Midwife check-up: how would you react?

[Einna88]

I have a quick question for those who are/have been pregnant....

Please envision this scenario. You go to your midwife to a check-up, but when you walk in, she tells you to leave the door open, explaining that they're busy that day and she might be called away during the appointment. So throughout your check-up, the door is open and people are milling back and forth and your midwife is distracted and not really paying you much attention.

She's pretty distant anyways and gets quite rude at one point...I don't know about you but I'd feel very uncomfortable with someone like that, but then I know she's busy and don't know if I'm being too harsh. How would you react?

[bonzo77]

I would be very cross, especially if I felt I had not been looked after properly as a result of the MW being distracted. Actually I would have said "I'm not comfortable with you leaving the door open, it's not private enough and could result in a breach of my or someone else's confidentiality. I'm sure if you are needed someone will knock on the closed door". Totally unacceptable to put you in this position. If it happens again I would be complaining.

[mmmnoodlesoup]

I would be upset but tbh as long as my bp, urine, baby heartbeat etc is all good, I would just move on. I've had rushed, unfriendly mw before but just get over it, and hope the ones supporting me while I'm in labour are nice. Otherwise ill definitely be kicking up a stink

[anastaisia]

Put in a very mild complaint. All the women who just put up with substandard treatment aren't doing themselves, other women or the midwifery teams a favour by not making people in charge aware of it. If staffing levels aren't high enough to deal with cases in a way that women feel is satisfactory then the best thing to do is to leave a paper trail that means the trust can't be unaware that women feel this way and so they need more staff. If women actually say 'this isn't good enough' then things are far more likely to improve than if they do nothing. If the midwives are saying they're short staffed but the appearance is that women are satisfied with the care they get then things are far less likely to change.

You don't need to blame the midwife in it - but could say something along the lines of it being inappropriate for patients to made aware of there being inadequate numbers of midwives to provide proper care in the way that you were, and that you feel being so over stretched impacted negatively on your midwife's ability to give you sufficient attention (though you fully understand that it was not her fault that it was busy/not enough midwives or something along those lines).

[BlingLoving]

Sorry, responses here are too mild. No medical professional should leave the door open. Ever. And because you re pregnant with all the nervousness and worry and hormones that entails, you don't freak out at the exact moment. This happened to me when I went for my first fertility appointment - after I saw the dr the nurse took me to another room to discuss the tests they. We're going to h ave to do and how I could not have sex etc etc all with the door open. I was so overwhelmed bya the entire experience, and as it turned out, already pregnant, that I said nothing at the time and then cried the whole way home.

Your op is written strangely - is this something that happened to you or someone else?

[Popumpkin]

Firstly, there's a huge confidentiality issue with leaving the door open during a consultation. A midwife is bound by confidentiality laws just as Drs are and you certainly wouldn't expect your GP to leave the door open during an appointment so that all and sundry could walk in and out would you?

Secondly, it's dangerous practice. If she was regularly distracted she runs the risk of missing something, which could ultimately harm you and/or your baby.

Thirdly, it's rude.

[buggyRunner]

honestly- if I was over due I wouldnt give a sh*t as long as I got a good sweep!

Joking aside it would have upset me with dd1- with dd2 I would have just accepted it.

It isnt on though but there will be a reason for it- the midwife would probably love to give you all her attention but they may be low on staff - had an emergancy or something. As long as baby is fine I'd be good as her being able to keep the door open may have a massive effect on someone elses baby

We have a population over load and the NHS isnt coping

[Bongaloo]

I don't know about the confidentiality issue - once you're on a ward or the day unit at our hospital, it's just a curtain anyway.

[TaggieCampbellBlackFriday]

I'd thank my lucky stars we have an NHS and free maternity services and spare a thought for women the world over who have nothing and a 1 in 8 chance of dying in labour.

[reikizen]

put it down to experience. I can vouch for the fact that the NHS is crumbling around us and very soon these will seem like trivial concerns when you have a telephone consultation (if that) with a midwife! Perhaps she was one of my colleagues at a neighbouring trust which has taken out a loan to pay staff wages and told every member of staff they have to re-apply for their jobs (when many were forced to go there 12 months ago after a huge NHS re-organisation ironically called 'making it better'). That might make me not as pleasant as usual, don't know about you. Seriously though, not good practice but not dangerous or negilgent so all is well...

[specialknickers]

TaggieCampellBlackFriday - but the NHS isn't free - we pay for it.

OP I think the treatment you have received is disgusting and you should absolutely complain about it. I would. Unfortunately, when you're pregnant you feel vulnerable and don't want to rock the boat, but unless we do (see the why do midwives lie on your notes? thread - can't do links sorry) the service will just get worse and worse.

Personally I think the NHS is worse than useless. I had my first child in the Netherlands and the care I got there was amazing - midwives with all the time in the world, appointments when you need them, a dedicated 24hr emergency helpline (with call out if you needed it - went through to your team of three midwives, all of whom you get to know personally during the course of your pregnancy)... and best of all, a maternity nurse with you in your home, cooking, cleaning, looking after the baby for the first 7 days after birth. This is all subsidised by the state.

Since then unfortunately I've had to deal with british midwives who have all been ill informed, distracted and unprofessional. I like to think that I was just unlucky, but given that I was at two different practices, I'm guessing this is standard.

[TaggieCampbellBlackFriday]

I take it you weren't watching BBC1 at 20.30pm yesterday, nor seen 'Freedom For Birth' (interestingly part of that is about a case in the Netherlands).

[iamwhaticallpregnant]

I don't think any health professional should leave the door open - imagine you had wanted to discuss something really really personal (something like depression or domestic violence) and had built up the courage to finally say something - and the door was open so you didn't feel safe enough to tell her how you felt.
My MW is very snappish and dismissive but I think that is just her way. She (your MW) might not have given a second thought about it and if no one had said anything previously she would have just continued. I wouldn't want to kick up a massive fuss - but if it made you uncomfortable it is worth mentioning to someone or it'll just continue for others who it might affect really really badly.
My doctor once (accidentally) left the tannoy thingy on as I explained I needed the contraceptive pill before a receptionist came balling in exclaiming "DR DR... you have left the loud speaker on!" So it could have been worse. That was a long walk back through the reception after my appointment .....

[tamster83]

well I think it's rude ! wether they are busy or not it's there job and should be concentrating on you while your there . and giveing you the privacy you deserve obviously if there was an emergency and they have to leave mid way thats fair enough . I cnt stand it when they are rude but unfortunately some are this is my 4th pregnancy and I've only ever had 1 really good midwife who I loved

[specialknickers]

No I wasn't Taggie, I'm pregnant for the fourth time after two horrible MCs (made much more upsetting by the "care" at my EPU) - I don't think watching programmes like that would help me feel more confident about my chances of a live birth this time.

I take it that you missed C4 news yesterday? They had an item about the inquiry over that the shocking mistakes at a midwife-led care in a unit in Ludlow, which led to the preventable death of a baby in 2009. That was bad enough for me.

[TaggieCampbellBlackFriday]

I saw.

But this is about a door not a death.

[hopeful92]

You have absolutely every right to feel angry about the care you recieved. Whilst you are at your appointment, it is the midwife's duty to make you feel comfortable, listen to you concerns and focus on YOU. She should have closed the door, and if she was needed they could have knocked! My midwife tried to weigh me with the door open with about 4 people sat right outside waiting, I told her no chance!

For those saying "be thankful we have the NHS for free and don't live where only 1 in 8 babies survive" well, yes, we are thankful for that BUT we pay taxes to recieve NHS care, it is not free!!

If I were you, I would be complaining about this substandard level of care you have recieved to ensure it doesn't happen to anyone else - imagine if you were a nervous wreck attending your appointment. Unacceptable.

[specialknickers]

Taggie are you a midwife by any chance? Because if so, then you would know that shutting a door to afford privacy for your patients affords them basic respect. Without that respect, perhaps you might also not take their concerns about their forthcoming birth seriously, and perhaps, on a bad day, maybe you would go about your daily tasks after delivering a baby without giving that baby adequate checks. Perhaps you would leave them for up to two hours without calling 999 and then perhaps the baby would die. A stretch? Perhaps. But this is what happened.

I'm sorry to say this, but NHS midwives I have met are much more concerned about "doing their job", i.e. filling forms, listening out to be "called away" during appointments, chatting away to junior staff that might be shadowing them etc, than focussing on the woman and the pregnancy in front of them.

[hopeful92]

specialknickers I agree. Although my midwife is nice enough, I must admit as soon as I try and ask her a question about something that is worrying me she brushes it off and goes back to her form filling!!

[coffeeinbed]

Did she listen to the baby with the door open?
Shocking, actually.

[TwelveLeggedWalk]

But putting up with substandard care in the Uk won't help women in Sierra Leone, the two are unconnected.
Putting up with this in the Uk might, however, mean that the next mum doesn't feel she can air her worries about her baby, or her body, or dv, or anything else which could put her and get child at risk.
I think you have to kindly say, sorry actually i'd prefer this to be a private conversation. And then go and donate to Medicene Sans Frontiers if it inspires you to want to improve women's health care in poorer nations.

[Emsyboo]

I would complain she doesn't need the door open if she was needed in an emergency they have a mobile phone they get called on, I have been in a midwife appointment when the mobile has gone off and she has apologised but explained she had to answer but in that case she didn't need to leave as it was just another midwife.
Privacy on a labour ward isn't ideal but they do offer you some privacy with the curtain and will not discuss anything in public. You have a right to confidentiality and the door being open is not acceptable. I find it hard to believe she cold have checked you over properly if she was distracted. And I personally wouldn't feel comfortable asking some of the questions I have asked my midwives with a door open which is part of your care.
They are held accountable and you can complain they should have given you a leaflet at the beginning of your pregnancy explaining who to complain to - I was.
Accepting this as the norm will not help you or any other mothers after you.