Midwife concerns!

[LittleK1989]

So I'm a first time mum to be and would like some advise if my midwife really is pants or if it's just me not knowing! I won't go into every single detail but basically first meeting she turned up 45 mins late, her attitude was that I get the time off work anyway, she didn't have me in her iPad so had to do it all manually, she didn't really reassure me about things just seemed very unapproachable! She gave me a leaflet on the tests I can be offered for downs etc but that was it. She didn't leave me a list of any other emergency contacts just had her number. I phoned her a couple of times and she didn't answer or call me back, thought I had an infection so I had to google my hospitals antenatal unit and they gave me advise went to the doctors yes I did have one (nothing major, thrush). Anyway my next appointment was 16 weeks (last week) and she said it was just a catch up how did I feel - I don't feel I can share anything with her I don't feel comfortable talking about my worries, so I just said I was fine - she said did I have my urine sample? I didn't know I had to bring one (bare in mind it's my first baby - how am I supposed to know these things? Honestly?) she said there's a tube on the front desk - my receptionist never told me. So did that went back in I said I'd had an infection - she said what was it I said thrush she said oh that's normal have you never had it before? You're lucky! That was that. There was another midwife there who tested my urine I heard her say I had something in it was it because of the thrush but nothing was wrote down my normal midwife seemed to bat it off. I had my blood pressure taken, she said have I booked my antenatal classes I said I didn't know I had to she said all the info should be in my Emma's diary pack? Again, I said I hadn't had that - the other woman said did I have a bounty pack? No. Surprise surprise my midwife didn't have a pack neither did the doctors but she gave me a book from 2016 and said all the info is the same. Said I need to book my whooping cough, next appointment in June and that was it.

Can someone answer me if this is normal and is it normal treatment? I understand the NHS is struggling so I do apologise if I sound very ungrateful I just expected so much more and I feel completely in the dark. I'm 17 weeks and everywhere I turn it seems to be that I'm expected to know everything. I don't have many mum friends to ask so I rely on google and supposedly my midwife but I don't feel I can!

Some advise or words of wisdom would be appreciate. TIA xxx

I think that's why I've never rang any of mine on their mobile- you never know who's on what shift but if I ring their central office they can tell me who's in and who's doing clinics where ("oh you could pop to see X at Y if she's got a gap, I'll ring her' was offered when I had RFM and triage told me to ring the community midwives and say that's what the matron had said to do).

When I was given my notes at my booking in appointment I was told to make sure I look through them as there was important contact information. There are about 30 numbers in there! For every possible eventually in pregnancy. And loads of other info too. I’m really surprised you only have your midwife’s number. This seems like a huge discrepancy between care in areas.

My midwife seemed like a nice person but was not up to the job. She didn't speak very good English. In the end I had to take a friend who spoke the same language as her to my appointments so that we could be sure everything was understood. She missed something very major though, which resulted in premature delivery as baby was at serious risk and had been for some time. I was also very unwell, thankfully a student nurse picked up on this (despite having just seen the midwife & been ignored / misunderstood).

I thought long and hard about whether to put a complaint in, but decided in the end not to.

OP - I've just come on here to search for others' midwives experiences as I've had a very similar experience to you. First time pregnancy and have no confidence at all in the midwife care which I am finding quite scary as a newb. Like you I'm not expecting special treatment but the level of care I've received falls well below even the baseline threshold some others mention re being a simple point of contact.
I now understand that a lot of the care needs to be driven by yourself but even getting the appointments in the diary had been an ordeal. I've been given loads of conflicting advice and numbers and generally have to call around four different numbers until I finally get an answer (just on booking an appointment, let alone medical advice!). Then, once I finally am able to have an appointment, it was extremely disorganised and unprofessional and the midwife was very dismissive of me and my concerns. I was told I needed to be measured but she didn't have the equipment. At a previous appointment a midwife had referred me to see a consultant, but I'd never heard anything further. I had done my usual ringing around five different numbers to try to follow up with what happened to that referral but the best answer I could get was raise it again at your next appointment (weeks later - hello?). Then when I asked at the appointment she completely brushed it off and basically shut me down every time I tried to find out whether that referral would go ahead and even just when I tried to ask what simply happened to my referral (was it lost or deemed unnecessary? I will never know). Then, it was a battle even trying to arrange the next steps that had been actually printed in the book about what to do- I was at my 25wk appointment and according to my notes I needed to book GTT and bloods. She seemed surprised that she/I needed to do that and when I persisted about trying to get it booked in seemed really grudging, and finally gave me some advice - which consisted of her fishing around her handbag to find a piece of old scrap paper, writing the tests I needed to ask for on the back of that and telling me to give it to my GP. Contacted my GP they knew nothing about it. So called back another number and turns out the midwife should have booked it/I need to book it at the antenatal clinic.

As I say- this doesn't even seem like the minimum level of care one would expect. Also like you it seemed like I was expected to already know everything as a first timer - eg not told about the urine sample either. There is a difference between hand holding and being simply aware of the fact that someone is a first timer and has no clue what is going on and mindful of that when seeing patients.
These are only a few examples and I could go on. To be fair I saw one midwife who was very thorough and capable and seemed to appreciate and adjust her manner to the fact that I was a first timer, but I have no idea what happened to her.

Sorry this turned into a bit of a diatribe - I really wanted just to say that your experiences sound very familiar and to ask more widely if anyone knows if there is anything we can do to change - eg is it possible to switch to a different service or even go privately?

Thrush is very common in women, especially in pregnancy and not dangerous to you or your baby.

Generally pregnancy information is on the NHS website. Bounty and Emma are not NHS medical advice and private enterprises trying to sell you crap. If I had my way midwives would never give this out.

If you think you are generally unwell eg infection of any kind then you need a GP’s appointment or go to a pharamacy.

You should have emergency numbers. If you don’t then ask for them. Ask if there is a list of what happens at each appointment. But if you need something different then you need to speak to up.

Running late will be because she is seeing other patients, including new mothers and their brand new babies at home.

But @wingingit1234 GTT isn't a set test, certainly not in my trust, you only have it if your urine or growth shows signs you could have GD. And bloods are at 28 weeks not 25 according to my notes (and the NHS website).

I'm not making excuses for what you've had and perceived to be poor but it just shows it's no wonder things get muddled when there are so many deviations (apparently) from the set protocol which is here
www.nhs.uk/conditions/pregnancy-and-baby/antenatal-appointment-schedule/#25-weeks-pregnant

OP, if you want more info then try the positive birth book, Nct course and a hypnobirthing course.

Sorry to hear you’ve found your midwife unhelpful. Whilst it is important you try to develop a good relationship with your midwife it is also essential that you take some responsibility for knowing what appointments you need to have and booking them in (I’m not saying you don’t) so that nothing is missed and you feel confident in your care. The below link is a good starting point. Your hospital notes and hospital website should also include a specific schedule of antenatal appointments for your hospital. If you can’t find this at your next appointment ask the midwife to show you it and get as many of the future appointments booked in as possible.

You must tell the midwife of any concerns you have - this is what she is here for and it is important your yours and your babies health. If the relationship is too damaged and you want someone else, first steps would be to talk to the Head Midwife about other options the hospital offers. The receptionist should be able to put you in touch with the right person.

www.nhs.uk/conditions/pregnancy-and-baby/antenatal-appointment-schedule/

I think this sounds like the not great end of normal rather than very bad treatment. It seems that there is an issue with you not receiving your folder - where are your notes? The lateness is typical, community midwives are overstretched and will typically come to clinic following home postnatal visits. The midwife mobile number is not useful as it will only be on when she’s on shift, calling the central team is better. This stage of pregnancy is a bit lonely in terms of midwifery care, it gets more frequent further on. Googling maternity services plus your trust should give you all the numbers you need - I think I got a sheet of numbers for labour ward etc once I reached viability.

Bounty and Emma’s diary are pointless. The NHS website is much more useful. If there literally aren’t any other numbers on your notes I’d google your local hospitals number and scribble the number on your notes.

I think the Emma's diary pack is the Bounty pack

just a catch up how did I feel - I don't feel I can share anything with her I don't feel comfortable talking about my worries, so I just said I was fine

How do you expect her to help you if you won't talk to her? If you have concerns, tell her, tell her that you feel like you've got no support from her.

If you have any problems, usually the GP will be first point of call, they will soon tell you if it's something you need to see the midwife for. If you feel it's an emergency then contact the antenatal dept. at the hospital. You can't be sure that the midwife will be on duty, so they will get someone to contact you.

OP, as many are suggesting you read some pregnancy/baby books, I just wanted to recommend Clemmie Hoopers “How to grow a baby and push it out”. I found this really helpful!

I think a lot of people are being a bit unkind towards you on this thread. Compared to my first appointment it definitely sounds like yours didn't go very well, and of course you're going to feel disappointed. I'm a first time mum too and very capable of research, talking to friends etc, but I get the need to be able to talk to your midwife and for them to be able to offer some emotional support too. Mine was very clear about how their support works etc and yours wasn't. If you're not feeling able to talk to her, maybe you could send her an email to explain this?

Hi @LittleK1989, I can understand your frustration about not knowing the ‘system’ and feeling as if you are not getting the help/support you should - mainly because you’ve not been there before and so don’t know whether to ask for something/do something/say something simply because it’s unknown to you and you’re not psychic!!

The Bounty and Emma’s Diary packs seem to just contain loads of marketing leaflets and not a lot of useful stuff so don’t worry that you’ve not received them - the most useful thing from them I’d say is the actual plastic wallet from the Bounty information pack as it’s the right size to hold your notes and stops them getting creased or tatty - but weigh that up against whether you want to carry confidential notes round in a logo’d pack that makes it obvious to anyone looking that it’s a maternity product - I was able to telling DH who was waiting to be seen by the antenatal Dr at an appointment we had at a small hospital with 1 waiting room for all clinics by the wallets they were holding!!

The NHS website page referenced above is good in that it tells you the range of dates for appointments and what should ideally happen at those appointments. Different trusts will have their own schedule but the NHS list is not just the ‘gold standard’ but the minimum input for surveillance, sometimes this is not always with the same people - so you may be seen at the hospital after your 20 week anomaly scan and that counts as one of your contacts.

If you aren’t happy, and sometimes we aren’t happy with our healthcare providers, you should look into changing - the first thing you should do is ask at you GP surgery whether they have more than one midwife that covers their practice and ask to see them if they do; if not you will need to speak to the hospital you are booked to and speak to the community midwife office/antenatal appointments team and find out how to go about changing to someone else - the negative of doing this is you may have to travel to another health centre or to the hospital for your appointments rather than being seen locally. I am having to change my hospital not my midwife because, while I’m happy with my midwife, I’m far from happy with the hospital I am booked with - a Dr specifically said I will be seen every 4 weeks in hospital antenatal clinic as I’m expecting twins and high risk in other areas only for the hospital to tell me he is wrong and my community midwife is expected to manage all my appointments except one more with the consultant clinic at 30-32 weeks (this is also against what the midwife said I should have in the way of appointments). Therefore, to get the appointments I should have through this pregnancy, I have to go to a different hospital which isn’t ideal but my babies health (and mine) is more important that where I give birth!!

Good luck and I hope you find a more supportive midwife going forward x

To be honest my midwife was the same but to be fair I've had two kids and never actually seen the named midwife on my folder as they've always been off sick. So I can imagine it's a very stressful (that's not perhaps the right word, maybe stretched is better) job.

I was actually luckily I was consultant led both times so had some good midwife care from the hospital clinics, those midwives know what they are doing!

Going against the grain here but your treatment sounds awful. This is my first pregnancy and I’m now 28 weeks. My booking appointment was an hour long and my midwife gave me so much information and asked me many questions. My 16 week appointment was around 25 minutes and she listened for the heartbeat, asked me lots of questions and again gave me additional advice. Checked I was booked in for my whooping cough, asked how my 12 week scan was etc etc. Had my 25 week appointment which was around 15 mins long, she again listened to the heartbeat and lots of questions asked. She has tested my urine each time and always books me in for my next appointment there and then and gives me a pot to bring my urine sample in. She also explains what will happen in each appointment etc so I know what to expect. I’m not surprised you feel a bit lost. I also don’t have any mum friends so would have been puzzled without her. I’m in a major city and a very large drs practice so Id imagine she is very very busy but the care I have had has been amazing. Also she has never been late!

Unfortunately because services are so stretched, your experience isn't unusual. I think women are generally expected to do their own research and find things out for themselves. That's all well and good as long as you've been made aware of this in the first place, which sadly many women aren't.

Have you had a good look through your notes? I know they vary between trusts but mine had a lot of helpful information, including emergency contact details. The NHS pregnancy website also has a lot of useful information, Including when your standard appointments should be scheduled and what to expect.

Any health concerns you can still go to your GP. If you Google your local hospital you will also be able to find the number for the labour ward, although they tend not to see us until we're more towards 24 weeks, and usually only for pregnancy related conditions or more serious illnesses.

I'm sorry you've had such a bad experience so far, and I hope you can either switch midwives or work towards building a better relationship with your current one

Grrrrr I know this thread has gone a bit quiet but I really need to vent.

The midwifery service in my area is an absolute shitshow. Following on from my previous rant, it only gets worse.

Got a call back out of the below about my referral weeks later (which I never heard back from, was told it couldn't be found, then told to ask MW at next appointment, but at next appointment MW said nothing she could do (didn't even seem to want to listen to what it was for to see if it should be requested again, was basically fobbed off)). Turns out an item in the referral should have meant I should have been called in for more testing, but I'm so far gone now it's too late and there's no point anymore.

Separately I've been calling round and round for the previous tests I needed to book in at my last appointment (just routine bloods). Should have been booked at that appointment but MW gave me wrong advice about what is required. Called several more numbers and no one can tell me what to do. Finally spoke to MW again who said I should come back to her again to get a referral form (i.e. what I was battling to sort out my last appointment with her) and take it to my GP practice to get the tests, or if they don't do that, the hospital. I threw my toys out of the pram at little bit at this, as not only did I specifically ask for this at my last appointment but I've already spoken to my GP who says they don't do these tests, and I also I don't have time to go back to this place at a particular time (she is only there one morning a week, at hours which don't work for my job), to pick up something which should have already been sorted at my last appointment. This is a simple routine thing - getting blood from a stone would be easier (pun intended).

Problem in particular is my GP practice has ceased to hold the regular MW clinics (the previous MW I saw once there was fantastic) so I've been sent to a nearby place but the nearby place is not actually set up to hold clinics and has none of the facilities it needs (I mentioned previously that I'm not able to be measured there because they don't have the equipment). The MW doesn't even have a computer. She is recording all her appointments in a A4 notepad where she is just handwriting all her appointment times down (it's not even a diary! She has just numbered all the pages with dates and times by hand!). So I don't think any of my notes of my check ups are being recorded anywhere (other than the odd scrawl being added to my notes). God knows how i will be able to find out or discuss my blood tests (perhaps they are being sent to me).

I should mention that these are not isolated incidents - just a couple of examples. I know the bloods thing isn't a big issue but it's a microcosm of various other issues which I've faced. I have encountered other similar difficulties pretty much every step of the way (including some more concerning issues).

My point is that I'm not expecting a rolls Royce hand holding service. I do realise that I need to take control of my own ante natal care but it is a constant uphill battle to even get the minimum care we should be getting per the official guidelines. Perhaps this would not be so distressing for subsequent pregnancies but I'm a first timer and pretty much clueless!

Most of it has to do with service itself, which in my area is in absolute disarray, and I know most of this is due to the service being overstretched. I'm not having a go at the MWs themselves in general, as I think most of them are actually working hard, just trying to do the best they can with what they have available (although I think I've also now been assigned a bit of a crap MW as well unfortunately).

Overall I feel sorry for the MWs for having to work in this environment (even my crap one) - not only are we not getting the service we need (which is scary for a first timer), but the MWs themselves are being stymied from doing the job they need to do. They are stuck in the middle between a failing service and frustrated expectant parents. It must be seriously frustrating and depressing for them.

@wingingit1234

I don’t really get what your complaint is? Something about bloods?
Something about a referral that wasn’t needed?
Do you have your green notes? I presume yes-that records your pregnancy.
I’ve had plenty of friends give birth in range of circumstances that meant these notes weren’t even looked at.
Pregnancy isn’t a medical condition, it’s a natural event, useless you have medical issue.
With bloods no news is good news. This I got a letter to give the all clear but with my first pregnancy I heard nothing back unless there was a problem.
You do have a choice of care- if your current clinic really isn’t fit for purpose pick another. I know with a home birth they just chiding you at home, midwives don’t really need loads of equipment anyway.