When it came to choosing a hospital for our maternity care, we thought it was an obvious choice. We went for the one closest to our house, knowing that when the time came to have this baby, the hospital was only a ten minute car ride away at most. I have to admit that we hadn’t got on with this hospital in the past, having had a bad experience there after Amy slipped and hit her head whilst at roller disco (you can laugh if you wish!). Our experience of Accident and Emergency was NOT GOOD, and since then we had chosen to go to a different hospital if one of us required emergency treatment – which was obviously not often but still.
Anyhow, we hadn’t ever experienced maternity, so we decided to give it a go and see how it went. Our first experience of maternity care under this hospital was our booking in appointment with the community midwives. I thought it went… ok. The more I thought about it, though, the more I realised that I wasn’t happy. They did acknowledge Amy as the other parent, and her details went in the “your partner” box at the start of the booking in notes, which was great. However after that it all went a bit pear-shaped. We explained that we had conceived with the help of a known donor who would not be playing a part in the baby’s life. Through the whole appointment the midwife referred to our donor as “the father”, despite me correcting her many times. So many times in fact that it got boring after a while… When it came to health questions about Superhero Donor, she wrote “unsure” for everything, despite me having an answer for all of her questions. It was like she didn’t believe that we knew anything about the other biological half of our child. The form was also labelled “you” and “your partner”, which when they didn’t actually want to know anything about Amy was silly. It felt odd to put our donor’s details under “your partner…”
Then it came down to the weighing and the working out BMI. I know I’m overweight. This was not news to me, but I was surprised by the way it was treated. My BMI came up at 33, which yes I know is “obese” according to the BMI scale. I was prepared to be told that I was overweight. What I was not prepared for, however, was to be made to feel like I was already a bad mother. I was told “the likelihood is that you will get gestational diabetes and hypertension”. Not “you have an increased risk”, but “the likelihood is”, which is just untrue. Talk to me about the risk. Talk to me about how to mitigate the risk… but don’t dismiss me immediately and tell me I “likely will” get these things. Plenty of overweight people don’t get GD or hypertension. But I was led to believe that I definitely would, which was quite scary the more I thought about it. I wasn’t given any health advice or asked if there was anything they could do to help. Like I’ve said before – it was almost like they thought “you’re fat. Accept your fate. Fatty.”
Medical history taking was fun times. They asked about mental health history. I stated that I had had post traumatic stress disorder due to a sexual assault. The midwife ticked “severe depression” and then told me that we would be being referred for extra assistance from the health visitor as we would likely need “more assistance” because I would “likely” develop post natal depression. Now; post traumatic stress disorder is not the same as depression. It’s similar, but it’s not the same. Depression is generally a chemical reaction, which doesn’t always have a traceable cause. That chemical reaction is what leaves you higher risk for PND. Post traumatic stress disorder is a physical and emotional reaction to trauma. They’re two separate things. I totally support them explaining what support is available and how to access it, but ticking “severe depression” and automatically referring us was… interesting. As was the lack of understanding about different mental health issues and their links to PND.
They asked if I had any blood pressure problems. I told them that I once had a BP reading that was the high-end of normal. She wrote “BP++++”. I said I had asthma as a child but it hasn’t affected me for some time. She wrote “asthma”. I said I had been tested for PCOS and misdiagnosed with it, before being told I didn’t have it. She wrote “PCOS”. She asked if we had had any help getting pregnant. I said we had used clomid. She said “no, I mean like IVF and stuff. Like, stuff to help you get pregnant”. I just smiled and shook my head… no… no IVF.
There’s a question that ALL women are meant to be asked at during a maternity booking in appointment. This is “do you consider yourself to be in a vulnerable situation? Domestic violence, etc.” but it needs to be asked away from the partner for obvious reasons. So, when the midwife took me off to do my height and weight, I expected that she would ask this question too. Nope. Not a sniff of it. I don’t know whether it was because she felt awkward, or because she didn’t think it was necessary to ask a lesbian couple about such a thing. I found it ODD. That question is SO important because it opens up communication channels between a woman and the health care professionals looking after her. But it wasn’t asked. Thankfully I’m not in a vulnerable situation…
The midwife then told us she would be referring us to the consultant. Didn’t really explain why. But we accepted that. The booking in process is a bit “rabbit in the headlights” for a couple going through it for the first time, and I definitely left feeling a bit like a freak of nature. The midwife who did our booking in was a student midwife, so I kind of put it down to that and put it in the back of my mind.
When I got home I looked at the reasons for referral to the consultant. “Asthma, hypertension, depression…” and then something that I had not expected to see. Under reasons for referral. In black and white… “current pregnancy by sperm donor.” I was confused as to why this was a reason for referral. Why was the fact that we had used a sperm donor a reason for us to see a high up medical professional for further assessment? After checking in with a few lesbian couples who had been through this process and finding out that not one of them had been referred for this reason, we decided that we would ask the consultant at the appointment.
The consultant appointment rolled around. We had no issue at all with the consultant. He was patient and listened to what we had to say, referred to the donor as a donor and was inclusive of Amy as the baby’s other parent. He was unable to explain why we had been referred due to using a sperm donor, but took some details anyway. The main reason for referral was my BMI, and he recommended that I do the glucose tolerance test at twenty-eight weeks pregnant and have an extra growth scan at thirty-two weeks pregnant. All in line with current guidelines, so exactly what I expected. At the end of the appointment, he asked if we had any questions. At which point Amy asked if we would still be able to use the birth centre. The consultant said that “due to my hypertension” I would be unable to. I explained (again) that I had never suffered with hypertension. I had a BP reading that was the high-end of normal once. I’ve never been monitored at home and I’ve never been medicated, so I told him I have absolutely no idea why the midwife wrote “BP++++” as it’s just not the case. He said “well… that’s a bit of a non issue isn’t it?” and then wrote in my notes that if everything stayed the same, I was cleared for the midwife led birth centre, my preferred place of birth.
The waiting room at the antenatal clinic was also what I spoke about in my blog entry entitled Families Aren’t Always Mum+Dad+Baby=Family . Posters spoke about “why dad is important” and “how dads can support mums” and such. I couldn’t help but think that was very uninclusive. Not just to same-sex families but to anyone that is not mum+dad+baby. So, as I spoke about in that particular entry, I compiled some helpful posters from Stonewall to take to my next midwife appointment.
That appointment rolled around (after it being cancelled once) and I went in at 17+5 for my 16 week appointment. It was with a different midwife and another student. I really don’t mind having student midwives, but I often think it would be nice to be asked if it was ok… Anyway. So, this appointment was just as “interesting” as the first. The midwife told us off for having a home doppler. Not because they’re not recommended. Not because women assume everything is ok just because baby has a heartbeat. Not because of any of the reasons that I discussed in my entry We Love You Doppler, We Do! Her reasoning was “you won’t find the heartbeat anyway.” As a couple who had found the heartbeat every time we looked since we got the doppler at eight weeks pregnant, I rolled my eyes quite a lot at this. I thought it would have been a good opportunity to educate as to why a doppler isn’t the be all and end all and why you should seek medical attention for any change in baby’s movement or any bleeding rather than just relying on the doppler, but no. Instead it was used as an excuse to belittle us. At least that’s how it felt. And that was certainly how it continued.
We asked about why the fact that we had used a sperm donor was used as a referral criteria to the consultant, at which point she said they refer “everyone who does IVF.” I told her we didn’t do IVF, at which point she dismissed it and said it was just something that they did for anyone who had used fertility treatment…
The student midwife did my blood pressure (normal) and then asked if she could feel my uterus. I laid down, rolled up my top and the midwife (not the student) said “ppshht. You won’t feel much.” Well THANKS for that! I know I’m overweight but thanks for the reminder and for voicing it so eloquently. I would have thought a more appropriate thing to say would have been “don’t worry if you can’t find it right away as the lady is still quite early” and then maybe mentioned BMI post appointment? But no, this midwife decided to go with the sarcastic response that was quite frankly rude and uncalled for. The student midwife tried to use the doppler, but after about thirty seconds it was snatched off her by the midwife. Amy had already pointed out where Eden hangs out normally, and hilariously the midwife did just about everything she could to find the heartbeat somewhere other than where Amy had said. Her not finding the heartbeat when Amy finds it so easily was making me anxious, but eventually once she put the probe where Amy said she would, there was Eden’s heartbeat. Nice and strong.
The midwife then asked if I had felt movements. When the answer was yes, she said it was likely gas as it was too early. So WHY ASK?! Also, I’ve had twenty-seven years to figure out what gas feels like. Those were (and are) definitely movements that I was (and am) feeling. I then went off to do a urine sample and she took it from me, promptly spilling it all over the side and down the back of a boxed in radiator. She then said “Well it was very full” like it was my fault she’d dropped it. Bearing in mind the tube was just over half full…
Anyway, so we got to the end of the appointment and she didn’t ask if we had any questions. Instead choosing to just say “it was nice to meet you both” and expecting us to leave. I took my chance and brought up the posters that we had brought in for them. First, she got offended and said “I don’t think I’ve been uninclusive”. I explained to her that it wasn’t anyone in particular who had. It was the environment. The things that were displayed. The paperwork, the posters and the words that were often used. I explained that I loved these posters because they don’t show any one type of family as “better” than another. They’re about how we’re all the same really, but we come in lots of different shapes and sizes. The student midwife was telling us that they have these posters in a local community centre and she thinks they’re great. The midwife said “Well we’re guests here (the appointment was at a children’s centre) so we can’t just stick posters up.” She then non-commitedly said she would pass the posters on to her supervisor. Then she cut us short and said “it was nice to meet you” again. We took the hint and left, feeling less than fantastic.
I’ll be honest. I had been feeling anxious for about three days leading up to this appointment. When I got home, I cried and I vomited. Overdramatic? Maybe. I always imagined that midwives would be like the “One Born Every Minute” type midwives. Clucky, mother hen types who are firm but supportive. I wanted someone to take an interest in Amy and I, not just tell us all the things that we are doing “wrong”. It honestly felt like from the minute we had registered with maternity services, we had been labelled stupid and bad mothers. I’m not saying we are the only ones – chances are they likely speak to everyone and treat everyone like that, but that doesn’t make it ok. As a couple doing this for the first time, it is scary. It’s so important that healthcare professionals are supportive and helpful as well as advising and guiding. The experience we had had so far was just essentially people telling us that we were wrong every five minutes or belittling our family status by constantly referring to the baby’s “father”.
I told Amy I was also worried about them listening to us. If they won’t listen about things like movements, why would they listen if something felt wrong? They treated us like we were stupid, so what if something went wrong and they ignored it? What if they treated us like we were overreacting? What if they were as rude and condescending during labour? I knew it would likely be different midwives during labour, but the ethos at the hospital in general wasn’t helpful and I didn’t like the feeling of thinking that we might not be listened to.
It was after the 20 week scan and another dose of the “groups for new dads” and “dads are important because” posters that I finally lost my shit. I literally cried for an hour and Amy had to talk me down. I was sick to the back teeth of being treated like crap because of my weight and having our family belittled. In order to qualify for the “obesity management” pathway at this trust, your BMI has to be over 35. As I said earlier, mine was 33, so I’m not sure why I was being made to feel crap every five minutes for being overweight. Not massively overweight either and without any weight related health problems. In fact, I’m pretty damn healthy and so is Eden.
We had floated the idea of moving hospitals to a Central London hospital that I work at. The only thing we had worried about was how to get there as it was a forty minute drive away instead of fifteen. I said to Amy that I would start looking into how possible this was to do, and the next day I did…
(To be continued)