Midwife gone AWOL...

[CJ47]

Sorry this is a long post please bear with me:
I had my blood tests done 8 weeks ago at my bookings appointment and heard nothing back, so assumed everything was normal. I am on midwife led care. Then last Thursday I received a text saying I had a random appointment at the hospital scheduled for next week, so I rang the hospital to ask what it was for and all they could say was I was referred to see a consultant by my midwife. Now concerned something must be up with my bloods I tried calling and texting the midwife with no response back. I tried the doctors surgery and they said they only had her mobile number too and there’s nothing in my notes. I was due my 16week appointment with the midwife today so I tried to assure myself all weekend I’d find out soon but they’ve just called to say it’s now been cancelled to next week. I do find this unacceptable to leave a pregnant woman stressing over what could be wrong with her and why she needs to see a specialist for this amount of time!! I’ve rung the hospital and doctors surgery multiple times and asked to speak to anyone else who could tell me and they’ve all said I have to speak to the midwife...who’s gone AWOL! I thought their job involved relieving stress not causing it. Not sure what else to do??

Honestly if it is nothing obvious it is really unlikely to be because of a problem. It is more than likely to be an automatic referral because of something that came up at booking (previous birth, family history, BMI, something previous in medical history). If it IS that, she should have told you that she was going to refer you. If it was blood test results then she should have let you know what the reason was for the referral.

She probably hasn't gone 'awol', she might be on leave, she might be doing other clinics or on days off. It is crap that there is no obvious fallback when someone is off, to pick things up like this so women don't end up worrying unnecessarily x

If you have a maternity assessment unit or helpline, possibly they could look up your blood results for you to see if they can shed any light? If your results come back as normal then it will likely be a routine referral (which will be done due to guidelines, not necessarily because you DEFINITELY need consultant input - ie 'your BMI is 19 or below so we refer you and see if you're alright and if you are we send you back to midwives') and at least it will put your mind at rest that it is an immediate physical problem.

It won't be anything to do with your bloods. It's a routine referral because you had some factor or other in your booking that indicated the possibility of consultant-led care. Your midwife is busy and this isn't a urgent query.

Thank you for your replies but please do not just make assumptions what it is and is not. I actual requested testing for factor V Leiden and assumed as I heard nothing back(in 8 weeks) the results were fine. The fact that I have now been referred make me concerned that I do have it and if I happen to homozygous I should have been on heparin daily throughout pregnancy as I am a very high risk of miscarriage. So apologies if to me that seems urgent but I would like somebody/anybody to clarify the situation as I have now been stressing about it since Thursday and no one will give me a straight answer!!

If there had been anything at all requiring urgent action on your bloods they would have called you and told you what it is, not booked in a non-immediate appointment. As you have heard nothing, your blood results almost certainly ARE fine and the midwife will review them with you at your 16 week appointment. If you want specifically to know about your blood results, call your GP surgery and ask for them. They will probably have been sent a copy.

16 weeks is the standard time for an initial consultant booking appointment if you might need consultant led care. It's basically the same history taking as with the midwife. Your midwife probably made the referral straight after your booking appointment because of your concern about Factor V Leiden or perhaps another factor like BMI, history of recurrent miscarriage.

I sympathise. I have health anxiety and waiting for blood results is hell for me and receiving unclear letters is not helpful during an already stressful time! I was shaking when I went in for my 16 week appointment and the midwife told me that if anything had been wrong with blood results, they always call. From previous posts I know that a lot of women have received ambiguous letters from the hospital because of things that were mentioned at the booking appointment such as BMI or family history of something. I hope you get some clarification soon.

Could you ring the GP surgery who your community midwife is attached to and raise the issue with them? It might help push her in to contact.

Thank you for your comments. I have rung the GP surgery a few times now, who have told me I need to speak to the midwife to get my results. I asked if they could contact her and they said they only have her mobile so I should just keep trying that, which I have. I also asked if I could get my results from another nurse or doctor and they said no. My 16wk appointment was meant to be today which was cancelled by the doctors surgery. So I am just left second guessing what it is(stressing!)

Easier said then done but do not worry. If it was something urgent that could put you or your baby in immediate danger they would call you and tell you to come in, not book you a consultant app a week or so ahead. Do you have a high BMI or any other pregnancy related issues that may warrant referral to see the consultant?

I have a normal BMI of 19.8, generally fit and healthy no known conditions. I am 32, first pregnancy and 12wk scan came back all ok. This is why I was put on midwife led care. I asked to be tested for Factor V Leiden as my dad has it, so if my results were negative they wouldn’t have referred me on. So I can only assume the results have confirmed I have it. I just think it is quite unfair for the midwife not to relay this information on to me(as the test was done 8wks ago)before referring me to see a consultant. Plus I would like to me told if I am homozygous or heterozygous as that determines how serious the situation is. Or if it is something else like they’ve decided I’m diabetic or anemic or coeliac or anything else they were looking at from my blood test I would like to be told!

I’m confused, did you have genetic testing for Factor V Leiden done? If so that can take several weeks or more so they may have only just got the result back.

Why were they screening you for coeliac disease and diabetes if you are low risk?

I specifically asked to be tested for Factor v Leiden as my dad has it and they took an extra vial of blood for this. It should not take long for results to come back, genetic testing is done via the blood sample (it’s been 8wks now). The other things are just general things they can test you for as I gave blood and urine samples and I’m just wildly guessing now what it could be if it’s not factor V Leiden!

I’m just asking because usually they start with a general thrombophilia screen which is a test of clotting and other proteins/antibodies in the blood. If that’s abnormal then the next step would be genetic testing which usually has to he requested by a specialist. I was wondering whether the consultant referral was to arrange the genetic test.

It should tell you in your antenatal notes what else they are testing you for but it would be unusual to screen you for coeliac and diabetes testing is usually done later in pregnancy just for women at risk.

Sorry OP, I wasn't making any particular assumptions, just giving examples of why you might have been referred.

If it's bloods they do tend to call you. If it is something that means you need immediate treatment they do call you (in my experience). Even if that's 'you need to be on iron'.

Your GPs are being a bit rubbish because of COURSE you can get your results from someone else! If your midwife went off sick or retired or something the results would still be on the system. If you don't have the results by your consultant appointment they will be able to access them. I can totally see how this would be making you that anxious; you could always call PALS at the hospital, or as I say if you call the unit and speak to their day unit or even ask for the email of the head of midwifery or the head of community services as they will be able to action things and even just look up the results and put your mind at rest. It's a system failure and it's not fair on you.

So update for anyone interested:
I managed to speak to a different midwife today who looked into my file. The first midwife had failed to take enough blood in the vial at my 8wks appointment so my clotting was never tested. She then failed to contact me over the 8wks to be retested. They could find no notes on the system for why she would refer me to see an obs/gynae consultant. She still never called me back since Thursday! The new midwife has now referred me to see a consultant haematologist, sent me for new bloods today and labelled me high risk until I get my results. All in all the first midwife appears to be useless and I’m starting from scratch (annnddd breathe!!).

So glad you're now getting this sorted OP!

that's shitty treatment :( I hope it gets better op

Fucks saaake. Sorry to hear that OP. Also good that you'll see Haematology as one way or another you'll get the info about the Factor V Leiden (I have a couple of friends with this, oddly enough, it's not THAT common!).

If you feel up to it, it would be worth writing to the Head of Midwifery and PALS. I know that things are taken much more seriously when they come from the patient than when other members of staff raise it. Even if something has befallen that first midwife, there should be a system in place to flag incomplete results and chase up on them if the individual who did them can't or haven't.