I was at a meeting at my local hospital last week and a topic was discussed that interests me greatly. It seems from a recent national survey of recent “end users” (that’s you and me) that most pregnant women feel they don’t have enough information when they first find out they are pregnant and through their pregnancy. The hospital experts in the room (I was the only lay person among the twenty or so professional women there, from obstetricians to midwives to health visitors to hospital and local PCT administrators) were baffled by the fact that most women questioned felt there had not been enough information given to them at the start of their pregnancy or available during their pregnancy and that they didn’t understand their healthcare “pathway” or choices. One very sweet health visitor said she believed that the information was all given out, but pregnant women “just can’t take it in”. Bless, you poor dumb things, too awash with hormones to think any more.
Another very learned obstetrician, who I admire clinically, suggested that perhaps things be written down for us. Implying that we poor ninnies are too stupid to listen properly. The patronising tone was too much for me to bear and so at the end of the meeting when they asked if the lay person had anything to add, I couldn’t resist but let them know of one of my most recent client’s experience.
I explained that far from being incapable of absorbing vital information, my lady who is well educated and highly motivated on discovering she was pregnant, but had been thoroughly put off by her GP. photograph by Annie Armitage
The first question she was asked by the GP was whether or not she was happy about the pregnancy, implying that an abortion was up for discussion. The GP seemed slightly shocked that a pregnancy test had been taken 'so early' at just 4 weeks pregnant. My lady was basically informed of nothing except the fact that Boots sold pregnancy tests (if she wanted her pregnancy confirmed) and that there was a photocopied piece of paper which she might benefit in seeing which was wafted in front of her briefly (but not passed to her as it was the "only copy"). She was given no information about her choices for having her baby: home birth, birth centre, independent midwife, local hospital with midwifery led unit or local obstetric led unit. She was just processed to go the local hospital. She was told nothing of growth scans, health scans or being assigned a consultant. In fact the GP informed her that there was no point in giving her any more time, as she may, of course, miscarry as a third of all women do at this stage. She should come back if and when she had made it to her second trimester to avoid wasting any more of the valuable GP’s time.
Hardly the lovely, dedicated, comforting, congratulatory experience you might hope for.
The maternity supervisor was nearly in tears by the end and said "But the first point of contact is SO important!" she said and then she added, "That poor lady!"
I pointed out that at least my client is clever enough to find all relevant information elsewhere and has the resources to hire a birth doula but what of the less able who are, well, less able!?
The Maternity Services Liaison Committee genuinely had no idea that this poor practice was going on. In my experience sadly, this is not unusual. But I suppose to be fair to them, they have no way of knowing how rubbish the GPs are being if we don’t tell them! Please, ladies, if you get less than perfect service, let someone know: your GP, your local hospital, your local PCT or even me. I will happily forward your comments to the powers that be. We can’t expect this ridiculous disjointed practice to improve if we don’t make a loud noise, as we are being dismissed (by other women – we were all women in the meeting I was at) as being silly girls who are too stupid to take information in.
You should expect a level of information from the very first time you go to the GP when you are pregnant. You should expect the following:
To have your pregnancy confirmed. (It may be too much to expect congratulations, but it would be nice!)
To be given health advice: about nutrition and supplements and what to avoid in the early days of pregnancy and throughout the next nine months.
To be given choices about where you receive your health care for your pregnancy and where you give birth.
To be told that you will be scheduled for two scans during your pregnancy, both of which are optional. The first scan at 12 weeks is to date your baby’s age accurately, to see if you are carrying multiple babies or just one, and to check the fluid in the nuchal fold to give you an idea of the chance of the baby developing Down’s Syndrome. You will need to make a decision at this scan, if you have a high chance of carrying a baby with Down’s Syndrome, as to whether or not you continue with the pregnancy, so have this discussion with your partner before you go. It could be that you will carry your baby to term no matter what, so you may choose not to find out about any genetic abnormalities at this stage and so may prefer not to have the scan at all. The second scan is to check for spina bifida and other possible abnormalities, look in detail at your baby's major organs and skeleton, check the health of your placenta and monitor your baby's growth. You may also find out the sex of he baby at this stage, but it cannot be 100% determined without Amniocentesis or a CVS. Again, if you would carry your baby to term no matter what, you may wish to avoid this scan as well.
If you don’t have this basic information from your GP or if you find them off-hand or dismissive of what should be an amazing time in your life, please do something to complain. We should be treated with respect and given all information that we require when we first contact our GPs about being pregnant and really, can’t expect anything to change unless we make a fuss. It may be too late for me or even my lady for her pregnancy this time, but perhaps we can make it easier for the women who follow us on what should be a wonderful path to motherhood.