My birth plan didn't 'go out the window' during labour. The time I spent preparing and researching I found really useful and I felt like I knew what all the options were in case it wasn't going how I would ideally prefer it to. It's really useful to look into things like what medications you would be happy with, where you'd ideally like to deliver, who you are happy with in the room, and to remember that you still have choices about what happens to you - this doesn't go away once you're in labour, you're still a person. You don't have to have a sweep at all even if that's what you've been booked in for.

I would do a birth plan if it matters to you, as long as you remember that obviously things may change as labour progresses as they are all different. My community midwife went through the one I did (which in hindsight was fairly over long, haha) and made sure I knew the implications of each decision.

I also recommend the positive birth book, it's great.

[MsChatterbox]

I think your care has been pretty shoddy tbh. I am on my second pregnancy, I'm 36 weeks and my appointment this week my midwife purposefully booked a double appointment (40 minutes) to discuss the birth with me. The appointment ended up lasting an hour due to her being on hold on the phone to book a growth scan in for me. I have also seen her at 28 weeks and 34 weeks. Both of these appointments lasted 20 minutes! I'm also booked in to see her again at 38 weeks. It's great that you've been able to find out the stuff you need online but at the same time some things differ by area/hospital which is why it's good to be able to discuss with your community midwife. I think its safe to say you can't rely on her for help so from now on if you have any questions that you can't find an answer to online/mumsnet I would call your maternity helpline.

[FourPlasticRings]

www.nhs.uk/conditions/pregnancy-and-baby/antenatal-appointment-schedule/

@Gammeldragz it tells you how many appointments to expect on there.

[Gammeldragz]

I've actually screenshot that as really good to know, is that pretty universal? That's a lot more contact than I'd expected, it's been 10+ years since I had a baby so I really can't remember how much I saw my midwives!

Our community midwives used to come into the surgery to see our patients but they moved that service a few months before the covid thing and so we have no communication/crossover with them any more.

I don't remember ever discussing a birth plan as such, but probably because I didn't particularly have one other than to have a home birth and only managed one out of three!

[Secretsout]

I'm a community midwife. Why on earth haven't you been seen for 9 weeks? Did you try to call and book in? (Not sure what the procedure is where you are?)

We do 20 minute appointments. Under Covid restrictions our women are having face to face at booking, 28, 32, 36, 38, 41 (incl. sweep if wanted)
Phonecalls at 16, 25, 30, 34, 40.

Your birth plan should be discussed at 36 weeks when the placental site is confirmed (if previously low) and presentation is known.

[Gammeldragz]

@LesbianMummies

Unfortunately the NHS think 10 minutes is adequate for a midwife appointment and so the midwives have the choice of giving the basic care or running horrifically behind and then having to skip their breaks / finish late unpaid etc.

That makes me feel less like moaning now. Was going to come on and say as a practice nurse I have noticed my patients' antenatal care has declined since the pandemic (hard not to, really!). I've seen several pregnant women during this and some aren't getting face to face appointments at all for months (so I checked their BP as otherwise it would not get done) and one I saw today hadn't been told to get her whooping cough vaccine, so I explained it and gave it.
I won't moan though, because I have the time to do these things as half my workload has been cancelled. Of course women are still just as pregnant as they were before but I imagine we now have fewer midwives as some will be shielded.

I will say this though... The way health care has reacted has massively increased the risk to everyone, while assuming covid19 is the biggest risk to all our lives. It really isn't. We still need universal health care available as people still need it. I worry about all the 2 week referrals that aren't being done (dropped by a third), all the routine screening and vaccination being missed (technically we are still doing these but people aren't coming in because they either think we're overrun with covid19 and don't want to bother us, or think they're going to catch it if they come in with anything less than a hazmat suit.

[Boopeedoop]

As a mum, my advice to you is to write about what sort of things you hope for, BUT! Put in it that you are flexible and open to all options regarding pain relief.

I put in my birth plan I didn't want an epidural, and when I changed my mind I was told no, because of my birth plan. I could sue them. (this was 19 years ago)

[howlatthetrees]

YANBU

[FeedTheFish]

OP, I had a similar experience to you with one of my community midwives. From experience (third pregnancy, seen loads of different midwives over the years) this is not the norm and it sounds like you've been really unlucky having to deal with this woman.

Take a look at this. I think it'll really help you: www.mumsnet.com/Talk/pregnancy/3895198-Invaluable-help-advice-and-support-for-anyone-pregnant-right-now

This is a thread with links to some fantastic support. It really helped me during my most recent pregnancy and as a result I had a brilliant birthing experience just a couple of weeks ago.

Good luck, I hope it all goes well for you!

[SnackSizeRaisin]

I wouldn't worry about the birth plan - just do some reading yourself. NHS antenatal classes are very basic and don't provide much that an average person wouldn't already know. When it comes down to it you don't really get much choice and hopefully they are following best practice so you probably don't want to argue with what they advise. It's a bit poor that you've had so few appointments. Usually they are all the same - measuring, urine test, bp, check baby's heart rate and position. I would try and get your blood pressure checked at 40 weeks, rather than wait 2 weeks. Pre eclampsia can happen with no symptoms, and is potentially life threatening.

[decisionsdecision]

YANBU however lots of midwives don't go through a birthing plan.

To be honest the amount of women who use a birthing plan when you get in the heat of the moment is minuscule.

[Healthyandhappy]

Also join count the kicks on facebook

[Healthyandhappy]

A birth plan? Goes out of window in labour. Have a water birth if able. If not have gas and air and diamorphine so u can feel baby and what your body tells u to do. Also when I feel the fire make sure midwife had a jug ready to pour water on u. Makes it easier

[UnderTheBus]

Another reason you need to have appointments between 30 and 39 weeks is to check position - baby could be breech or t transverse which can be really dangerous if you go into spontaneous labour and don't know about it!

[UnderTheBus]

I have an appointment in 2 weeks but have no idea what it is for. Reading what people are saying, it sounds like it will be for a sweep but I am guessing.

She will probably check and measure you again, test BP and urine. And offer a sweep if you would like one. You don't have to have one. They may also want to book you in for an induction if you want one. Most trusts want you to be induced before 42 weeks so this would need to be booked around the time of your 41 week appointment even if you may not need it.

[RhubarbFizz]

Whilst my birth plan was totally useless in the end, and writing it made me feel worse as I could not have it - and that was just my opinion, I too found the lack of interest in Both the pregnancy and birth a shame from my midwife. I was a tick box exercise. There must be some fab ones out there. I wish I had the money to go private in retrospect! The few times I had to go in for monitoring - well those midwives were just amazing!