DO I HAVE TO SEE A MIDWIFE LEGALLY?

[JL1]

I am 9 weeks pregnant and do not wish to see a lecturing midwife. Do I have the right to refuse treatment until the birth? If not, why?

who will monitor your BP urinalysis,fetal growth etc interpret your results,plan any interventions.have you had a bad experience thta you expect "lecturing"

legally you have to register the birth

I'm sorry but I think it's disturbing for someone to be so arrogant as to think they no better than a professional when it comes to something that may harm a defenseless baby. I think it should be illegal if it's not. What are you going to do when your child is sick in the future make him/her suffer because you think you have too much spirit to get them a safely prescribed medicine??? As an adult you can do what you like at the risk of yourself but your poor baby deserves a healthy start to life and if there should be any problems that may be prevented then you should have a good think about your responsibilities as a mother. I commend peoples kindness on here as they have tried to gentley ask you to think carefully about your decision and give support, I however can't believe your front and attitude. I get people tell me whats right and wrong for me and my baby constantly and I get given all sorts of unwanted advice, however I don't go making a huge drama out of it. If I want the advice i take it if i don't i leave it. Get a grip you certainly don't seem the type of woman who would have trouble putting someone giving you unwanted advice or a lecture as you put it in their place. I think your quest for individuality is distrubing and needy.

"that could prove less risky with some business claims of how much risk factor. who remembers the drug thalidemide?" Quoting JL1's husband -

what on earth has that got to do with not wanting to see a midwife and it it doesn't make grammatical sense either.

I don't know why OP bothered posting, unless a troll. It is always refreshing when people take on board the advice they are given and change their mind. I think everyone, more or less, has advised seeing a midwife-for the sake of the baby if not the mother-and yet I get the impression that OP has a closed mind (and probably a dominating DP.

OK mrsboogie, how about we have an experiment. You can free birth your next baby, without any medical assistance. I won't have my next child have the MMR. I'm willing to place a substantial amount of money on it that my hypothetical child is less likely to come to harm than you (or your hypothetical next baby).

I'll take measles (which is NOT the dreadful disease it is made out to be, although it can be in the case of other complications) over a haemorrhage at home or undiagnosed breech baby any day.

If you have no medical care in pregnancy then a referral will be made to social services when the birth/pregnancy is "discovered", as it will be.

I'm sure seeing a GP instead of a m/w will get round that though.

However a lot of GPs will not see pregnant women for routine antenatal care. Partly due to money as they won't get paid extra for it so will be wanting to shunt you onto a m/w. Partly because they may feel out of their depth.

Midwives train for 3 years in that one discipline. An average GP will have done 6 or 4 months as an Obs SHO where they run round labour ward cannulating and assisting in sections. They don't generally have as much knowledge as a m/w when it comes to normal pregnancy. I'm sure they can monitor your BP, dip your urine, etc perfectly well. But as a m/w I've seen women with major complcations who have seen their GP who did nothing for them. One woman had had major itching to her hands and feet, so bad she was bleeding through scratching and the GP had done nothing. Thankfully when I saw her for a routine check up the next week no damage had been done to her or the baby - but it could have been a very different story. I'm sure some GPs are great though, may be worth talking to your GP and seeing how happy and confident they are about caring for you.

But Stripey - why would a woman be referred to social services if they don't have medical monitoring during pregnancy? Why is this putting a child at risk?

What about the tiny percentage of women who go through an entire pregnancy without knowing that they are pregnant until they are in labour?

I think that refusing ante natal care is stupid, but hardly on a par with child abuse. Social services have more pressing matters.

Haven't read all the threads, but I am wondering ... what about a middle ground?

See GP of choice once per trimester - 12,24,36 weeks. Get routine bloods done there during first trimester. Rhesus issue important, as are STD issues.

Have a 20-week scan for anomalies, placenta position (GP can refer)

Monitor own urine, BP, heartbeat, etc whenever you feel the need.

I think legally a birth has to be attended by someone, so just ring a m/w when in labour and ask her to come to be in the house on hand in case of haemorrhage/resuscitation issues, etc.

You can probably do the rest.

Monitoring your own bp, urine, heartbeat etc is all well and good, VirginBoffinMum, as long as you have the knowledge and expertise to interpret the results properly. I am a registered general nurse, and I know enough to know that I don't know any more than the basics about the potential complications of pregnancy and labour - and if that's true of a trained nurse, how are two totally untrained people going to know any better?

During my training, I did a stint in Obstetrics, during which I did my best to learn how to palpate a lady's abdomen in order to assess the presentation of the baby - and even with the guidance of a trained midwife, and a certain amount of knowledge, it's by no means an easy thing to do.

I assume that there are other mothers, like the OP, who want to go through pregnancy and childbirth unattended by any professionals. All I can say is that this is a disaster waiting to happen. If a woman wants to gamble with her own health and life, that's up to her - but she does not have the right to gamble with the life of her baby, imo.

ILoveMyDog - its a child protection issue. Its not really about some women (like the OP) who don't believe in medical monitoring in pregnancy. Its to keep tabs on women who may have other motives for not "registering" their pregnancy. Otherwise women could go and give birth and then sell their babies to child prostitution rings, or beat them black and blue.

Obviously the OP is a different scenario but thats why that safety net is there.

Thats only for women who don't "book" their pregnancy, or are late bookers. Women who book but then decline care won't get an automatic referral (I don't think) unless people think the child is at risk.

How is it a child protection issue? I don't understand why not registering a pregnancy (rather than a birth) is grounds for social services to become involved?

I don't think it's advisable, as most midwives I've met are quite happy to keep monitoring to an absolute minimum as long as the mother and baby are healthy and no reason to think there will be any complications.

You do have that right but you are being selfish if you refuse all treatment until birth. Your baby could be breech - you won't know. Your baby could have the cord round his neck - you won't know. Your placenta could stop nourishing your baby and your baby could starve - you won't know. This is the start of a very long couple of decades of putting someone else's needs over and above what you do or do not want so really, suck it up.

When I was pregnant with both my dd's i saw my gp for appointments to check urine, bp listen to heartbeat etc. I only saw midwife at hospital appointments which I think was the 20 week scan and another one around 32 weeks?

If you don't have a midwife and don't deliver in hospital or with a midwife present at your home how will you get the paperwork to take to the registrars to register the birth of your baby?

You're kidding Georgimama - I think that freebirthing is absolutely crazy and although I would love to have a homebirth because it seems such a lovely thing to do I would never support the idea of foregoing medical care in pregnancy. I was not advocating the OP's approach at all.

What I was saying is that the OP is proposing a course of action which, yes, involves some risk to herself and the baby she is carrying and for which she got quite a bit of flack on here but my point is that a person who neglects to have their child vaccinated against a potentially fatal disease, which is what measles is, make no mistake, is taking at least as great a risk.

Ok, not many children get measles at the moment because the herd immunity is only now being lost but as the numbers of cases rise a child will die or be left brain damaged. Just as if lots of women declined antenatal care - eventually one of them would die or her baby would. Why is one risk acceptable and the other isn't?

In fact I would got so far as to say that people who don't have their children vaccinated are putting other children at risk as well as their own because when an epidemic starts those babies under the 13 months cut off will also be exposed. This wouldn't happen if older children were immune.

"Measles isn't as bad as it is made out to be"? How much worse can a disease get than causing death, brain damage or heart problems? My sister was left with a heart problem after having measles and pneumonia as a 6 month old baby. And so what if the complications are what cause the serious problems? the complications arise out of the virus!

I don't know if you have ever had measles - if you did it obviously wasn't a bad case. I have and it was. I would never put a child at risk of exposure to such a potentially devastating illness for no good reason..

There was a woman on the telly the other day explaining that she hadn't had her child vaccinated and she had time to repent this at her leisure as she sat in a darkened hospital room beside her child for 5 days not knowing if it was going to die. She said she now bitterly regrets it. Just I'm sure as the OP would bitterly regret it if her baby died of a complication in pregnancy through her failure to receive medical care.

ILoveMyDog - because some people will not book their pregnancy as they have no intention of registering the birth. If the birth isn't registered and the child isn't known about then its at risk - the parents could do what they want with the baby and noone would know.

I've only had to inform social services of a "concealed pregnancy" once. That was a lady who didn't find ot she was pregnant until she went into labour. As a m/w you make a judgement of whether you think the mother poses a risk to the child and fill out the form accordingly. I didn't think there was any risk at all and made this clear on my referral. I wouldn't be suprised if social services didn't even follow it up to be honest, but if they did it would only have taken them minutes to "close the case" and leave them alone.

I lived in Central Asia when pg and never saw a midwife, I came back to Europe for a scan at 16 weeks plus usual blood tests etc, had another scan there at 24 weeks with a local doctor, got my colleague at work to check my blood pressure regularly, and then was screened, watched etc by doctors in Belgium before giving birth there, from 37 weeks onwards.

Many countries like US, France etc don't have midwife care as standard, you see a gynaecologist. But it doesn't sound like you'd feel safer with that. I would say the key things were the anomaly scans, 20 week scan and the blood tests, and regular blood pressure tests. doesn't matter who you get those services from but you need them.

Also, why not hire an independent midwife who you trust? They go into the profession to help women and babies so there must be some nice ones!

Sunnygirl, my (official) care schedule this time wasn't all that different from what I have just recommended, and between you and me I didn't get a lot more in my first pregnancy over 20 years ago anyway (eg only one scan in those days, plus a handful of simple blood tests).

There are umpteen accurate blood pressure gadgets on the market now, and the OP can use one of those as a unskilled person, also the urine dip tests, and alert someone if she is worried. Ironically she will probably be keeping a closer eye on her own health than the average mum only having 'official' BP tests every 8-12 weeks, for example. She also won't have the problem that I had once with them mixing my samples and files up with someone else in a busy clinic, and nearly being admitted for pre-eclampsia instead of the poor woman who actually had it (or vice versa of course. A bit of me wonders if more mums should engage with their own monitoring like this anyway, on top of professional care, as an extra set of checks and balances.

Personally speaking, though, I have agitated for more care than this, and I wouldn't dream of giving birth without a skilled pair of hands there to manipulate the cord if it's around the neck, deal with an unexpected presentation, sort me out in case of haemorrhage and/or retained placenta, or resucitate the baby. I think you would have to be more than bonkers to ignore these risks, because even in so-called straightforward births these can happen more frequently than we all might like.

Regarding paperwork for the birth, mine got lost once and all the Registrar did was ask which midwife was in attendance, I think so she could chase it up if necessary.

This thread is throwing up some very interesting converstaions. I am slightly concerned that some trusts appear to report concealed or unbooked pregnancies to SS. It would be very interesting to here the CM (oyal College of Midwives) view point on this, especially with regards the info them have pyblished recently re supporting (that does not mean encouraging, but aknowledging a woman's right)freebirthing.

No matter what anyone's opinion is, a woman has a right to decline care and a baby has no rights until it is born. This is obviously a very emotive subject and not something I am wanting to have a discussion on this thread about, just stating a woman's rights.

For some women, previous contact with health professions may have scarred them so much they will be scared to make contact. Others may be in denial about their pregnancy. I am not denying these women need help, or that antenatal care does, in general, improve pregnancy outcomes, just that there is a huge gap in the system for these women. I also want to point out that I am not reading the OP's opinion as this as i have not the information to judge it on this level, I just things this thread has digressed slightly.

I am in the very lucky position of working as an Independent Midwife. However through this I have come across many women who have been abused by the maternity system in tha past. I think we need to be very careful about dectating what is essential care. i have many clients who decline scans and blood tests. They often only have an abdominal palpation, fetal heart ascultation and Bp check during their antenatal appointments. These appointemnts, however, tend to last between 1 and 2 hours. a lot of my time is taken by listening and debiriefing and by being vigilant you can pick up most problems. I know I have gone off at a bit of a tangent here, but I guess what I am trying to say in essence is that some women will alays make choices in pregnancy that others see as reckless, be that smoking, eating soft cheese or declining antenatal care. However to remove a woman's choice on these matters could lead us down a very slippery slope regarding the whole issue of choice for all childbearing women.

VirginBoffinMum - my concern is not the frequency with which monitoring occurs (though more frequent monitoring should ensure any problems are picked up sooner rather than later), nor the ability of an untrained person to perform monitoring tests such as urinalysis or bloodpressure monitoring. But the correct analysis of the results of these tests does require a degree of knowledge and experience that a lay person just does not have - and cannot gain off the internet, imo.

As I've already said, palpation of the uterus to discern the baby's position is not easy even when you are being properly taught how to do it - so how is a lay person to be sure that their conclusion is correct?

Curlywurlycremeegg - you are absolutely right that a woman has every right to decide what does and does not happen to her body - during pregnancy as much as at any time - but during pregnancy she is also responsible for the wellbeing of another life, so, along with the rights to decide what happens to her own body, comes the responsibility to do her best to make sure that the decisions that she makes are in the best interests of the child she is carrying.

I don't want to end up in the position where a woman could be prosecuted for having a glass of wine or a cigarette (as I believe can happen in America) and I believe that there is plenty of information and support available to allow women to weigh up the pros and cons of the decisions that they make, to reduce any potential risks to the baby they are carrying. But in this thread, the OP has repeatedly ignored the sensible points that have been raised by other posters - how will she and her partner know if there's a preventable problem with the baby, what will they do if there's a problem during the birth (and how will they detect the problem early enough to do anything about it), how will they feel if their decision results in a dead or permanently disabled baby. People have suggested that, instead of the 'lecturing midwife' she wishes to avoid, she finds instead a friendly, supportive midwife (such as yourself) who will listen to her and provide the sort of care that she needs.

VirginBoffinMum - my concern is not the frequency with which monitoring occurs (though more frequent monitoring should ensure any problems are picked up sooner rather than later), nor the ability of an untrained person to perform monitoring tests such as urinalysis or bloodpressure monitoring. But the correct analysis of the results of these tests does require a degree of knowledge and experience that a lay person just does not have - and cannot gain off the internet, imo.

As I've already said, palpation of the uterus to discern the baby's position is not easy even when you are being properly taught how to do it - so how is a lay person to be sure that their conclusion is correct?

Curlywurlycremeegg - you are absolutely right that a woman has every right to decide what does and does not happen to her body - during pregnancy as much as at any time - but during pregnancy she is also responsible for the wellbeing of another life, so, along with the rights to decide what happens to her own body, comes the responsibility to do her best to make sure that the decisions that she makes are in the best interests of the child she is carrying.

I don't want to end up in the position where a woman could be prosecuted for having a glass of wine or a cigarette (as I believe can happen in America) and I believe that there is plenty of information and support available to allow women to weigh up the pros and cons of the decisions that they make, to reduce any potential risks to the baby they are carrying. But in this thread, the OP has repeatedly ignored the sensible points that have been raised by other posters - how will she and her partner know if there's a preventable problem with the baby, what will they do if there's a problem during the birth (and how will they detect the problem early enough to do anything about it), how will they feel if their decision results in a dead or permanently disabled baby. People have suggested that, instead of the 'lecturing midwife' she wishes to avoid, she finds instead a friendly, supportive midwife (such as yourself) who will listen to her and provide the sort of care that she needs.

Apologies for the double post - my laptop appears to have gone a bit potty this morning!

sunnygirl My midwife care led to my AND, contributed to my bad birth experience and then PND.

I was councelled through my next pg by MNers and wouldn't have gone without AN care, but I can understand SOME reasons why burying your head in the sand can protect the mother from a stressful pregnancy.

I would like to clarify that my experience was partly due to the personality of the mws, partly due to lack of continous care, partly due to NHS under-resourcing and partly due to MY personality and needs not being met. Nevertheless it was a horrible experience.

Starlight - I am so sorry if what I said has reawakened bad memories or upset you - that was certainly not my intention - and I can fully understand your deep reservations about midwives, following your first pregnancy.

I can only imagine the impact that a traumatic pregnancy and birth will have on the mother - which is why I am definitely recommending finding a sympathetic midwife - one the mother gets on with, who will give the best of care that that particular mother needs.

sunnygirl You haven't upset me at all. I've processed the whole experience enough times I think and as I said I'm sure part of the problem was me and need for control(I wanted/needed my birth plan confirming in week 1 for example but mws weren't interested in discussing it - although they really should have picked up on my anxiety).

Unless I went private there was no chance of me choosing my midwife. I never saw the same mw twice throughout my whole experience inc postnatally (or HV for that matter) so my PND wasn't picked up either.