Question about midwives

[BlooQ]

Hello!
I wonder if somebody can answer this for me. This happened a while ago but I still wonder about it.

When I was pregnant, I had my first conversation with the midwife over the phone, and she said to me that I needed to book my first appointment with her. That was fine, but she insisted that this appointment should happen in my house. I said to her that was unfortunately impossible. It was mostly for personal reasons but basically

1. I didn't want anyone to know about my pregnancy at such an early stage, as miscarriage can happen (and, sure enough, it did) and my stepdaughter was at home at the time (she was going to work but only every other day, and I couldn't risk her being at home while my midwife visits)
2. My stepdaughter especially couldn't know about this, as this would have been difficult for her. She had lost her mum just a couple years before this, then her dad found himself a new girlfriend and now this girlfriend was pregnant... She was just at a vulnerable phase and I didn't want to burden her with this until much later in the pregnancy.

Well, I explained all this to the midwife. She wasn't understanding about this at all, and she said, my stepdaughter being 18 at the time, that she should "get over herself". She also said that she needed to establish whether the baby was to come to a healthy and functioning home, so she needed to see my house! You can imagine how furious this made me. I thought, how is this any of her business?

But then, I thought - is it? Is the midwife legally authorised to assess my home, to see if it's safe for a baby? I mean, there wasn't even a reason for her to suspect something wouldn't be right with my home. This was the first time she'd even heard my voice, let alone met me. So, I was really wondering whether this is something she just made up (to make an excuse to come to my house).

I did manage to get an appointment with her at the hospital at the end (after I complained about her at the hospital, but unfortunately, there are like 2 midwives for my area altogether so they couldn't assign anyone else for me). But I miscarried at the end so it was all irrelevant. I'm just wondering about this in case I get pregnant again (although I think I'll probably go private this time!)

My midwives insisted on the same and I thought it was very odd and a really inefficient way to use what I am told repeatedly is very scarce resource. I have bad friends in the same geographical area but under different community midwives who met theirs at their doctor - no one I know had to have a home visit! Very odd!

Not bad *had friends!

She was bang out of order saying that about your stepdaughter and her attitude stinks

The thing is though these are the rules that have been made for her, not what she has made herself. For most women this works well but for you obviously it didn't for you.

Home vists do however provide HCP's with a valuable insight in people's lives and a way to identify risk factors. It was either my midwife mate or a midwifery documentary I've watched at some point that explained this, in particular for people from different countries and cultures it was valuable to see their home situations because they'd find things like bottles being stored on the side for later use or really really poor sleeping arrangements - something that wouldn't have been identified at a hospital visit because the parents thought this was what they were supposed to do

Hi!

I'm only currently in my first pregnancy but this seems odd to me not just from my own experience but from what I've heard from other recent mothers too. Usually, your first midwife appointment is at the hospital or surgery. They ask you questions and also I had bloods taken as well as height, weight and a urine sample.

I did have another visit a couple of weeks after at home which was basically just more questions about my health and immediate family and from what I hear, that is common but the very first appointment is usually at a healthcare setting.

And there's no legality preventing them from assessing your home, why would there be? From a safeguarding point of view it is their responsibility really to keep an eye out for things that may be harmful to you or the baby - or other children in the home. Obviously you don't have to allow them access but I have heard of referrals being made by worried midwives when families were non-compliant.

And by non-compliant I mean not speaking with midwives at all not just not letting them in homes (sorry nearly created a bit of scare mongering there with poor wording)

My midwife came and sat in my living room, at no point did she ask for a tour of my living accommodation/assess how we lived.

I understand the home visit once a child is born but to fill in my green form? Just seems silly she has to leave and drive to my house and back when she could have seen another person in that time if we had visited her at the gp/children's centre.

With my last pregnancy they came out to the house, whereas this one I have to have my first appoint at the gp surgery. I much preferred the midwife coming to the house, this time round I will have to sit in the waiting room of our small village surgery and be called through by the midwife. I have yet to go to this surgery without bumping into a friend or a friend of my parents, so I'm quite concerned about the lack of privacy. It seems that different options are more preferable to different people. There was no need for her to speak to you rudely though!

In my first pregnancy my booking appointment was at home. Saved me a trip to the doctors surgery! In this pregnancy I've had 1 home visit from midwife to check baby's position, there wouldn't have been an option to see her elsewhere in that particular day. I've also had an ante natal visit from the health visitor.

I'm 36 weeks with my second, and have never had any home appointments during pregnancy. I had a few after DD was born, and a few from the HVs after that.
Must be another thing that varies by area!

There is no official guidance on wether the booking visit should be completed at home or in clinic. Many midwives prefer to do them at home though as it means the woman has as much time as it takes without being restricted to an appointment time, most women are more comfortable in their own surroundings and of course it slows better assessment of social circumstances which means appropriate support can be put into place. This midwife should have worked with you however to find something mutually suitable and had no right at all to speak to you the way she did!

I'm overwhelmed by the number of responses in such a short time! I wish I had found this website sooner.

It looks as though this is some rule that's in place, and that some midwives follow to the letter, while others take it more loosely. As MrBensMrs said, she had a home visit and her friends didn't.

The thing is - my stepdaughter was about to leave to the university only a few weeks later. So I was very clear with Karen (the midwife) that she was welcome to come around any time after that. I mean, I can have an army of midwives around, just as long as my stepdaughter (bless her) is out of the house! I must say, in case you're wondering, she is at a much better place now, a couple years down the line, a well adjusted happy young lady, and if I were pregnant now, I think she'd be very pleased and excited.

It makes sense that she would want to assess if there was anything I was doing (perhaps unknowingly) that would have been dangerous to this potential baby. I was mostly surprised that this would have to be established so soon, at my booking appointment, when I still had 8 months of pregnancy to do. I think maybe there was a bit of a miscommunication and maybe I just didn't make it clear that I don't want to keep her away from my house, I just needed to time it better (although later this was resolved). I was just wondering about the legal aspect of it all, because I had no idea.

Other than that, I didn't really have any problems with her, she was nice enough, giving me all the information I needed. Another thing that surprised me - and this wasn't her fault, it's just how the system works. She asked me whether I was planning to breastfeed at my first appointment and gave me brochures to read about it, fair enough. A bit soon maybe, but fair enough. But on the other hand, I had a silent miscarriage at 8 weeks, and I only found out at my first scan at 12 weeks, but I had no idea this could even happen. I mean, I thought you always knew if you were having a miscarriage - blood, pain, etc. I was naïve then, of course I know that now, but honestly I didn't have a slightest inkling about this silent miscarriage being a possibility. So, I'm thinking, instead of information on breastfeeding, maybe at the first appointment they should inform, especially 1st time mothers-to-be, that there is a possibility that
a, they might miscarry
and
b, they might not even know they did, and only find out at the scan.

I understand this could possibly freak some women out a bit, but surely there's a sensitive way to inform about this. Maybe give a brochure that explains that the probability is low, but it's there.

Oh well, it's water under the bridge now. I don't even know why I'm bringing this up but it's nice to hear other people's opinions!

Different areas do different things and they can change their rules in a relatively short period of time.
I had my only MW appointment at home with this pregnancy at 36wks and she never went past the living room, my HV was coming for a pre-birth introductory visit today (37+1) but I was admitted to hospital yesterday to have baby tomorrow so I've missed her. She's going to see me in a fortnight.
With my son 8yrs ago (different area) I had no MW visits at home until after birth and again missed having HV pre birth visit as I was having baby.
Last year I had a late miscarriage and the start of pregnancy appointments were slightly different than this pregnancy just because they've changed policies in past year.

I'm 23w and all midwife appts have been at the GP surgery. However, I was meant to have a Health Care Assistant come to the house today to 'discuss baby feeding and ante-natal classes' but she didn't turn up!

My first pregnancy i had the 16 week appointment at home, this one they all seem to be at the gp.

Theu dont have to but think its worthwhile having a good relationship with your midwife but their attitude to you bloody stinks.

I would see if you could use a different hospital with different midwives next time round

I'm expecting DC4 and never has a mw asked to come to my house before baby was born

that some midwives follow to the letter, while others take it more loosely
Not really, it would depend on the trust and the place providing the care. They all have different rules and protocols so it's not the same across the country really. A bit annoying for women who want to know what to expect I suppose!

Congrats on your pregnancy btw, sorry I should have said that in the beginning

Very odd, I've never had a home visit from a midwife. As far as i know they dont do that in my county. Seems odd how maternity care differs county to county.

With my first I had my booking at home but this was because my midwife was based on a children's centre and the appointment was on a Saturday when it was shut. They also came to me for my sweep as the centre wasn't appropriate for an internal. This time booking was at the surgery add one changed docs in between, and I'd imagine all future ones will be too.

Could even be a case of the trust not wanting (or not being able to afford) to pay for rent and upkeep for facilities.

In our area if you are under the home birth team visits are at home, if you plan on giving birth in hospital apts are at GP surgery. In all 4 pregnancies no one has assessed my living accommodation for suitability.

My midwife will be doing a home visit but not until I'm like 34-36 weeks pregnant so I have time to get the nursery set up so she can see where the baby will be sleeping? Surely she shouldn't be doing home checks that soon as you won't have even prepared yet

I've 6dc. 7 pregnancies & never had a home visit during pregnancy from a MW or H.V.

I do not think legally any hcp would have the 'right' to enter your home.

At our booking in appt (at the dr's) she just asked was my living accomodation suitable. We explained we were moving house to somewhere more suitable and she was happy with that. I wouldn't want her visiting tbh, this place is definately not suitable and there are packing boxes from one end of the flat to the other!