Unable to understand midwife

[ElleMcElle]

First pregnancy and I'd been feeling reasonably calm about things - but I had my booking in appointment with the midwife recently and am now really worried.

I'm booked into a large London teaching hospital where - unsurprisingly - lots of the staff trained abroad. I cannot stress enough that I have ZERO problem with this! My issue is that I have a very mild hearing issue which hardly has any impact on my day to day life - except that I really struggle to process spoken sound when a) there's lots of background noise or b) the person speaking has a strong accent.

Both of the midwives I met with had very strong accents and I could only understand maybe one in five words they said and kept having to ask them to repeat things. My husband was with me at the appointment and afterwards confirmed that it wasn't just me - they did have strong accents and even without my hearing problem, he struggled to understand everything that was said.

The midwives seemed great - knowledgeable, friendly and with a really nice manner. But I'm worried that I'll be in labour and simply unable to understand what's being said to me (the problem gets worse when I'm stressed and I'm sure there will be lots of background noise too). I get embarrassed and frustrated when this issue rears its head at the best of times - so the idea of dealing with it during labour is very upsetting. It can make the person with the accent feel like you're blaming them somehow - when I know that it's MY problem. I'm already starting to worry that the midwives will think I'm being awkward / difficult and hate me!

I'm not sure how to address this. I can't exactly ask for a midwife with Received Pronunciation (!) and I'm worried that expressing this issue will make me sound racist - which isn't the case. Any ideas about how to deal with this would be appreciated.

Tell them you have a hearing problem and are struggling to hear what they are saying please cam they speak slowly and clearly

It's a difficult, and real, issue.
I think the fact you have a hearing problem could be used to your advantage here, if you can't understand them properly, you can blame it on your hearing rather than their diction.
Remind whichever staff are attending you that you have hearing problems, and may need to ask them to repeat themselves or to speak more slowly ( which gives you more time to process any accents).

Phone the antenatal clinic and ask to speak to the head of midwifery (or equivalent). It's ok to say you need to see a midwife without a strong accent. It's not a racial thing, I imagine a strong Irish accent would cause as many problems as, say, a Ghanaian one. Emphasise that it's to do with your disability and you are in no way displeased with the professionalism of the midwives you met the other day.

Yes - Irish, Scottish, Northern - makes no difference what the accent is - if it's strong enough, I have real problems!

Phoning the head of midwifery sounds like a good idea - thank you. I think there is also a section on my notes where I can mention it, so perhaps if they can see there's something written down, it won't seem personal against any one individual.

I just don't want to offend anyone - it's quite a weird and unusual thing and because there's so much bitching about immigration etc at the moment, I get anxious about being misinterpreted and lumped in with all that!

The whole thing makes me really anxious and frustrated with myself. I come across as a stupid posh woman who can't understand anyone who doesn't sound like a news reader!

Sometimes the hardest thing about having a disability is accepting it will have an impact on your life. I also get anxiety related to mine as well, when I think I am letting people down.

When you go into labour, you get whichever midwife is available but you can make a card up to show them to explain they need to speak clearly. You may have a succession of people coming to talk to you, even in the simplest of births (oh the glamour) so this will save explaining it several times over.
Without wishing to minimise, there may come a point in your labour where you are quite happily away with the fairies, you'll stop listening to anyone and your body takes over.

I think because it's only rarely a problem (most people's accents aren't THAT strong) I've never quite got to the point of accepting it as a disability and telling people about it - so I still think I SHOULD be able to understand and get really angry and frustrated with myself when it affects something important (e.g. makes me look stupid in a work meeting).

Looking on the bright side, I probably won't be able to hear them anyway, over the sound of my own screaming!!

Please ask for someone with an accent you can understand. I did this when we got married and it wasn't a problem at all. It's not offensive- you have needs and they need to be catered to. Just one less thing to worry about.

Definitely explain that you have a hearing issue but if you do end up with a midwife you can't understand ask if they can write down important things they are saying to ensure you understand.

It's frustrating because I'm the same! Huge history of hearing problems in my family and I'm just like you! My work actually involves speaking to rgn's on the phone and sometimes I struggle to understand them. They may be able to put a note on your records and tell them again when you go in that you struggle to understand string accents, they won't be offended, in fact they usually find it quite funny! And at least if you get a midwife you don't understand they've been warned!

I'm Polish and I always tell my clients that I'd rather repeat myself as milion times than have them leave my office feeling confused because of my funny accent :) tell them you struggle I'm sure they'll understand :)

I've had a version of this issue too; similar circumstances. A couple of things:

• I found that the proportion of non-British midwives was much lower in the labour ward than in the antenatal community midwife pool for both my births, so it hasn't actually been an issue during either of my births.
• no one wants to admit that they are a bit deaf, but believe me life becomes much simpler once you get over that obstacle. I've since done something about my hearing and got hearing aids (I'm 37, but my hearing is dreadful). They make the world of difference. I don't need to wear them every day and can cope without, but they mean I can function in loud situations with lots of background noise. I wish I'd done it years ago.

Anyway, that's a different thread altogether probably, but getting it put in your notes/birth plan that you struggle to hear sometimes will just allow people to adjust themselves for you.

I would stick a sign on the front of your notes so that everyone who sees you is aware straight away. Most people probably aren't going to read through the relevant sections before they meet you (because there's not enough appointment time allocated to do this).

If it's King's then in my experience you will see a lot of midwives in antenatal appointments at Midwives House and a few different Clinical Fellows in your scans all of whom may well have strong accents but most of the midwives on the labour ward were British as far as I remember.

Just thought whilst reading this OP I'm not sure if you have already seen it but there's a MN post asking for opinions on behalf of the council of Midwifery and Nursing about a proposed drop in the level of English requirement for EU applicants... might be worth adding your current experience to that thread?

Thanks again for these responses - I appreciate the support here!

I think a prominent sign on the front of my notes is a very good idea - I'll do that.

@mummabubs - Thanks for steering me in the direction of that. I've posted my experience there, as it does seem relevant.

@Quodlibet - Yes, it's very frustrating! Unfortunately, hearing aids wouldn't help my particular issue, as it's a neurological problem (with the way my brain processes sound) rather than a problem with my ears. I've been given the rather vague diagnosis "auditory processing difficulty" and told that there's not much they can do...

Elle a bit of a radical suggestion... but something you could try is contacting the university that supplies your hospital with student midwives and seeing if one of the students would like to caseload you. You could pick one that you get on with and, crucially, understand... and another benefit for you would be having someone you already know with you when you're in labour.

@CurlyBlueberry - Thanks for the suggestion. Would that mean that I would have a student midwife in addition to a more experienced one - or just the student?

Elle you'd have both, a student wouldn't be left alone with you entirely. I mean, she might be alone with you, but at times when if she wasn't there you wouldn't have a midwife at all, if that makes sense! She might be asked to do basic observations on you, place monitors etc but she will be working under her mentor's close guidance.

I definitely think you need to say something. My midwife for my first pregnancy did not speak very good English (not just a strong accent) and I found it very stressful. I kept having to explain things in several different ways because she didn't understand the problems I was discussing with her. It didn't make me feel very confident that I was getting the best advice.