Wednesday, 18 November 2009

oh, baby

I am bringing a new angle to the blog today, so apologies if I am lowering the tone somewhat but I have something I wish to say. I am currently 40 weeks and 6 days pregnant and am anxiously awaiting the arrival of my first little baby. I'm excited and dreamy. I can't wait meet this little fairy and kiss her all over. I want this time in mine and my lovely fiance's lives to be sweet and happy. But instead I really feel frustrated and let down by the level of antenatal midwifery care provided by the NHS, so much so that at times I have seriously considered paying for private care. Don't get me wrong, I know the NHS is an essential service. Thank goodness that we all have access to healthcare without the worry of massive bills and insurance premiums. The trouble is that, along with other pregnant women and new Mums I know, I feel that I have been massively let down by the NHS in terms of the care provided in the build-up to having my baby, and I dread to think what lies in store for me when I actually go into labour.

When I first discovered I was expecting a baby I coudn't even get to see a midwife at all for several weeks. An experience I have since discovered is pretty much universal amongst pregnant women in Greenwich Borough. Finally, at 16 weeks gestation, I was allocated a midwifery 'team' who I have had 10 appointments with throughout my pregnancy to date (ie. one appointment every two and a half weeks), never seeing the same midwife twice and thus rendering the idea of continuity of care a non-entity. At my first appointment I was asked if I would mind having a student midwife 'caseload' my pregnancy, attend my appointments and, supervised by a qualified midwife, deliver my baby. Thank God for Amy, my saving grace, I am so pleased that I agreed to this as it has been the only way I feel I have been able to have access to decent advice and support. Without Amy I wouldn't have even been able to phone a midwife. Instead, you have to leave a voicemail message on the team answer machine and wait for someone to respond, usually with 72 hours, although often not at all.

Last week, at what was in theory to be my last ante-natal appointment before the birth, we discussed how events would progress should the baby not arrive on her due date. I was advised to do everything possible to bring on labour: curry, pineapple, raspberry leaf tea, and lots and lots of lovin'. No problem. I would be given a cervical sweep at 41 weeks gestation, then if nothing came of it, I would be given a second sweep the following day, as research shows this increases the chances of labour starting naturally, therefore giving me more chance of having my planned water birth at home. A chemical induction at 42 weeks will be performed in hospital and means a much greater chance of medical interventions such as Pethidine, epidural, forceps, ventouse and caesarian, simply because of the unbearable ferocity with with contractions come on.

I went along yesterday to my antenatal appointment, fully expecting to be offered a cervical sweep there and then to try and get things progressing, as I had been advised last week. I was perfectly happy for this to be the case. I'm pretty keen to meet this baby afterall. I was shocked when the midwife, another midwife who I had never met before, booked me straight in for a chemical induction for next Wednesday (41 week and 6 days). So I asked when I would be given the first sweep. That afternoon? No, came the reply, they might offer me one the day of the induction. I questioned this as it contradicted what I had previously been told, and the midwide responded that someone else might be happy to offer me a sweep, but that she was personally not comfortable to perform it, as last time she had done a sweep the woman's waters had broken and she didn't really like it! I have to say that I was pretty shocked to get this kind of offhand and unprofessional treatment from a fully qualified midwife with two children of her own. I mean, what exactly is being a midwife meant to entail? Yes love, bodily fluids are part of your job. Get used to it! Other concerns I expressed to this woman were brushed aside. I was told that I didn't really know what I was talking about so I shouldn't think about it.

My grumbles are perhaps twofold: firstly, I am outraged that antenatal care is so dreadfully underfunded (I have had other issues with the care provided during my pregnancy to do with underfunding)that women are unable to see a midwife more than 10 times out of 42 weeks, and even then it is never with the same midwife, thus offering zero continuity of care, and no relationship between the pregnant woman and her midwife. However, for the mostpart, the actual midwives have been outstanding and supportive whevever they have been able, despite the obstacles. But secondly, the issues I encountered yesterday with one particular midwife left me wondering whether her appalling and uncaring attitude would be allowed to prevail if better guidelines and set procedures for the care of pregnant women were in place? Why can't every expectant mother have a midwife allocated to her who she can see every week throughout her pregnancy? How can this be too much to ask?

Luckily, immediately after my appointment yesterday, Amy was able to book me in for a sweep tomorrow at the fetal assesment unit. If Amy had not been there to support me I would either have had to accept the inevitable chemical induction next Wednesday (assuming the little blossom doesn't arrive of her own accord), or attempt to contact the midwife team via their voicemail in order to ask for a second opinion, not knowing whether I would ever hear back. Most women don't get an Amy though, and it simply isn't good enough that I should have to rely on an unpaid (make that fee-paying) student, however capable she may be, in order to provide sufficient care for my unborn child. I may require a chemical induction afterall, but I would like the opportunity to explore every avenue before that becomes an inevitability and am outraged that I should have to battle for the privilege to do so.

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