Substandard Midwife support

[WeGoAgain123]

To say I'm livid is an understatement.

Now, I could be overreacting due to the miserable time I'm experiencing due to my morning sickness so please feel free to talk me down if I need to.

So, having used the e consult system back when I was 4 weeks I was told to self referral at my local maternity ward which I did right away.

At said self referral I mentioned I thought I needed a higher dose of folic acid (my bmi is 32) but they just told me that anything like this would be covered in my booking in appointment.

I had my booking appointment this week over three telephone, I got all the way to the end when she asked if I have any question at which point I mentioned my bmi (obviously they can't see me or weigh me over the phone). At this point she got very serious and said I needed a higher foes as the FA I'm getting in my pregnancy vitamins is so tiny in comparison and there's a risk of birth defects. She agreed with me that I the absence of this one question being asked at the self referral should be something I should bring maybe write in about.

Anyway, fast forward to today. I call the surgery asking when I should know when my prescription is ready...they have none as the midwife as forgotten to request it for me! So that's potentially another 3 days without it.

I messaged the designated midwife I was given at booking and explained the situation and her response to me was "the gp could have prescribed this to me early on in the pregnancy" is she implying I should have ignored what the maternity nurses said and just gone to my gp.

To be honest, I knew I needed a higher dose but I didn't realise it was over 10 times more (confusion of micro grams and grams - I have thought just eating some folic acid heavy foods would suffice for the short term)

Am I being unreasonable, I'm so nervous for my scan now in case something is wrong.

I threw my guts up and struggled to keep water down , never mind vitamins and my baby showed no signs of neural defects at my 20 week scan. The baby takes what they need from your body.

You're being unreasonable but you're stressed and pregnant so cut yourself some slack.
If you've been taking folic acid anyway just take more until you get the prescription. 12.5 of the small standard folic acid tablets will be equivalent, I'd just take 12 rather than faffing around trying to break one.

How far along are you and when is your scan?

I genuinely think my care this pregnancy has been really poor. The blame is on COVID and I get that NHS staff are massively over worked etc. but for the care to decline so much is a real concern. I have had to advocate for myself in a lot of circumstances this time, many of which could be detrimental to baby!

I think ultimately you need to look after yourself and perhaps buy some in the meantime until prescription is sorted?

I don't think it will have too much of an effect and I am sure everything will be fine :) but it is additional stress you just don't need!

THIS!

You're being unreasonable but you're stressed and pregnant so cut yourself some slack.

Just order some online? My booking in appt and subsequent consultant appts have all been over the phone so far, only seen a midwife about twice and I’m 31 weeks. I understand your anxiety but the NHS is in absolute dire straights right now x

I don't think it's unreasonable for you to be annoyed by their lack of organisation being blamed on you. You've raised this as a potential issue lots of times and been passed around.

I'd suggest trying not to get annoyed by it, and just taking it as a lesson that you need to be an active advocate for you and your baby to make sure nothing else like this is missed. Do it in a friendly and polite way rather than being livid and it'll be more likely to be effective.

Unless you have a close family member with neural defects I think you're making yourself too anxious about this.

If you knew you needed more folic acid by googling, just take extra tablets.

Did the midwife forget, yes but ultimately it's not the biggest deal in the world.

Try and relax, otherwise you're going to have a miserable pregnancy.

Does the NHS prescribe folic acid? Just buy it from Boots like everyone else.

Thanks for your responses

I have tried to take more of the folic acid tablets I bought myself from amazon but I just can't swallow them. I can just about swallow the 3 pregnacare max tablets that I force myself to as I'm barely keeping any food down and know I need everything.

I know I'm stressed. This is my third pregnancy, but my last one was over 10 years ago and I know the care I'm getting is nowhere near the same. Added on that I'm high risk due to age and bmi.

The morning sickness I have is 100 times worse than any of my other pregnancies so I'm stressing about the reasons for that too (google is the worst!)

I guess I was just frustrated that I was told a gp could have prescribed them but I haven't been given the option to see one nor has anyone I spoken to successfully acted on getting these prescription strength FA tablets into my hands for me.

I'll step back though and not take my frustrations out on the midwife...I'm just have my rant out on here to you poor folk 🤣

Thanks for giving me some space to talk it out

You know you need a higher dose of folic acid, but you didn't just go to a shop and buy some? Or order it online?

I think if no one had alerted you early on that you need folic acid, and at a higher dose, you'd have a complaint. But you did know, and it's available to buy.

@Marylou2

Does the NHS prescribe folic acid? Just buy it from Boots like everyone else.

For high BMI's yes.

I have bought some but it's only 400 micro grams whereas I need 5grams (over 10 times stronger)

I can't physically swallow 12 horse size tablets without vomiting 🤮

@gordongrumpy

You know you need a higher dose of folic acid, but you didn't just go to a shop and buy some? Or order it online?

I think if no one had alerted you early on that you need folic acid, and at a higher dose, you'd have a complaint. But you did know, and it's available to buy.

I only knew through googling being pregnant with my high risk.

I can't buy this strength over the counter, I can't swallow 12 horse pills of folic acid without vomiting. I can barely keep food down at the best of times.

Pure folic acid aren't horse pills, you can get small ones.

But you can also buy 5mg on Amazon www.amazon.co.uk/Folic-Acid-5mg-Manufactured-Guaranteed/dp/B07QFWSD98?tag=mumsnetforu03-21

The NHS is falling over, there are elderly people waiting days for ambulances, this is small fry you can sort yourself.

@WeGoAgain123
you need 5 mg, not 5 grams! DO NOT EAT 5 GRAMS OF FOLIC ACID.

www.rcog.org.uk/en/patients/patient-leaflets/being-overweight-pregnancy-after-birth/

OP, you may be able to buy 5mg folic acid online. If not, and you want to take several, you can buy just folic acid tablets from Tesco etc which are very small. Taking several Pregnacare tablets will mean ten times the other vitamins too.

Please try not to worry enormously, I know it's easy to say, and it's true the 5mg is recommended but I expect there will be more research into the optimum dosage in the future which might well be lower. You've been taking folic acid which many don't and the risk of a neural tube defect is very low.

@gordongrumpy

Pure folic acid aren't horse pills, you can get small ones.

But you can also buy 5mg on Amazon www.amazon.co.uk/Folic-Acid-5mg-Manufactured-Guaranteed/dp/B07QFWSD98?tag=mumsnetforu03-21

The NHS is falling over, there are elderly people waiting days for ambulances, this is small fry you can sort yourself.

As far as I'm aware, elderly nhs patients don't use maternity services.

Thank you for your replies but please don't belittle me with statements that are irrelevant.

Thank you for the link.

[quote Loki01]@WeGoAgain123
you need 5 mg, not 5 grams! DO NOT EAT 5 GRAMS OF FOLIC ACID.

www.rcog.org.uk/en/patients/patient-leaflets/being-overweight-pregnancy-after-birth/[/quote]
Ah yes sorry. Typo, I knew it was mg x

I bought the extra folic acid online, my prescription for it never actually materialised.

I know I'm stressed. This is my third pregnancy, but my last one was over 10 years ago and I know the care I'm getting is nowhere near the same. Added on that I'm high risk due to age and bmi.

Sadly I don’t think any NHS care is anywhere near the quality that it was 10 years ago, even before the pandemic. This is my first pregnancy but a lot of my friends have 2/3 kids already and they’ve commented a lot on how poor the midwife care is in comparison. I’ve only just met my “actual” midwife, and I’m 25 weeks, in a county with a “one midwife” policy. They’re doing their best, but my appointments so far have been a quick urine sample and telling me to look on YouTube.

You don't need five grams of folic acid! Folic acid tablets aren't horse pills so you could've bought those if you knew you needed it. You're pregnant, sick and stressed so everything feels 100x worse than it really is. Many women struggle to keep anything down never mind tablets so don't stress. Midwives and doctors forget things sometimes, they're human.

@WeGoAgain123 pheww:) Its easily done:)

So the way I did it (also high BMI) is I bought 200mg ones and one day I would take 2 tablets and the other day I would take 3.

I bought Pregnaplan which has the folic acid in the active methylfolate form as I am heterozygous for the MTHFR gene and this ensures I get the right dosage. Loads of people have this badly functioning gene.

I’m 37 weeks pregnant at the moment and I’m afraid my experience is that care doesn’t really get any better. Get used to needing to be well informed, advocating for yourself, navigating contradictory information and pushing for what you need.

I didn’t know I needed extra folic acid due to BMI until I was about 9 weeks and nobody has ever mentioned it to me. I didn’t increase my dose after that. Baby is showing no abnormalities on my scans, so you’ll likely be fine.

The pregnacare tablets are awful. Especially with nausea. Boots have some normal dose folic acid which are tiny and much easier to swallow. I took those when I’d thrown up my pregnacare ones.

With @Greytminds and @TakeYourFinalPosition (and my comment up thread) - the care really isn't great at the moment.

I only had my son 3 years ago and it has been drastically worse this pregnancy (35 weeks), both pregnancies 'high risk' due to GD. I shan't get political.... :)

But definitely push everything, stressed out and overreacting or not, do what you can for yourself and push/chase up in the meantime

Not unreasonable but unnecessarily stressed. Your BMI isn't that high you will be fine. Tiny tablets of 400mcg are cheap and very available. I went to the GP for the high dose before I started to try to conceive he has to look it up on Google to check I was right!

The midwife is probably looking after 100 women and she’s only human and covid has made things worse.

I understand why you’re frustrated but equally, I never had anyone tell me about folic acids until my first check up at which point it’s hardly helpful as the basics have already been formed.

These are the kind of things that pregnant women should know but some don’t. At least you’ve been taking some. You also knew you needed a higher dose due to your BMI so again, you don’t need to wait for them to tell you, just start taking it.

Chalk this up to experience and moving forward, take responsibility for your own health and follow your gut, as right now everything is a mess.