Offended by my midwife

[TurquoiseWeekend]

I'm 17 weeks pregnant with my first baby and at my last midwife appointment, she asked if she could refer me to the "Early Start Programme" due to me having had anxiety in the past. This was a bad year I had around 4 years ago. It lasted around a year and I dealt with it well and have been fine ever since.

I said yes as she didn't really explain any more about it, thinking any extra support must be a good thing, and went on my way.

I googled the service a few days later and was horrified that my midwife had lumped me in with the other types of people the service helps. The website describes the service as an early intervention programme for vulnerable first time parents, who's difficulties include severe mental health problems, substance misuse problems, learning difficulties, homelessness and teenage pregnancy.

DP thinks I'm being a snob for being offended by this, but I was so upset. This baby was planned, I'm 28, he's 30. We so wanted this baby. We have a lovely home together, really good family and friends around us and we just generally live a boring, normal, happy life!

The woman I've been referred to has left lots of messages on my voicemail asking me to call her back. I can't pick up as she rings me during work hours and I can only use my phone at lunch. I haven't rang her back yet as I'm just so embarrassed that my midwife sees me as someone that I'm really not.

Should I say something at my next midwife appointment? Is my DP right? Am I being a snob?

You're being a bit daft.

It's a strange reaction.

Yanbu... the health visitor suggested something similar to me when I had dc1. I was alone with no family support with Judy dh but I had plenty of friends etc which she wasn't interested in. I'm a teacher and in my 30s and I found the implication terribly insulting. I solved the problem by never having the health visitor back again.

Having a baby is a huge emotional upheaval. She's looking out for you. As Gin says, you're being daft.

I think you’re being very honest about your reaction and I think a lot of people would secretly feel the same and not say it out loud. So I wouldn’t worry about that! I do think you’re prob overreacting- your midwife is just doing her best to make sure you are well supported (and to make sure she is following all the local guidelines for care). It may be that this programme in your area offers help with anxiety. If you don’t need the support just thank them and explain you’re doing fine. No one is out to trick you. Is there a VM function if you call back the number that keeps trying you?

I wouldn't see this as a negative and tbh, it doesn't matter what your social status is, age, first time parent etc. Every pregnancy is different and hormones can run wild, it's good she's picked up on any indicators that you may need support.

Early preventative support is very beneficial and better than waiting until a crisis occurs. I'd take this as a positive and see what you can gain from it. You never know it might give you some tools if you need them in the future. Good luck with your pregnancy 🤰

Hmmm. I don't think you are being a snob, no. It doesn't sound entirely appropriate based on your mental health history. I would probably discuss it with your midwife and explain, now you've had time to look into the service, you don't think the referral was appropriate.

For comparison (if it helps) my mental health history is a LOT more chequered than yours (bipolar disorder, self harm, lots of medication, overdoses, hospitalisation*)... and all I've had to do is provide a bit of additional information for the psychiatrist who reviews the maternity files. Last pregnancy it didn't even get flagged that far, just a brief chat with my midwife. I do think the HV team kept an extra close eye on me after baby was born, but it wasn't made into a big deal.

*not comparing to belittle your experience in any way, just I would say on paper I'd be much more of a risk IYSWIM.

As somebody who in the past has suffered with anxiety badly just like yourself I think I would be a bit “unnerved” by this. Not ashamed but I do understand where you are coming from, especially if you do not see yourself as suffering as bad now. We all know anxiety is not something that goes away and will never return and I’m sure you may have anxious days now still. However I am in agreeance with you that you wouldn’t put yourself in the same catorgry as the women this programme helps at this time. Maybe at your next appointment or even call the lady back and say you appreciate the advice and help but you are in a really good place and have been for some time now and don’t feel you need the programme at this time. Explain to your midwife you’ve researched it and you don’t feel you need it but you know the resources are there should you feel you need some help or advice on the future. X

YANBU. Just ring the woman back and say you don’t want to be referred as you have no need of the service.

I agree with more, it’s great that you’ve being honest about how you feel.

Help is help though, so I wouldn’t turn it down. Instead, tell the women you’ve been referred to that you feel a bit weird about it. Be as honest with her as you are with us.

Yes you're being a snob. You don't want to be thought of as "one of those" people because you're so much better.

But you have suffered from anxiety in the past, hormones, baby, sleep deprivation etc can all bring that back. You're statistically more likely to suffer PND and they're trying to make sure you get support if needed.

Call the lady and tell her you don't think you need the support she offers, you have lots of support in place but thank you very much.

I suffered depression at 22, pregnant at 32 and I got offered similar. I saw her once, confirmed I was good thanks and that was it.

You're pretty ignorant. People can be vulnerable to mental health issues for many reasons, this service caters for all and supports you as an individual. You're not being lumped in with anyone, and you're no better than someone with a learning disability or substance misuse issues, you're simply different.

The only thing to be embarrassed about is your attitude.

First time Mum who has had issues with anxiety in the last 5 yrs. I’d be insulted if she didn’t refer you. That program is not just for people who you see as lower than you on the scale of winning at life (don’t know how to say that more gently). But I also think you are underestimating how dangerous anxiety and new babies can be and how close to the edge that pushes many people who have all manner of good support and background behind them. I know of more than one mum who have exactly your home and family life but who either attempted suicide or seriously considered it in the first 3 months of their precious and much wanted babies arrival. Personally I think drug use pales in comparison to let level of danger and impact that suicide would have.

So don’t judge so quickly and be open to well meaning support. Hopefully, hopefully you won’t really need it.

I was 39 when I was pregnant with first.
Settled happily with DO.
Homeowner.
Good job.
Very 'respectable' and probably seen as middle class yummy mummy.
I'd had anxiety in the past.
I was referred to a similar service. Thank God.
It helped me process my emotions (admittedly screwed up because I hadn't really known my own mum). Therapist helped me manage my emotions, and helped me identify and deal with Post Natal Depression.
Please don't be alarmed or insulted. Be grateful that this service is available to you when there are so many funding cuts.

Give it a try, it may not be suitable for you, or it might help You through what can sometimes be an emotionally turbulent time.
Congratulations on your pregnancy

I wouldn’t be offended, I’d be proactive and have yourself removed from the programme. Just say you’ve looked into it, don’t meet the criteria and don’t want to use their valuable resources.

Thanks everyone for your replies. You've all given me a lot to think about.

I didn't mean to come across as thinking I was better than anyone and admittedly, yes I am ignorant to the things that the women on that list of things face, because other than the anxiety, they are things I've thankfully never had to deal with. That doesn't mean I look down on people that have, just that I didn't feel I was at that place in my life.

Sorry if I did offend. I didn't mean to come across at all that way.

There is no implication.

Everyone who might need support gets for their own individual circumstances, and support is there for a very wide range of need.

They are being conscientious about making sure you do get support IF you need it given that you have suffered from anxiety and pregnancy is a time when you (anyone) can be vulnerable to a recurrence of any MH pressure.

It’s never a bad thing to take a relook at how we view other people. It’s how we learn to be a bit kinder and more understanding. I know you think you’ve nothing against the vulnerable people you mentioned but your terminology and outrage tells a slightly different story.

Good luck OP and exciting times ahead with your new baby! I hope your anxiety stays well away, it’s an awful thing to struggle with but many many mums do, not least thanks to the massive dump of hormones, so don’t be afraid to ask for help.

I think that your midwife has a duty of care. I remember the Mum who took her child from the labour ward and killed herself near Clifton suspension bridge. I remember thinking at the time that new mums can be overwhelmed by birth and stereotypes are all wrong. In your shoes I'd be grateful that your midwife was following procedure. Phone the person concerned and as someone above said, if you do not need help you will quickly be signed off and they can use their resources on a mum who does need it.

I think you are reading too much into it! If you don’t think it will benefit you then just phone them and politely turn it down.

I think it’s actually a really good thing that you are being offered access to mental health support antenatally. That’s something that can potentially save lives yet is not available in a lot of areas.

I would be praising your midwife for being proactive and paying attention to your past history - there are plenty of other threads on here where people are complaining that their midwife is unhelpful, doesn’t seem to care and is “fobbing them off”.

From my experience I would be very glad that the midwives are being proactive in letting you know about such services being available. I have a diagnosis of bipolar disorder and very similar history to one of the PPs, and unfortunately pregnancy tends to bring about a depressive episode for me (all planned and very much wanted, at a good place in life and career) it’s just my chemistry. With my first pregnancy I went to my midwife as soon as I recognised my early warning signs but didn’t tell me about any services that may have been able to help so I went to my GP and it took almost 3 months to get the help I needed and restarted on my meds, I was in a very dark place by that point and would have been so grateful for any signposting or referral to specialist services. We have since moved to a different area and both further pregnancies I have been referred to the perinatal mental health team at my booking appointment just as a precaution and it has made such a difference just knowing that I have that safety net.

Your midwife was just doing her job well and you can always decline if it’s not for you 🙂

Of course it’s fine just to ring up and say thanks but I don’t need the service, I’m not sure why the midwife referred me etc. The. Tell your midwife at your next appt that you appreciate the thought, but you don’t need the service as the anxiety is in the past and was dealt with. Stay calm and polite - just say no thanks

I was referred to the same programme for similar reasons to you, and with a similar background, but refused it as I was concerned I might meet clients from work there (I work in social services).

I discussed it with the midwife and decided NCT classes would be a better fit for me, and an early referral to the HV to get a clearer picture of post natal support.

I understand your response, although it did sound a little clumsy! :) - As someone who works in (roughly speaking) this kind of field, based on what you're saying and my knowledge of these types of services it sounds as though it wouldn't be right for you, however, rather than being offended or doing as some others have done and stopping seeing the midwife/health visitor, why not just have a chat with her about the way you feel about it and try and understand what her rationale was for suggesting this to you. It could be that's she heard this service is for Mum's with a history of mental health and jut has a habit of over-referring or there could be a specific reason in terms of your history or something the course provides that could suit you. xxx

I don't think that you're being a snob, I totally understand where you are coming from and I think that some hcps are very quick to try to get you on these schemes without actually thinking whether it's entirely appropriate for their patients.

I had a similar issue with a hv in my last pregnancy. I had a history of mild depression and very historic abuse and she made a lot of assumptions about my husband and I too.
She wanted to sign me up to a similar program and didn't explain it, it was only on researching it myself that I discovered it involved parenting classes on basics like changing a nappy, what tantrums were, what weaning was and how to start weaning and various other very basic child care things, I had been a professional nanny for years which she knew and I often advised parents on this kind of thing! It also involved weekly and then fortnightly visits for the first 3 then 6 months and then more visits until the child was at least 1 and basically very heavy involvement from the hv team for the first 12-24 months. She also made it clear that she expected me to use two counselling services she'd found regarding the abuse which were both completely inappropriate for my circumstances and too far to travel whilst leaving a newborn at home, as when asked if I was interested in counselling for it I said if there was anything suitable I'd be happy to consider it.
After finding out more about the programme and the counselling I spoke to her again and said that I didn't think it was right for me and she basically made it very clear that I didn't have a choice in the matter and she would consider it a safeguarding concern if I refused to participate in the programme or attend the highly specialised and not appropriate counselling sessions. Thankfully her boss and the hv I saw afterwards felt differently but for a few weeks I was in a state about it thinking I was going to be seen as a bad parent for refusing to jump through the hoops.