Most women have a trouble-free pregnancy but occasionally antenatal care may not go the way you’d planned. With good communication from your midwife and doctor, nothing should be insurmountable and problems should be dealt with quickly. Here’s what to do if…
…You’re refused a homebirth or told you can’t have one
Unfortunately this does still happen and the first thing is to find out why you’re being told it’s not possible. Ultimately, it’s your choice where you have your baby, though obviously if a midwife genuinely believes it’s unsafe, she has a duty to inform you of the risks. However, the majority of women would be suitable for a home birth and should be supported in this choice. If your midwife isn’t keen to support you, contact a supervisor of midwives who can help. (See box opposite for details.)
…You can’t get into your chosen hospital
You should be given the choice of where you have your baby. This isn’t just home versus hospital, but the choice of maternity units. If your midwife considers that you should have shared care with a consultant, for example if there are concerns that your baby appears to be a lot smaller than he should be, you’ll be advised to give birth in a unit where there’s back-up from doctors. You’re entitled to choose which hospital you’d like to use and your midwife should be able to book you under the care of your chosen hospital. If you have any problem with this, phone the head of midwifery at your chosen unit, who can resolve the problem for you.
…You want to have a second scan but aren’t offered one
National guidelines advise that women should be offered two scans during their pregnancy. If this service isn’t available (due to financial constraints) ask to transfer your care to another unit where the scans are offered, but make sure you contact the Healthcare Commission (0845 601 3012), which works to promote improvements in health care services. It’s possible to pay privately for a second scan, but if you express your concerns to your midwife or doctor, it might be possible to arrange another scan. By the end of 2009 all areas are aiming to offer pregnant women two scans.
…You don’t want a certain test (eg HIV)
Your consent needs to be obtained for every test that’s taken, even if your midwife considers it essential or standard. You can only really consent if you fully understand why the test is recommended and the implications. Some people worry that having an HIV test will affect insurance policies but this isn’t the case. If you have all the information on the tests that are offered, and the benefits of them, then you might feel happier having them, but ultimately it’s your choice and this should be respected. You don’t have to have any test you don’t want.
…You want to get a second opinion or supoort from another consultant
Everyone is entitled to ask for a second opinion, and your midwife or GP should be able to organise this for you. However, consider why you feel you need it. If you’ve left the clinic feeling confused, having not properly understood what was said, you can ask to return for another appointment. Next time be more prepared, with a list of questions that you’d like answered, or take a second person with you.
…You’re turned away from your maternity unit
When maternity units are very busy this can happen but it’s not as bad as it sounds – you’re not expected to drive around trying to find room at the inn. When you’re in labour, phone the maternity unit and let them know. In the event of them being full they’ll inform you of the next closest unit with space. You might want to check out other local units, and how to get there. Units close when it’s unsafe to admit any more women at that time. It’s often only for a few hours as the situation can change quickly once more midwives come on duty or women have given birth.
…You can’t get an appointment with your midwife
If you contact the surgery and find your midwife is fully booked, contact her directly (ask the surgery for her number if you don’t have this) and insist that you need an appointment. Most GPs will be happy to carry out an antenatal check if you feel you need to be seen, but all women do still need a midwife to provide care during their pregnancy.
Many areas hold drop-in clinics where pregnant women can turn up and see a midwife without an appointment. Your maternity unit should be able to give you information about which clinics offer this service in your area. If you have difficulty getting through to your midwife, phone the hospital and ask for the Community Midwives Office or the Head of Midwifery and explain the problem you’re having. It may be that you’ll need to be allocated an alternative midwife who has a smaller case load.