Should i make a formal complaint? Views please

[Liskey]

Had a review of my childbirth experience a few months ago with a senior MW. She's sent my notes onto PALS who've called to say they think i should make a formal complaint against one of the midwives.

Background - induced at 36 weeks due to pre-ecampsia- DD blood-oxygen levels taken during labour - 2nd time this was done she was cut very badly and ended up with stitches (and I had an emergency c-scetion as the results weren't good).

DD had some stitches for this cut - which DH was advised at the time would fall out naturally or be removed 5 days afterwards. 2 days later one of the MW's decided to remove them - not sure why - she told me she was doing this but i was still fairly out of it having had a general and didn't know the doctor had said to leave them in - they hadn't put those instructions in her notes.

I don't ant to get the MW into trouble but now know she didn''t follow procedures at all.

This very much depends on why the stiches were removed.

If the wound looked infected then she did the right thing. How did the wound look, can you remember?

i don't think it was infected - nd the notes don't say that either. I just reember her roughly pulling them out and saying oh i think its time they came out.

I should say as well i was also very upset about the MW's care with feeding DD.

I wasn't advised to wake her up and feed her - she ended up having only 1 good breastfeed in 24 hours - as she was prem she didn't wake up to feed and i didn't know then to wake her every 2/3 hours.

sounds like you have several issues with this individual.

Surely you were seen by more than one midwife though?

What is PALS?
What would you get out of complaining?
Is it the stitches (what were the consequences of early & rough removal) or the breastfeeding advice or both that you would complain about?
What outcome would you like, a formal reprimand, an apology, just an acknowledgement they did wrong, better training for MWs and advice to moms like you? Or?

Am not saying you shouldn't complain, I just think you need to be happy with the answers to those last few questions in order to decide.

sorry that was meant to be plural MW's - shift patterns meant no consistency of care -this has apparently been addressed since I was in by introducing feeding co-ordinators and making sure notes are kept in chronological pattern - mine were all over the place!

Patient Advisory Liasion Service - liase between hospital and patients.

DD has a scar on her head from the cut - which should eventually be hidden by her hai. I really want it not to happen again to another dazeed and confused Mum as i felt i let my daughter down by not knowing what was best for her at this time.

The feeding overall probaly upset me more as it eventually led to me bottlefeeding DD which I beat myself up about for ages - so I'm pleased thats been addressed already.

I think this is a secondary issue, did her head heal up well or not?
Was the initial wound caused by the fbs ( fetal blood sampling)? If so I have seen many scratches from that proceedure but never a wound that needs to be stitched.
I would be asking questions about who did it and how much training and sepervision they had recieved.

supervision

It was indeed by fbs - trainee doctor under supervison did it. MW reviewing my notes couldn't beleive it either till it stated it in there! Its healed well now and DD not affected at all by it.

My son still has scars on his bottom and lower back from being slashed while inside me in a breach position....which they didnt know about until i was 10cms dilated!

He is 7 years old.
I didnt complain becsuse when i weighed it all up, they saved his life.
I too had those awful awful guilt feelings so i know how you must have felt.

On balance, I tend to think that if PALS are recommending that you complain that if you can stand the stress of it you should complain. Presumably it's not in their interest to make trouble, they are thinking the same as you. Another woman shouldn't have to go thru this.

i think there are 3 issues here that you could potentially complain about:

1. the fact that dd sustained a cut
2. the removal of the stitches
3. lack of advice re bf a premmie baby

which of these did pals advise you to make a complaint over? personally i would be very much guided by them - they know which issues "should" have a complaint raised about. hesitate to use the word should - we are all entitled to make complaints about care we believe to be substandard - just meant that if pals think something is significant enough to advise you to make a complaint, then i think that is saying something iyswim. removal of stitches and the bf seem to be obvious cause for complaint. and if the stitches were infected, as has been suggested, then your dd should have been referred to gp or back to hospital i would have thought. she was prem fgs! the cut could have been unavoidable, but if it's a question of poor supervision, then again cause for complaint. so pleased your dd has healed well, but in some ways that's irrelevant in terms of whether you should complain. i know it can take a huge amount of energy and time, but if pals recommended that i complain about something, then i think i would feel i had a duty to do so. and presumably they can help you with the complai8nts procedure?

Thanks for that everyone - i've an appt to go back to hospital to see lady from PALS and she's noted I'll probably be making a complaint - She'll be helping me make it - she's suggested the issue i have to complain about it the cut to DD head both the fact it was done and the stitches removal.

Its taken a long time for me to do all this as it was DD birthday yesterday - so a year since it all happened.

I'm really positive the stitches weren't infected and nor were they coming loose as apparently the midwife said. Its helped me in a way come to terms with DD's horrible birth experience reviewing the notes and then realising (as the senior MW said) there were things that were wrong with my care

I would only complain if you really believe that there are lessons to be learned by the professionals involved.

If the cut was an accident that was just one of those things which couldn't have been avoided then i see little point. If there was no adverse result of the stitches coming out early then again i would see little point in this either.

Complaining is very stressful. You might wish to raise questions and find the answers before you complain as the answers may show that the midwife had a valid reason to remove the stitches.

Quite frankly I don't understand the issue really. You had fbs which resulted in a ElCS because of the result. Ie your baby was in distress so the fbs and following action saved the baby from hypoxia. You cleay had a thorough team caring for you. Also to complain against the midwife when you were upset by the size of the cut which was made by a doctor seems unfair. It may have been totally appropriate to remove stitches a couple of days later - it depends on the wound. Go and enjoy your baby and let this rest and let the teams carry on doing their work in what seems like a diligent mannor.

I have just re-read and had a thought, i note the senior midwife self referred to PALS - I may be being cynical but would she have done this if she didn't think that the actions taken were appropriate but that she knew you were querying the issues and to give you piece of mind?

I asked for my care to be "reviewed" rather than making a "complaint" in the hope that any lessons that could be learnt were, but hopefully made it clear that I wasn't making a complaint as I felt that the staff were probably doing their best at a very busy time. Would that be an alternative for you?

Cheers for the comments.

Smoggi - I was surprised the senior MW had referred to PALS to advise me to complain. She'd said she'd write me a letter which I could review and then see if I had any reason to complain - I'd said then that I wasn't interested in getting people into trouble but felt there were improvements that could be made. Pretty much like you said breathslowly - sounds like they have improved some things since I was there.

Alexandra - those comments seem just a bit patronising. The trainee doctor cut my daughters head so badly stitches were needed which no-one has ever heard of with this procedure I've spoken to - whilst under supervison which obviously wasn't very good if she could do this. Then the MW removed the stitches early against procedure this could cause problems if she did it again to another baby - so its more a training need for her.

If, once you have had your answers to the initial questions you are still not satisfied and you think that procedures were ignored then you should complain.

Complaining is stressful, as i said, but if there were errors that can be fixed then this shouldn't put you off.

Good luck whatever you decide, you may find that at the least those involved will issue a formal apology, not least for not fully explaining what was happening when it was happening. Not that i think it is what you are looking for but do not expect to get any compensation there would have to be some serious errors resulting in a specific injustice before this would ever happen as the NHS just doesn't have money in the pot for redress.

Thanks Smoggi - no i'm not interested in money - just in a change to procedures so it wouldn't happen again to anyone else.

Liskey - please do also mention the lack of BF support in your complaint. This is also something that can and should be covered by procedure. In your case, if they had given you a simple piece of advice about waking to feed, sounds like that would have helped a great deal.