#AlwaysAsk – Rainbows and Unicorns Revisited

Tommy’s has launched the #AlwaysAsk campaign highlighting research about the value of women’s insight into their own bodies during pregnancy.

It’s about empowering mums to be to always ask when they feel something isn’t quite right rather than focusing on technical language around medical red flags such as specific symptoms.

Fear of wasting time or being a nuisance has been shown to be one compelling reason for failing to discuss a concern. A poll filled in by 1,300 women on the Babycentre website showed that more than 60% worried about wasting time before raising a concern, and almost 30% of didn’t speak up because of their concerns

The campaign offers helpful advice on how to ask these questions and this is valuable material

  • Don’t play it down
  • Even if you don’t think it is related to your preganancy ask
    Be specific – what has changed
  • Begin by saying, ‘I am concerned…’
  • Ask health care professionals for names
  • Make a list of your concerns and write down the answers
  • It’s ok to say you feel vulnerable or frightened
  • Before you leave the appointment – consider whether you have asked all your questions and are satisfied with the answers
  • If you can’t make yourself heard or you don’t agree or you feel uncomfortable, say ‘Let me think about that and get back to you’

This campaign is backed by organisations such as the NHS England, the Royal College of Obstreticians and Gynaecologists and the Royal College of Midwives.

It’s not referenced directly in the Tommy’s press release but the Royal College of Midwives press release mentions the importance of staff taking concerns seriously.

Staff also need to give women permission to share their concerns by actively asking if they are worried and taking their concerns seriously.

This is welcome as when I first read the Tommy’s campaign note I couldn’t see reference to a parallel campaign to get healthcare professionals to act on this.

One line from the campaign struck me.

We would rather reassure you 100 times than miss spotting a problem once

I have sat in too many rooms and spoken to too many parents of lost babies that did find the courage to speak up about their concerns only to be ignored to feel confident that expectant parents acting on this campaign will be listened to and treated seriously.  Our experience is we looked for reassurance and were dismissed as neurotic.  Important tests that should have taken place didn’t happen and basic guidelines were ignored.

The RCM release goes on to say:

“An educational resource is currently being developed, using feedback from the women and staff who helped make the film, to provide practical tips for midwives to help them work with women and ensure women feel safe.”

We already know from the NHS Maternity Review, the Lancet recall to action on stillbirth and further research that official guidlines are often ignored or not implemented consistently so I am skeptical of whether practical tips will carry sufficient weight to change long standing cultural views of “midwives know best” that contribute to the horrors of Morecombe Bay and beyond.

It’s not clear whether the term ‘midwives’ is being used in the umbrella sense to act as a shorthand for the full range of healthcare professionals involved in maternity care but if not it should.  Any guidance or guidelines should cover consultants, sonographers and administrative staff not just midwives.

I don’t want to be too negative.  This is a good campaign and one that will help reach a wider audience through waiting rooms and multiple translations.  Although partners are not directly referenced there is a recognition that they too need to feel empowered and able to challenge health care professionals on the quality of ante-natal care.

As a parent that has lost his sons I am keenly aware of the need to challenge complacency from health care professionals that have seen it all.  Even knowing what I do it is still hard to take that step when frightened, exhausted and intimidated.  Any campaign that helps parents to be takes those steps and feel supported in those decisions is to be welcomed.



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