deeply upset -can I refuse certain care?

[newtzy]

I am pregnant with my fifth pregnancy. All my other pregnancies I have had no complications and natural births. Baby no.4 is now 4years old and I had a water birth with her being an older yummy mummy of 4 I decided this time to have a home birth. We have recently moved so we are in a different place than where I had all my other children. I am wanting some advice on care about what my rights are - crazy I know seeing as I have had four but I feel I am being made to feel like a child with this care system where I live and being in a highly emotional state already this is not helping. I have suffered PND after all my births but have always had it controlled by a doctor with anti depressants which work well....when I went to my booking appointment the 2 midwifes sucked in their breathes over the PND and said oh dear and then said even though I wanted a home birth I was to have consultant care because of the PND.....they then went on to upset me further stating that I needed a long term care from a health visitor and a physicatric nurse....I have never ever had or needed these with my other four and used my doctor for regular checkups and I have perfectly happy healthy children and my pnd was controlled well. They also moaned about my BMI being 1 over the average - and that my father who is now deseased had diabeties and going on about tests - never had any problems with anything in my previous pregnancies and do not have diabeties. I feel so stupid now that I just sat there stunned not saying anything - I feel that my care is being taken out of my hands and I am only 3 months and hating and fearing this pregnancy - I know its very silly but I have been breaking my heart over all of this and worked myself up into a state over it last night - literally sobbing...they made me feel like a child and I am 37 with a brain and have had four kiddies before. My partner is not much help and he is reluctant to help me stand up to them - to be honest I feel is not really bothered. I feel very alone in this and really wanted some advice as I want to write a letter and complain and refuse certain aspects of my care. I know different places do different things but surely you do not have to take it if you dont want to.

WTF???????

Of course you can refuse it, unless you are insane and they would be able to section you, which is very difficult.

And 1 over your BMI????? Mine has been more over that and I've never had a problem with my four babies.

I would complain to the supervisor of midwives - maybe ask advice from AIMS?

I'd be tempted to sell everything I had and pay for an IM!

Aww, bless you, I am not sure what you can do but I'm sending you a - that sounds bloody awful.
Can you make an appt to see consultant, tell him/her what is going to happen not what hey say, and just let the midwives get on with being eejits?

Thank you so much FlamingoBingo - I have been teetering on tears all morning but just burst into tears with relief as I know I am not mad. I will do just what you said - wish I did have enough pennies for a IM.

thanks also RubyBlueberry

find out who is the head of midwifery and complain

it is an utterly inappropriate way of dealing with someone

PND is very common - i agree if you have had problems in the past it is good that this is recognised AND you get extra help, but not like this ... there are ways of doing things

being over weight is too (altho' and 1 point over i can't see how it such an issue)

they sound really horrid - if your partner can't support you, do you have a good friend or family member who could be some moral support

Consultant care because of PND? What exactly is an obstetrician going to do about your PND, unless s/he is also a psychiatrist?

Sounds like your midwife is crap. Ask for another, or complain. Talk to your GP too.

You don't have to take anything you don't want to - and I would say this is especially true for anyone who comes to your house eg a HV or CPN. You can refuse - and you should, by the sound of things!!

Errr if you don't try for the birth you want aren't you more likely to get PND!!?? I'd point that out!

Oh you poor thing. No idea what to suggest but i would think you shouldn't panic too much because all your medical history at old GP's will point to the fact that you are not crazy in the slightest and that your PND (which is very common!) has been successfully managed with AD's!! So you should be able to refuse the care surely as you dont need it!? Sounds crazy to me, i agree with asking advice from AIMS. Good luck hope everything gets sorted and you feel better really soon.

I agree, complain to the head of midwifery.

What good is consultant care for PND? They deliver babies, their experience of postnatal care of mothers is limited.

You have coped with PND with your last 4 babies, why should this time be different?

Is there an alternative hospital nearby you could change to perhaps?
You are quite within your rights to refuse anything you are not happy with so stand your ground. I think you also need to have your partner on side too - can you sit and talk this through a bit more - or maybe just show him the post you wrote (edit if needs be) as I suspect he just doesn't understand what you are going through and being a bloke burying his head in the sand.
I would write out the way it is going to happen as you would like it and why, and then make it clear to the hospital that they need to support you through this not interfere.

Thank you so much all of you for your advice and help.

I was put under consultant led care beacuse i was a high rik factor. all beacuse i suffered pnd,my mum is type 1 diabetes, dad died at 54 with heart problems and i have no bladder sensations since birth of son 5 years ago.

I am 22 weeks with 2nd, i went to see the consultant and put my case forward. i explained to them how i felt what i wanted and no one had bothered over the last 5 years(all except pnd,which they did bother about).

They agreed to midwife led care, a c-section (which i wanted)and they would just keep an eye on me afterwads with regard to pnd.
so do go to see the consultant and put your ccase to them.
good luck

Newtzy, I am so angry for you, I can't believe what has happened.

Don't take any crap off these midwives. No one has the right to treat you like this. You should be treated with dignity and respect all throughout your pregnancy and your personal point of view should be taken into account even if you change your mind at any stage. They are not qualified to judge you on your PND - leave that to the doctors.

I would complain to the head of midwifery at your local hosp, as well as your GP surgery's patient liaison group if they have one. You can even complain to the Royal College of Midwives. I don't know how it is where you are but in my area the midwives are attached to the surgery so I would change to another surgery if an alternative midwife couldn't be found at my current surgery. I would also ask to see another midwife at the hosp for all my antenatal appointments if this isn't too far away for you to get to.

All medical staff have to follow a certain standard when dealing with antenatal care. Look at this www.nice.org.uk/CG62
These are the clinical guidelines they have to follow. Please please take your time and have a look at this (a bit long I know) but it tells you what to expect from medical staff. They all know about these - it was a GP who told me about them. There are also similar guidelines for induction and labour (natural or otherwise).

Also I would get hold of the consultant details and check with him/her whether it is really necessary to be under his care just cos you've had PND in the past. I bet they'll be asking themselves why the midwives have referred you when you have no complications.

And don't be afraid to pick up the phone and call everyone - I'm always calling the hospital with my questions cos I find them more helpful than my GP surgery. Don't be afraid to pester people and certainly don't let them fob you off.

In the past I've been bounced between my midwife and the GP in the surgery. The GP couldn't understand why the midwife couldn't have done her job instead of sending me across the corridor to see him. I said look I'm the patient and I don't care who deals with what just deal with it. He felt sorry for me cos I'm so huge and made an exception. So be aware of being caught between different points of view between doctors and midwives.

So speak up if you're not happy with something and tell them so.

Don't let two bullies who ganged up against you ruin what should be a happy time in your life. You have had four great pregs in the past so please don't feel negatively about this one just cos of these midwives. If I was near you I'd come down and give them a piece of my mind. Grrrr. I hope this has made you feel a bit better now. And congratulations on this pregnancy!

PS My partner is leaving all decisions to me so I know I can't rely on him which is why I've done all this research. Also my dad died this year of diabetes and I don't have it so I would ask "WTF has this got to do with anything?" I would also say "WTF has PND got to do with this pregnancy?" There are signs up all over the place in the surgery and hosp saying that the staff will not deal with abusive patients but just be aware that you, as a patient, don't have to deal with abusive staff either. You are a lady who is pregnant, not a mad woman, and you should be respected and treated in a civilised manner.

I'm 36 and this is my first pg-was also referred to consultant led care by the 2 midwives at my booking appointment due to my "history" of depression. This history refers to one episode of depression 15 years ago following the death of my father.

I saw the consultant once-he couldn't work out why I was there as depression following death of a parent was understandable to him. HHe said I'd be seen one more time at hospital before referring em back to midwife led care. On the next visit, I saw an SHO, who, unknown to me, had only been there for 3 weeks.He decided baby was breech and that I had to come back for scan and ECV. Meanwhile, I was seeing midwives at my gp surgery but never the same one twice. None of them could work out why I'd been referred to consultant led care. Went back to the Senior House Officer who once again, couldnt work out why I was there as baby was most definateoly not breech (bodes well don't you think, when he can't even read his own notes?). He reluctantly agreed to sign me off then took my bp straight after I sat up, with my arm dangling freely. Not surprisingly it was highish at 144/86. He wouldn't wait a bit to take it again, just ran out of the room and came back telling me I was to have checks from the community midwife team for rest of the week due to "your suspected pre-eclampsia" (no protein in urine but he said it just hadn't shown up yet). He laughed when he told me I'd have to come back.

The midwife that came to the house was going to be the new one for my surgery so finally there'd be a familiar face. After confirming I did NOT have PE, I told her I had decided not to go back to the hospital.Gave my reasons and after one more appointment at surgery when all was well, she rang up and cancelled the hospital appointments. At 38 weeks I am finally back on midwife led care-better late than never. And I've put in a complaint about the numpty SHO.

You have a right to be treated with dignity and it's never too late to find your voice. I am sick to death of people being discriminated aginst because of depression - it shouldn't be lost on the midwives that healthcare itself is one of the most likely professions for depression and most people go on to make a full recovery. Don't let yourself be bullied-my pregnancy might be in the latter stages but I feel so much better for following my instincts.

just to give a slightly different angle re. the consultant led care. all hospitals should have their own guidelines for those felt to be most suitable for midwife led care. at ours any previous history of depression would get you consultant led care. this doesn't mean you never step foot outside a hosp but that one of the consultants might see you at around 20 weeks and if all well discharge you back to the midwives.
these policies are put in place to protect the safety of mums and babies, but at any time you do not have to have anything you don't want. as others have said contact the head of midwifery re.complaints and the supervisors of midwives for support (your local hospital switchboard should be able to put you through to them).

good luck and hope it all goes the way you want

Thank you so much all of you for your wonderful thoughts, help and support and also www contacts. Just wanted to update you all....

I contacted AIMS and got a smashing email back from them with suggestions on what to put in a letter of complaint and support. I also contacted my GP surgery and put a complaint in to the practice manager there - who thankfully was a women - she could tell how upset I was and said she would contact a midwife who was in the surgery this afternoon....at 5.30 this evening I got a call from a different midwife who listened to me and also stated she could not understand why I would be referred to a consultant over PND when PND is treated by midwife care/GP care and understood my wanting a baby at home. I told her I am an experienced mother of 4 and do not need the constant interference of H.V or CPN either - if I need it I will ask for it. Thankfully my partner has seen how upset and riled up I am over this and that I am not going to lie down and be walked all over - so he rang up the consultants office and spoke to the secretary and stated I would not need an appointment and am not having consultant lead care unless absolutely necessary. I know its not easy for our guys but at least he is trying

The midwife who phoned me is coming over tomorrow to change my notes and to cancel all hospital care and to have a chat - so I will get to talk to her a bit more about how I would like this my antenatal and prenatal care to go forward.

You all gave me strength today and I would like to thank each and everyone of you for your posts.