Do you see the same MW, and do I have to see the 'trainee'

[bigeyes]

I have calmed down now but was quite annoyed earlier at my MW appointment.

Back story

Met MW at booking visit at home - she was great, really warmed to her and I was quite chuffed as never felt I had a good rapport with DS MW

Turned up for first MW clinic appointment and was called into a room by a trainee (almost qualified she said), no one asked me if I minded. She was not able to find a vein so MW had to come through and I broke down in tears as my symptons seemed to have disappeared and this happended last year when I had a MMC. The traininee said that this can happen and as I hadnt had any bleeding I should be ok, MW came in again and booked an early scan (9wks)

In the meantime....
Son has had slapped cheek virus - hence two sets of blood tests for me
Extra blood tests to check B12 as this is borderline and was v low following MMC
Had consultant appointment - another breakdown in tears re birth was referred to specialist MW

Today the same thing happended, the trainee called me in and I stated that I would rather see MW, she must have dialled through the MW came out and said she was busy could I see trainee. I went in not happy, she tried to take my blood pressure by pressing the thing on my arm to keep into place which resulted in an 'E', so she swapped it for a dial faced one. I told her I was 16 weeks tomorrow and she said oh so you're 15 weeks, then I'll not listen in fgs I know its not an exact science.

I waited to see MW who then said it is not possible to see her all the time and they are a MW down and that she has a clinic the PM too (why that was relevant I dont know?) She seemed a bit indignant about it all, I tried to explain that I didnt find the trainee very understanding last time as politely as I could. I then had to go through the two additional non-routine blood test details and results and what needed to be done next etc - I dont think the trainee would have been able to do all this anyway as she had to ring through last time about viles and forms.

AIBU to expect to see the same MW for continuity of care?

My pg is marked high risk and I have consultant led care. I now feel I have to see who I am told to see (as MW said I would not always be able to see her) I feel I have no choice as if I kick up such a fuss and want to see MW consistently, I will only irritate her and lose any of the 'warmed to feeling' I fetl initially.

We did get to hear the heart beat and it was v special as I had DS with me, and he has only known for a week.

Thanks for reading through - at least ive got it all off my chest.

Sorry to hear of your troubles bigeyes.

My hospital has a designated team of mw's for each area so I dont always see the same woman. I personally dont find this an issue as it means that when in labour there is more chance of a friendly face.
However, it is also a teaching hospital. And whenever there is a student there has always been a fully qualified mw present, even if just in the background.

You should take your concerns further, especially as your pregnancy is a highrisk. Staff shortages or not, you should never be left alone in the hands of a student herself. Having a mw in the next room is not good enough in my opinion and is only wasting more time for everyone.

Thanks shonno, I have nothing against medical trainees as in the past when at hospital and with DS MW who had a trainee, they are introduced and have always asked if I had any objections.

I think I proably wouldnt be annoyed about not seeing the same one every time if it had been a more experienced MW. Its a scarey thought as this one is to be fully qualified in a few weeks.

Should they be using her to mop up appointments if they are a MW down anyway (my MW told me they were a MW down)

Staff shortages are not your problem, you are having a high risk pregnancy and regardless of the risk you are entitled to care from a qualified midwife.

You can have a supervised trainee only if you agree, but the qualified midwife should be present at all times otherwise how can they train them?

It is worrying that the trainee you mention is soon to be qualified if she is making such glaring mistakes with the basics and she is not being corrected as the qualified midwife is not even supervising her.

I would complain to the Head of Midwifery at the hospital.

With regard to continuity of care, I didn't see the same midwife for every appointment with last pregnancy and it was fine because they all knew what they were doing.

Got to say where I am there is 4-5 midwives that cover the area where I live. They did let me know at my booking appointment that over the pregnancy I would probably see them all. Which is fine but then I'm wondering what happens at the birth?! Who's there then.

But as unsaid if ur a high risk case you should at least be seeing a qualified midwife rather than a trainee. But as for the same person each time if there's a shortage It's alot to ask. I work for the nhs and within our services ur lucky if you see the same person each time. But everything should be written in details in your notes and shared with the relevant care providers so shouldn't be a problem.

I havent seen the same MW twice. Sorry you're having a crap time of it.

I'm not sure if it's the same set-up in your area as mine, but a team of MWs are attached to a certain number of doctor's surgeries, so you could change doctors and get reassigned to a new team. Or Sure Start Centres usually have MW drop-in sessions every week where you could be sure your own MW would be there, or you could see a different one if you'd prefer.
I've found it's pretty much impossible to get an appt with my own MW aswell unless I book at least month in advance.

Don't know if this is any help, sounds really shite at the moment for you, hang on in there, I hope things get better.

Sorry you are having a crap time of it.
My pg is also high risk/ consultant led. My booking in appointment was a total farce with a trainee who took 1 hr 45 and many errors in my yellow book. My notes were sent to a completely different GP surgery in another part of London (similar road name). My 16 week appointment was organised at 14 weeks but I received no notification of it so did not attend. The earliest it could be reorganised for was 18 weeks, then that appointment was cancelled with one hour's notice. It has been rearranged for this week, 3 weeks late and my bloods have all gone missing. I cannot get through to a MW on the phone. Oh and NHS classes and labour unit tours have all been cancelled due to budget cuts.
Other mothers are reporting similiar stories including

(cont- bloody iPhone) simply being told to go to their GP for AN care as MWs are overstretched. That would be fine except GPs say WTF are you seeing me for and refer everyone back to MWs.
I'm less worried about seeing the same MW and more about getting even the most basic care. This is London BTW, and more budget cuts are on the way- yippee!

I see one of a team of 5 community midwives so don't always see the same one. As I'm not having a home birth I'm not really bothered about building a relationship with them. I can understand your frustration. If they are going to use the trainee to take appointment surely she should only take low risk ones? Some of mine have been blood pressure and urine dip test (which didn't even pick up an infection I had anyway). If you have further complications then you need to see an experience midwife. I think maybe you do need to kick up a fuss.

Yikes - no wonder you're concerned and don't feel bad about taking this further! When I had my booking in appointment (with an experienced MW) she gave me the utter heebeejeebees...I didn't feel safe with her (shan't bore you with the multiple reasons why), I didn't feel like I'd be looked after by her and I absolutely didn't feel any level of confidence in her as a MW.

I decided to just `get on with it' - perhaps I was expecting too much, I didn't want to rock the boat etc etc...after several issues with the pregnancy and a couple of hospital admissions my husband had had enough of me moaning about the community midwife and explained to the hospital that the lack of confidence I had in her really wasn't helping me and that this just wasn't acceptable. We were immediately assured I'd be changed to an alternative MW.

I'm afraid it did take three attempts of prodding the hospital to change me; I evetually spoke to the head of the midwife team and I was changed although a little grumpily but on the plus side, I now feel very much better and more confident with my care...ooh, and new midwife seems to have spotted a host of things that experienced but far too laid back midwife had neglected to bother looking at. Hope this helps!

I feel same. Also high risk consultant led pregnancy. Also seeing trainee Mw who seems to have no clue. Always calling someone else to find out what to do. I trust her to check wee and do bp that's about it!! Seeing her tomorrow in For 16 week check. I'm 16+4. saw her at 15 weeks as bleeding for week that another story tho. I was more worried leaving her than I was before I saw her! She couldn't find hb. Constant at Epu found it in seconds.... She was trying to find hb in totally wrong place?!?!?
Anyway I would rather she didn't even try tomorrow. How has is that.... No confidence in her at all!

I am low risk but would still not be happy about being seen by a trainee without a fully qualified and experienced midwife present at all times. Surely if there was an issue that she missed because she was not fully trained or properly supervised there would be a major question of liability. This seems like a risk for both you and the trainee and is certianly not fair on either of you. I am very surprised that this is allowed anywhere and am sure that it can't be considered good practice.

If I were you i would definitely call the hospital maternity manager (or whoever) and say you are concerned that you are not getting the appropriate level of care and would expect to be seem by someone who has at least completed their training.

Im a nurse myself and as a student training in mental health I would never every have been left alone with someone classed as high risk, and that as far as I am concerned goes for all disciplines, I think you are been very fair considering what is happening and my advice to you would be to approach your consultant with your concerns its awful that such a stressful time for you is leaving you feeling unsupported by the very people that should be giving you the most understanding- failing that PALS are very good in these sort of cases

Ive got my first appointment tomorrow im early on and its a bloody group, ive been ranting for over a fortnight lol because I am a community nurse and the likelihood of me bumping in to someone I know through work in this appointment is high - my secret will be well and truly out then, discussed with the midwife, advised to 'stop creating issues' Ill show her an issue when my complaint hits her department mutter mutter lol (themightyskim, about to be disowned by local midwives service lmao)

I'm 29 weeks and haven't yet seen the same mw which I am disappointed about.