Midwife under strain?

[Silverfoxlady]

Hi all,

I am just wondering if anyone else is feeling the same.

There is a new system for midwives in my area so that there is one midwife that follows the pregnancy from start to finish. But it has been such a different experience to what I was used to with my other children who were cared for by a team.

For example, she gave me a mobile number to contact her, but she can take up to 5 days to respond, once she took two weeks. I usually end up leaving a message for the group of midwives for help, and she calls straight away.

During my appointment my blood results showed that after 4 weeks the iron tablets I have been taking are not working as well as they should (haemoglobin dropped from 105 to 104 - meaning I am now slightly anaemic, and a small rise in ferritin from 14.4 to 18 but still lower than 30). She said there is a new guidance stating that I could have IV iron, but then she left a text message saying the hospital said to keep going with the tablets. Now I am exhausted all the time.

She said my urine analysis showed high levels of infection, and she sent the sample to be tested, but three weeks later no reply.

I understand that she is super busy (her small team has to cater for a large area where I live), but I am wondering if I should be making more of a fuss? My partner thinks I should.

I just assumed that this is how it is with the NHS being under so much strain.

Hi
I had the exact same issue. I live in an area where there are community midwives but no hospital with a maternity ward so I ended up just relying on the advice of the hospital I was planned to give birth in as they were more reliable. It was that bad that no one turned up to do my baby’s heel prick test when she scheduled to do so so I had to again contact the Hospital to arrange it who were brilliant even though they are not supposed to continue with the community care. Is this something perhaps you could do?

I would put a complaint in and I would also deal directly with the hospital like pp says.

This is why I never understood why having one midwife was seen as a positive. I was under a team of midwives. All my appointments were at an antenatal centre attached to the hospital. I always had a central number to call if I needed to.

They were professionals and all had access to my notes. I filled in a survey at one point actively speaking out against this idea of one midwife.

I'm not surprised she's under strain. Is there another central number you can call and ask to be treated under a team or is this the only option?

Are you in in NI under the new Continuity of Care model?
outcomes for mums and baby are showing to be much better generally, so do flag if having issues

I think it’s when they’re out of area and not attached to a hospital when it becomes a problem, I never had a central number even the GP surgery I used to see her at couldn’t provide me with a number other than her mobile. I’ve seen another thread about similar issues.

The hospital and community midwives are all part of the same team, in some areas a community midwife can be out doing a visit in the morning and in the theatre scrubbed up to help with a caesarean in the afternoon. It sounds like the helpline number (usually based at the hospital) just isn’t being made clear enough so people think they are bothering the hospital when that is the number they should actually be ringing. Cannot understand why a community midwife number would be given out for advice as on average they may only work 22.5 hours a week so unlikely to be able to get back to you quickly, never mind might be on annual leave etc. As for an iron infusion, I have never heard this being suggested to a woman with an Hb over 90. Is it definitely anaemia causing the exhaustion, many pregnant women are exhausted without being anaemic.
Urine dipsticks often pick up potential urine infections but most of the time they come back clear and unusual for woman to be contacted if result clear. Sounds like just need to ring the helpline to get reassurance that urine test result was clear if worried about it and request another check for anaemia at next appointment if your worried Hb dropping again

That’s really strange, all community midwives in England are employed by the local hospital maternity unit, their official base is that hospital, their overall managers exactly the same ones who work on the delivery suite/ward etc. Some women opt to deliver and have their hospital based antenatal care at a neighbouring trust so the community midwife they have may not be employed by the hospital they have chosen but they will still be employed by whatever hospital trust covers the patch where you live. The GP surgery just probably don’t have the maternity helpline number, however ring any department (antenatal clinic, delivery/birth suite, maternity ward) of the maternity hospital she is attached to (usually the one your are booked to deliver and have your scans at) and they will be able to give you the maternity helpline number. There is usually no reason to be contacting your named midwife directly

Hi
I think where I live is a bit of a strange situation, the hospital where she is ‘based’ had a maternity unit that shut down so she works out of the GP surgeries in the area. When I called them they said I needed to call a different hospital (not the one I was due to give birth in) as they are attached to them apparently but whoever I spoke to again gave me the midwives direct numbers instead and non of them answered their phones (probably because they were with other patients). It seemed a very unorganised system and was just glad I had the help of the hospital I was giving birth at. I even had my sweeps done with them even though it was 45 minutes from my house as I couldn’t get hold of community midwife to arrange.

Yes does sound like a strange system, we have a system of named midwives and ladies booked into neighbouring hospitals to deliver. If a woman needed to speak to a midwife or get any advice she would be given the maternity helpline number of the hospital where she is due to deliver, the community midwife would just do her community check ups and postnatal home visits. Things like appointments for sweeps would have been booked at the woman’s previous appointment. The community midwives work in teams in all areas (even if each allocated a ‘caseload’ of women) and there is someone working everyday from each team 9-5 365 days a year. The hospital the team is attached to can always contact the midwife/midwives on for that team if a woman hasn’t been able to get hold of them. Even if a phone is out of signal temporarily etc the team always have at least daily routine communication with the hospital so a message would never take more than 24 hours to be passed on. They are their employer’s, they manage them in exactly the same way they manage the midwives based in the hospital. I think there is a common misunderstanding that a woman should speak to her ‘named’ midwife for advice (e.g. a lot of literature states ‘speak to your midwife’) this is much more appropriate to a foreign based system where your midwife/ob gym is on call for you 24/7, it doesn’t really work for the UK maternity system. All women should be given a central number they can contact at their first appointment and if they are given a community midwife number it should be made clear that this is for non urgent issues only. E.g. has not received maternity prescription exemption certificate, if it is anything at all the woman needs a response for within the next few days they should go via the central hospital number given. Even e.g appointments and certificates etc can always be sorted through the team so is simply a case of having the hospital pass a message to the team and any member of the team can sort. If e.g it’s about an appointment 4 weeks away then the team might understandably wait until the named midwife is back off annual leave etc. Also I think it needs to be understood that even if the midwife is working that day and has received the message, she may not have time to respond to non urgent issues for a while due to workload. Obviously if it’s urgent to the woman then would always recommend the woman rings back to highlight this and the midwife will undoubtedly bump this up on her very long to do list