"Lack of care at Maternity Outpatient Clinic"

I am heavily pregnant and my care was assigned to Fiona Stanley Hospital by 12 weeks by my GP. I had a phone consult at 16 weeks with a midwife that collected my medical history. They asked if I had any questions and I said I wanted to speak to someone about the VBAC or planned c section I needed to decide upon, as I’d had an emergency c section with my child a few yrs earlier.

They said this would be discussed at the next consult. Then I had another phone consult after my 20 weeks scan from an obstetrician. I asked about c section/VBAC and the obstetrician would not discuss but said they would send me some brochures (1 page mostly saying talk to your ob-gyn).

I then had no appointments until I had a diabetes test and had a phone call coming up to 29 weeks from an obstetrician that said my results were fine, then that I should be on iron and vitamin D tablets. When I queried this, I felt I got no clear answer. I asked to speak about the VBAC/c section option and they said they had sent me brochures and asked what my decision was. 

When I wanted to ask questions, the obstetrician said it would be discussed at the next appointment which would be face to face with an obstetrician. I then got a letter in the mail saying that I had another telephone appointment booked with a midwife in a few weeks time. I ended up calling the hospital in tears at 30+ weeks, because I had not been to the hospital at all in my care (I didn’t even know where to go if I went into labour), I had reported on the two short and unhelpful phone calls that I had been very sick and under a lot of pressure (severe chest infections with multiple rounds of antibiotics, laryngitis and a number of other health issues) and I kept being told someone would talk to me about the birth options ‘at the next appointment’.

The person I was put through to on the phone was kind and booked a face-to-face with a midwife. Unfortunately, as I had not been to the hospital, most of this appointment time was spent back-dating the blue pregnancy book as I had never been given it, nor had it been filled in. I had received no measures of my blood pressure, testing of my urine samples or measurements of the baby from the hospital before 31 weeks.

In addition, I had been really struggling with a number of health issues and additional workloads due to Covid-19, and the hospital had not only missed a number of appointments but had (and still has) neglected to do the mental health check that is scheduled to be completed between 28-30 weeks.

I ended up seeking out my GP who referred me to a psychologist where I tested with moderate levels of depression. Given I had PND after my first child and had been reporting poor health and stress, I find it extremely concerning that the hospital neglected my care at such a vulnerable time. If I had not been proactive and called to fight for a face-to-face appointment and sought support through my GP, I feel there could have been significant consequences.

I hate to think that this could happen to other expectant mothers that don’t have the strength or skills to advocate for their basic care. Following this, I have had one appointment with an obstetrician. I had asked both on the phone (1 month earlier) and at the midwife appointment to get a copy of the medical notes from my previous birth (which ended in emergency C section) so I could make an informed decision regarding VBAC/planned c section.

Despite this, these notes were not available at this Obstetrician appointment and I was told that it would be my personal responsibility to follow these up. I was told that a good 4 weeks + is required to book a planned c section given hospital demand. Those only obstetricians can book this and that I could go away and think about the decision, but my next appointment with an obstetrician would be after 36 weeks (when c sections are planned for 39 weeks). As I went to leave the appointment, the obstetrician stated that my mental health is all good. A very inaccurate assumption. When I responded and said no, they said but it’s managed by your GP right? And just wrote another line in the file. 

I have felt very unsupported by the hospital and that I have been asked to make decisions without being fully informed. I do not trust them, and so would be wary to try a natural birth with them (which I feel I would have been inclined to try at another hospital with a more supportive or informative team). I feel like my options have been limited by the lack of care provided and that my care has been fully reliant on me advocating for my needs to be met in a time when I was already struggling physically and mentally.

I understand that coronavirus has been a difficult time, but I also believe that another hospital's patients have not gone without face-to-face appointments throughout this time, instead the hospital administered additional safety precautions. I am deeply concerned at the number of missed appointments resulting in missed checks and tests.

Thankfully, my baby appears to be doing well, but I would hate to think of the results if something had been wrong such as my blood pressure issues, or the baby not growing at the expected rate etc (as it would not have been picked up), as well as what would have happened if I did not have both the insight and strength to identify I was not coping mentally, and a supportive GP who provided care when the hospital had not.

My experience to this point has been extremely lacking in care or service and I am very disappointed with the hospital.