Saying NO to an examination...

[peeapod]

I wanted to share my experiences from yesterday but didn't really want to so publicly. I hope this helps someone here as I can write more open and anonymously.

So yesterday I was experiencing tightening pain across my tummy. These started at about every ten minutes and wasn't disapearing after a bath or relaxing etc.

They were pretty damn painful and when they got to every 6 minutes it was decided that it was best to go to hospital to make sure everything was ok.

When I entered the assessment unit on the ward I was asked to undress from the waist down and cover myself up. I did so, but when the midwife came in she was like you'll need to take your knickers off. I said uh, why?

She said, so I can examine you. I said what do you mean? She said well I need to know how dilated you are and I can only do that by examing you.

After explaining that actually thats the exact reason why I am booked in for a C section next week (and completely freaking out over these pains because I have such a low pain tolerance) she huffed and said well you wont get a C section based on a few contractions. I stood my ground (with my ohs help) and she eventually said that she would go and get the doctor to explain it to me.

When the doctor came in he was really lovely. He showed us that the monitor I was on wasn't recording any contractions, and that thats what its job was (as well as recording baby's heartbeat). He asked if he could feel my tummy which I agreed too, luckily it co-coincided with one of these pains and he was able to reassure me that these were just very severe braxton hicks because he couldn't feel any tightening of the uterus.

I just wanted to share with you my story because I really think its important for women to be 100% clear on examinations, especially internal ones. I was in such a vunerable position and it was just assumed that I would consent. The midwife wasn't able to deal with my refusal without resorting to threats and misinformation, which without my partner being there could have forced me into consenting to what would have been an incredibly traumatic experience, could have actually started labour and increased the risk of infection. Ironically if I had consented it would have actually made my C section more in doubt because thats the reason why I needed one..

If anyone is in a position they don't feel comfortable in whether thats in labour, pregnancy or anywhere remember that no-one should have the power to force you into consenting to things you really don't want to do. Especially remember that its your body and your boundaries and that health professionals need to respect that.

I don't look on it as the midwife or the doctor being in charge of my care, but I see it as a collaboration and a negotiation. If a procedure needs to be completed in a certain way and only that way I never assume, and I always ask questions and I always feel 100% comfortable before I consent to it. In case of emergencies I try to plan in advance and my oh also knows my tolerances etc.

Work with the professionals, they might know whats best clinically but they don't know you and your personal situation.

Er...

My notes are full of shit anyway so they wouldn't gain anything from them.

Why haven't you corrected them then?
Or complained about them being shit.

You are actually actively accepting shit and saying that everyone should. Which is utter bollocks! Potentially life threatening bollocks.

As for CBT, you make the assumption, that Peeapod is somehow a bit thick and hasn't explored the possibility... or indeed tried it. Again CBT is NOT appropriate for everyone.

Moomin - don't be fooled by the kind MW giving you a shoulder rub whilst the other MW gave you a VE.

This is a classic ambush situation, taught to MW to make sure you comply and to give you the illusion of choice.

Imagine the scenario of the doctor coming in and saying "your uterus is contracting, the monitor is showing regular contractions, I need to see how close we are so I know how much time we have to get you down to theatre". How is this not a valid reason to examine?

it would have been a valid reason and in that scenario I would have probably asked again. However, I have had no show or no waters breaking and that is the position I have been left with. If those 2 things happen then I will be able to get a C section sooner (not that I want to, it might be needed though). Nothing has been mentioned about needing a VE. there are ways around it.. if you ask..

I did simply state Im not having any VE unless its necessary. which it wasn't. case closed.

example of why its important to always question and never just accept.

I actually have with red pen and intend to for the next 20 weeks. But they don't read them IME anyway! Its for this reason I am writing EPIDURAL in big fat red pen on the front of my notes so there's no doubt.

I won't go into my opinion of the NHS as it's irrelevant to this thread. The midwife was very wrong to have not read the notes. Complaining won't change that (it never has).

I think it would be good if perhaps women had a different colour wristband so professionals could see at a glance - or would this be labelling and frowned upon?

Just one thing Red - I agree about the MW being appalling.

But the idea that CBT/addressing mental health needs is always to get us to 'comply' I am uncomfortable with, as somebody with mental health needs.
My symptoms and MH illness are not convenient and can make me a tricky patient- and some HCP will try to brush me aside because of it. I myself, in the middle of an episode, will gladly pronounce I'm not clinically anxious or obsessing... everyone else is just ignoring my reasonable concerns, the fools.
It doesn't make my ill health a good thing or 'fighting the power'. It is an illness, and I've joined many a campaign to insist it is treated as such: thus, the suggestion that someone showing mental health needs get treatment is to me not writing them off, but highlighting a disgracefully neglected area of the NHS.

The NHS would love me to be 'just a hysterical woman' and not treat me ( the situation, to me, has remarkable parallels to the way women are ignored with gynie/pregnancy care ), people uncomfortable with mental health would love it if I were a rational, ignored heroine. But the situation for me is:
-I have complex physical needs which are on my notes, and I understand these well and should be consulted and listened to
and
-I have mental health needs, which cause me suffering. I deserve to be treated for these, they are real health needs (but 'anxious' must not be confused with 'stupid' by HCP). After therapy, I have felt better and been able to communicate better.

FFS, the reason change doesn't happen is not just due to complaints being ignored, its because of the attitude of "oh it won't change anything anyway" too.

Bad attitudes, particularly within maternity persist because of how you react to poor care too. Coupled with excuses, like the ones being made on this thread, to let off those like this midwife, it encourages the wall of silence and to 'put up and shut up'.

As peeapod quite rightly says, it is important to always question and never just accept. It doesn't just apply to internals but all aspects of care. 99% of the time asking questions isn't a problem and being a pain in the arse, might not just benefit you in some way but it might ultimately might help to save someone else's life.

People are not there to be processed conveniently in hospital, they are there to be cared for.

I don't think people should put up and shut up at all, that sort of attitude is where bad care begins.

But I do think people should also understand the logistics of what they are requesting.

*Moomin - don't be fooled by the kind MW giving you a shoulder rub whilst the other MW gave you a VE.

This is a classic ambush situation, taught to MW to make sure you comply and to give you the illusion of choice.*

This is not really helpful. Moomin was happy to be examined, therefore there wasn't an issue. You are presenting this as MW waiting to coerce and trick women into "something terrible" rather than what Peeapod herself is saying which is that MW should listen on a case basis.
This is exactly the kind of wording I find very dangerous: part of consent is that some women will accept, some refuse. Acting as if those who feel OK with it have been 'tricked' or are 'wrong' is not actually what this thread is about.

As peeapod quite rightly says, it is important to always question and never just accept. It doesn't just apply to internals but all aspects of care.

Yes! This pretty much sums it up...
Between HCP and patients.
And between women and other women: it is OK for one person to say no, another to say yes, another to feel therapy helped them etc'.

I learned a very long time ago after many many serious complaints against the NHS that it doesn't get you anywhere (except to be perceived as "the one who complains") and therefore have given up. I rarely put my faith in the NHS and as such have spent thousands on private insurance and births. I wasted SO much time, and nothing changed. It will take far more than people complaining to change the system unfortunately.

allisgood1 - this is something that you have learned and this is how you have reacted as a result.

Other people might not have the same experience. Its not fair for you to discourage others from trying. It makes you as bad as the people who failed you as you then become part of the problem stopping complaints being effective.

If there is anything I have learnt about the NHS, it is that there are ways to get the system to listen and for it to change in some ways. Not necessarily through complaints directly, but at least encouraging the groundswell of popular opinion and thought to change direction, which relies on not making excuses and supporting others in their individual fights.

We need to encourage people to ask questions, as they are as important as complaints. Places like MNs are incredibly important for this reason.

I do agree with redtoothbrush 100% in that. Please don't give up allisgood and don't encourage others to do so either. It would be a very very sad world if we accepted sub standard services and care just because we were worried about nothing happening. We need to fight for it. We shouldn't have to mind, but we do.

Oh ok I was ambushed by midwives... well that changes everything. I've decided my birth experience was horrible and I never want another VE ever again.

Seriously, what is the possibility that they were using a power trick on me going to change? I felt comforted, I had a healthy baby and a great birth experience. I'm sure it's the same for many women. It makes no difference to me whether she was being kind and comforting or evil and controlling

You knew you had a compound presentation from a scratching sensation? Wow. I couldn't feel a fucking thing. All I knew was that I hurt. A lot. And I couldn't get the damn baby out. It took the registrar shoving his fingers inside my cervix before he found the errant hand on the face. Should I feel inadequate because of my insensitive cervix now?

I complained about the midwife, who treated me during my 1st PG, "her attitude was discussed, and dealt with accordingly. We can assure you, that our midwifes are trained not only to treat but to care for our patients." - This is the response I got. Coincidentally, she was the midwife who saw my before my 1st scan with my 2nd baby 2 years later and she was lovely.

Now, I go private or have home births - much less stressful!

I do believe that VEs are not mandatory, and should not just expect people to have them because that's the "norm" but if a certain situation required I needed one, and there was no other option I would grudgingly, consent. I am not embarrassed easily, trust me, I'm not embarrassed by pap smears (only 24, so only had one to rule out) or anything of the sort but there's just something about VEs that made me feel clinical and very embarrassed.

Of course that was my first labour. Second time round, DS managed to crown before I realised he was coming out. Maybe I do have the world's least observant vagina.

MummytoMog - ROFL. With my firstborn I slept throughout the whole labor and then gave birth in the bath. He's my first and only BBA. I also slept through dc2 & the twins labor - labor weirdly, makes me sleepy!

MummyToMog that made me giggle; I also have a very unobservant vagina. I was insisting to the midwives, my OH, my mum, the doctors, and anyone else who would listen, that I was about to have a massive poo and they had to promise not to look (I was heavily reliant on gas and air by this point, in fairness!) and get rid of it quickly because I didn't want my baby to see it. They kept telling me it was the baby's head, no-one would listen to me when I insisted I just needed a poo. Nine minutes later, DD was out

This has kinda gone off on a tangent now, but there have been a lot of issues raised in this thread relating to awareness of notes and standards of care which are really important.

In my prev pg a junior doctor wrote some comments about examining me into my notes. When I read them after my trip to the hospital, I was shocked as he hadn't touched me. I brought it up with the consultant at my next appointment and he was horrified, corrected my notes and suspended the doctor.

My point is that not all NHS staff take notes with a pinch of salt - maternity notes are a legal document. And we have a responsibility to ourselves and our babies to check and question our notes. I got excellent care after my complaint and there was no sense of being treated as a problem patient.

IMO anyone who seriously thinks that a grown woman who intends to bring another human being into the world shouldn't be treated as a responsible adult, that she doesn't deserve to have procedures explained or that she shouldn't ask valid questions about what's happening to her body and her child... Well, why not?