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...

I have never knowing treated any patient disrespectfully. If you have been treated badly, please do complain.

@RosesAndHellebores why are you so obsessed with introducing yourself as ‘Mrs’? It’s cringeworthy are you just dead proud someone agreed to marry you or what??

[quote Blueeyedgirl21]@RosesAndHellebores why are you so obsessed with introducing yourself as ‘Mrs’? It’s cringeworthy are you just dead proud someone agreed to marry you or what??[/quote]
Because that is how she wishes to be addressed, so why shouldn't she be addressed as such ? Other people insist on being addressed in all sorts of diifferent ways and their needs are usually respected.

@chattycaterpillar you seem to not be hearing what people are saying.

All those questions together draw a picture of who you are and the risks (if any) surrounding your pregnancy.

For my first I was a 32 year old with a masters degree, owned my own home outright in a stable relationship with the baby's father. Our baby was planned and he was supportive of the pregnancy. Neither of us had had any social service support previously - I was low risk for DV or additional support - great. My care focused on health, which I was low risk for too.

That's very different to a 17 year old woman with little formal education, in an unstable relationship currently sofa surfing.

The medical pathway wouldn't change because of these factors, but the 17 year old might be referred to a youth midwife or to the HV team earlier than me so that support can be put in place to give the baby the best start.

I saw your previous posts about disclosing past MH issues and weight and you seem to really fear that the midwives will judge you. They won't.

@flipflopjump

I have a job to do. Sometimes this means asking questions a patient will be offended by. As a professional I don't get to skip questions because I assume they are unnecessary for that patient or because I won't like the answer or think they might annoy the patient. I am not there to judge, I am there to provide appropriate care and I need information to do so.

At a National level education levels are known to be correlated with outcomes. We wouldn't know this, or be able to take steps to improve standards, if we didn't collect this data. At an individual level it's a really helpful shortcut to know what level to start pitching information at. I'll then adapt my approach as I go along to suit that patient.

As others have said, a question that may feel irrelevant or intrusive to some, may improve care for others or even save their life.

At the end of day if you are unhappy about what you are being asked tell the person doing the asking or speak to their superior.

If the education question were needed so you could pitch information properly it would be needed in virtually all care settings.

The education question is asked for the sake of researchers, which many women would be fine with. But they are being made research subjects without their consent and at a time when they reasonably expect things to be more focused on their individual needs not the State’s.

@Blueeyedgirl21 at risk of being repetitious, it's an equality issue. If a stakeholder in my care is addressed with a title I expect to be afforded the same level of courtesy. Time and again I have sat in outpatients and heard men called in as Mr Joe Bloggs; women as Jane Smith. Time and again a Dr has said to me I am Mr Pompous Gittison, hello Roses. And time and again I respond "how lovely to meet you, you may call me Mrs Hellebores" they blush a little and say "oh, er call me Pompous". Too late because they have already attempted to subordinate me. My accountant and solicitor don't use my first name whilst expecting me to call them Ms Smith or Mr Jones. We are all on first name terms as equal stakehders. The difference is that I pay them at the point of delivery and wouldn't if they exercised sexist micro aggressions designed to keep me in my place as grateful supplicant. The NHS is a shocking bastion of sexism and accounts for why maternity services in this country are so poor.

My title is Mrs because I am married. That is a statement of fact. If I were single it would be Miss. Alternatively I could chose Ms but I don't.

@flipflopjump

I have a job to do. Sometimes this means asking questions a patient will be offended by. As a professional I don't get to skip questions because I assume they are unnecessary for that patient or because I won't like the answer or think they might annoy the patient. I am not there to judge, I am there to provide appropriate care and I need information to do so.

At a National level education levels are known to be correlated with outcomes. We wouldn't know this, or be able to take steps to improve standards, if we didn't collect this data. At an individual level it's a really helpful shortcut to know what level to start pitching information at. I'll then adapt my approach as I go along to suit that patient.

As others have said, a question that may feel irrelevant or intrusive to some, may improve care for others or even save their life.

At the end of day if you are unhappy about what you are being asked tell the person doing the asking or speak to their superior.

If the issue is how to pitch the way you give information then I’m sorry but you are still assuming far too many things. A woman in front of you might be educated at degree level and have not sat a GCSE biology. She might have no idea at all of what you are telling because you ASSUMED. In the same way, a friend of mine is nit degree educated. She has been a carer for her parents most if her life. By I can promise you, when it comes to health, she knows her stuff inside out. That’s the consequence of spending 30 years in and out of hospital with someone with chronic health issues. You assuming she’ll need basic info presented in a different format would just be patronising.

Can you not see how this is creating just as many issues as it’s solving them?
What about you know just listening to the person you have in front of you rather than assuming they know or don’t?

As for collecting data, there are rules around that. And that includes getting the consent if people and explaining how and why this data is going to be used.
Any reason why you are not getting patient consent first?

@Twizbe the situation you are describing just doesn’t say anything about whether you are or not low risk.

See for example how abuse starts in pregnancy. And how abuse is not restricted to lower socio economic background.

As for your 17yo, you don’t need to ask question about being degree educated and what not. Just asking her address will tell you about the sofa surfing if she feels she can trust the MW enough to tell her. As it stands, all the questions about her education, how long she has been with the father blablabla is more likely to stop her from asking for help.

I understand the rationale for the questions but in our case it didn't result in any extra support. I disclosed a history of depression and pointed out pregnancy, birth etc were likely to trigger another bout, was told the midwife would refer me to antenatal support and... Nothing happened. I'd also disclosed that DH a lot older than me (which increases risk of some conditions) and that we had no family support expecting that this would also mean more support.

What actually happened was me and DH struggling a huge amount with a high risk pregnancy and difficult birth. I was diagnosed with severe PND at four weeks which I suspect could have been avoided if I'd got actual support. HV then said they couldn't provide support for PND so we were left alone to get on with it.

[quote TheNameOfTheRoses]@Twizbe the situation you are describing just doesn’t say anything about whether you are or not low risk.

See for example how abuse starts in pregnancy. And how abuse is not restricted to lower socio economic background.

As for your 17yo, you don’t need to ask question about being degree educated and what not. Just asking her address will tell you about the sofa surfing if she feels she can trust the MW enough to tell her. As it stands, all the questions about her education, how long she has been with the father blablabla is more likely to stop her from asking for help.[/quote]
Exactly my worry @TheNameOfTheRoses, that these questions and the manner they're asked could actually stop someone from asking for help.

Surely better to say, "we can refer for support with homelessness / housing if that's an issue, is that something you' like more info on "

I've had 3 children a number of years apart and was never asked questions like those at booking in appointments.

Sometimes I have pangs of regret of leaving midwifery and then I see threads like this and think nah- absolutely not baffling as to why morale is through the floor and staffing is already at critically low levels. There are questions we have to ask, if the woman doesn't want to answer them that's fine, if they want to escalate it upwards to ask why its NHS policy and put across their concerns, then great. If they think they shouldn't be asked then campaign against them, fab.

If I call you Jane Jones - that is your name.

If I call you Mrs Jones, you are just as likely to correct me to say it's Dr Jones, Mx Jones, Ms Jones, Reverend Jones, Professor Jones, or you don't believe in titles and just to call you Jane.

Male or female doesn't matter I will call you by your name initially and then follow your lead on how you want to be addressed.

For what it's worth. I don't introduce myself with a title. I tell patients my name and job role.

@Dysco This thread makes me despair

@flipflopjump depressing isn't it, I feel for everyone still working within midwifery, I do worry about how the ever increasing shortages will affect patient care, but I'd encourage anyone to get out and find a job where you aren't increasingly treated like shite. I get £40k for working Monday to Friday from home, get on with my own work with no ridiculous expectations, it's bliss.

@flipflopjump but when I have already provided you with copious forms noting my title and full name and it's also included on the referral I shall hardly have to correct you. When you refer to the consultants as Nick and Sally, etc, you may address your patients informally. For as long as you address drs formally, you may address the patient formally. I simply don't understand why other women are complicit in the misogyny. Most particularly if you are going to ever examine me intimately I would prefer a professional and boundaried relationship, not a chummy one.

@Dysco

Sometimes I have pangs of regret of leaving midwifery and then I see threads like this and think nah- absolutely not baffling as to why morale is through the floor and staffing is already at critically low levels. There are questions we have to ask, if the woman doesn't want to answer them that's fine, if they want to escalate it upwards to ask why its NHS policy and put across their concerns, then great. If they think they shouldn't be asked then campaign against them, fab.

The OP and most posts in agreement seem to recognise this is a policy and accepted practice issue, not an individual midwives being nosey issue. Discussions and threads like these that are a part of that process of voicing concern and building a constituency. This builds up and informs things like MN campaigns on maternity care, as well as organizations like BPAS who agitate for change.

@NumberTheory no its full of people being pedantic and trying to gotcha a midwife. There are plenty of channels this could be challenged if people were actually bothered, and any explanation of how it does help many women is responded to with well me me me.

@RosesAndHellebores

Referrals get titles wrong more often than you imagine.

"Hello I'm Jane Jones, one of the doctors " is what you will generally hear where I work.

@Dysco and @flipflopjump I genuinely don't understand why this thread makes you despair. I am saying the manner in which these questions were asked, with no explanation as to why, concerns me as it may make some vulnerable women feel judged and less likely to ask for help.

To me, it makes more sense to ask if someone has dyslexia/ reading difficulties, ( explaining that pregnancy letters can be provided in an alternative format), makes more sense that asking whether the person has a degree. Most people who don't have a degree are still completely literate.

I really don't know why questioning the format, ( with no explanation as to why these questions are being asked), at the booking appointment makes you think we are attacking the whole midwifery profession.

As an example, I am overweight, ( BMI 28), it is a sensitive issue. I would probably have felt more relaxed if the midwife had explained why they took BMI at booking, instead of just asking me to get on the scales etc.

[quote chattycaterpillar]**@Dysco* and @flipflopjump I genuinely don't understand why this thread makes you despair. I am saying the manner in which these questions were asked, with no explanation as to why, concerns me as it may make some* vulnerable women feel judged and less likely to ask for help.

To me, it makes more sense to ask if someone has dyslexia/ reading difficulties, ( explaining that pregnancy letters can be provided in an alternative format), makes more sense that asking whether the person has a degree. Most people who don't have a degree are still completely literate.

I really don't know why questioning the format, ( with no explanation as to why these questions are being asked), at the booking appointment makes you think we are attacking the whole midwifery profession.

As an example, I am overweight, ( BMI 28), it is a sensitive issue. I would probably have felt more relaxed if the midwife had explained why they took BMI at booking, instead of just asking me to get on the scales etc.[/quote]
You're assuming it makes women feel that way, and questioning the way its delivered when you have no insight into how effective it is. They weighed you as being overweight adversely affects overall health and this can increase some risk factors during pregnancy- what did the midwife say when you asked them why they were weighing you? In an ideal/dream world appointments would be as long as needed so everything could be combed through in detail, that's not the case though.

[quote Dysco]@NumberTheory no its full of people being pedantic and trying to gotcha a midwife. There are plenty of channels this could be challenged if people were actually bothered, and any explanation of how it does help many women is responded to with well me me me.[/quote]
People are playing “gotcha” because the explanations given don’t address the central point. And you are doing the same now by prioritising the good of other women over the woman being treated. Of course the response to “but other women” is “me, me, me” it isn’t other women being treated. People expect a provider to be focused on them, not to be ticking boxes for the benefit of managers and researchers.

The OP’s main point was - in what other area of health care is this standard? Where is the trust relationship between a provider and patient, where the patient can expect to be the provider’s primary concern and other matters subjugated to the that concern, abrogated to this extent as a matter of policy?

But @Dysco, I'm basing this on the opinions of people who say it has upset them. My friend dropped out of her uni course at 19 as she was, ( at the time), in an abusive relationship with a horrible older man. She saw the sense to dump him at 21, so when she was pregnant at 25 he wasn't an issue. She is however completely literate and has no issues reading information. Dropping out of uni is however a very sensitive issue for her, yet also irrelevant to her pregnancy.

Surely you can see how in her case asking about dyslexia/ reading ability would have been less upsetting ?

I'd also like to clarify, I do not have the "perfect life," that has been referred to upthread. I might have a degree and stable housing/ job, but I was very worried about disclosing previous antidepressant use at my appointment, ( I did answer honestly , as we were directly asked if we had ever taken mental health medication). But I can say honestly it does make you feel judged. So whilst I understand questions about mental health medication are necessary, I want to avoid other women being made to feel judged for stuff that isn't relevant, ( degree, rent or own etc) .

[quote RosesAndHellebores]@flipflopjump but when I have already provided you with copious forms noting my title and full name and it's also included on the referral I shall hardly have to correct you. When you refer to the consultants as Nick and Sally, etc, you may address your patients informally. For as long as you address drs formally, you may address the patient formally. I simply don't understand why other women are complicit in the misogyny. Most particularly if you are going to ever examine me intimately I would prefer a professional and boundaried relationship, not a chummy one.[/quote]
@RosesAndHellebores - you’re coming across as very Hyacinth Bucket. With your attitude you’re never going to get the best from a medical appointment.