To say this pissed me off about my booking appointment ?

[chattycaterpillar]

I had a pregnancy booking appointment recently, and was talking to a friend about this yesterday, and she agreed this equally pissed her off about her's too, ( she had hers 12 months ago in the same NHS trust).

The actual medical questions were almost skimmed over, ( I wasn't asked if I had any medication allergies, even though I have a serious allergy to doxycycline). But the amount of nosy, social questions asked to "judge," your suitability to parent was ridiculous.

Examples on the proforma list included:

• How long have you been with your partner ? ( Yes, it is a long-term relationship so wasn't an issue for me, but my friend's child was conceived after a short fling and she didn't want to be answering exactly how long it was).

• What is your highest level qualification/ are you educated to degree level ? ( I'm educated to degree level, but interested in the medical relevance of this. Imagine getting asked that at any other medical appointment ...)

• Are you employed ? Is it full time work, what do you do for work ? What does your partner do for work ? ( Why on earth is it medically relevant what my partner does as his job ? )

• Does your partner have any other children ? ( No, but again, not medically relevant...)

• Do you own or rent your property ? ( Why, do you want to take a look at my mortgage deeds....)

Seemed to be a lot more interested in asking a list of nosy, intrusive questions than either a) a serious physical health condition I have that could impact the birth, or b) my medication allergies.

I'm just trying to work out in what other medical scenario this would be appropriate...

@hayley013 even before COVID, I don't think partners attending the midwife appointments was encouraged. Certainly not now - my DH is allowed to the scans and that's it. Totally unnecessary for them to be at routine midwife appointments.

@LabelMaker

They had his occupation in the notes but clearly in an emergency they didn't look at the background information of course they wouldnt. And there was a higher chance he was in the Dock than a solicitor in due to there being more criminals than solicitors.

That's just poor thinking skills. At any one time there will be more solicitors in court than there will criminals. And an even larger majority of people will be non-criminals in the court for other reasons (e.g. jurors, witnesses, Prison Officers, victim liaison officers, secretaries...)

Yabu. These questions are to identify vulnerable women/ babies who might need additional support or even be at risk of domestic violence. That you think they are silly questions is a sign of your privilege.

@Phineyj

I haven't read the full thread, but I did ask the midwife at my booking in appointment (politely) why they were asking some of these questions and she could not or would not tell me. Nor were subsequent midwives able to explain and in fact normally got shirty if you asked anything at all (I was particularly interested why the appointments were booked for 1.30pm every time when I never, ever got seen till 4pm - this was years ago, before Covid).

There was also very little attempt to gain consent for gathering and processing the data (except a single box on the initial booking in form which asked 'do you consent to health surveillance?') I did ask about that one and was told it was opting in to health visiting.

I can see the point of it but it is yet another example of how a completely different standard is applied to informed consent, to pregnant women, than in most other data gathering situations.

Why they ask is on the NHS website and like anything in healthcare you can decline to answer. Sure they should have been able to explain, but these questions for some people really really help, it would be a shame for them to not be standard just as some are dubious. If it's recorded on your notes it's bound by the same data protection requirements as any other information contained within them, if you're really arsed you could also ask the hospital to explain why.

@PurplePansy05

YABU. They are asked to check your support network and future environment for your baby. Professionals have a duty of care and if you were finding yourself in difficult circumstances they'd refer/signpost you accordingly.

In which case the midwife team should be creating a caring environment for the pregnant woman, set within a clear therapeutic framework with transparent objectives.

@OnceuponaRainbow18

Mine asked me if I smoked, I said no. Then they asked me to do a carbon monoxide test!

The carbon monoxide test can also indicate whether you are exposed to a gas leak at home or high levels of pollution where you live or work.

@SpinningTheSeedsOfLove Which is what good midwives do. If you haven't had that experience then it's regrettable, there are many reasons for this, some not easily solved atm.

As I've said before there is no point asking anything if they don't listen. At my first post natal visit the community midwife said to me oh lots of support with your parents downstairs. She asked three times and three times I said "no they aren't my parents, they are our neighbours who have popped in to see the baby". When Inlooked at my record she had written lots of support, parents downstairs.

She was so concerned about my physical well being and relationship with my husband that she wanted to discuss pelvic floor exercises and my sex life. When I said I didn't wish to discuss either with a stranger she took her left elbow in her right hand and waved her left hand back and forth telling me that "if I didn't do the pelvic floor exercises that's what sex would feel like for my husband". Not too much concern about women's rights there. I thought "no" was a refusal of consent - one would think a midwife would understand that wouldn't you. My midwife didn't understand no; my husband did and does.

I wonder how much she would have supported a vulnerable mother.
1994.

A good % of my students had parents who were blood relatives
Marrying your cousin or second cousin is not unusual there were leaflets in school to spot sighs of diseases that were more common in those communities

Because I don't want to use the safeguarding services of NHS maternity care. In the same way that some women choose to have unassisted births or choose not to use all of the maternity services offered. I don't know if it would be flagged if you choose not to answer questions - possibly. I don't know fully about how safeguarding in schools works and whether you have to inform the school of your occupation in the same way that you do when registering a birth. I do think we are too reliant on schools to deal with social issues.

^^ I don’t think you understand how safeguarding works.
The questions are screening questions.
From them If a risk is identified then safeguarding processes may be followed.

So by asking everyone they attempt to screen out mums, babies and families at risk.

As far as I’m concerned anyone who objects to these processes, either doesn’t understand how many lives they may save. Or doesn’t think that children and vulnerable people are worth hcps bothering about and trying to identify them and protect them from abuse.

I know some of the questions may seem intrusive but why would anyone whinge and complain about it? if your life is perfectly fine that’s great, but by agreeing to the process it helps midwives screen out the women and babies who may lose their life.
I don’t know what kind of person objects to checks on the most vulnerable in society.

Appreciate all of the people who had hcps that maybe didn’t listen. And that’s not acceptable.
But that was your one experience and it is not a rationale for these questions not to be asked.
If anything it’s a rationale to encourage more vigilance for slap dash staff that don’t listen. And for the government to invest more money, so staff that are overwhelmed and harrassed with their workload can actually spot signs, take on board what their patients are saying and action things.

It wasn't my one experience, it was my experience time and time again. Based on my experiences of midwives and health visitors they are the last people on earth I would trust with the wellbeing of my children. Grown up now. Most of them when I asked a question, said they didn't know or weren't an expert.

@RosesAndHellebores

As I've said before there is no point asking anything if they don't listen. At my first post natal visit the community midwife said to me oh lots of support with your parents downstairs. She asked three times and three times I said "no they aren't my parents, they are our neighbours who have popped in to see the baby". When Inlooked at my record she had written lots of support, parents downstairs.

She was so concerned about my physical well being and relationship with my husband that she wanted to discuss pelvic floor exercises and my sex life. When I said I didn't wish to discuss either with a stranger she took her left elbow in her right hand and waved her left hand back and forth telling me that "if I didn't do the pelvic floor exercises that's what sex would feel like for my husband". Not too much concern about women's rights there. I thought "no" was a refusal of consent - one would think a midwife would understand that wouldn't you. My midwife didn't understand no; my husband did and does.

I wonder how much she would have supported a vulnerable mother.
1994.

That sounds awful. Hopefully now 18 years has passed standards have improved but I am sorry you went through that.

@Papayamya

If it's recorded on your notes it's bound by the same data protection requirements as any other information contained within them, if you're really arsed you could also ask the hospital to explain why.

Some of the information you answer also gets recorded on your child's notes and so it's not treated the same as most information you give to your HCPs.

Only the other day we had the announcement that BPAS had had to advocate for mothers to stop the NHS from instituting policy to routinely record information on how much alcohol a woman says she drinks on her child's medical record. It can still be recorded there, as is other information on the mother, it just won't be routine. Information on medical records, especially children's, gets shared far and wide in some circumstances.

And the NHS's record on privacy and anonymized data and cyber security is far from pristine. In 2018, more than 6 months after the WannaCry attack brought parts of the NHS to its knees, not a single NHS trust passed NHS Digital's cyber security check.

And it isn't all in the past. There were publicised breaches during COVID testing and just 5 weeks ago: Massive NHS patient data breach.

Agreeeed I've had 4 children. My experience of tactless and rude midwives and health visitors isn't a one off either.
While I'd agree that these services desperately need more money, it doesn't actually cost a penny to be tactful or to explain why certain information is sought.

Indeed ImAving and mine were born almost 28 years ago. Even then the staff never stopped complaining about how overworked they were. Even when there were more midwives on the post-natal ward tha mothers.

Covid has led to many more women dying from domestic abuse than pre-covid.

How many more?

Because according to the ONS the number in England and Wales was the same for Apr19 to mar 20 as it was from Apr 20 to Mar 21. And the number was lower in Scotland for last year than the year before. I know it’s common to want to pretend there we’re all these ills that came from lockdown, but statistics don’t bear that out.

Just to clarify some points:

1. I didn't have any personal problem with the midwife and I wasn't trying to find fault. I understand that she was reading through a set list of, ( rude and intrusive !) questions, and it would have been the same whoever asked/ whatever midwife was allocated.

2. If some of the questions, ( e.g. degree status), were part of a public health survey, then they should ask consent for you to voluntarily answer questions for a public health survey. I'd have probably happily said yes and assisted, but, you shouldn't really survey people for public health research without their informed consent.

3. I think it would be a courtesy and put vulnerable people at ease if they asked what they meant to ask/ explained the "support" on offer, ( although my friend, who was struggling in difficult social circumstances), was adamant that any actual practical, useful or meaningful support was not offered ).

E.G " Do you have a degree ?" is going to put people's backs up/ make them feel judged. Why not ask, " We can provide extra support with reading documents related to the pregnancy if you have difficulties with reading. Do you have dyslexia or other associated difficulties that would mean you'd like to take us up on that ?"

Instead of do you rent or own, " are there any housing difficulties, e.g. overcrowding, accom. in disrepair you'd like us to refer you to Citizen's Advice for Housing support for ? Local council's have a legal duty to provide suitable accom.for pregnant women and their babies, so if homelessness is an issue, do you need the contact details for housing options ?"

Surely that might put people more at ease....clearly transparency and explaining clearly and honestly why you are asking might make people feel more at ease.

And I definitely do not lead a charmed life. I have my own issues, ( BMI of 28 so in the overweight category, worried about having to disclose previous antidepressant use), and I can assure stuff like this does make you feel judged.

People on this thread have explained why information is sought.
If a midwife was to say, we ask these questions because some people, sadly, aren’t in a position in life where they are stable, and they and their babies are at risk of harm and abuse, would this change things? Would it encourage people to speak up? Would it calm the moaners and whiners about having to say their partners name dob and whether they have stable accommodation?

Probably not.

Is there anything stopping you asking if you want to know why a question is asked? Absolutely not.
And you can always refuse to answer.

But when children have lost their lives and lack of professional curiosity has been blamed as a contributing factor, I can’t understand why anyone objects.
Even if you personally have had unhelpful experiences, it’s not actually about you (even though I’m sorry for people who had bad experiences). It’s about new born babies and vulnerable new mums who may need help and if asking questions like this helps identify people why complain?

Also, if nhs care is so rude and intrusive,
And you don’t like the quick questions they use to filter out those in need, then there is always the option to pay for yourself and avoid it.

Asking have you any housing difficulties may not prompt some people to identify they don’t have stable accommodation.
The questions have to be clear and not open to misinterpretations.
Going through every possiblity is more time consuming. Which as I’ve said nhs practitioners don’t have.
Again brings me back to my point if you don’t like the care provided you can refuse to answer.
Or pay private.
But don’t suggest these questions should be removed, when there are women and babies who rely on their circumstances being picked up by a time poor hcp.

@Agreeeeed certainly people can chose to pay privately, which actually means they pay twice. They have already paid the NHS which is free only at the point of delivery and is funded by the people for the people. There is as yet no tax rebate on private healthcare payments and neither can one opt out of the NHS.

All too often those who run the NHS seem to forget it is not free and expect all its users to be grateful supplicants for care which is all too often suboptimal.

I think your way of wording things are more likely to make women in precisely the situations they need to know about, clam up more, out of embarrassment and possibly shame. Asking in the way that has clearly got your back up might be a way to open the conversation.

Imagine a 17 year old being asked if they rent or own - no, I live with my mum. Are you in a long-term relationship - sort of, my boyfriend and I have been together for a year. What's your boyfriend's DOB - he turns 45 this year.

I think YABU and need some perspective. You're coming at this from the privilege of a woman who has a stable relationship, stable housing, stable employment and everything else.

@Agreeeeed

Also, if nhs care is so rude and intrusive, And you don’t like the quick questions they use to filter out those in need, then there is always the option to pay for yourself and avoid it.

Asking have you any housing difficulties may not prompt some people to identify they don’t have stable accommodation.
The questions have to be clear and not open to misinterpretations.
Going through every possiblity is more time consuming. Which as I’ve said nhs practitioners don’t have.
Again brings me back to my point if you don’t like the care provided you can refuse to answer.
Or pay private.
But don’t suggest these questions should be removed, when there are women and babies who rely on their circumstances being picked up by a time poor hcp.

It’s pretty telling how judgmental the whole system is if there is no obligation on private providers to do this. You only have to put up with being “safeguarded” if you aren’t prepared to shell out again to go private.

But the problem is CWB that many HCPs don't twig the cues. There's a huge difference between a 17 year old young woman wearing no rings, whose next of kin is her mother, and clearly cannot be post graduate or professionally qualified and a professional woman in her mid 30s, who reports two previous miscarriages and whose next of kin is her husband. It doesn't take a lot of nouse to quickly weigh up and adjust tone so it is sensitive to different people with different circumstances. Isn't that something that post graduate professionals should be capable of?

Whilst many on here are putting the argument that identifying issues helps to refer the woman on to get help.
And whilst I haven’t RTWT what I have read. Is some have said that it helped them when they have asked for help, but more have said there wasn’t any help.

I think there does need to be some acknowledgment that the questions themselves put peoples backs up and are quite condescending to some and to others who might need help if it was available could see the questions as saying you aren’t suitable to have a child and then are not giving honest answers because they fear being judged or getting SS involvement.

What has having a degree got to do with raising a child and being a good parent. What do they take from it if you say you haven’t got any qualifications. Are they going to pass your details on to the local college for some free courses so you can get a degree or does it mean they will look at you and raise a red flag that you are not qualified to look after a child.

I actually tried the 'pay for it yourself and avoid it' option in desperation, as my local trust kept appearing on lists of worst maternity providers in the UK, the local papers were full of horror stories and the way they handled the prenatal appointments was threatening my job. It's not actually possible to opt out unless you've got squillions. The NHS dominates the whole of the system.