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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

AIBU to complain about my community midwife? Feeling lost in 'the system'

30 replies

user1487755366 · 08/11/2020 20:16

Sorry this is LONG.....

I am currently 35 weeks pregnant with twins. Due to carrying twins, the pregnancy is judged high risk although it was going relatively smoothly until about a fortnight ago. At booking in, I mentioned my history of depression and anxiety which are largely under control.

At a 9 week private scan, I found out that it was twins and was advised by the private clinic to inform my midwife in case I needed extra time for the 12 week scan. I called my midwife but she didn't document this anywhere and when I got to my 12 week scan the sonographer said that I should have let them know in advance as they don't normally do the nuchal test for twins at that hospital as I would need a longer slot. I said that I'd told my midwife. They were luckily able to do it anyway - when I bumped into my community midwife at the hospital she claimed that she didn't know anything about it.

I was then allocated to the high risk midwife who takes care of twin pregnancies and I saw her in clinics instead of a consultant after growth scans. Everyone I met at antenatal clinics were great - lovely staff. At about 25 weeks pregnant, I started experiencing signs that my mental health was suffering - I know what the tell-tale signs are for me as I've been seriously ill (medicated, suicidal etc.) with depression and anxiety in the past. I called my community midwife and told her I was feeling depressed and feel I needed help. She asked me no questions apart from whether it 'was related to the pregnancy', I said 'in part' - she said she would send me a leaflet to self-refer to the local talking therapies. She never sent the leaflet and did not ask about it (or any aspect of my emotional health) at any future appointments. When reading back my pregnancy notes recently, I noticed that there is a box for 'emotional health' for each appointment. She has written 'well' or left it blank each time. Thanks to support from DH I ended up seeking out private counselling which has helped (but dented our savings)...

At 33 weeks-ish, I developed extreme itching of my hands and feet at night. It was more like burning than itching on the soles of my feet and was extremely uncomfortable and distressing. It started on a Friday night so I called the PAU at the hospital who told me that I should contact my midwife asap on the Monday to arrange blood tests. I texted my community midwife about this and received no reply and no answer to the calls. In the afternoon, having not slept all weekend, I contacted the high risk midwife who arranged blood tests for me. That night, I experienced reduced movements and went to the hospital. The babies were fine but the blood tests weren't good and I was diagnosed with obstetric cholestasis - my levels were in the 'severe' category. I was in most of the night waiting to see the doctor and also had scans of babies and of my liver the next day and further bloods. I was told that in normal times they'd run weekly bloods but now, due to covid, they would contact my community midwife and ask her to check in with me weekly about symptoms. I wasn't very happy about this and quite worried as there is a risk of stillbirth the conditions and I could feel my symptoms getting worse.

The next day, I tried to contact the midwife as symptoms were much worse including some warning symptoms from the leaflet they gave me. No response. Contacted the high risk midwife. No response either.
Day after (averaging about 1-2 hours sleep a night at this point and very anxious and tearful) I hadn't felt one twin move and went back to hospital. They could see how distressed I was and took another blood sample. Results the next day showed an elevation of my levels (100 is the danger zone for stillbirth and mine had gone from 43 to 83) in a few days). I also said I was struggling to make contact with midwife.

I had growth scan and clinic appointment booked for a few days later and planned to discuss with the high risk midwife then. Unfortunately, she was on leave (explains her lack of reply to my earlier contact). I saw a consultant instead who didn't seem overly concerned but ordered for blood tests to be safe. He also said that as babies were fine and scheduled for early delivery anyway at 37 weeks (I was 34+5 at this point) that he didn't see the need for me to be seen again. All the reading and guidance I've read about this condition is that regular monitoring after 34 weeks is a must so I didn't feel hugely comfortably leaving it this long. He said we'll see what the bloods say and take it from there. When I called the hospital to get my blood test results (which are still high but have dropped a little), the hospital midwives were lovely and said they'd ask the doctor to call me. This doctor didn't seem to care at all and dismissed my concerns saying 'we won't deliver you early' (not what I asked for) and told me that we'd take more bloods and just see...I said that the weekly phone calls from the community midwife weren't happening and I wasn't getting any sleep but just got a 'there's not a lot we can do about the symptoms' and nothing else.

So now I'm just under 2 weeks away from birth and don't know what to do....do I complain about my community midwife? will anything get addressed at this late stage and is there any point? do I insist on more bloods? (1-2 times a week at my levels is what the official guidance says at a minimum), do I try to the high risk midwife number - I think I overheard hospital staff saying she was back next week? I feel like I'm having to take control of my own care and nobody seems to care apart from the lovely PAU midwives but I don't feel like this is in their role/remit. Everyone else I know with either twin pregnancies or cholestasis is under one, named consultant. I have both and just don't know where to turn and it's really impacting my anxiety. I cry most of the night either in pain from the itching/burning or from worry...Don't know where to turn.

Thank you if you got to the end of this and have anything you can help with here.

OP posts:
DFAMA · 08/11/2020 20:23

That's really not good enough, yes I would be making a complaint. In the meantime is there a mslc at your hospital? They can kick things into gear if you speak to them

Mamadothe · 08/11/2020 20:25

That sounds awful OP. I would definitely take this further. Can you call the hospital and ask to speak to whoever is in charge of the midwifes?

Definitely do not just leave it.

SpeccyLime · 08/11/2020 20:33

That’s awful OP, I’m so sorry. I think you should complain - and also don’t worry about making a pest of yourself with your consultant etc, because you’re entitled to much better care than you’re getting.

Wowzel · 08/11/2020 20:35

I would call or email PALS with what you have written here, and ask them to get the supervisor of midwives/lead midwife to contact you.

HermioneKipper · 08/11/2020 20:50

Yes awful. Definitely complain. She sounds useless. Poor you, you must be so worried. As a fellow twin mum I know how uncomfortable those last few weeks are too.

Oblomov20 · 08/11/2020 20:51

This is very poor. Please complain.

Waveysnail · 08/11/2020 20:52

I'd complain about inability to contact community midwife. As you said the high risk midwife takes the place of the consultant so your named under her. I'd contact the high risk midwife as u said she has provided good support.

ohnothisagain · 08/11/2020 20:54

Take it further, but don’t expect anything to happen. Its standard nhs care - i’ve never seen the same midwife twice, and there was 0 documentation between them (no twins, but significant risk factors). Community midwifes are pretty useless (health visitors are even worse). The midwifes in hospital were great though!

Twigletfairy · 08/11/2020 20:56

Absolutely complain. It probably won't improve your care at this stage unfortunately. In the meantime I would try the high risk midwife again, and explain exactly why you are contacting her instead of your community midwife

LongWinterNights · 08/11/2020 20:57

Echoing above, your care has absolutely not been good enough! When is your next appointment? Is there any way you can flag it with your high risk midwife? Or failing that, get back in touch with the hospital team and highlight the gaps in your care. Although it’s stressful, try to write down a timeline as it will be useful if/when you write a formal complaint. Sorry this has been such a poor experience for you.

twig1234 · 08/11/2020 20:59

This isn't good enough care. Can you try PALS.

Sorryusernamealreadyexists · 08/11/2020 21:04

My community midwife and health visitors were appalling, bordering on dangerous. Were planning to let me get to 40 weeks with a breech baby! (Among other things) I complained to pals but nothing was done

Indecisivelurcher · 08/11/2020 21:05

Totally agree with previous posters. Ask your husband /partner to fight your corner so you don't have the extra stress. And if you are worried about reduced movements then go in to triage, straight away. Better a false alarm than a missed warning. Good luck op nearly there!

WorriedNHSer · 08/11/2020 21:06

It absolutely is reasonable to make a complaint. Your care sounds atrocious. If you have not been able to make contact with a midwife you trust each week as you've been advised to then there is nothing wrong with contacting the maternity assessment midwives. They should completely understand your concerns and be happy to help you get the care you need and if they are annoyed for any reason you shouldn't care at all. You and your babies should be your only priority.

I'm really sorry this has happened to you, it must be really scary.

PALS might be a good first place to start when it comes to a complaint but the assessment unit midwives also ought to be able to help you work out who to contact to organise a new community midwife for the last few weeks of your pregnancy. Unfortunately supervisors of midwives no longer exist but there will be a community midwifery manager who should be able to help rearrange your care.

OverTheRainbow88 · 08/11/2020 21:08

I would go to the assessment unit and say you’ve got reduced movements and they will then check babies.

My friend had that itchy problem and was induced straight away

Bella37 · 08/11/2020 21:12

Absolutely complain. I would contact PALS and tell them. How worrying Flowers

OhTheRoses · 08/11/2020 21:20

Write to the Director of Women's and Children's Services and set out briefly and clearly where the care has been inadequate and about the communication difficulties.

Note clearly and simply that you expect to receive optimal care to ensure the co tinged safety of the pregnancy and safe delivery of your twins. Ideally you woukd like to see a consultant weekly from now and you wish to have an emergency contact for a hospital based high risk midwifery team.

Thank them for their continued support and assistance and say how sorry you are that you have had to write but the safety of your unborn babies and safe confinement is paramount to you and so far your confidence in the quality of care has been undermined.

Good luck.

LunchBoxPolice · 08/11/2020 21:21

Yes contact pals. Totally unacceptable handling of your pregnancy.
I contacted them at the start of my pregnancy when I was told I probably wouldn’t get a 12 week scan due to the covid situation and they were very helpful and it got sorted straight away.

Thatwentbadly · 08/11/2020 21:25

I would ring the pregnancy ward at the hospital and ask o speak to the head wife or a PMA midwife. Explain the situation and say your trust in your community midwife has broken down and ask if your care can be handed over to the high risk midwife.

magnarocks · 08/11/2020 21:26

I'd try and contact Head of Midwifery at the hospital trust you're under. You're not being unreasonable, BTW. Thanks

Simarilion · 08/11/2020 21:27

I would definitely complain and I would actively tell the midwifery teams that you have complained - I'm a healthcare professional and honestly we tend to walk on eggshells if we know someone has already complained. That is clearly poor care & please don't worry about troubling the hospital team- just calmly state the guidelines and that the high risk community team are uncontactable. If you know the consultant's name call their secretary & say the same.

Fedupmum88 · 08/11/2020 21:50

Yanbu!

In my trust if you got to the maternity assessment unit 3 times with reduced movement the policy is to induce you. In your situation I’d say your baby’s are definitely safer out then in. I hope you’re ok you must be worried sick 😞

user1487755366 · 09/11/2020 10:15

Thank you for all the responses. I'll be calling PALs and trying to contact the high risk midwife for information. it is mega stressful having to do all this pushing.

OP posts:
Fleura · 09/11/2020 10:40

That sounds super stressful, I’m so sorry.

I had obstetric cholestasis in both my pregnancies. Do get in touch with ICP Support - www.icpsupport.org/. They also have a private Facebook page where you can get lots of support from women in a similar position. Professor Catherine Williamson, who was world leading on the condition when I was pregnant 6yrs ago, is one of their patrons. They will have the latest protocols depending on your blood test results and can support you in having conversations with your midwife/doctor.

LouLou2020 · 09/11/2020 10:51

Can you find the section of the NICE guidelines that covers your condition and read up on what it advises, then contact your hospital and ask why they aren’t following the guidelines?