Finding a good GP and midwife on the NHS.

[KeyboardMum]

Hello Mumsnet users! This thread is aimed mainly at Women using the British NHS.

How do you find a good GP and midwife?

So far, my experience with my current healthcare professionals has been nothing but dire. My local medical centre failed to provide me with the correct information I needed to proceed with arranging a midwife, and the receptionists have been particularly frosty and sarcastic when I have tried to arrange to see a doctor. The one doctor I have managed to speak to (over the phone) was really snooty with me, rushed me whilst I was trying to discuss the details of my pregnancy and didn't inform me about any of the processes I would need go through in order to get a midwife. They said that they would follow up the phone call, but didn't. Nothing has arrived through the post, no leaflets or medical advice...

To be honest with you all, I was thoroughly underwhelmed by the whole shambles. I pay my taxes, I don't smoke, have a drug problem or abuse alcohol. I haven't been hospitalised for anything. Other then the injections we had to have as kids, the most I have ever asked for from the NHS is treatment for tonsillitis. Now, I'm at a point in my life where I'm vulnerable and really do need the support of the NHS, and I feel as if it's staff are failing me. I'm worried that I'm not going to find a suitable bunch of healthcare professionals, who will really care about mine and the childs health. It's quite stressful.

8 weeks LMP this Monday, with 21/09/15 being the first day LMP. Two positive pregnancy tests, and I still don't have a midwife. This is my first pregnancy, and other then the practical advice my online research and books are offering me, I am very much in the dark. I don't want to inform my family until I have a scan to show them. Other then the support from my SO, I'm very much alone in this - which is probably why I feel so let down by my local team.

Can anybody suggest anything? Or should I knuckle down and accept that my experience of the NHS during pregnancy will lack humanity and empathy?

I think you've just been unlucky. I rang my doctor, receptionist gave me the number for the midwife, rang the midwife and booked in and she's lovely.

I haven't needed to see a GP at all throughout my pregnancy. In my area you just self refer to the midwife. I didn't get a choice of midwife but the one I have is great. Can you just self refer or is there a reason you need a GP?

Thanks for the response. Perhaps I have been unlucky. Did you have to fill out a form before you could see your midwife?

In my area you fill in a form at the surgery, that gets sent to the midwife who then contacts you and then away you go. Had my DD 9 weeks ago and my midwife was excellent, as were her stand ins when she was on leave.

It sounds as if you've got a weird set up where you are, do you have a local children's centre (sure start)? That's where all our local midwifed operate from and they are a welth of resource, you could try them to find out the procedure if your medical center is being rubbish. Although surely dealing with pregnant women is common place for them so it's strange they don't appear to have a procedure.

I would ring sonography dept and find out if they will be sending you an appointment for the 12 weel scan, I would also try the antenatal dept to get your first 8 week appointment with a midwife - explain you have had no luck via your GP. At the 8 week appointment they do blood and urine tests so they should be keen to see you. Hopefully this is more a problem with your GP surgery than your midwifery care, I have had similar. At your first midwife appointment they will give you contact numbers for community midwives so in between appointments and scans you can ring them with any questions - though your GP should also be helpful with giving you appointments if needed. I often ring the midwife first and ask if I need to see a GP and if they say yes then I can say that the midwife has advised it incase I need to justify it. I found everything fairly fragmented until towards birth when they really do go to town looking after you and your baby, until birth you have to be V proactive often it seems. Congratulations!

Hello keyboard Mum, I was a midwife for ten years and it seems standard practice to book women in at 12 weeks which might be why you have t heard from anyone yet.
I used to send a letter to all women when I received a booking form notifying me of a pregnancy. This has changed now as the numbers of midwives has fallen and in my local area women now refer themselves straight to the midwifery team.

Not sure where you are or what the practice is in your area.

One thing I will say is that when we sent letters, leaflets etc to women in early pregnancy (before booking) we got complaints from time to time as they arrived on occasions after a woman had miscarried.

However I am concerned that nobody has explained the procedure for arranging booking or what the plan of care is after that.

You can certainly phone the hospital and ask to speak to the community midwives office. You might need to leave a message but ask someone to phone you back and just have a chat with them.

I had to do urine then docs gave me a central booking number and then they booked my appointments my friend had a cpl of issues but only because she wishes to have a baby out with her healthboard. Do u mind me asking where u are?

You can't self-refer in my area, I was told to speak to a GP first. This is what I mean, there doesn't seem to be a set process with clear guidelines. I'm just expected to know what to do, when I actually have no idea.

I would bypass GP, ring community midwife team and say GP won't give you an appointment in time and get an appointment direct with them. Also check you are in the system for getting a 12 week scan app.

Why don't you just make an appointment to see GP. Rather than bombard him with questions, ask a simple opening one, "can you explain how the antenatal process works at this surgery, what do I need to do to access it?"

@Alfieisnoisy Hopefully I will get a nice midwife like you!

It must be a horrible thing to miscarry, however I don't see why that should stop information from going out to new mothers. Perhaps the leaflets should contain some information about miscarriages and helplines/websites for the women dealing with the emotional trauma of it - that way it caters to both instances.

I'll take your advice and try to speak directly to the hospital, it's probably best to cut out as much admin as possible!

As someone said why can't you just get an appointment with your gp? It's very normal to not see a midwife until you are 8-10 weeks so don't worry about that.

@SilverBirchWithout I attempted to make an appointment to see my GP, but all I could get was a phone call.

Like I mentioned in my original post, I didn't know what to do. So, I didn't know what questions to ask or how to approach anything. All I knew, was that I was pregnant and I had to tell my Doctor. I hoped that my GP and local surgery would be able to shed some light on the processes and what I should expect, they failed to do this.

I was going to see what Silver just said - any way you can ring early for a same day appointment? Would be harder to fob you off if you were sat right in front of them. Hopefully once you have been referred your midwife team will be lovely and you've just had a bit of bad luck to begin with.

I'm sorry you've had this experience. It does sound like your GP could have been more helpful.

In my experience (this is my third pregnancy; I had one MMC and one child) NHS maternity care is really excellent, but not a lot happens in the first trimester apart from a booking in appointment and a 12wk scan.

I think it's quite normal that your first contact with a midwife isn't until quite late in your first trimester - I think I had my booking-in appointments at about 11 weeks and 10 weeks with my first and second pregnancies. To be honest, there's not much a midwife can do for you before then except tell you to stop drinking and to take folic acid!

Both my local hospital maternity services now have a self-referral form which was easy to find. Personally I was glad to avoid a fairly pointless appointment with my GP which in my experience would go like this:
Me: I am pregnant
GP: When was your LMP?
Me: (date)
GP: OK I will refer you to the maternity service. Expect a letter in the post.

It's worth knowing that the sonography department, which will call you for a 12 week scan, is often separate from the Midwife service, so you might have two appointments close together.

If I were you I'd look online/contact the hospital which you'd like to deliver at to find out if you can self-refer. Hopefully you'll find once you are in the system the care will be good when it matters - which is in the second half of your pregnancy, really.

@danikagrace I do feel very fobbed off. We are moving soon, so we will be switching practises. Perhaps I will be able to get an actual appointment this time! I really do hope that this experience is just a one-off. It has been mentioned, earlier in this thread, that I could contact a hospitals midwifery office directly and that you can also self refer to a midwife. I might just do that you know.

Keyboard, no I didn't need to fill in a form first, just spoke to the receptionist at the GP surgery, who gave me the number of the midwife. She asked me what the date of my last AF was and booked me an appointment for 6 weeks.

@Quodlibet This is a really helpful response, thank you.

Perhaps I am taking it a bit too seriously! I am quite unsettled.

It does seem like the best course of action I can take is to see if I can self-refer. It's a bit late now, but I'll get on to them tomorrow. There's a few hospitals I can deliver at - I'm in the Coventry and Warwickshire area. I wonder if it's worth ringing around and asking about the care they provide?

Thank you all for your responses, I'm feeling a little more positive about it all now.

At my unit, women can self refer via antenatal clinic using a form over the counter. We introduced this because of some less helpful GP practices and women who didn't have a local GP.

Booking is around 10-11 weeks generally and first scan at 12 weeks. Some hospital have online self referral.

The hospitals website often has a maternity section with this info.

With mine after I got confirmation from urine sample I was pregnant i asked receptionist what next step was and she gave me a central booking number they arranged both appointments and I'm seeing midwife for first time on Friday I'll only be 9 weeks however this is appointment I was given I think they see you anywhere between 9-11 for booking app and then u go back for scan

My friend is a diff area and she had to do a self referral form at gp surgery the midwife then collects and calls to make an appointment

It really depends where you are as to the exact process. They changed here between last year and this year. Last year i just had to tell reception at the GPs and the MW then phoned me back to arrange an appointment. This year I had to have a GPs appointment, then they got the MW to phone me to make the appointment. I saw GP at 5wks, had MW appointment at 10wks and scan at 12wks. I'm high risk due to my health and chose to go to a bigger regional centre hospital rather than my local district one and so far care has been fab from both my MW & consultant. I have an extra 16wk scan on Friday. My GP has just left the practice though so we'll see what happens there.

Where I live you see a Gp either in an appointment or telephone consult and they do the referral. Apart form take folic acid, avoid alcohol there was no advice to give. I didn't get a midwife appointment till I was 10 weeks. As for a midwife I saw a different midwife at EVERY appointment before during and after delivery

Wow, look at all these responses. Thanks folks!

Wishing you all the best with your move, I hope it's as easy and stress-free as possible for you and that your new doctors surgery (if your moving that far) are much more attentive. Let us know how you get on if you try to self-refer, good luck!

@danikagrace Thank you :) will do!