2013-12-12

I’m the sort of person that reads their medical notes. Is that normal? Well when you’re pregnant round here they give you a copy of your pregnancy-related notes called the ‘blue folder’. It is computerised, but you also have a copy to take around yourself.

At the midwife appointment earlier this week the midwife went through a huge long questionnaire and the answers comprise my notes so far. These got printed out into the blue folder.

Now I should say, my work involves questionnaires and also developing services including health services. So it was interesting for me to see what questionnaire had been ‘imposed’ upon the midwife by NHS Lothian, and to what extent the midwife had chosen to deliver said questionnaire according to the guidelines.

She clearly hadn’t felt the need to follow the suggested wording too closely.

I get that, you’ve got to do it in your voice and it needs to feel fluent. You don’t want to be winding people up by seeming too bureaucratic.

But.

There’s a reason they set up their systems as they do.

So I was interested in….

What she guessed rather than asked me:

  • How do you describe your ethnic origin (White British)
  • What language do you usually use at home (English)
  • Female genital piercing (No – which is right, although something I have seriously considered, so is none of her damn business to guess and she might have got that wrong)

What she didn’t ask me at all:

  • Are you and your baby’s father blood relatives?
  • Is there any other information that you feel is important for your maternity care?
  • Have you ever been notified that you are at increased risk of CJD or vCJD for public health purposes?
  • Are there any health and safety issues related to your work?
  • Self harm?
  • Overdose?

Where she wrote in something different to what I told her:

  • Healthy diet (not as much as usual)
  • Keeps active (Used to swim three times a week, have been sedentary during pregnancy)
  • Are you taking any medication prescribed to you by a doctor, or have you stopped any medication recently? (she only mentioned Cyclizine, though I told her had at that time taken four other prescription drugs during pregnancy)
  • During the past month have you often been bothered by feeling down, depressed or hopeless? (I said yes, because of the nausea. She put no)
  • During the past month have you often been bothered by having little interest or pleasure in doing things? (I said yes, because of the nausea. She put no)

My pregnancy nausea really doesn’t feature in my notes, despite taking over my life. But then the midwife thought the solution to my nausea might be ginger or homeopathy so what do I expect? No-one’s interested in my pregnancy nausea.

More worryingly this makes me think they might not be taking an appropriate interest in my mental health, particularly as I had told the midwife I’d previously had a depressive episode triggered by a medical condition. I would suggest that telling her I felt low mood relating to pregnancy nausea might be significant. (And as it happens I AM an expert in mental health so I do know about that)

I am concerned that anything that subsequently occurs relating to the nausea or my sedentary lifestyle or my mental health might not be taken seriously because it is not represented in my notes.

Honestly, this erodes my trust in the midwife and annoys me.

But then I am feeling pretty bloody annoyed at the moment.

This midwife is on holiday when we next go in and we’ll be seeing someone else. That might not be a bad thing.

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