Mental health midwife

[sarah00001]

Hi, I'm nearly 25 weeks pregnant and I've been suffering from pre-natal depression. I struggled to become pregnant having had 3 ectopics, and in the end to have IVF. When I found out IVF was successful, I was so worried about losing the baby, I developed OCD and was terrified of something harmful happening that would affect the baby. It affected my relationship with my partner and he moved out a couple of months ago. He's given me very little support and just gets very angry and nasty with me when I display signs of OCD. I have felt extremely lonely as I don't have close family nearby and I don't have any close friends in my area who I can talk to. I have been prescribed anti depressants which I was very against taking, and referred to a mental health midwife. When I first met with the midwife, she said that she would need to inform social services about me, in case I had problems coping with the baby when she's born. I didn't think much of this at first, but now I'm really worried. My main concern is whether this would ruin my chance of having IVF in the future, as you have to complete a welfare of the child assessment. If I am known to social services then, I am worried that this would prevent me ever being able to have IVF again. I feel quite angry that social services have instantly been informed, even though I have not given any indication that I would be unfit to look after my child. I can understand if I was self-harming, doing drugs, talking about suicide or doing anything that would suggest I wouldn't be able to cope with a child, but I have been doing my best to look after myself and protect my child and the most harmful thing I have done is drink a cup of caffeinated coffee!. I'm really starting to regret now asking for help and fear this is going to haunt me in the future. I want to be removed from social services records, but I don't think this will be possible.

Has anyone else gone through a similar experience or can offer any advice?

Thank you, Sarah

OP, I just want to reassure you that social services won't come knocking on your door, nor would this prevent you from accessing fertility services in the future. The referral is perhaps a little OTT, but SS will have been informed 'for information only', in case you struggle when the baby is born. They have so many real problems to deal with that you aren't going to be a priority for them, trust me! You've done the right thing in seeking help, and I hope you start to feel better soon.

Thanks for your reply, she did say that it was for information only and they wouldn't just come knocking on my door. I don't think it should affect me accessing ivf in the future, but I'm still concerned, as I just don't know. I just would rather she hadn't informed them straight away like she did.

sarah, I currently have a baby who is attempting to escape so I can't post properly now as needs lengthy post but I'll post again in a bit. I didn't want to just read, run and forget.

Don't worry. Its fine. Will post again shortly.

Thanks Redtoothbrush, look forward to hearing from you.

I had a CS for anxiety related reasons and at the last moment they referred me to SS out of the blue which I found really upsetting and worrying. I felt very betrayed by the process and part of the problem was because I wasn't coping so well with my anxieties at the time it did help to feed it rather than provide the reassurance it was supposed to. I didn't recognise it at the time but hindsight is a wonderful thing.

First thing: You NEED your mental health midwife. You obviously have some health problems you need help with. You are also quite lucky to have a specialist midwife who will understand you and your needs better than someone who isn't used to dealing with pregnant women. You did absolutely the right thing in getting the help you need. Don't ever question your decision to as it is the best thing for you now and in the future.

Secondly, with the changes in your home situation, your lack of support and your medical history she's acted in the right way for you whether you want to believe it or not. Women with a history of problems during pregnancy are at significantly higher risk of more mental health issues after the arrival of the baby than the general population. This can include the small risk of severe problems but more generally its more the risk of PND that they are worried about. Its nothing to do with anything you've done wrong so please don't think that. Its just that without any support they are more concerned than perhaps they would be.

Thirdly, they are trying to help. Its not a judgement on you or your ability to parent. SS has a reputation and a stigma that it doesn't merit in many cases because we tend to only here about the bad cases and not the ones where they have had a positive impact. Referrng you now is so you aware of and given priority to support services should you need them. They want you to know they are there and what they can do to help. Being 'in the system' now will help you get access much quicker than if they had to process you at the time because of the paperwork. They are NOT saying you are a risk - they are saying you might be someone who might need more help than someone else and they are happy to provide it. There is no shame in this. They won't come knocking at the door and they definitely won't be trying to stop you being a parent now or in the future. Its opening a welcoming door not closing one in your face and that's the way you need to see it.

Lastly, as difficult and as scary as it feels, go along with it. Unfortunately you don't really have a lot of choice as if you don't engage then it will make them worry more than if you are happy to deal with them. It sucks and it does feel like you can't be trusted but that's not what its about. If you engage with them they can't say you are doing anything wrong or you aren't concerned with the welfare of your baby. It counts towards you rather than against.

We never needed support of SS in the end. I never saw a social worker. Their 'involvement' didn't even include any visits apart from the HV having a few more appointments at home with me which although a pain probably was a good thing.

Please try not to worry (I know you will precisely because of the reason you have been referred!). It sounds a hell of a lot worse than it is in reality. I know I probably can't make you feel much better about it, but it WILL be ok.

I had PND after the birth of my son but no contact with social services. We had IVF treatment to conceive again and the previous PND was not an issue (I declared it as part of my medical history). I don't know if things would be different if I'd had contact with social services but for me a history of depression was not a barrier to IVF treatment.

It sounds like you're having a really tough time. Please don't let this put you off seeking help if you need it.

I'm a front line mental health worker and just want to offer you a perspective from the other side so to speak, we work tirelessly to keep baby and mum together, and in my experience mental health midwives are excellent at what they do. Don't be afraid to be honest. The more people know the more that they Can help. Good luck and don't worry, you are far from alone

Thank you everyone for your advice, I really appreciate it.

I'm so sorry you're going through this - I have been in a very similar situation throughout my pregnancy (now 41 weeks). Like you I had experienced IVF and ectopic pregnancy, and developed OCD at the start of my second trimester. We don't have mental health midwives in our area but having referred myself to mental health services (I had gotten to the point where I could barely prepare and eat food I was so scared of food poisoning) my regular midwife referred me to children's services. I was devastated, it felt like I'd been punished when I'd actually done everything I could to get well, sought help, been honest, complied with the CBT and started to improve. I was advised on MN that social services wouldn't come out, but they did. Not a grumble - people gave great advice and reassurance just warning you that it's quite possible they will visit you. I am myself a qualified social worker (older adults) so I was a bit surprised too.

What I can say about that is our social worker is quite lovely, she only came out twice - once for an assessment, once for a meeting with mh social worker and midwife to let them know the outcome of our assessment (which was basically she doesn't think I'm a risk, but she wants to check in after the birth to make sure I haven't developed post natal depression or psychosis). She was very supportive and transparent, and her main concerns were how I would cope after the baby was born (there is an increased risk of postnatal problems, as you will know by now). I don't know how much contact you and your partner have but the SW will want him involved and you will want to present as united a front as you can if that's possible. You're complying with your treatment, you haven't hidden anything, there are good reasons why you developed OCD in the first place that are understandable to anyone with half a brain. The worst they will do is treat this as a 'child in need' situation, which would mean they think you need a little more help and support to look after the baby. So in my case they will check after the baby is born that I'm OK, nothing else will happen unless I am falling to bits, in which case they may offer some support. What would cause a problem for you accessing IVF in the future would be a safeguarding referral. This is where they think you are an actual danger to your child. Nothing you've said even remotely suggests that. Nothing about the simple fact of having OCD suggests that. Safeguarding thresholds are high, really high, the example our social worker gave was that if I start bathing the baby in bleach we're going to have a problem.

What kind of support do you have around you hun? Do you have family close by? Are you getting access to talking therapy/CBT? Are your obsessions/compulsions quite specific or quite generalised? These organisations are quite helpful:
www.maternalocd.org/
www.pandasfoundation.org.uk

Just wanted to make sure I'm not talking out of my bottom (which is a serious risk!) I checked the code of practice for the Welfare of the Child Assessment and it specifically states 'child protection' would be an issue - which I erroneously called safeguarding (it's been a while since I studied social work). So don't fret about the impact on future IVFs, just focus on getting well in this current pregnancy, you've been through so much to get here.