What can you do if you don't like your midwife?

[marsup]

Actually it's not really that I don't like her, but I don't feel much confidence in her.

She takes blood samples without cleaning/disinfecting the spot first (or is that normal in UK? I haven't been in this country very long, but at the hospital here they did disinfect first). I asked her if the sample was to test for gestational diabetes and she looked at me as if I was a hysteric and said 'It's a perfectly standard test'. When she measured the height of the uterus I asked her whether there was any way of guessing the size/weight of the baby yet and she said that there was no point because if the baby was too big to come out they would find that out during labour.

Does all that seem normal compared to other mumsnetters' experiences? Maybe I am expecting too much (mumsnet sets a pretty high standard for intelligent communication).

No, she sounds pretty rude. Your questions were perfectly reasonable and frankly even if they were silly, she should give you a proper answer - you are entitled to ask anything you like!

Is she the midwife who'll be delivering your baby? I saw a different one every time I had a check up and someone completely different delivered DD. Luckily she was great. I was dreading getting a dragon. If she is the one who's going to be at the delivery and you really don't feel comfortable, I would ask to change. It's not an unreasonable request - just say you don't think you really click or something. I mean, you really don't want to be treated like an idiot and with a dismissive attitude when you're in labour! Good luck.

The MW would not test you for GD without telling you.... well maybe this one would. There is no reason to standard tests for GD. (Where are you from?)
IME I took the MW's words always the wrong way... DH came with me twice and every time he said afterwards... gee you are quite abrupt with her - I swear I was not...

I think we tend to missunderstand MWs sometimes !
Not saying she could have been nicer.... or more diplomatic but she was right on both counts ! But your question is a common one so she SHOULD have a better way of answering it....

Ness - no one will deliver her baby.... marsup will give birth - however hopefully someone will deliver flowers later ????

I changed mine or sacked her really. I went to the Gp and said she was rude to my children (long story) and could I have one from a diff practice...

As it was I got home visits for the rest of my pg - great with two ohters.

In my experience, GD isn't tested for by a blood test anyway. Mine involved 1) glucose showing up in the routine urine tests a few times in a row 2) Glucose tolerance test in a hospital 3) blood/urine tests in diabetes clinic.

I wonder if what your MW meant by "it's a standard test" is that it was just the "usual" blood tests. Of course, she's said it in completely the wrong way and seems very rude!

(IMO) She's also talking c**p about the size of the baby being discovered during labour. IME they'll pack you off for a growth scan to find out if they suspect a large/small baby. Having said that, they did only discover DS1s size after he was born (but I digress).

I don't remember having the blood test area cleaned before the test in any of the tests I have had.

The MW I had with DS1 was very matter of fact and a bit brusque and I don't feel I "bonded" wither her. However, she was absolutely fantastic after the birth and her bedside manner was exactly what I needed then.

If you don't have confidence in her then talk to your GP. You need to have confidence in her if she's looking after all your antenatal care.

My midwife wasn't great but like Ness I tended to have a different one every time I went to clinic. When I actually went into labour it was just me, dh and a young male midwife who didn't look much older than my ds (15). I was expecting a lot of instructions, but he was wonderful and just let me get on with it (I was lucky the labour was perfectly normal). After dd was born I couldn't thank him enough and all he said was "why are you thanking me... you did it all yourself" which I suppose was true!!

No blood samples should be taken without an explanation and the woman's consent. @standard' tests tend to be checking haemoglobin and antibodies. The area should be cleaned with an alcohol wipe prior to taking blood samples but I am aware there are differing thoughts on this one. The practice in my area is to clean the skin first. This midwife sounds as if she has poor communication skills. You certainly do not have to see her if you do not want to marsup. You could ask to speak to the senior midwife about it.

I didn't have much confidence in mine and I just arranged another day to go to the GPs - my MW had a clinic on a Monday, so I made sure I went on Tuesdays and saw the good midwife. I didn't feel confident enough to say I wanted to change so made some excuse about other commitments on Mondays.

Hhmn... not sure what to do. As pupuce says, what my MW said to me was actually correct, it's more the way she said it. With the question about size, for example, she could just have said that what she could tell was roughly the size of the uterus which was not necessarily related to the size of the baby; she could also have told me that the height of my fundus was perfectly on average for my 28 weeks, which I found out afterwards as I saw she had written down 28cm and looked up mumsnet to see what the average height should be. She is not a brilliant communicator, but I guess I have mumsnet/the internet for that! She is probably quite competent otherwise. (Are they likely to have internet connections at the hospital when I go into labour, for last-minute advice? ) I don't know about the question of disinfecting the area before taking blood samples, either... I lived in France for most of my adult life before I came here and I think they overmedicalise a lot. I do have a big black bruise on my arm where she took the sample, but my skin is more sensitive now I'm pregnant anyway (normal I think) so that is probably not her fault. AND I'm not sure how I'd go about changing - this is 'community care' so there is basically one MW attached to my local medical centre.

So what WAS she testing for if not GD?? It's not that I mind or am going to worry, I just like to know what is going on.

If you clean the skin with alcohol prior to drawing blood, it hurts!!! This is because unless the alcohol has completely evaporated, a small amount is taken by the needle through the skin and sets up a reaction (think of getting it in your eye). Cleaning the skin hasn't been shown to prevent infections, and conversely, not cleaning skin hasn't been shown to cause infections, so its perfectly OK not to use a disinfecting swab. I actually had to ask my midwife NOT to use the alcohol swab (in the same area as Mears ).

She was probably testing for anaemia, and to know your blood group, I think they test for rubella antiboies as well.

The blood tests are for rare antibodies, too, not just rubella, etc. And maybe HIV? That's what my Community midwife told me and I liked & trusted her a lot.

If you're not communicating with your midwife, though, it's worth trying to get appointments with another, if at all possible. Some of the examinations can be pretty intimate.

GD test is quite an ordeal, I'm pretty sure. You have to drink a horrible concoction of high sugar/glucose yuck stuff and they take the blood sample some 1-5 hours later. GD test is not routine in the UK, although it is in US and may be in France, too. How to interpret the results is also somewhat controversial, from what I can pick up. I would try to avoid myself unless I met some risk factor.

Marsup - there are bloods taken twice in your pregnancy.... how many weeks are you ?
My list is not exhaustive
The first time (around 12 weeks or so) is for
blood group
rhubella
HIV (but you have to agree tp that - can NOT be done wthout consent)
HB level (aneamia)
Antibodies

Second time is for HB again and I 'm sure something else.
They woudl only test IME for GD IF there was a reason to suspect it like too much sugar in your regular urine test, you looked too big for your dates,....

I'm 28 weeks, so I guess it was for anemia, but probably something else also...? I did have the 12 week hiv/ blood type/rubella test.

It's good to know the not disinfecting bit is fairly normal, thanks Tissy. And the GD test doesn't sound like much fun, I think I'll pass on that one unless there are warning signals!

At 28 weeks you will be getting tested for anaemia. If you are rhesus negatibe you would alod be getting tested for antibodies. All women get an antibody test at 34 weeks also. If you are not rhesus negative it may be that they yest everyone in your area for antibodies at 28 weeks.