Mothers alcohol use shown on medical records

[RegularHumanBartender]

I have just stumbled across this on the Sky news homepage and I am horrified. I have no words! Apologies if there is already a thread, I did scan the first page but I couldn't see one.

Talk about reducing women to sacred incubators! I am struggling to form sentences I am so incensed by this. Not sure if this is even the right place to post.

news.sky.com/story/mothers-alcohol-use-could-soon-be-shown-on-childs-medical-record-prompting-privacy-fears-12073153

[Clymene]

I live in an area with large pockets of deprivation. I can see that the children of some people I come across on Facebook local groups have facial markers for FAS. And I can also see that those children's mothers seem to lead chaotic lives with men who seem aggressive. I very much think the two things are connected.

I would like to know the number of women who have children born with FAS who aren't previously known to Social Services. I suspect it's vanishingly small.

Is that something I could do a FOI on and, if so, who would I ask?

[SimpleComforts]

Is it not relevant for doctors to have any of a woman's medical or lifestyle information then?

[Clymene]

Interestingly, talking about maternal health, I have an autistic child and have had to talk through my pregnancy numerous times during assessments.

[FlorenceNightshade]

@Clymene it’s the same with any health condition that presents in childhood. The assessment always includes pregnancy and birth. Also in mental health. Even in adults in their 30s presenting with mental health problems for the first time.

Early years has a huge impact on our lives in ways that still aren’t fully understood.

[Clymene]

Aargh pressed post too soon! No one has ever asked about drug or alcohol use. I wonder if I weren't a white educated middle class woman whether that would be different?

[BoomBoomsCousin]

@hopefulhalf

There is no child in law until birth; the mother/patient’s right to confidentiality is and remains paramount

This is true but hours after a baby is born a new medical record is created it contains the maternal antenatal details as well as the details of the birth (Also previois pregnancies). This happens in every English hospital I have ever worked in.

I had no idea about that hopefullhalf.

That’s atrocious. If a mother has had another child who they had adopted, or an abortion, or a miscarriage that really shouldn’t be information that’s available to the child or any hcp who isn’t treating the mother.

[FireUnderTheHand]

That’s atrocious. If a mother has had another child who they had adopted, or an abortion, or a miscarriage that really shouldn’t be information that’s available to the child or any hcp who isn’t treating the mother.

Totally agreed (would adopted part would come in though since it isn't 'medical'?).

It is no one's business but the mother's if she had an abortion or miscarriage at any point and should never be disclosed to anyone without her express consent.

[hopefulhalf]

Previously removed children would certainly be on tbe record. In terms of previous pregnancies it is usually just year and outcome also sex of previous children.

[OvaHere]

@hopefulhalf

Previously removed children would certainly be on tbe record. In terms of previous pregnancies it is usually just year and outcome also sex of previous children.

So in theory an adult who believed themselves to be an only or eldest child child could access their medical records and discover their mother had carried a pregnancy to term prior to their birth?

[Fallowdeerhunter]

@movingonup20 Helping a pregnant woman who drinks 2 bottles of vodka a week is a very different thing to ‘marking’ every woman who has even a glass of wine whilst pregnant. And do you think this would unroot secret alcoholics? Of course not!!

[hopefulhalf]

Yes, certainly if they were born after 2000. But probrably before that, maybe recorded in a different form.

[OvaHere]

@hopefulhalf

Yes, certainly if they were born after 2000. But probrably before that, maybe recorded in a different form.

Thanks. I had no idea that was the case. I find that a little shocking tbh, I don't think that section of information should be passed on even if in the majority of cases there's no unexpected surprises in it.

[Clymene]

I had an abortion and a miscarriage (the abortion was pre 2000) before I gave birth to my first child.

Both were routinely mentioned in my pregnancy meetings with any new HCP. It was excruciating in retrospect. I was also asked about previous pregnancies when I was having a heavy bleed by paramedics when colleagues were with me. Again, excruciating

[hopefulhalf]

Well you need to be 18 to acsess your records so any of that information would be at least 19 years old. After 18 years of records you'd need to know where to look .....I don't know, the very first few adults may now be doing this I guess. Before it would have been written in a sort of medical code G4P2 means 2nd baby 4th pregnancy.

[hopefulhalf]

So reading between the lines either an abortion or miscarriage. But only a medic, midwife or now half of mumsnet would know.

[hopefulhalf]

It's very misogynist when you think about it. Alcohol (or drug use) in the current pregnancy is far more relevant than a 8 week termination 10 years ago, but it is always recorded.

[FireUnderTheHand]

I find that a little shocking tbh, I don't think that section of information should be passed on even if in the majority of cases there's no unexpected surprises in it.

I completely agree and find it to be a serious violation of the woman's privacy. Women who have been raped, became pregnant, and made a choice (either way) should not be outed on their child's medical records (just one scenario) regardless of the outcome. It isn't the newborn's business (or the adult they will grow into) on any level. Where there are surprises it could cause great familial unrest at best and complete breakdown of the mother/child relationship at worst.

[CuriousFluff]

Does the child not have a right to an accurate record of their health from the day they were created?

[ScreamingBeans]

Well that data won't be available will it, women will simply lie.

[CharlieParley]

I think they have a right to that information, for me that includes details of the pregnancy. Lets not lose sight of the fact the child's medical records first and foremost belong to the child.

Medical records about the pregnancy belong to the mother, not her child. And the mother's medical records first and foremost belong to the mother.

I believe Rh disease is placed on a newborn's medical records. Should the same privacy concerns be used to restrict this information and why/why not? Technically, any harm caused is purely down to maternal biology.

My mother's family lost almost all subsequent babies due to RH disease for several generations. As all firstborns were girls and for whatever reason only those subsequent babies who were female survived, the family had no male children until my uncle was born first. And lucky for me, my mother survived. My brother survived because by that time, treatment was available for a Rh(d) mother with a subsequent RH(D) child.

There's nothing any of my foremothers could have done to prevent these losses. We inherit the Rh genes, behaviour has nothing to do with that. There's also nothing they could have done to stop their bodies producing antibodies that attacked their unborns before the advent of treatment, behaviour has nothing to do with that either.

So while recording a disease the get us develops because of the mother that is not caused by the mother's behaviour but instead by inherited genes and an antibody reaction she has no control over is not an ethical issue at all. But more importantly, recording Rh disease on a baby's record is the recording of a disease the baby suffers itself, hence it belongs on its medical record.

What is at issue with recording the alcohol consumption of the mother during pregnancy is that this is the recording of the behaviour of the mother in the medical record of the child regardless of whether this behaviour had any actual impact on the child.

So these are not the same thing.

[StFrancis]

[quote FlorenceNightshade]@StFrancis as a HCP I will always believe that it is in the patients best interests for staff to have all the relevant information. Wether that’s a mother or an infant.

Woman who don’t engage or who aren’t honest flag up anyway. By opening a dialogue about alcohol or drugs or any other risky behaviour there is a chance to provide support.

The issue is complicated because the child becomes a patient when it’s born and it’s medical history starts in utero. You can’t give a full
history without mentioning maternal health.

On balance I think it’s necessary to include the information if it’s available[/quote]
I agree. My point is that the possibility needs to be considered that weakening confidentiality for the mother will, despite intentions, actually reduce the availability of that information to HCPs.

If the aim is to have more information available and this policy leads to less information being available then it is a bad policy. One of the reasons for patient confidentiality is precisely to increase the chances of a patient confiding in their HCP, safe in the knowledge it will go no further and can't be used against them.

Personally, were this policy brought in I would seriously consider declining to answer the questions on the basis that I would be uncomfortable, on a point of principle, with the balance of rights that had been arrived at for reasons already stated on this thread.

I know full well that I have never smoked or taken drugs and that I don't drink while pregnant so would not be concerned about risks on that score and I would hope to add my little rebellion to help make the point about a counter-productive policy. I suspect I would not be alone in that approach.

I do find that I am becoming more and more 'difficult' with age...!

[ScreamingBeans]

Does the child not have a right to an accurate record of their health from the day they were created?

No.

What my mother did when she was pregnant with me, is up to her to tell me if she wants, but none of us have the right to demand our parents account to us for their feelings, behaviour, culinary habits etc. unless they have really signifcantly affected us.

The entitlement and control freakery of thinking we have the right to demand our mothers account to us for every little thing, is bad news for women.

[TreestumpsAndTrampolines]

Does the child not have a right to an accurate record of their health from the day they were created?

Clearly not since a court has already ruled information about inheritable diseases can't be.

Apparently unless it's women's medical history or if they had a pint before they knew they were pregnant.

One enduring memory of my second child's birth is the midwife telling me that if she couldn't get a clear trace while I was on the ball, she'd force me to lie on the bed (she used the word 'force'). Despite the pain, and having only had short naps for the best part of a week because of contractions, I gave a mini-speech on body autonomy I was so angry at how I was being treated. Especially since they were refusing to listen to a word I said about what was going on, and how it was exactly like the first birth.

[CharlieParley]

Correction to the third paragraph from the bottom from my previous comment (Sorry for the muddle)

So, recording a disease that develops because of the mother that is not caused by the mother's behaviour, but instead by inherited genes and an antibody reaction she has no control over, is not an ethical issue at all.

[BoomBoomsCousin]

FireUnderTheHand
"Totally agreed (would adopted part would come in though since it isn't 'medical'?)."

I was thinking that if the mother's pregnancies were recorded on the child's medical records and she gave up a child for adoption/had an abortion/miscarried/still birth then that could be seen from the child's medical records and the discrepency in no. of siblings. Equally if child had a sibling but their medical records showed that the mother had not been pregnant before, information about the other child's parentage is made available to hcp's treating the first child.