Please welcome back Afni who is sharing her story of her two pregnancies and her experiences both good and bad as part of a series of blogs related to maternity safety.
Over to Afni….
Dear reader, you will recall that I was sharing the early days of my first pregnancy where I was diagnosed with hyperemesis. I had received a mixed reaction; really supportive GP, really unhelpful midwife.
So after some persistence on my part I tried to get an appointment with a consultant. I wanted someone who would know all about hyperemesis, but more than that I wanted someone listen, to truly understand how awful it was and to make it all better. The first appointment was arranged by my midwife who for some reason picked a day which was the very day I said I wasn’t free.
It’s the little things like this that start to really stress you out.
The doctor I saw thought I needed counselling to cope with the emotional despair and anxiety, so I was referred to a gynaecologist who specialises in mental health and anxiety. Initially we got off on the wrong foot, with the gynaecologist refusing to see me at my first appointment because I turned up without my notes. I had not forgotten them; its just no one had told me that I needed to bring them along. I am sure as the reader you will be thinking but surely she would realise this, but you may recall I am being sick all of the time, I have barely eaten a thing and I am shattered, so my brain isn’t working as it should do – so when you feel like that the more simply instructions you can give the better.
So I had to wait for a second appointment. But.. at the consultation, rather than listen to my concerns and my desire to take away the symptoms of nausea and vomiting, she said I had to take anti-depressants. There was no discussion as to the pros and cons of this, or whether I could take them given my allergies or whether there were any alternative treatments. Nothing – just here you go have some pills. So I went back home with little to help me stop this incessant sickness. I now started to feel a degree of despair, which I would suggest was different from depression. Its a feeling of hopelessness rather than deep sadness. So my wonderful GP referred me for cognitive behavioural therapy which did help over time.
I kept seeking solutions; none of them worked. For example the midwife told me that if I drank yogurt based smoothies that would make it all better but these just made me even more sick. I felt like I and the GP were the only ones who truly understood what hyperemesis felt like. I kept searching and found out about a pregnancy club who could provide me with the kind of support I needed. They told me that it was ok to change my midwife if I didn’t feel cared for or safe. At this time I also had the support of a friend who was a midwife who spoke to my midwife on my behalf because I simply felt like no one was listening to me. This helped me gain just a little bit of control. I changed my midwife and was referred to an anaesthetist who would understand what drugs I could and couldn’t have in labour – one of my main anxieties.
KEY THEME NUMBER TWO – TAKING CONTROL AND TRUE PARTNERSHIP WORKING
Taking control is not just about asserting my needs as an individual it is about co-production and partnership as a way of delivering and receiving care. It involves working in equal partnership between health professionals and those they care for. One of the frameworks that really help describe what this is, is that of Nesta’s six principles of co-production:
- Building on people’s existing capabilities: altering the delivery model of public services from a deficit approach to one that provides opportunities to recognise and grow people’s capabilities and actively support them to put them to use at an individual and community level.
- Reciprocity and mutuality: offering people a range of incentives to engage which enable us to work in reciprocal relationships with professionals and with each other, where there are mutual responsibilities and expectations.
- Peer support networks: engaging peer and personal networks alongside professionals as the best way of transferring knowledge.
- Blurring distinctions: removing the distinction between professionals and recipients, and between producers and consumers of services, by reconfiguring the way services are developed and delivered.
- Facilitating rather than delivering: enabling public service agencies to become catalysts and facilitators rather than central providers themselves.
- Assets: transforming the perception of people from passive recipients of services and burdens on the system into one where they are equal partners in designing and delivering services.
Patient Safety Now 