Can you opt out of seeing the community midwife?

[Everstrong]

I had my booking appointment this week and had a really poor experience.

Firstly the midwife was an hour late, not because of any emergency, she got both the start time and location of the clinic wrong!

When she eventually arrived, she rushed us through as quickly as possible as she had other patients at that point. Didn’t dip my urine (even though I had symptoms of a urine infection and ended up having to see a GP later that day who dipped it and started antibiotics) and was generally very slap dash.

I had similar experience in my last pregnancy, appointments always 45mins to an hour late (even when you are the first appointment) and last time got told off by the consultant for having 4 growth scans (midwife thought I was measuring small so kept sending me, consultant said it was a waste of time and she needed to learn how to measure).

My pregnancy is deemed high risk so I’m under consultant led care and have been told a home birth is a no as a paediatrician needs to be on hand when I deliver so can I opt out of community midwife services?

Sadly not, as they will do your urine, bp, iron checks, measurements etc. I was consultant led but they did not do any of the things that the mw did. Having a similarly bad experience of the community mws now I’m home post birth...

I believe you can opt out of the community MW team, but there could be a safeguarding issue flagged up if you opt out of all care, especially give that you’re high risk.

I personally wouldn’t opt out of MW care, and would put up with the lateness of the appointments.

It depends on how high risk you are - consultant led sometimes means just one appointment with them, or it can mean all your appointments are at the consultant clinic so you'd see the hospital midwives. Second baby usually has less appointments than first, and you can see the GP for some rather than the community midwife if you prefer.

You can request a different midwife. They may ask you to attend a different clinic. I would speak to your surgery about your options

Yes you can opt out. I spoke to my GP about our community midwife and by his reaction I clearly wasn’t the only one who had requested not to see her. He did all my appointments after that

Without wanting to give too much away and out myself, I am a hospital based HCP so can easily do my own BP, urine dips and get bloods done without having to see a mw.

I can’t afford to take annual leave every time I have a midwife appointment and it’s a big inconvenience for my patients as the fact the mw always seems to run late means I end up with a 3 hour clinic being cancelled. My bosses aren’t particularly keen either.

Said MW asked DH to listen to my heard and lungs rather than booking in to see the GP. DH is a medic and said he’d certainly do it but if something was unusual I’d then have to see a GP anyway to get a referral.

You should not be using annual leave for midwife appointments. The hospital will be well aware that you are entitled to reasonable paid time off for appointments.

Only issue of getting someone to take bloods is who actions them if issue arises as result would normally go to your midwife (or would here in scotland!).
And please dont use annual leave for appts. You are entitled to time for these.

Don't use annual leave - you are entitled to this time off.
I had a lovely community MW but it was a bit of a waste of time as I was consultant led with a lot of appointments, scans, clinic time and the hospital more than duplicated what the community MW did
I was further complicated by the fact that my Hospital was in another trust from where I live so they both kept entirely separate notes - both of which I had to carry around (mind you I probably would have been ok with just the hospital ones)
However with my first pregnancy also consultant led I didn't have as much hospital time at the beginning so still needed community appointments although where I lived this was with my GP.
Consultant led can mean very different things - my friend only saw them for 1 additional chat and that was it. I was in every week from 18wks (my pregnancy felt like forever). So it may depend on what it means for you perhaps chat over your concerns with your GP

Can the antenatal clinic in your hospital see you?

I was high risk and consultant led so the midwife and I had a chat and decided there was no point me seeing them as well. She was very pragmatic when I raised it and agreed that all the appointments were a bit overkill. All my BP readings etc were done by the midwife at the hospital ahead of each consultant appt so I didn't miss out on any care. In fact they were the ones that spotted it when I did develop borderline pre eclampsia. I'd have a chat and see what can be agreed

I would ask if you could have your midwife appointments at the hospital ANC rather than in the community because you are working at the hospital and it is easier than trying to get time off for community appointments (although they tend to run just as late as community clinics).

I don’t think it would be a good idea to just not have any midwifery care at all.

What about turning up for your appointment when you think she'll be ready for you? Half an hour or so. If she dares to complain, tell her you expected her to be late again.

I wouldn't be terribly amused if I sat there waiting for 45 minutes without much of a reason. No matter if my employer had to give me time off or not. It's not fair on your employer either TBF.
As it is, my hubby and I work for ourselves, so we can't have people running late because they feel like it. Ob sometimes runs late, but that's because he delivers babies at the MLU across the road and sometimes has to run off in the middle of his appointments.

To be fair, if you are concerned about her not being thorough enough, then I'd voice those concerns (and make a complaint if necessary).

I asked to have all my appointments at the hospital antenatal clinic, rather than the community midwife. Ask if that is an option.

Do not use your annual leave for antenatal appts. You are entitled to paid time off work to attend. Save your annual leave for some rest time towards the end of your pregnancy, or if it will be your first child go on holiday whilst you can!

Do get somebody objective to see you during pregnancy though. Your community midwife sounds disappointing, but I think it's important to try not to treat yourself as a HCP. Hopefully the hospital ANC can see you instead.

I was consultant led on my second and third, with my third was having cervical length scans every 2 weeks and growth scans but the community midwife still wanted to see me, it was only 4 or so appointments with them I think I'd just do it, its extra check ups at the end of the day and they need to do your bloods later on.

Totally agree with pp that you need someone objective to see you, even if you're a midwife or obstetrician. There really isn't that many appointments before 34 weeks. And your work must know that you're entitled to time off for AN appointments, using annual leave is not right.

Work will give me time off for appointments but I feel like I’m taking the piss when I say the appointment is at x time and then end up coming back hours later because they’ve run late. And if I end up getting back really late I’ll have a waiting room of pissed off patients and that’s pretty stressful! For that reason I’ve booked annual leave so it doesn’t feel like I’m taking the piss.

I was consultant led for my last pregnancy in the true sense of it- appointments with the obs every 4 weeks. Extra scans etc. I can’t honestly remember if I also had all of the community midwife appointments to (it was 8 years ago!)

I’m going to ask if the ANC at the hospital can see me, that way I can always phone down and see how behind they are and then pitch up at the right time.

Definitely won’t be treating myself as obs/gyn isn’t my specialism (nor DHs). I was a bit when she said just to get DH to check my heart and lungs. Things are pretty strict about treating people you know as your judgment will always be clouded.

I'd just try to change midwife or book very first appointment of the day so they can't be too late. Tbh ANCs often over run, plus 2nd time you don't actually do to a midwife that much, so it's prob not worth stressing over that much