Not happy

Ok so had another appt today and it was ment to be with the doc.It was booked in for the doc. So go in...its not with the doc but with a registrar. ok no worries im cool with that i guess.

Anyway she goes thru normal stuff not very helpful at all.I had a scan done on fri and i had to ask her what the results are and all i got was yep thats fine.
She checks bubs heart doesnt tell me what it is at all.

Then i say i do have some things i want to go over as the last doc missed it due to needing to send us to the ward for monitoring ect.Ok so i give her my birth plan thing. I do say im aware that these things cant be planned per say but i have got on there what is NOT to be done and what im ok with ect.

so the very first part of it i have written :

"Forceps are NOT to be used or even discussed unless Ventouse has been tried and failed several times and i Have been fully explained the situation and given express consent or elected to have a c/s instead. BUT i am aware however that the situation may arise where they are necessary, in which case the most senior and experianced Ob on shift is to use them and NO students or Registrars are to attempt forcept delivery."

Very clear i thought......apparently not this woman then tells me that i need to be aware and prepared that it may happen.AND that they dont have a doc or Ob on shift so if it is needed it will be a registrar who use's them.And for me to bear that in mind. UM HELL NO im sorry but should a hospital have a doc or at least an Ob on shift at all times???

So thats strike one. Next thing on my list is : NO internals unless medically needed for the saftey of myself or bubs.
I explain to her i am aware one is routinly done upon admission and im ok with that BUT other than that i do not want one unless 100% needed.
She then tells me that it is routin to do them during the whole labor process to check how i am progressing ect so i need to be aware that that to will happen.............

GRRR getting mad now that is strike 2

the 3rd thing on my list is : NO males are allowed in the room.

to which she the tells me that most of their consultants are male so there is no way out of that. NOT HAPPY!!!! first of there were no males with my last two at the same hosp so why MUST i now just accept there will be.The last one i had was that nothing was to be done to myself or bubs without Imformed consent from myself first. To which she said that that is how it should be.....(insert her pause) BUT sometime when you have been doing the job for so long these things do get forgotten in the heat of the moment,but we do try to be sure to explain all things to you.

WOW all 4 of the things i have down she has just told me they can not or will not follow so how do i go there to have my baby who may i add is due soon and feel safe to know my needs/wants will be respected??

Can anyone tell me what the diff is between a Ob/doc and a registrar??

And does anyone know if it is common for a hosp not to have at least one OB on shift at all times??

Am i just being silly or am i right to be worried now

My understanding is that a registrar is a head Ob. I was only ever seen by a registrar, who was the head Ob for the team looking after me.

Are you going in as a public or private patient?

Sorry no advice but Im curious to see what everyone says. After reading some of the horror accounts on here of things being done without consent it seems concerning to me the lack of respect for your wishes. Hope you get some answers.

A registrar is in training. Doctors start as interns then progress to residents then registrars and finally consultant. Most registrars would have between 4-10 years experience. Unfortunately she was right that many hospitals only have registrars at night and there will be a consultant on call but the time between deciding to use forceps and using them is not long enough for someone to get there. It would be the same if the senior
Doc on was male. All going well there might be a junior doc who's female but if they needed the experienced person there may be no choice in gender.
Most of this would only be an issue in the wee hours but babies love being born in the wee hours. I guess she thought it was better to tell you now than in labour? consent however should be an absolute, no brainer. Very disappointing that anyone would dispute that. When all he'll breaks loose in a hospital and patients are unconscious then people make the best decisions possible, but with an awake patient and bubs parents around there is no reason to compromise on consent.

How awful that you were just dismissed by this registrar. There is no way she should have done that, even if she felt things on your birth plan were unreasonable.

First of all the registrar is a level below the consultant. She is like a newer obstetrician, and may well not choose to be an obstetrician as her career develops. She is completely qualified to do your antenatal appointment, and also attend your birth, but she would not attempt something complicated by herself as she is in training of sorts.

If I could address the four points on your birth plan for you. I understand you not wanting forceps, and this is a common point on a plan. Sometimes ventous will not be attempted before forceps as the baby's head is too high. So there will be times when the suggestion is forceps with no trial of other instrumental. If this happens you are absolutely within your rights to say no, in which case you would go straight to CS. You can ask that they use ventous first, but it may be that would not be appropriate.

Second point, saying no to internals. This is a very valid request. A skilled birth attendant can assess your progress without a vaginal exam.

Third point, no males. This is a common request, especially for Muslim women. There is usually a female doctor on staff, and most midwives are women. If there is a complication which requires the attention of a senior doctor and the only available one is male you may wish to reconsider at that point.

Fourth point, informed consent. I'm so sad you had to write this down. Nothing should ever be done to you without consent. In an emergency there is still time to say what is happening and why, and allow you to say "yes", unless you are unconscious in which case the doctors will work in your best interest. If you are awake, then NOTHING should be done, from an episiotomy, to clamping your baby's cord, without it being discussed either beforehand or at the point of action.

I forgot to say you are well within your rights to refuse a VE. Much decision making is based on "progress" in terms of dilation but noone can make you have an internal and they should have flexibility in their practice to proceed without that information... In consultation with you... The patient!! (novel concept sometimes unfortunately) It may make them a but twitchy if you were a long labourer, and it could then bring talk on intervention forward, but you are also within your rights to refuse this, though it would probably be an idea to consider the opinions of your midwife etc

I have found through my experiences with 2 ds's and as a doula that some obs/mids will say one thing about your birth plan and then next will say another, and I 100% absolutely understand your frustration when such responses are given. But the important thing is that the preson you have for your labour is willing to comply with your wishes, if you get a mid who isn't it is within your rights to ask for a new one. So I think make sure your df absolutelu knows off by heart your wishes and is willing to stick up for you while you are in labour and if he feels a bit unsure about this maybe look into getting a doula.

With my first pregnancy I asked if it was possible to put on my file that I didnt want to see a particular dr and was told no couldnt do this as a public patient but I could request not to see any male drs mids etc (didnt help me as the dr was a woman) but this is the same across all public hospitals so definitely you can do this (regardless of this drs ignorance it is a rule) and as far as the stirrups go, it is very rare anyone would use stirrups over a vac and if they do it is usually cause they are a very experienced older dr who knows this way

and as far as the internals, how disgusting this drs response is, noone has a rights put their hands in a woman vagina without consent, including when that woman is in labour!

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How awful that you were just dismissed by this registrar. There is no way she should have done that, even if she felt things on your birth plan were unreasonable.

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Thankyou

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First of all the registrar is a level below the consultant. She is like a newer obstetrician, and may well not choose to be an obstetrician as her career develops. She is completely qualified to do your antenatal appointment, and also attend your birth, but she would not attempt something complicated by herself as she is in training of sorts.

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hmmm see she told me it would be a registrar who would use the forceps if they were needed. grrrr glad i asked thankyou again

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If I could address the four points on your birth plan for you. I understand you not wanting forceps, and this is a common point on a plan. Sometimes ventous will not be attempted before forceps as the baby's head is too high. So there will be times when the suggestion is forceps with no trial of other instrumental. If this happens you are absolutely within your rights to say no, in which case you would go straight to CS. You can ask that they use ventous first, but it may be that would not be appropriate.

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Thanks hun yep i was aware of these points and thats why i put in there that i am happy to have a c/s if need rather than the forceps. I did explain to her my reason for it was that quite simply i dont think there's enough traning in how to use them correctly and the chance's of things going wrong are to high for me. And there for i only want them if all other options are gone or in dire emergency. But she made me feel that if they say its needed then i need to accept they will be used and by a registrar :S

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Second point, saying no to internals. This is a very valid request. A skilled birth attendant can assess your progress without a vaginal exam

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. Yep thats what my understanding was,i even told her the reason for me to add this is the last time i was given one it wasnt neccasary and was done even tho i had said no(was told it had to be done,i was to young/naieve to know better) and was also screaming at the woman doing it that she was hurting to the point where i kicked her in the head. Again its nice to know i was right

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Third point, no males. This is a common request, especially for Muslim women. There is usually a female doctor on staff, and most midwives are women. If there is a complication which requires the attention of a senior doctor and the only available one is male you may wish to reconsider at that point.

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Yep im ok with that it was more so if all was going ok thats why i was shocked she told me that that wasnt possible

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Fourth point, informed consent. I'm so sad you had to write this down. Nothing should ever be done to you without consent. In an emergency there is still time to say what is happening and why, and allow you to say "yes", unless you are unconscious in which case the doctors will work in your best interest. If you are awake, then NOTHING should be done, from an episiotomy, to clamping your baby's cord, without it being discussed either beforehand or at the point of action.

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Again thankyou so much.I had done so much looking before i decided what i wanted/didnt want. So i thought i knew what was ok and not and she just really made me think what was the point if there not going to listen anyway.
Im going to write it all down again and attach the pamplet i have from the hosp on my rights and pack it in my labor bag. I dont know what else i can do really.

Jas - thanks hun,they dont make you feel very safe do they,im starting to wonder if ignorance was bliss.

Thankyou to everyone else to :D

Can you get a doula?

Does your birth partner know your preferences? Are they willing to speak up for you?

Do you feel comfortable in refusing VEs? If you plan to refuse the routine ones i would also refuse the first exam upon admittance. Unfortunately once you agree to one, this (wrongly) can be seen as consent for all VEs.

The doco that Bellybelly Kelly posted this morning talked about written forms you can give the health care provider stating your refusal to consent to certain procedures.

Thanks kate.no i havent seen it yet im going to go find it now and have a read.

Yep DH and i have had many chats and he is on board fully we wnet over things so much so we were both happy and understood what we were asking so thats nice to know he will back me up.

Thats a good suggestion on the first VE and i think i will need to think about it and consider it too.Thankyou. A doula is out DH is comfy with it and i respect that and he made a huge effort to know what my wants are and he respects them and agree's so im happy and now feel safe he will make sure its respected :)

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A registrar is in training. Doctors start as interns then progress to residents then registrars and finally consultant. Most registrars would have between 4-10 years experience. Unfortunately she was right that many hospitals only have registrars at night and there will be a consultant on call but the time between deciding to use forceps and using them is not long enough for someone to get there. It would be the same if the senior
Doc on was male. All going well there might be a junior doc who's female but if they needed the experienced person there may be no choice in gender.
Most of this would only be an issue in the wee hours but babies love being born in the wee hours. I guess she thought it was better to tell you now than in labour? consent however should be an absolute, no brainer. Very disappointing that anyone would dispute that. When all he'll breaks loose in a hospital and patients are unconscious then people make the best decisions possible, but with an awake patient and bubs parents around there is no reason to compromise on consent.

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This is what i wanted to say!



The only issue i see that you cant be protected against via your support person is the fact of a male Dr. You are a public patient at a pubic hospital and have no say in who is on and when....

I just had a thought...you could have an induction on a day that there was a women on but then they cant do an induction with out a VE....

Just shouldnt be this complicated should it :(