to expect a 'birth reflections' service to be more accommodating?

[needabetterusername]

I've namechanged as I don't want to be recognised on this.

Basically, the local NHS trust runs a 'birth reflections' service for anyone who wants to talk about their birth and how it was handled. I rang to ask for an appointment, and they returned my phone call a fortnight later.

In order to have an appointment, they want me to come back to the maternity department. And I just CANNOT do it. I know that ultimately I need to take a deep breath and find a way to get over such ishoooos. However, in order to make use of such an appointment, I also need to be able to speak coherently and ask the questions I have - and I know that if I force myself to return to the department, I will end up a shaking, crying wreck and completely incoherent, and it would be a waste of their time as well as mine.

I've explained this to the midwife who runs the service, and am just getting the 'we can only do what management allow us to do' type response. She's refusing to come to my home, and 'asking' (without, it seems, any expectation of agreement from 'management') whether she can hold the appointment at the GP practice. She's offering an appointment in the hospital coffee shop, but I need more privacy. She's offering a telephone appointment, but I'm concerned that this may compound misundersatndings which led to what was difficult during the birth. And I know that it'd be pointless to force myself to go to the hospital.

AIBU to expect a more accessible, accommodating service? I mean, they've set themselves up for women who are feeling a bit crap about it all to start with.

If I ABU, how/where else am I going to deal with this?

And if I am NBU, how do I stand my ground and insist upon an appointment outside of the hospital?

It does sound like she's tried to be accomodating to be honest, although I can understand your concerns.

If you feel so awful that you think you will go to pieces just visiting the maternity dept, then no YANBU. Perhaps your GP would help? Could they contact the service and recommend that you have a more personal treatment? Or if you feel up to doing it in steps, how about going to an appointment at the maternity dept and letting them see you go to pieces? That might help them understand that you need different treatment to the women who are just curious.

I think she´s doing what she can tbh.

If you need to see someone, you generally have to go to their place of work!

I imagine they are trying to use their time as economically as possible (home visits take a lot of time), but I don't think you are unreasonable to expect them to have thought about the issue of trauma on returning to the maternity unit.

I hope she can see you at the GP surgery. There must be somewhere else in the hospital. The psychology department, for example. This may be service issue for them to think about, so it may be worth standing your ground (whilst also recognising that it's not her decision) ...

"don't think you are unreasonable to expect them to have thought about the issue of trauma on returning to the maternity unit."

That's my point.

I like the idea of asking my GP to mediate. She was symapthetic throughout the pregnancy.

But I don't think there'd be any value in me going knowing that I will fall apart simply to show them. They've got access to my notes, and my notes clearly describe what happens to me whilst I'm there.

FWIW, I had a telephone conversation with a senior midwife to go over my birth experience with DS1. It worked fine. I wrote a list of the questions I wanted answering and it was really useful. Admit this would not be your first choice, but worth a thought.

It may not be on your notes in the way you think. I was shocked to find, at myt birth reflections meeting, that a midwife had noted down that I was "unco-operative" during examinations. I was as co-operative as I possibly could be, but they hurt! I was the one who suggested using Entonox so that she could examine me.

As for falling to pieces - be prepared that you might go to pieces in any case, wherever the meeting takes place. That would not a waste of their time or yours - it would be part of the healing process. If you need more than one meeting in order to cope, then they must surely accommodate that.

perhpas one of the community midwives could come and see you at home?

there will be constraints on their time and their availability and she has tried some compromises

i think that if you say you simply cannot cope with coming back to the ward, then she might well be able to go the extra mile

birth afterthoughts meetings at the trust i am invovled in will take place in a room off the EPAU and not within the labour/AN/PN suite itself, you might not have to go back to the ward itself?

they are trying to bee accesible and accomodatin, they've offered potential compromises..

am fairly sure the early part of my notes would say
'Lulumama is totally hysterical and needs to calm teh BLEEP down!' I did see the MW wh owas with me at that point later on in the year and apologsied for my hysteria.

Its normally the labour ward midwives that do this though as comm midwives may not be up to speed enough about hospital proceedures to be able to help.

But you really would have thought they could find a room somewhere else in hospital for you, how would you feel about going to the scan dept, or the postnatal ward? Would that be an option?

my notes would say "Jamie needs to stop bellowing like a cow and concentrate on pushing"

to the OP, if you are also that distressed, you might want to consider getting in touch with Birth Crisis or the birth trauma association for some more help and support

Have you asked a community midwife to come to your home? Where I am they do that as your listening service and if you wish to make a complaint about anything they can usually help you put it together before you send it off to the hospital.

OP YADNBU

I would wait and see if she can arrange this at GP's. If not, I would contact PALS or the midwifery managers and discuss your concerns directly. It is not uncommon for women to have this issue and they should be doing their best to help you through. In the long run it is better for them to resolve this early, than face a possible complaint.

Do you still have access to a HV? Could they help with this?

I really hope that they can find somewhere else for this very important discussion. They didn't have these sessions when I had my children, but I know that it would have been very difficult for me to go back into that building to talk about my experiences. (I did go back for my second birth, but I made sure I'd changed consultant for that.)

If the hospital is really supportive of these debriefing sessions, they should already have protocols in place to support mothers who don't want to go anywhere the place where they experienced distress. You won't be the first person who has a negative reaction to going back there, so they really do need to get it right.

Fleegle's advice is good - GP's surgery but if not then PALS or head of midwifery.

It strikes me that you need rather more than "birth reflections" - a service that is probably under-resourced and not designed to include home visits.

Only if you are unable to revisit the hospital, it sounds as if your experience was horrendous enough to warrant rather more formal discussions and I'd be inclined to go down whatever route it takes to get them.

yanbu. they should be able to offer a more appropriate alternative room within the hospital than the coffee shop.

If she could do the coffee shop, could you ask that the meeting be in the chaplaincy ? I'm sure the chaplains wouldn't mind

CMOTdibbler - your idea of the chaplaincy is an excellent one. Many hospital chaplains are good at understanding and supporting people through their hospital experience and most likely will have a private meeting room available.

Thanks for all of your thoughts.

I LIKE the chaplaincy idea. I'll ring the midwife and suggest it tomorrow. (And I know that the chapel is about a mile from the matenity unit on the hospital site, too!)

And I agree that I'm in such a state over all of this that a single 'birth reflections' session probably won't suffice. I'm not really expecting it to. But I hope that it could at least help me to think realistically about what happened and how I deal with it. And that's why, if I can't access it in a non-terrifying venue, I think I'd be better off cancelling. Getting into a battle with the maternity services won't help.

I think she is trying - could you not see if she can find a private room in another part of the hospital? Agree chapel/chaplaincy is a good idea - and GP seems reasonable too - another possibly perhaps the location of your local community midwifes - mine in surestart centre?

I've rung suggesting the chaplaincy. Not heard back. It's beginning to seem as though they're going to insist I come to the maternity department. In which case, I've decided, I'm going to cancel and look elsewhere for some help. I don't want a fight with the hospital. I just want to get this crap out of my head, by whatever means.

have you thougt about to her and listing the problems?

re write....have you thought about writing to her and listing the problems?

I am very sympathetic and so sorry you feel like you do about the birth. I too had a horrible first birth, coupled with existing phobias. I was offered an appointment to see the Head of Midwifery to discuss my second birth, as I was getting help for a phobia at the time and the psychologist thought it would help. I found going back to the ward as awful as I thought it would, in fact, I did have a panic attack in the corridor as I remembered it as the one I had paced up and down so many times during the (three day) labour. However, going back there was helpful for me in the end, I did cry, but got through that and saw that the ward was not the gates of hell but a perfectly ordinary hospital ward, and the Head of Midwifery sat for an hour discussing the birth. I came out feeling much better and was glad I went, given that I did have to go back as an emergency (not the planned home birth).

So, I think a few things might help. I would go to the top if you are not finding the birth reflections person helpful, write to the Head of Midwifery or whoever explaining you found it so traumatic you don't want an initial meeting on the ward and that it seems reasonable to find another venue. The GP's surgery does seem sensible. She may have other suggestions; clearly they need a protocol for this. Secondly, take someone with you who knows you will get upset and cry (inevitable when discussing this distress) but still want to have your say. You can always write out what you want to say so they have a copy of it, so if you cry or can't articulate what you want, they will still have it. Thirdly, consider going back to the ward at some point, even just to slay those demons, but only when supported. Other organizations might help too.

I knew that the unit where I gave birth didn't have to go out of their way for me, they didn't do anything wrong in the first birth, I just found it traumatic anyway. But the fact that they were so kind, found time and just listened and understood made such a difference to me second time around. But this is a brilliant midwife-led place and I can imagine not everywhere is the same. Good luck though, I think you need to talk with someone.