Treated like an alcoholic by midwife?

[MyMabel]

Anyone else been in this situation?

Ok our telephone consultation appointment I was asked how much I drink prior to finding out I was pregnant - I said (honestly) I had about one or two gins every night, the occasion glass or two of wine instead. Couldn’t tell them in units as I have no idea.

I was never drunk, never drank until DP was home as we have a toddler DD so wanted to make sure if anything happened one of us can drive, plus I wouldn’t drink while solely responsible for her. - again, never drunk or even dizzy. Just a glass or two while watching telly before bed. I suppose with COVID and all I was just bored?

Anyway, was asked if I drank since finding out- said no, because I haven’t.

Come to my face to face appointment; Midwife explains that due to my alcohol intake before being pregnant I’ve been referred to speak to someone. I was in a bit of shock to ask questions and just said ok. But after I left I felt mortally embarrassed and now a bit worried they think I’ve got a drinking problem?!

Maybe I’m not BU in the sense that they could perhaps help someone who struggled with alcohol by doing this routinely.. but AIBU to think I really don’t need to speak to someone regarding what I drank in the evenings?

Did I really drink THAT much too much? I get it was too much and probably not healthy for my body.. but I don’t think it’s that bad?!

I was honest with my midwife and said I drank too much but when it was the TWW I didn't drink and since being pregnant I haven't and she was happy and it's never been mentioned again so this seems strange!

That sounds like a lot to me, but I have on average 2 or 3 drinks a year. I imagine it's just policy.

That said, I got shamed by a midwife for eating bananas. I mentioned my first born was massive and I was worried about how big the second one would be, and she said I was in control of that. She asked me what I ate in a typical day and when I mentioned a banana as a snack she suggested that this was a huge problem and to stop eating bananas immediately. Ironically, she was utterly enormous so I didn't follow her food advice. So some midwives are just weird. Anyway, if you're not drinking now while pregnant, there's no problem.

@Belladonna12 Did I really drink THAT much too much? I get it was too much and probably not healthy for my body.. but I don’t think it’s that bad?!

This is what I was answering - to my mind she wasn’t asking about it in reference to the pregnancy, she was asking whether people thought she was drinking too much generally. I get that she stopped drinking when she found out she was pregnant, but you’re still questioning why she was referred - who knows. I would have thought the simplest explanation is that she’s a healthcare professional, she has a responsibility to mother and baby and because the OP reported home measures and regular drinking, the MW thought it best to refer on to make sure that the support was there if she needed it. I’m coming at this from a slightly different point of view because I’ve had health professionals seemingly railroading me into things I didn’t want and thinking they were being a bit heavy handed - not realising until after the intervention that I’d actually either learned something or been helped in some other way by whatever the intervention was. If the OP doesn’t attend the referral, she’ll never know will she.

[quote pam290358]**@Belladonna12* Did I really drink THAT much too much? I get it was too much and probably not healthy for my body.. but I don’t think it’s that bad?!*

This is what I was answering - to my mind she wasn’t asking about it in reference to the pregnancy, she was asking whether people thought she was drinking too much generally. I get that she stopped drinking when she found out she was pregnant, but you’re still questioning why she was referred - who knows. I would have thought the simplest explanation is that she’s a healthcare professional, she has a responsibility to mother and baby and because the OP reported home measures and regular drinking, the MW thought it best to refer on to make sure that the support was there if she needed it. I’m coming at this from a slightly different point of view because I’ve had health professionals seemingly railroading me into things I didn’t want and thinking they were being a bit heavy handed - not realising until after the intervention that I’d actually either learned something or been helped in some other way by whatever the intervention was. If the OP doesn’t attend the referral, she’ll never know will she.[/quote]
You keep saying that you are leaving the thread but then you always come back!

I took the question to mean that was her drinking before pregnancy so bad that she needs to be referred even though she is no longer drinking. Obviously the MW thought "it best to refer" but that doesn't mean she was right to do so and other midwives on this thread have also said they wouldn't have done that. She didn't get all the facts and ascertain how much OP was drinking each night. It's not good enough just to assume that they were large measures and that she always had two. She also shouldn't have referred her without discussing it first as that totally defeats the object of the exercise. You may not mind the paternalistic approach but it doesn't work with most people nowadays and is not how healthcare professionals are supposed to operate. Decisions on treatment, referals etc should be discussed and agreed on.

@pam290358
Thanks for sharing you experience.
I agree that the OP’s question definitely opened up the conversation and raised further questions about daily drinking. It was a good opportunity to explore the effects and misconceptions.
For example, people talking about the health benefits of the Mediterranean diet and the inclusion of daily, low-level alcohol consumption within it, but not recognising that the Mediterranean diet is not just daily drinking, it’s drinking a glass of wine or beer with a meal. As such, two gins before bed wouldn’t be considered part of the Mediterranean diet.

From various NHS websites it seems that the AUDIT-C alcohol scoring system, advises that if a patient scores 4+ points a referral for advice mandatory. If the OP has advised that she is drinking more than four times a week she would score 4 points before any questioning about the amount of alcohol consumed. Another point is added if 3 or more units of alcohol are consumed each time. I don’t think it’s a stretch by the MW to consider that home measures would total 3 units, but in any case it appears that the reason for referral is the number of times a week - and it appears not to matter if the person advises they stopped drinking after a positive pregnancy test. If the drinking took place 2 months or less before the positive test, it still warrants a referral. Not commenting on whether this is right or wrong, but as a possible explanation as to why the MW referred the OP.

@pam290358

From various NHS websites it seems that the AUDIT-C alcohol scoring system, advises that if a patient scores 4+ points a referral for advice mandatory. If the OP has advised that she is drinking more than four times a week she would score 4 points before any questioning about the amount of alcohol consumed. Another point is added if 3 or more units of alcohol are consumed each time. I don’t think it’s a stretch by the MW to consider that home measures would total 3 units, but in any case it appears that the reason for referral is the number of times a week - and it appears not to matter if the person advises they stopped drinking after a positive pregnancy test. If the drinking took place 2 months or less before the positive test, it still warrants a referral. Not commenting on whether this is right or wrong, but as a possible explanation as to why the MW referred the OP.

Could you link to the guideline which states that it is mandatory to refer someone for advice if they score 4+ points even without the patients permission. Everything I have seen would requite further reasons for referral than just 4+ points and even then I am sure discussion and agreement with the patient would be expected.

Did quite a few searches on various NHS and research sites and the info was from one detailing the AUDIT-C, which is the shortened version of the more detailed AUDIT questionnaire - if I can find it again, I’ll post a link - but the shortened version relies on the first three questions with a cut off of 4 points for a referral. Was only posting this as a possible explanation as to why the MW referred because there was some variation between sites, and differing points of referral. This one seemed to be specific to pregnancy as it went into more detail about the relevance of pre-pregnancy drinking in the immediate period before a positive test. Couldn’t find anything specific about discussion or agreement before referral, as the terminology used was ‘mandatory’, but I agree, generally the other NHS sites I’ve visited, stress that treatment plans of any kind should be discussed and agreed with the patient.

@pam290358

Did quite a few searches on various NHS and research sites and the info was from one detailing the AUDIT-C, which is the shortened version of the more detailed AUDIT questionnaire - if I can find it again, I’ll post a link - but the shortened version relies on the first three questions with a cut off of 4 points for a referral. Was only posting this as a possible explanation as to why the MW referred because there was some variation between sites, and differing points of referral. This one seemed to be specific to pregnancy as it went into more detail about the relevance of pre-pregnancy drinking in the immediate period before a positive test. Couldn’t find anything specific about discussion or agreement before referral, as the terminology used was ‘mandatory’, but I agree, generally the other NHS sites I’ve visited, stress that treatment plans of any kind should be discussed and agreed with the patient.

You seem to know a lot of detail for someone who can't provide a link. Every version I have ever seen requires more than just four points before a referral. The fact that it doesn't say the patient should agree to referral means nothing. It's pretty basic.

When did you all find out you were pregnant? Were you drinking a lot up to that point?

im talking 09 here but i had the opposite i was called a liar when i said im teetotal.

the same appointment we had an almighty row over something else that caused her to be suspended for unprofessional behaviour.

i was 29 at the time and he was my 2nd baby he was also a fertility treatment baby(if it makes a difference)i was on 4 years of clomid tablets to even get pregnant

at my first appointment all the usual questions asked and alcohol intake came up and i said zero when asked. she replied yeah yeah no
bullshit now how much?
me being me(i am my user name and more)i got really abrupt and said bloody zero im telling you ive been teetotal my whole life. who do you think your swearing at?

she put zero with a question mark next to it

goes then to last period.my reply never

her reply dont dick me about now miss*** when did you last see?

i blew at this point and said loudly and abruptly
"listen here you unprofessional bitch if you were competent enough to check any bloody files you could see i have severe pcos and never ever seen a period(still haven't and im 41) this baby was 4 years of the strongest strength clomid tablet that this bloody practice was prescribing ,i found i was pregnant at 2 and half weeks by taking weekly tests not due to a missed period as i dont bloody have them. dont you ever raise your voice to me ,call me a liar or ever speak to me in that manner.
you might speak to other patents this way but i wont stand for it"

the doctor came in at this point as he was room next door and heard most of the conversation and asked me to another room to find out what happened

i and my partner)explained what went on and his reply was thats it your the 3rd (clinic opened at 9am this was 10am)who complained today but they went to the receptionist to complain your the only one ive witnessed and heard, shes only been here 3 weeks and we have had enough"

i then goes on to say(nicely to the doc) "well im no push over mate she might get away will talking to others that way and they are to scared to say anything back, im not one of them, I will not be talked to like that by any one and especially not a professional. and the fact ive been called a liar twice in the space of 5 minutes is not bloody on.

i get asked to come back that afternoon for a appointment with the manager and senior doctor

i go and find out shes been suspended for unprofessional behaviour and intimidating actions as she tried to "persuade/bully" the girl before me to have an abortion(we know who he was talking about as we are a little welsh village in the south wales valleys and everyone knows everyone,) she was 15 and the midwife didnt agree with underage pregnancies and tried to bully her in to it.
(she kept the baby is roughly a few weeks older than mine)
im know around here as the woman whos had 2 babies without periods and the one that home educates it really is that small here

i had a lovely midwife at the next one and even an personal apology in the mail from the practice manager

hvs i declined all services so had no dealings with them