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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To expect continuity and possibly quality of antenatal care in central London?

93 replies

merryberry · 03/12/2007 15:44

This AIBU is a lot about letting of steam and organsing my thoughts, but if you can make it through this endless post, I would really appreciate your thoughts.

I am 27 weeks pg with dc2. Having just had a poor experience for the nth time at the hands of the NHS. What do you think I might expect/request for the rest of my pregnancy? I have a meeting on Friday with the relevant head of midwifery where I can discuss these concerns.

Problem: shared care between hospital and GP when the relevant professionals NEVER see each other. And where I am asked not to have bloods done at my local GP but go into hospital as the results will get lost otherwise. What's the point? Am I just a burden they are splitting the cost of, or is this supposed to help me someway?

Problem: seeing a midwife in the hospital where I'd like to give birth. I saw one when I was booked, who was working out her notice and didn't know who I would see next (not specifically who, actually which team of midwives). My next appointment with hospital midwives is actually the head of midwifery as she controls access to the midwife led birth centre I'd like to go to. I carefully booked the date months in advance for Thursday pm when I could get childcare, so I could concentrate on the meeting. It's recently been changed to Friday lunchtime when I can't get care, and I couldn't rebook to another date before Xmas. I'm going anyway with ds1 in tow and fingers crossed I can avoid crying in front of him. Am I just being airyfairy to attempt appointments that work around my life, or should I expect my life to work around the appointments?

Problem: seeing a midwife in the community. I can't. I live in the hospital's catchment area, but not the community midwives for the hospital. Anyone heard of this before? Can it be right?

Problem: seeing my GP for antenatal care. He's nice in that space-cadet overworked fashion medics often are, but every time I see him he asks me why I'm not seeing a midwife. (Answer, because you told me I can't). When I last tried to see him for my 22 week appt, I called 10 days in advance of week 22 but couldn't get an appointment for 5 weeks (ie 25 weeks PG). Wonderfully, he called back and said that it was up to me whether I bothered to see someone else at the surgery, he personally thinks that the 22 week check is mainly meaningless and I could save my effort for the 28 week check. So I didn't bother, especially given I'd just had in-patient care at 20 weeks and knew everything relevant was fine (bloods, BP, fetal heartbeat). Was that irresponsible? I was given the impression today by my endocrine consultant that that was a flaky choice/advice.

Problem: conveyor belt care that doesn't work, part 1. Today I had this endocrinolgy consult (every couple of months these happen). I attend a mixed antenatal clinic where there are 30-40 other women waiting for a variety of services. My notes got lost in the melee, after 1.5 hours I politely asked to reschedule as I had to leave, and was there any chance of just doing my bloods before I left? I was treated as if I was absconding from high security by the HCAs, whipped into see the consultant 10 minutes later and told I looked stressed by her! Cue tears and 'I don't trust the NHS, this is not your problem but I can't stand it anymore' breakdown from me. Did a bit of our consult (no blood test for thyroid function, no time). Couldn't stop leaky eye crying all the way home on the sodding bus. Anyway, is this par for the course, or is it worth a complaint/suggestion letter??

Problem: conveyor belt care that doesn't work, part 2. I was in the neighbouring hospital as emergency admission at 20 weeks when an ovarian cyst popped painfully. I was misdiagnosed with D&V despite lack of D or V, had to argue with 3 people for antibiotics (which worked) and was not given an ultrasound during a 60 hour admission (Sat-Mon). Neither were the two suspected ectopic pregnancies over the ward able to have ultrasounds during that time. I got a scan on the Wednesday from my main hospital: was actually my 20 week scan and the sonographer had a look for me and pointed out the remants of the popped cyst. The fact there was no ultrasound at the weekend for a major teaching hospital with a large maternity unit still leaves me blinking. Any thoughts about this?

Is this all fragmented shite that I should agitate about, on my behalf for now, and later on others behalfs? Or should I gird my loins, get over myself, wax my stiff upper lip etc? I think I am being reasonable when I judge it all - the sweet suffering overburdened individual staff members excluded - a steaming pile of shite.

Some important context:

I enjoyed my last labour despite the fact it was poorly managed by A.N.Other central London hospital - I'm not going back there. They dehydrated me, screwed up a simple induction and discharged DS with severe jaundice. He was readmitted to my current choice of hospital 12 hours later into NICU for 8 days. Guess what I'm saying is - 'aw, but you have a healthy baby' is not a cop out for poor care. I didn't have a healthy baby last time round.

I've only recently stopped working clinically, scientifically and managerially for the NHS after 20 years, and again probably know way too much about how it (doesn't) work.

Thank you for reading all this. War and Peace it ain't.

OP posts:
ScottishMummy · 06/12/2007 08:49

margoandjerry- congratulations on your wee bouncer!you have had a bad experience

i never saw the same mw for duration of pg - until i went under consultant lead care and themn allocated to high rik team.overall though london maternity is shocking

merryberry · 06/12/2007 18:22

called by midwives today (unexpected) because Dr on Monday reported worrying about me. wow, nice. will see her monday not tomorrow (appt screwed up again it seems, but also have this chest infection/pluerisy thingy and not really fit to go in anyway).

got off the phone and cried yet again, as it was so unexpected to have someone take an interest and so useful not to have ot get out of sickbed tomorrow but go in monday instead.

OP posts:
margoandjerry · 06/12/2007 20:16

that's a bit more like it merryberry...let's hope they keep it up. You need a bit of looking after, you poor thing.

MarchMum · 06/12/2007 22:20

and some chocolate/cakes I think as well :.)

merryberry · 10/12/2007 14:12

Oh PHEW!!!!!!!!! I am not being unreasonable!

Finally saw a midwife today, after pleurisy kept me in bed over weekend. Baby fine. Head down already. My BP excellent.

Absolute magic visit. Managed to not cry, which as some of you know is a joy in itself when you?re used to shitty stuff happening all the time. Saw a consultant midwife and she has taken me on her case load. Case load midwifery is for where shared care isn?t appropriate (or in my case, isn?t working). You have a named midwife. No guarantee she?ll birth me of course, but it?s her I see next time as well, which is grand. She has timed our next meeting so I can go straight into her natural/waterbirth workshop afterwards.

Talked through recent NHS experience and ds1 birth. Found that the ultrasound experience at the second hospital when I was an emergency admission was NOT usual. She had almost same first birth experience, next one came in 4 hours, god I should be so lucky. She is happy to take me onto birth centre despite me being higher risk (fat, 40 and thyroid but usually fit and well practised at managing myself in labour). Only difference they have noted with women on thyroxin is an hour long dip in baby heartbeat after taking the daily dose. Not a problem, as long as they know what it is. Can you believe they have that much knowledge, I can?t, other midwives have sucked their teeth at the very idea of a chronic condition PG being treated ?normally?? And finally, the birth centre has 22 permanent midwives on staff, no agency staff 90% of the time.

Place is as nice as can be in that old building. Very quiet this am. Maybe 2 women in labour, could hear a newborn. She saw me in a room with a nice empty birth pool. Oh, what a dream that would be.

Went down to have bloods taken in the antenatal clinic as per usual. Was a ?queue? of 12 women, each blood taking about 10 minutes! Row broke out with swearing between husbands about placement on queue. I left before security arrived and went to another floor?s phlebotomist who was in and out so fast it was incredible. She couldn?t do the research study bloods, but that?s just not my problem now, I?m not having ds1 sit and watch grown call each other a*holes in a health care setting. Naff, huh?

Anyway, I think I have learnt not to just expect the worse and just sit there and take it, but to raise it with them. Will keep this thread posted...

OP posts:
GLAMpresentsforMAMAplease · 10/12/2007 14:40

I'm so pleased for you merryberry . That must feel like progress and a big relief.

merryberry · 10/12/2007 14:43

yes, huge relief thank you glammmama. my head has been churning with this stuff for weeks now. has been impossible to relax fully or look forward very constructively, TBH.

OP posts:
HolidaysQueen · 10/12/2007 15:51

that's wonderful merryberry - let's hope with you finally have some semblance of decent care, and hopefully with you feeling better from your horrid chest infection, that the rest of your pregnancy is lovely and relaxed from here on!

MarchMum · 11/12/2007 02:24

Yay - excellent result!

merryberry · 17/01/2008 19:32

Back to square 1 now. Now 33 weeks PG and not sure when, who, where my next appt is going to be. Need to vent, very upset.

At my second mtg with HoM at beginning of january, she was having a day's leave, and the midwife who welcomed us into the unit clearly picked me up and did my check unexpectedly. This mw2 is lovely, actually came to ours when ds1 was first out of hospital in 2005.

She asked me to book next appt with HoM for w/c 4th Feb. Took a week to get through, to find HoM on leave for Feb. Fair do's. But they coudln't tell me who would cover, who i should make appt with. On Tuesday I left a msg asking mw2 to call me and advise. No reply, so rang HoM mobile this lunchtime asking who I should contact, as her cover. Nothing again.

It's making me cry TBH. It's the sort of ropey care that led to ds1 having a ropey delivery and barely avoiding serious complications from jaundice.

Yet despite being so sure this is an issue and aproblem I just can't seem to find the ommph to insist on my basic antenatal care. Let alone a bit of extra support for the fact I actually quite enjoy giving birth, but am now scared of the NHS. [insert feeling very very sorry for myself emoticon]

Options:

  1. grown a backbone, make a fuss, get on with it, trust to being lucky to get through it on the day.
  2. freebirth under the kitchen table
  3. run away to either parent's area of residence on the grounds the NHS is not as shite in either as in central London maternity
  4. find 3 grand + and maybe an indy midwife at this late date
  5. and THIS is sheer desperation: go back to GP who was initially supposed to be doing shared care and throw myself on his mercy

Bugger, crying again.

OP posts:
cheshirekitty · 17/01/2008 21:07

The main problem with the NHS is lack of staff. In order to get the NHS back into the black, staffing has been reduced. There is only 24 hours in a day, and if there is not enough staff, care will be compromised.

When you write a complaint to the hospital I hope you are sending a copy to your MP. You get what you pay for in this world, and the NHS has been starved of funding for years. Brits pay less for their health care than any other comparable country ie France, Germany.

All the complaints to hospitals will not achieve what should be happening ie adequate funding/staffing levels in the NHS.

merryberry · 18/01/2008 16:50

still no call back, left another msg this am.

also dawned on me have not been sent results of last set of blood tests.

at least not blubbering about it today. angry instead. will sort this out now.

OP posts:
PippiCalzelunghe · 18/01/2008 17:34

same here. midwife care with first pg in london was a shamble. never same midwife. none of them cared one bit, looking at watch while doing apt and arranging for lunch, getting annoyed if you ask one more question etc. once I was crying and sobbing while lieing on the bed and if wasn;t for the fact that she couldn't hear hartbeat she would have not noticed. GP made me cry too and had to change surgery. wrote a letter of complaint but did not change a thing. like you say pg was very straight forward and labour even more so so my reasons for a real complaint were really low. also because no particular bad exp at birth and midwife there was good I am fairly relaxed but to be honest it was so straight forward I could have given birth in the park and would have not made any difference. I was home after 6 hours.
this time around, I'm 29 weeks, it's aq bit better. I've seen the same midwife each time and she is lovely lovely lovely. it is shared care so will have to see gp when she's busy. they were also very late in doing blood tests and they kind of lost them so I am under no illusion that the system has improved a bit. I am in a better area which in a way makes a mini difference but still... people back home are appalled when I tell.
Didn't know that it was better outside london, I thought it was a general NHS thing.

bossykate · 18/01/2008 17:50

i'm sorry, very sorry, but as i said ages ago on this thread (paraphrase) i do not think you will achieve anything better than this on the nhs in london.

i'm sorry if i sound defeatist. there simply aren't enough staff, the institutional will isn't there and the govt makes big empty statements on continuity of care etc, but with no extra resources to back up the headlines

i can recommend independent midwives if you are in central/south/west london. fwiw, i know women who have remortgaged to fund the care, in case that would help you. caroline flint (runs the birth centre near st george's in tooting) has a hardship scheme. she is lovely but you probably have to give a huge sob story and swallow your pride to ask to be considered.

for you.

bossykate · 18/01/2008 17:53

if there's anyway you can afford it, imho, the money for an iw is well spent. they can only do homebirths, however, as they are not insured to work in hospitals - not insured for homebirths either come to that.

would you consider a doula to help you through the process?

merryberry · 18/01/2008 18:09

thank bossyakte and pippi. tbh, dp just came home and says i need to march up there and sort it out. but that's not reallya n option as i can't make a phone call without crying and will not distress myself out by going to see them at this stage. and for what? more nonsense next time round?

first midwife is booked up. just contacting the others now. Thank you!

OP posts:
merryberry · 18/01/2008 18:10

indy midwives that is.

at least we don't have to remortgage. phew.

OP posts:
PippiCalzelunghe · 18/01/2008 18:21

merryberry sorry for not giving you any advice... I haven't got any. I am just resigned as well ...

merryberry · 18/01/2008 18:31

thank you bossykate, will be asking for other leads if my first set of 4 are all booked up!

OP posts:
Prunters · 18/01/2008 18:37

If you are on the west side of London then I can recommend an IM - she is in Oxford but does births in London if the geography's right. She's fab.

merryberry · 18/01/2008 18:40

thank you for that, but i'm in tufnell park...so working my way through the few based in central/east london and north of barnet first.

sage femme are busy. currently have enquiries waiting at 3 other practices.

OP posts:
Blu · 18/01/2008 19:40

For anyone in S London looking for reasonable continuity, you can try and get on the lists for the Albany mw's in Peckham, or the brierley Midives - both community based teams working out of Kings. You always see one of the mw's in the team, and they make sure you have met them all before you go into labour.
Brierley only do women planning a hb, though - but they do accompany you to hospital and remain your mw once you get there, should you need to transfer. (I was with Brierley)

hertsnessex · 18/01/2008 20:53

Merryberry, I hope you find an indy, if not please please think of hiring a doula, the support from now until after your babies born may just keep you sane!

Cx

merryberry · 19/01/2008 19:20

Phew, found an independent midwife. Start seeing her on Monday. yet to decide if to go for home birth as well.

Poor MW2 from the birth centre left a msg to say she would do rest of my care. She's have been lumbered, I have to say, trying to calm me down. This way is best.

OP posts:
hertsnessex · 19/01/2008 20:48

pleased you have found an indy, i hope you birth goes well and im sure your care will dramatically improve.

cx

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