Can I change midwife practice?

[kallia]

Does anyone know if I can change midwife practice whilst not changing which GP I'm registered at? I don't want a different midwife from the same practice - I've seen 3 so far and they've all been pretty poor, and I wondered if a different practice might be better. Not sure how to go about this as I was assigned to the team automatically from my GP. Anyone had any experience of this?

Unfortunately not - most midwife teams work across several GP practices and cover a geographical area. My midwives team cover about 12 or more GP surgeries and an entire town/suburb of a large city.

I’ve never seen the same midwife during all 3 of my pregnancies, I think your expectations might be a little high, even more so at the moment. I’ve seen a midwife twice and I’m 29 weeks, I’ve had 2 appointments over the phone. Your gps will have a team of midwives attached which will probably work in neighbouring surgeries (that’s how it works where I live), even if I chose a different hospital to give birth the community midwives are the same people. I’d have to move house to have a different team.

Your midwife usually isn't anything to do with your GP and they are from the hospital you are giving birth in. Sometimes they have a clinic or a room in a local health centre or GP surgery but they aren't actually part of your GP clinic.

How far along are you now and do you have other hospitals nearby?

Sorry to hear you have been having problems, what sort of things have you not being happy with? I wonder if this might be an expectation thing as well, 3 midwives is a lot to see and have issues with all of them.

I'm 12 weeks, I like the hospital generally (Chelsea and Westminster) and they have a great birthing centre. So I'd rather not move hospitals if I can avoid it, although I could go to Roehampton in theory. The midwife unit is not at the hospital though, it's in a separate building about 20 mins walk away.

Mainly it's admin stuff they're not good with. They gave me two different addresses for my first appointment and I had to ring round several different places before someone told me which one I had to go to.

They lost one of my urine tests, so I went back to do a second. They didn't give me the results at all - I had to call them twice before they finally got back to me with the results.

I've had really bad HG to the point I was severely dehydrated and was fainting a lot (lost a stone in 10 days and couldn't stop shaking). My husband came with me to the centre to check I made it okay and got a good ticking off from the midwife for coming because "partners aren't allowed". Then she said I wasn't severe enough for anti-emetics because "clearly you can walk on your own so I think you're fine". (GP disagreed and prescribed them).

It's not the midwives themselves, I think they're fine, but the organisation/admin seems pretty poor. Maybe it's standard and my expectations are too high, but I've been disappointed.

@kallia did they give you a schedule for your appointments/ what to expect at each? My schedule was bloods and urine test at the booking appointment and a scheduled call at 16 weeks to discuss the results. I'm assuming that is in cases where everything is normal and they obviously ring you earlier if there is a problem, but I've seen someone else here post their appointment schedule and the timescale between testing and a results appointment was the same so it doesn't seem weird to me that they didn't reach out to you with the results if you are still only 12 weeks.
Its annoying that they lost your sample but mistakes can happen.

The midwife unit won't be in the hospital but it is still part of it.

Your GP will just have a preferred local hospital so when you contact your gp about being pregnant they refer you to the antenatal clinic at the hospital, but other than that your midwife care doesn't have anything to do with your GP. Some GPs don't even refer you and you have to do it yourself.

Hopefully your experience gets better from here.

No not yet. The first appointment was at 8 weeks, and just went through my medical history and took bloods/urine. She didn't say what the plan was for the other appointments apart from to ask if I wanted the nuchal fold test done at the 12 week scan. I didn't know I have another at 16 weeks, certainly nothing's been put in the diary.

I got a text with the blood results the next day (all clear) and then a phone call to say the urine results had been lost. So I presumed I'd get a next-day text with the second urine results too. When I phoned they seemed a bit surprised that I hadn't and promised to get back to me (they didn't, I had to chase them up again).

I understand mistakes happen and I'm not blaming anyone, but if this practice is really overworked/understaffed then I wondered if I could move to a different one.

I’ve never been contacted with results after blood or urine tests, they just ring if there’s an issue, otherwise they might just say at the next appointment “everything was fine”. My urine sample at my booking appointment had been contaminated (or lost?!) they just asked me to redo it at the scan (12 weeks), I didn’t know about it until they saw me at the next appointment. Where I live the midwives only book scans for you, all other appointments you book yourself, you can see on the nhs website when to expect appointments there’s a schedule if you are just having midwife led care. If the midwife wants to see you again sooner you just book an appointment sooner, they usually say when to book it.

Sounds like you might be expecting too much.

With urine/bloods - no news is good news. It's not like a normal "test" it's more a screening and you'll only hear if you need to.

Other stuff not ideal but tbh I don't think the admin will necessarily improve if you switch - welcome to a long road!

@kallia do you not have a breakdown of how your hospital structures appointments/ what you can expect included in your maternity notes that you got given at your booking appointment?

There is a page in my notes that goes through what typically happens appointment wise. I had a booking appointment at 9 weeks, but I won't have another in person one until 25. My 16 week appointment will be over the phone.

Thanks. I think I might have been expecting too much. I've always had "all clear" texts re my bloods or urines in the past but maybe it's different in pregnancy.

@luxxlisbon - no I don't have any list of hospital structures/appointments. I have my first scan on Monday but no idea what to expect or how long it will take apart from to drink 1 pint water 45 mins before.

Midwives come from the hospital not GP surgery and are allocated based on your area.
Based on what you have said, I suspect you’re under the cherry team maybe? And further more, if your in Wandsworth your local hospital is St George’s however you are close to Kingston but wouldn’t be officially in their area as the same as Chelsea. Apologies if I have misread you’re posts.
Kingston birth centre is next to delivery suite, and at George’s birth centre is 2 floors above delivery suite

I'm under the Heather team at Chelsea & Westminster. St George's is a touch closer geographically but I've been to C&W for other tests/operations so I chose to sign up there as I know the hospital and have had excellent care there in the past. But I'm wondering if it's too late to switch to St George's. It seems like other people are getting a lot more info than I am.

Maternity services are woeful across the UK. I am not saying individual midwives aren't doing the best in a crappy situation, they are but the service is routinely not up to par. I think you have high expectations tbh. Where I am they would only contact you if your bloods or urine sample was abnormal, so getting a text is better than not.

With my first I couldn't register with my local midwife until I'd moved GPs. I was still registered at my old GP as it was only 20 minutes away so I'd never seen reason to move it, but I had to in order to see the local midwife as the midwife team at my old GP wouldn't travel to my new address (once baby born)

So no, I don't think you'd be able to move without moving GP too.

@kallia all trusts have problems, poor staffing, underfunded etc. If you want to transfer to St. George’s, there is an awful line referral form. Lots of people do late transfers.

Okay thanks for all your thoughts. I'm sorry if my expectations were too high. I just feel a bit administratively abandoned - have no idea if/when my next appointments are happening. Do I get my notes soon or are they all digital nowadays? If they're digital will I be able to access them?

If digital you'll have an app. Last pregnancy I had paper notes. This time an app. Due to covid my 16 week appointment is on the phone

The schedule for appointments due to covid is very hands off. I'm a second time pregnancy so would have less appointments anyway but my schedule is booking, 16 weeks then 28 weeks.

Many hospitals are digital but you should have an app. Equally many trusts are still on paper

I don't have an app or paperwork yet, but maybe it comes at a later appointment at my trust.

I got the notes at my booking appointment with my first 2 children, this time it was after my 12 week scan as the booking appointment was over the phone due to covid. I’m surprised they didn’t hand them to you if you had the booking appointment face to face, maybe your area uses an app?

Hi Kallia.
So I’m in London but not a hospital you’ve yet mentioned. It’s my second baby, 4th pregnancy in London. I have also had HG - which was entirely managed in early stages by my GP, not my midwifery team, who would redirect me back to the local GP.
I have multiple losses so sometimes get seen for an early scan, but not always. For most women their first appointment at all is at 12 weeks. Mostly I’ve connected my notes at my 12 week scan appointment. It sound like you may not have gotten these yet? Usually it’s these notes that allocate how maternity services work - when to expect your next appointment etc.
In covid (and before) the next appointments (for me) have been booked with the receptionist as I leave the current one. No letter is given/sent but the date is hand written in the maternity notes or you remember.
Bloods and urine is collected routinely and you tend to get a phone call (unscheduled) to inform you of results - only if there is a problem. Otherwise as posters have said no news is good news and you can ask at your next appointment.
For HG in last pregnancy - when I had multiple hospitalizations - my regular dipping was done by myself or the nurse at my GP practice. Unfortunately weight loss tends not to concern the midwifery team in the first trimester. I lost more than 1.5 stone (well over 6% of my pre weight). I didn’t put it back on and at 40 weeks had gained very little. As scary as it is, it is one of the criteria to be diagnosed with HG. Are you on the HG boards here? I found them really helpful. It’s not a nice way to experience pregnancy but there is support available.
It is a confusing experience at first. But midwifery services are sparse at the beginning of a pregnancy and increase towards the end. You are expected to do quite a lot of reading yourself and self monitoring. However if ive ever had any problems and have had to attend maternity triage post 20 weeks (such as for movement checks etc) generally I’ve found services slow but helpful.

Oh - and all three London boroughs that I’ve ever received maternity services from have been useless on the phone! Maternity appointments are usually not via the centralized admin, so the process is quite different. Those that answer the helpline (if there is one) don’t always have access to your notes

You'll get your notes / app after the first scan /when you see the midwife after the scan. There wont be much for you to see at this point though so dont expect to see lots of information. If you haven't got a 16 weeks appointment booked yet, ask the midwife at your scan, chances are they'll book it at that appointment anyway.

You dont need to ring them to ask for results. No news is good news. Theyll contact you if there is an issue or if anything gets lost. If everything's fine at the next appointment they'll just say it came back clear. Midwives are very very busy and understaffed as you can imagine, lower your expectations and contact them if you have any concerns.

At your stage in pregnancy, midwives are very hands-off. The fact youve seen three midwives by 12 weeks is a lot!

The reason you don’t know your schedule yet is because it sounds as if you don’t have your notes? I collected mine at my 12 week scan.

I found the appts very sparse until 28 weeks when they ramped up. But if I had any concerns I could call and a midwife would get back to me.

With test results, unless there was an issue I would get the results at my next appt.

You’ll find your swing with it, but I know the early part of pregnancy is such a worrying time and you feel like you want more at that point!

I hope it does get more routine for you ❤️

Hi op congratulations and sorry your experience hasn't been what you expected so far, as others have said, like a lot of nhs services admin is a nightmare.

Usually timeline goes like this (but this differs in region, below is my experience in the Nw)

8 weeks - booking in at hospital
12 weeks- scan at hospital and see a mw after
16 weeks - community mw appt (you have to book this at your go) just for a chat, listen and measure bump, urine and bp test
20 weeks - scan at hospital
24, 28, 32, 36, 38, 40, 41, 42- community mw as above

However with covid a lot of the community appts are being cancelled or done on the phone!