Thursday, 13 October 2011

A mine of midwifery misinformation...

On a day when it has been reported that standards of care in many hospitals are woefully inadequate, I had a midwife appointment at University College Hospital. I have so far thankfully found little to complain about in terms of the standard of care at the hospital, a far cry from my experiences at the Royal Free back in 2007. However, the midwife I saw today was an exception to the rule.

I heard staff talking about how short-staffed they were today due to midwives having called in sick, and saw one midwife trying to deal with a long line of patients. When the time came for me to see the midwife (and by this point it was twenty minutes or so after the scheduled appointment time) she apologised for the delay.

I was feeling both anxious and somewhat unwell, and was interested to see what my blood pressure would be today. Surprise, surprise, it was low (70/44). The following exchange then ensued:

Me: It’s quite low, isn’t it?

Midwife: That’s good.

Me: Well…yes, I know it’s safer that it’s low rather than high-

Midwife: That’s right.

Me: - but actually it’s not all that good feeling faint a lot of the time…

Midwife: You’re very anxious, aren’t you?(Laughs)

Me: Yes, I am. I’ve been seeing the psychiatrist here because of the traumatic time I had last time I gave birth. I am feeling very anxious at the moment...not sleeping...

Midwife: Are you taking anything for it?

Me: No…I haven’t been offered anything.

Midwife: Then you must have a very supportive partner. Did you get post-natal depression last time?

Me: No.

Midwife: Well then. And was your baby alright?

Me: She had some trouble breathing…she had a suspected GBS infection and was taken to the Special Care Baby Unit…

Midwife: No. I mean now. Is she okay now?

Me: Yes, oh yes.

Midwife: So you’re booked for a C-section on 31st October. Is your partner planning to stay?

Me: Stay? When?

Midwife: Overnight.

Me: Can you do that?

Midwife: Yes, in a side room with you and the baby.

Me: But I was told I can’t have a side room because I’m having a Caesarean and they have to keep an eye on me…

Midwife: For the first 24 hours, but after that you can.

Me: Oh! I will book one then.

Midwife: You can’t book them.

Me: There’s a sign out there (pointing to the waiting room) about how to book one, though…

Midwife: How would you book one? Think about it!

Me: So why does it say you can on the sign?

Midwife: Well you can, but only once you’re on the post-natal ward. And if you book you have to pay for it.

Me: I am willing to pay for it!

Midwife: I know you are but you can’t book in advance.

WHAAAAT? You get the picture. You know that feeling you get when you’re talking to someone who doesn't know what they’re on about, and so just bullshit you and change the story with every statement they make? Well, that was one of those situations – not at all reassuring in a clinical setting, especially when you’re already feeling anxious!

After palpating my abdomen and declaring the baby’s head is down, I retorted “Are you sure?” I went on to explain that I was told this last time, but after 48 hours in labour, a scanner was wheeled in and the suspicion I had held for weeks was confirmed: the baby was breeched and suddenly it was all systems go for an emergency c-section. The midwife today was most put-out that I doubted her word and uttered the classic “I have been a midwife for a long time, I do know what I’m talking about!”

In short, I left today’s appointment feeling more insecure about my care and how I’ll be treated once I am admitted on 31st October. Yes, the midwife was under pressure due to the short-staffing, but her adversarial, defensive and patronising manner made the exchange unpleasant for the pair of us.

Oh, and the nonsense about the side room? I telephoned the hospital once I got home, and once I had navigated the dodgy 'phone system (this involved being cut off twice...), I was told that I wouldn’t be allowed one if I’d had a c-section, just as I had been told before. I explained that a midwife told me that wasn’t the case after the first 24 hours, and so I was then allowed to book a room. Who knows who has it right and what will happen? As for partners being allowed to stay overnight, it was the first the woman I spoke to on the ‘phone had heard of it.

One last confused note: the midwife bluntly told me that I was 'lucky' to be granted a c-section as I live ‘out of the area’, and it is now policy to only let women have c-sections at their ‘local’ hospitals (in my case that would be the Whittington). If this is correct (and remember, it came from that mine of midwifery misinformation!) then that’s appalling; so much for patient choice.

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