Continuity of care?

[TinyTerror1]

Does anyone else feel like they are being passed from pillar to post a bit? (sorry this is a bit rambly)
At 6 weeks I saw my GP and she gave me details for my midwife, who was off sick that week. I spoke to her at 7 weeks and saw her at home at 9 weeks when she put me down as CLC (consultant led care) because of my age (40 year old FTM).
I had the booking appointment with initial blood tests at the local children's centre at 10+5 with a different midwife, then my scan at 12+3 at the same centre with another different midwife (I'd been told I'd see my midwife then so I'm assuming she was off sick again).
I booked into my local GPs surgery to see my midwife at 16+3 (last Thursday) - although the receptionist said my midwife hadn't been around much lately - and it was yet another different midwife when I turned up. I asked if my midwife was off sick and they just said yes, with no suggestion of whether it was long-term although I'm beginning to think it is.
In between all this I had a scare at the 12-week scan and saw a consultant at the hospital for a detailed scan and CVS. I spoke to the hospital midwife and said I was under CLC and she said 'oh, who is your consultant?' and I didn't know. When I saw the midwife at 16 weeks they didn't know either and said I'd probably find out at my 20-week scan, which is back at the hospital. They also had no idea what had been happening in my pregnancy and I had to tell them.
I then have an appointment at 24 weeks with the midwife at my GP surgery, and an appointment at 28 weeks at a different children's centre, and I don't even know what that is for!
I'm beginning to feel a bit out on a limb as I haven't even seen the same person twice. Is that normal?

The other problem is that I've got my midwife's mobile number to call any time with (non-urgent) questions but if she's off sick then who do I call? The main team is available 9-10 every morning and that's it. Or am I being daft and if it's non-urgent then I can just wait and call the next morning?

I don’t know how normal it is but it was the same in both my pregnancies. I never saw the same person more than once. Have to say it didn’t bother me, everyone was perfectly nice and professional. I had straightforward pregnancies though so can see it could be unnerving if you’re having issues.

It’s normal. And NHS is under tremendous pressure due to Tory cuts - they’re doing the best they can.

Midwives give you their number more for emergencies, of course they have a lot of patients so responding over small things probably won’t happen as they simply don’t have time to do it. If you’re concerned then book a midwife appointment or see your gp, there’s also a list of numbers in your notes. Emergency hours is usually triage, and again if it’s an actual emergency then you just go in

I apparently had a midwife assigned to me, but the first and only time I met her was when she came out after the birth to do my discharge appointment. I mostly saw different midwives every time, although did by chance see a few more than once, but it didn't bother me. I didn't expect any of them to know anything about me or my pregnancy without looking at my notes, and as far as I'm aware the notes that you carry around are the only ones (but perhaps it's different if your consultant-led, I have no experience of that). But yes, basically it sounds normal from my experience, although I'm sorry that you're not feeling properly looked after.

Is that number definitely just for your midwife and not a general duty midwife number? Perhaps it's best to ask at your next appointment. Presumably anything urgent you could call the maternity ward, and anything that isn't urgent could just wait until the next morning.

Thanks. Sorry, yes I do know the NHS is under immense pressure and I do appreciate everything they do.

That said, the midwife I saw last Thursday was professional but not helpful and when I asked a question (about flaky nipples) she looked at me like I'd grown two heads so didn't really help the way I'm feeling. I was told the appointment was to get the results of my tests so I'd have thought she'd have known I was referred to fetal medicine and had been seen at the hospital, even if she didn't know the upshot of that.

A lot of people on here talk about 'my midwife' as though they see the same person a lot so I was wondering if I was unusual in that respect. Sort of reassuring to know it's 'normal'.

The mobile number is definitely for my midwife, it goes to a voicemail with her voice on it. I don't have a duty midwife number, just the number for the whole team which is only available 9-10am. And it's definitely not for emergencies FranticallyPeaceful - everything I have says to call triage for an emergency.

I would have thought it would use less resources for her to answer a question over the phone than for me to book with the midwife or GP and I assumed that's why I have it. So far I haven't needed to call but there's another 20-odd weeks to go so I was thinking ahead. Anyway, if it's all fine and normal then I will just shut up and put up.

It's so hit and miss. Where I work most midwives work part time, so that doesn't really help to try to provide continuity. As your pregnancy progresses you will see the midwife a bit more regularly - so hopefully you will get to see the same person.

I've always seen the same midwife so I can see how it could be disconcerting to feel like you always see different people. In your case it does sound like it's a staffing issue and shouldn't affect the standard of care.
I've been under consultant care this pregnancy and have always seen a different doctor at every appointment. This hasn't really been a big deal but I can see if you were anxious it could be unsettling.

As far as numbers go - if it's non urgent I'd just leave a message and they'll usually phone you back. If it's something urgent then call triage and they'll advise. Or you can book a GP appointment as standard.

I think it varies loads in different areas depending on their staffing capabilities, plus tbh if your midwife is on-and-off sick leave over a long period of time (e.g. signed off for a few weeks, but then comes back for a few weeks, but then signed off again etc), it's really unfortunate for you but it can't really be helped, can it?

I've seen a few different midwives and I saw loads of different GPs during the first half of my pregnancy as I had hyperemesis. I didn't really mind though, the vast majority of the healthcare professionals I've seen during my pregnancy so far have been really great. I do have a named midwife, I saw her at my booking appointment and then not until my 24 week appointment. But since then I've had all my midwife appointments with her. I don't think it makes much difference tbh though - like you I have her mobile number but she never, ever answers and if you leave a message she never gets back to you. I'm sure she's just too busy. She also clearly doesn't really remember anything about me each time I go to an appointment as she has to check my EDD, recalculate how far along I am, and quickly skim read the last set of notes each time. But how can I expect her to remember the ins and outs of my position when I bet she has soooo many other women to care for? I wouldn't be able to remember all that info about all those people. So even if you see the same person each time I doubt they remember much about you if anything anyway so I don't think it makes any difference whether you see the same person or different people tbh.

I'm 33 weeks I should have said btw.

Thanks Meadowhay. I do get the point. I guess I'm a fairly private person so for me seeing the same person would make it easier to talk about things that are bothering me each time rather than having to blurt out questions that feel a bit stupid or awkward to a stranger each time. I wish they could just be up front and explain that my midwife is off sick but I expect that is against data protection and I do understand that too.

Like I say I just feel a bit out on a limb. I'm self-employed and work from home and I don't have many close friends with children so it's hard to know who to turn to!

I'm under consultant led care as well. I've seen the same consultant but I'm made to book appointments well in advance so that happens. However the appointments don't always correspond with exactly the weeks on the booking schedule. I've seen different midwives each time plus accompanying students but I'm glad as the first one was rude. With GPs I've been told to try and book appointments with the same one, and as the surgery rota is online that's what I do anyway.

In regards to working at home - as I sometimes do I've been told by a midwife I've seen to book antenatal classes or go to pregnancy yoga to meet other mums. As I have various family members and a close friend who work in child health that work part-time plus a friend who is due 3 weeks before me, I'm not too bothered. However as I know dads get together as well if you meet people you get on with at antenatal classes, I've booked them particularly as my OH is taking parental leave on his own.

Btw One problem with sick workers is that they may not know how long they will be sick for. So when my one of my GPs have gone off long term sick or one of my sister-in-laws' has been on long term sick they can say that they are sick to patients, but otherwise they can't.

In my last pregnancy I saw a different midwife every time, and I had a LOT of appointments. The only person I 'knew' and saw more than once was my GP. My labour was overnight and the midwife looking after me went off shift halfway through, so I had two different ones then as well! When DD was born we saw a different midwife at every appointment in the first few weeks, but generally saw the same couple of HVs after that. That was in 2014.

This time (29 weeks) I've seen one midwife twice, and every other appointment has been with someone else. I'm seeing the consultant today for the second time, and I'm interested to see if it's the same one! I'm under my local hospital/GP for my MW appointments, and a totally different hospital for the consultant ones (my local hosp doesn't have a labour ward, which is annoying but understandable), so I don't know if I'll have met the staff who'll be there during labour.

It doesn't really bother me, although I can definitely see why it would be nice to see the same MW/GP/consultant/etc at every appointment.

Where I am I had a community midwife team based at my GP, so all my routine appointments were with one of them - I didn't know which one until I got there! Allegedly they were a team of 3, but I saw 5 different ones over the course of my pregnancy. They were all very lovely and professional, so no complaints, though I do think it might have been nice to feel I had one in particular to build a bit more of a relationship with. The phone number I had was just for the team - any out of hours issues there was an emergency number or I was advised to call delivery/assessment at the hospital.
My scans were done at the hospital, so a different set of staff altogether. Then the hospital midwives for the birth.

My pregnancy was low risk though, I didn't have consultant appointments or anything like that. At the very least it sounds as though communication is seriously lacking for you. Plus if you've been told you've got one midwifes number then I would assume she was your midwife.

Only time I saw the same midwife was after baby was born and the only reason she came every time is cos I asked her to as I had severe PND and she was amazing.

I guess I am in a similar position to you in that I am self-employed, work from home and in my case I actually moved to this area to be with my fiance/partner and so I don't know anyone/have friends here or family. It will be different once the baby is born as then you can go to baby groups and things where you can meet other mums in the same position as you.

Anyway, when I first started seeing the midwife, I saw the same one 2 times in a row. She indicated to me that she would be my regular midwife. I never got given a telephone number for her, just the community midwife one with the one-hour window for calling.

Fast forward and so far I have seen about 7 different midwives during my care, plus two consultants. I never saw the original lady after 12 weeks. Finally, at 32 weeks, I see a midwife who says she will be seeing me from now on at the GP surgery and then just the different ones at the hospital. I do get where you are coming from. It can feel a little bit as if you are having to manage your own care and so on, which I don't mind but can be disconcerting.

Overall, I have found that the midwives I have seen have been fine/professional, but the fact I have been seeing a new one every appointment has meant that I have had to repeat my history and what is going on at that point each time.

The issue I have found with that is that as a patient it is quite hard to know what you need to flag up or should be telling them. For example, I had a growth scan that was not checked by anyone. The sonographer had told me it was fine so I could have just taken her at her word. It was only because I had noticed a change on it and gave it to the midwife to check that it was looked at, flagged up for the consultant to look at and action taken to check what is going on with baby.

The impression I have got is that the midwives find it quite challenging to keep going over a new patients file in a small window and pick up all the different things that need doing or may have been missed. For example, blood test results or checking you have been told about/had a vaccination etc. The last one was kind of going over all the different things trying to ensure that they had all been done/covered/checked etc. I also had the same experience as someone else said in that because the maternity services for my area are so busy at the moment I can't even get my midwife appointments to be for the week I am supposed to be having it.

Thanks @Gottabestrong that makes sense and is sort of how I'm feeling. I'll bear in mind that I need to keep track of things that might need flagging up. I'm hoping things will get clearer after my 20 week scan. I was feeling especially disheartened after the last midwife appointment as she was so unhelpful. Hormones aren't helping! Good luck with your last few weeks of pregnancy! X