Missing out on midwife care

[Vangough]

I am pregnant with my second child (due April) and am hugely concerned that I will end up going through the horrific experience I had with the birth of my daughter at Kings 2 yrs ago.

The problem is where I live (I am up the hill in Crystal Palace) I am already 24 weeks yet I have only just had a phone call from a midwife at the Heshima centre (I was told all local antenatal midwife care was disbanded) It was only when I wrote to PALS at Mayday that I got that phone call.

Until now I have had ante-natal appts with a different midwife each time through Kings. Nobody is 'allocated' to me like if you are lucky enough to be in the catchment for Paxton Green/Oakwood/The Lanes etc. I have had no opportunity to discuss how I feel this time around, or build up any kind of trust/relationship with a midwife...let alone actually know the midwife I will get when I go into labour. I have No guarantee of getting a room, No guarantee I will not be made to crawl around the labour corridor for 6 hrs in advanced labour again.

I have had an apology from Kings about what happened the first time and whilst they assure me I will not be ignored, bullied and generally made to feel unwelcome again this time, I may still have to wait hours for a room. They even admitted there is a 'postcode lottery' when it comes to Midwifery care but said they can do nothing about it.

Nobody even came out to see me and my newborn once we were home last time....they were too busy. If midwives are 'too busy' to visit first time Mums and newborns, just exactly who are they seeing?

It's so frustrating to hear friends talk about 'their midwife' and how they 'just walked into their labour room on arrival at hospital' and how 'safe' they felt. I feel anything but safe ! Even though I have begged the self-referral practises in my local areas nobody can fit me in ! How is this fair? Am I the only one in this Midwife 'black hole' !? It's very isolating :'( Does anyone have a magic wand?

[The Nappy Lady]

Vangough, this is awful and must be even more frustrating given how close you are to some excellent midwifery teams.

I am guessing a private midwife, or even a birth Doula as a less expensive option are beyond your budget? It's the only thing I can suggest as a possible solution.

I do hope things work out for you.

Molly

[Ellen09]

Hi I understand how fustrating the situation must be for you. have you thought about making an appointment with your GP and explaining your concerns and past experiences to them? if you are having problems with midwife care in your area others must be in the same boat. I had my baby two weeks ago under bromley, everything was generally fine but i never had a midwife "allocated" and saw different people at appointment.

Just to reassure you, nobody came out to see little one when we were sent home even though the hospital assured me a referral had been sent. I contacted a midwifery helpline at kings and they were fantastic and got a lovely midwife to visit me the next day

[R&A]

I spent most of my labour in a toilet in the antenatal ward on my own (my partner was sent home) so that i didn't wake the other patients up as i was making so much noise. This was just 2 weeks ago.

The midwives didn't think i was far gone enough to send me to the labour ward... never mind arrange for the epidural i had requested before i even went into labour.

It was only when i started pushing that they believed me (!) and thankfully my partner arrived in time as i was rushed to the labour ward being shouted at 'not to deliver down here'

I should have read the warning signs when the midwives bragged that the previous day they only had 'natural' deliveries with no doctors needed...

The midwife who came up to the labour ward with me had an argument with another member of staff in front of me (whilst i was pushing) about the fact she didn't know where anything was in the labour room and she wasn't meant to be doing deliveries. She delivered the baby but i certainly didn't feel safe

Had i known the care would have been so poor i would definitely have paid up for consistent and quality treatment - no question about that.

The after care was even worse. Every day i had to explain my story to a new midwife. Each time i was given inconsistent advice and sometimes medically questionable. e.g. you don't need to have salt baths, you just need to rinse with water... I pleaded with each new midwife that my episiotomy didn't feel right and i thought it was infected. I was fobbed off for two days. Eventually a midwife told me it 'looked fine to her' but took a swab anyway. That swab was lost...

I managed to grab a doctor the next day who dealt with me properly and informed me it was infected as i had feared. I am on a 15 day course of antibiotics and now have thrush which is making breast feeding impossible. My episiotomy has broken down and i have to go back to be re-mended in a few month's time

one midwife told me 'off the record' to go to a health shop for a natural remedy for my infection...?! unfortunately this comment didn't surprise me and i didn't have the energy to say anything

i think my situation was made worse by the fact it was over xmas (poor weather etc) and staff turnover was probably greater due to people being off on holiday. Also there were one or two really amazing midwifes but they were in the minority. I found the care given by the doctors to be truly amazing and i'm very grateful to them.

Anyway - i'm happy with the new arrival. A fantastic xmas present

[kristymac1]

Oh R&A that sounds just dreadful, I do hope you, Mr R&A and the little one are so blissful in your new family that the birth 'care' is well on the way to being a distant memory.....

Vangough - My daughter is now nearly 3 and we used an independant midwife Verona Hall, who is now a very good friend and will be part of all our lives for ever (hopefully). Verona does a variety of different 'packages' and if nothing else is well worth a phone call for a chat (she really is lovely) - veronahall.co.uk.

Wishing you all the very best xx

[littleEDfamily]

R&A, I am so sorry to hear your tale, as I remember your previous posts in late pregnancy and had my fingers crossed for a smooth labour for you. The terror of Kings (and most other NHS hospitals) is that it's such a lottery as to who you'll get. Although some of the staff are undoubtedly wonderful, there are some I wouldn't trust to pack my groceries!

As much as the main thing is getting your baby out in one piece, you just can't under-estimate what a fly in the ointment it is to feel so neglected (and have people be so obnoxious to you) at one of the most vulnerable times of your life. I was ranting for weeks and weeks (ok, months) about my experience at Kings, and relatively speaking I got off lightly.

I hope everything heals up soon, and the hideous memories start to fade.

vangough, I have no magic wand, and I hope this isn't taken the wrong way, but would it be worth exploring a private option? I don't advocate places like the Portland, but there I hear there are some fabulous midwife led private establishments in South London (I'm sure I have seen some threads on here before).

[Susie1791]

I also used Verona Hall as my midwife and it's definitely worth talking to her as I was very nervous about my whole care throughout my pregnancy and the birth, I had heard too many horror stories and it was just wonderful having someone dedicated to me, I instantly relaxed. As for the birth, best laid plans and all that, I ended up in Kings having a c-section but Verona was with us every step of the way and for 6 weeks after, so Vangough if you feel it's not right at Kings and it's making your whole experience stressful, it's at least worth a call.

[Vangough]

Thank you for everyone's comments, I knew I wasn't alone in my experience at Kings, I guess I was hoping things might just be a bit better now. Sadly it seems not.

R&A I totally know how it is to be ignored - that was my biggest problem at Kings, they didn't believe I was as dilated as I was, or that I needed to push when I did. How can any midwife not recognise that a woman can actually know her own body ? That was part of what their apology was for. Therefore (if you can face it) I would suggest a stern note to Kings PALS when you get a minute free as they do take it seriously, and it's only when women complain about being treated like this that those midwives who are the problem are identified.

I think the advice about going a private route is sound, and it is something I am investigating. We are seeing the Birth centre in Tooting soon if anyone knows anything about that !?

thanks

[curlykaren]

just a thought...do you have any friends who live in the catchment areas of the doctors surgeries that offer midwife cover? You could always 'move' temporarily. It would mean being at your friends house for your midwife appointments but thats got to beat going to kings. At least that way you could build a relationship with a team of midwives, one of whom would meet you at kings for the birth?

[The Nappy Lady]

R&A I am appalled by your story. It really upsets me to think that in this day and age, in this country that women are being (not) cared for in this way during one of the most important, life changing moments in thier life. OK, I know from others that time heals and memories fade, but why should women have to go through stuff like this when there is no need.

This is what I mean about you needing someone there with you (if at all possible) from start to finish who can negotiate/shout/beg on your behalf. I don't know if it would work every time, and I appreciate for you R&A that your partner got sent home, but I think if you can have an independent midwife or a birth Doula with you it may well make a difference, though I know not everyone could afford this option.

I too know Verona Hall (I actually did a nappy demo for her when she was pregnant with her first baby!). She is a lovely lady who exudes calm and would agree with what others have said - more than worth calling her for a chat if nothing else.

Molly

[sillywoman]

Vangough, are you registered to have your baby at Kings, or at Mayday? I know that Crystal Palace is - as you say - something of a black hole for midwifery care, but the key to getting the antenatal care you want would seem to lie with continuous contact with whichever hospital you are booked with. You should (as you know) be seeing a midwife every 4 weeks at his stage in your pregnancy and if you're not being offered that by Kings/Mayday then they are putting the health of you and your baby at risk. I would suggest a quick and urgent email to the head of midwifery outlining the care (or lack of) that you have received so far and perhaps explaining the reasons for your anxiety. A bit of foot stamping at this stage may well pay dividends - as I said before, continuous contact is the key. Get the contact details of a key person (if it's Kings I can help you with that, just PM me) and email/ call every few days until you get your concerns properly addressed.

For the birth itself - The Birth Centre is absolutely lovely and will give you the care you want, but at a price sadly. A cheaper option, & one that might work very well for you, would be a Doula. A woman who has had children herself, who is also trained as a birth supporter. She acts as friend (both to you and your partner), advocate and general helpmeet. They visit you a coupe of times before labour to get to know you & discuss your concerns/ hopes for the labour & birth, then they arrive once you go into labour and stay with you until the baby is born - however long that takes. You can also arrange t=for them to come after the baby's born too. Again, I have a list (somewhere) of registered Doula's in SE London, PM me if you would like it.

Postnatally, Kings aim to do at least 3 home visits to Mums and new babies in the first 10 days - usually they're pretty good on their postnatal follow up care. If there is a health issue for either Mum or Baby then they will visit more often. you may get different midwives at each visit, and yes, you should be prepared to have to repeat your story to each one as R&A found. They do write it in your notes, but they prefer to hear it from you as they get a better sense of issues that are important to you that way. After 10 days your care is usually passed on to the Health Visitors and GP's (though the MW's can keep you on their books for up to 28 days if they think you need it - they're not trained to keep you beyond that point). I don't know why no-one visited you last time - "too busy" doesn't sound right - I would be questioning this hugely, as again, no visits at all is very dangerous & there are new baby checks that need to be done (were you asked to bring your baby to a clinic at the hospital perhaps, sometimes they do that at Kings)?

Anyway, if you stay with the NHS then it sounds like you'll have to be quite pro-active in finding out exactly what care you should be getting and making sure you (and your baby) get it. If I can help you do this in any way please PM me.

[Vangough]

Any recommends for other private birth units in the local area would be appreciated ! The birth Centre in Tooting is a good half hour drive for us and anywhere closer means less speed bumps ;)) (not fun when you're in labour !) thx

[Mellors]

I am in central ED and had my second baby at the Birth Centre in Tooting (after a horric first experience at St Thomas's). I cannot recommend them highly enough - they were just marvellous, worth every penny. It took us about 20 mins I seem to think at 11pm on a Frioday night to get there - loads better than the trip to St Thomas. If you fancy it, they are just as set up for you to labour at home though, and in fact thats what I would do if there is a next time. they can always take you to Kings if it gets tricky.

Caroline Flint (who owns the Birth Centre) was my NCT teacher 1st time round, and I just adore her. The after care is second to none as well.

Do PM me if you want more info.

[sillywoman]

Have also heard that The Birth Centre have a special fund so that women who have had previous severe trauma who might not be able to afford the full fees can apply for special consideration to be part funded by them. Might be worth asking them about?

[Mellors]

I did a deal on my fees, and you pay monthly in advance before the birth, so at least its all done with and you have forgotten about it afterwards. She actually told me she makes practically no money out of it (rich husband), but does it for her love of midwifery services. She is a wonderful woman.

[R&A]

Thanks for your kind comments everyone.

I will be writing to kings mainly because what happened to me just doesn't seem like a one off.

If it was down to bad luck i'd accept what happened and move on.

however, from speaking to other patients/friends/nct women it isn't a one off - the same bad events/errors happen time and time again.

There were three main serious conclusions that i will try and pass onto other women in future and would be the basis of any letter i write to kings....

1) If you want an epidural - ask a doctor

2) '1 in 2 episiotomies get infected' - this is a quote from a midwife - push for proper salt baths or equivalent if you're still in hospital. I was denied this and just told to rinse with water. Again if you think you have an infection ask for a doctor.

3) 'More than half the babies in special care are in for dehydration' - quote from a nurse in special care. - push for a proper breast feeding counsellor and do not rely on midwives who do not get trained in breast feeding

If i had been told any of the above i may have been home for xmas instead of both of us lying sick in hospital

Consistent care may not have helped as at least the high staff turnover meant i was exposed to the good midwives at some point during my (preventable) 7-day stay

[Smiler]

R&A, Sorry about your experience, agree with others that if you can face it it'd be good to take the issues up directly with Kings, through the Patient Advice and Liaison Service (PALs). I have always found them to be helpful and on the two occasions when I complained (by email) I received constructive responses from a senior midwife / doctor.

[Monkey]

Sounds like it's worth a letter to Tessa Jowell...

[sillywoman]

R&A Wrote:

-------------------------------------------------------

> Thanks for your kind comments everyone.

> I will be writing to kings mainly because what

> happened to me just doesn't seem like a one off.

> If it was down to bad luck i'd accept what

> happened and move on.

> however, from speaking to other

> patients/friends/nct women it isn't a one off -

> the same bad events/errors happen time and time

> again.

>

> There were three main serious conclusions that i

> will try and pass onto other women in future and

> would be the basis of any letter i write to

> kings....

>

> 1) If you want an epidural - ask a doctor

> 2) '1 in 2 episiotomies get infected' - this is a

> quote from a midwife - push for proper salt baths

> or equivalent if you're still in hospital. I was

> denied this and just told to rinse with water.

> Again if you think you have an infection ask for a

> doctor.

> 3) 'More than half the babies in special care are

> in for dehydration' - quote from a nurse in

> special care. - push for a proper breast feeding

> counsellor and do not rely on midwives who do not

> get trained in breast feeding

>

> If i had been told any of the above i may have

> been home for xmas instead of both of us lying

> sick in hospital

>

> Consistent care may not have helped as at least

> the high staff turnover meant i was exposed to the

> good midwives at some point during my

> (preventable) 7-day stay

Number 3 = fantastic advice, I would just say though that some pretty comprehensive research has shown that salt baths/ washes have no measurable impact on the healing of wounds or trauma's. It will heal just as quickly with clean water as with salt water. So actually in that instance the midwife was right. But I guess if salt water makes you feel better, then go for it.

Not intended to detract from you experience in any way.

[SianandTony]

there must be a reason as to why the midwives do not advise bathing in saline, i had second degree tears, and was advised just to shower as normal. was concerned mine has become infected but they have turned out fine(been nearly 3 weeks). i was given dissovable stitches

[Belle]

I wrote to Tessa Jowell when I complained to PALS and got a v standard letter type acknowledgement - got the impression her office were just not interested and v much not wanting to be seen to criticise King's (understandble in one way, in that my complaints were unproven of course) - just not v helpful. However I found King's exemplary in there response, they took lots of time to go through my notes and identify the errors and reasons why they occurred where possible at every step. They also apologised a lot which did make me feel better!

[pebbles]

What i'm about to advise is a bit cheeky so anyone - please don't tell me off - it's just an option for Vangough

For many reasons, 5 weeks before my due date with no1 I decided i wanted to try for a homebirth. To be totally honest, I didn't actually think I would succeed but what I wanted was the majority of my labour to be at home with a midwife with me. I phoned all the private midwives in the area however as I was so close to due date they were all fully booked so then I phoned Kings and they have 2 community midwife teams - East & West team. A midwife came out and saw me 3 days later with a box of goodies which basically was everything i needed for my home birth. She spent about 30 mins with me going through exactly what would happen from moment i went into labour - ie i was to phone them immediately to tell them it had started and then keep phoning them to either be reassured by them that i was in labour but was still fine just me and hubby to when i decided that i must have been cm and i needed her to come - she came 15 mins later and never left me.

The reason I went for "home birth" and this midwife also acknowledged this as correct is - when u r in labour they come out and see you and if you are past 4 cm they stay with you however most importantly if at any point in time you decide that you want to go into hospital you will be taken into hospital and STRAIGHT INTO A ROOM. they can't promise they will stay with you as if there's another homebirth they would have to go but if they aren't called out to anyone they will stay with you.

i know it's not the answer to all your problems ie definitely having a midwife you know with you throughout labour however it would mean that you would go straight into a room when you arrived and it would allow you to spend as much of labour as you want/can cope with at home but with a midwife.

i actually ended up having a homebirth although i never thought i would, i just was cheating the system!!!

good luck and if you have any further questions please just ask

[The Nappy Lady]

Good thinking Pebbles. My first home birth was supported by Kings Community Midwives and was fine, even though I had never met the attending midwives before.

With a homebirth you can ALWAYS change your mind and transfer to hospital, but until then get 1-1 midwifery care at home - what could be better? I know at least one truly brilliant midwife on the East team.

Molly

[Mellors]

You're lucky if it works like this in your area. I also decided to have a home birth with No 1 about 6 months into my pregnancy, and there were no available midwives at all (Kennington/St Thomas's), hence I ended up with hospital and a nightmare.

[Vangough]

Pebbles, I hear what you are saying, and as I am still fact finding I will consider any option right now. I haven't discounted a home birth but I had complications last time (even though it was a natural birth) that may preclude me. I will investigate.

Very interested to hear you can 'do deals' with the Tooting birth centre ! I'd love to hear more on that (if you don't mind can I PM you Mellors?) I too have liked Caroline's attitude so far speaking to her on the phone.

The latest news is all my foot stamping also gave me a call today from a lovely lady at 'Crocus' - the midwife led practise via Mayday. I hadn't been told anything about them until I complained ! We are going to chat again later this week. She said if I want, I can be allocated my own midwife now who will do all my ante-natal checks, get to know me (I cried at that bit) would deliver me, and take me through to post natal care too. She promised all her midwives were lovely too. This of course would mean transfering my booking from Kings to Mayday though. But it is another option to seriously consider.

So, the moral of this story is COMPLAIN. I know far more now I have talked to hospital senior management, and at last feel I might have some control over what happens this time around. There is a huge miscommunication between the PCTs and local surgeries, I know more than my local doctor does about what midwife care is available to me. Surely offering advice should be part of their remit? otherwise how do you find out about it?

For the last 2 years I have also thought 'this is just how it is on the NHS' - but it is not, nor should it be. Care is inconsistent and was in my case, non-existent, and this is just not acceptable. The more women that hilight this, the more the NHS have to recognise it and do something about it. It also makes you feel alot better !

Thank you everyone for your help and tips, they may not be a magic wand but I feel alot more informed now than I did a few days ago.