"Antenatal physiotherapy experience"

About: Victoria Hospital / Maternity care

(as the patient),

I had severe SPD in my previous pregnancy. At 7 weeks in this pregnancy I went to the GP and asked to be referred to the ante natal physio as a matter of urgency to help avoid the extreme pain I suffered last time. I couldn't walk on my own at the end of the pregnancy and required a wheelchair and crutches, etc. They lost my referral and I had to chase it up through another GP.

I eventually got another letter saying I could come for an information session. I phoned up and said I didn't want to waste a space in the class, as I already had the information I needed from last time, and really needed to see an actual physio as a matter of urgency. I was told that they are 'too busy' to see all the girls with SPD and if I wanted anything further to happen, I had to go to the session and take it from there.

I went along, requiring the help of my husband and crutches to get there. We were told to sit in very uncomfortable seats which I refused to do, and asked for a 'proper' seat which I was given, but no one else was, even though it was a room full of girls clearly in pain. The hour was a complete waste of time - working on the assumption that we can all read I feel we should have been posted out the leaflets and given even 20 minutes of the physio's time. Some of the advice given was pointless to me, I am far past the point of being able to do some of their exercises as they cause me too much pain, yet the person holding the session clearly wasn't interested in this.

The person holding the class opened the class by saying 'this is it, this is all you get, there is nothing else available so don't ask'.

At the end of the session I asked for crutches which I was given to me as quickly as possible and then hurried away to ensure no further conversation could take place.

One of the leaflet's they gave us was copied from the POGP leaflet which is brilliant and comprehensive, but the version they gave us conveniently left out the advice that manual therapy is crucial to limit pain.

I am now taking paracetamol and codeine phosphate, can't leave the house without crutches or a wheelchair, and am completely dependent on my husband to go anywhere.

I think the hospital is brilliant and I think the NHS are wonderful, but I do not think this service addresses the needs of people with severe SPD and the GP's think they are really helping you by referring you here, when in my opinion it's completely pointless. Even the midwives I have spoken to all agree and know it's pointless.

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Response from Louise Ewing, Patient Relations Manager, NHS Fife

picture of Louise Ewing

Dear SJC1983

Thank you for taking the time to tell us about your recent experience of antenatal physiotherapy. I took the opportunity to share this with the Lead for the Service who then shared it with the team who were very disappointed to read your account. She offered me the following response to share with you:

"This class was started several years ago, partly in response to high numbers of patients being referred to ante natal physiotherapy and the need to make the best use of physiotherapy time, but mainly because we as a team recognised that our first treatment session with a patient generally took the form of advice on posture, exercise, pain management etc. This was being repeated to every patient individually and often the patient did not appear to require any further intervention after this session.

It was decided to run an information class to reduce repetition by the therapist and also give the patient swift access to self management advice, as well as providing a forum for patients to discuss issues and solutions as a group. At this appointment patients could also be provided with crutches if required.

Each session is introduced by the therapist as a 'typical treatment session' in group form. Patients are addressed as a group but time is made for individual questioning. The patients are told they are officially 'on treatment' for the duration of the pregnancy and thus able to access treatment on a one to one basis if they feel in need of further care.

All patients are required to attend the class prior to getting one to one care to ensure equity of service to all and for the reasons detailed above. The exception to this rule is patients who are over 36 weeks pregnant as they may need practical support to get through the last few weeks.

Several indicators led us to believe we were pitching these classes right. Firstly we have used patient satisfaction surveys which have consistently showed a good or very good level of satisfaction with the class. Secondly there is a very low uptake of patients seeking additional care despite it being offered as an option for consideration".

If you would like to be seen again then this certainly can be arranged. We would also be happy to meet with you to discuss your concerns further, as this is not an experience we would want for any woman in this situation.

Thank you for taking the time to share this


Louise Ewing

Patient Relations Manager

NHS Fife

01592 648153

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Update posted by SJC1983 (the patient)

Dear Ms Ewing

Thank you for taking the time to respond to my story. However I find your response condescending and distinctly lacking in compassion.

In response to your points raised - I would like to make the following points again, as they seem to have been missed in your response.

- I did not need the information as it was my second pregnancy. I am sure this information is helpful first time round and I never suggested otherwise, and I am glad that this service is available to first timers who need support and advice.

- I had to ask the physio directly for the crutches - they were not offered. Furthermore, a few weeks later I rang to ask if I could have a wheelchair and I was told no, they are not offered. Nothing was offered apart for some tubigrip.

- We were told repeatedly that no further treatment was available to us. We were absolutely, categorically NOT told that we were 'on treatment' for the duration of our pregnancies - you have not been given accurate information about what they are telling girls in the class and I have a friend who was in the class who can vouch for this. Like I said, we were told 'this was it' and they were 'too busy' to see us all.

- Perhaps this information at the classes is good enough for people with other conditions, but in my case my midwife said that in 18 years she has never seen SPD so severe at such an early stage in the pregnancy. I told the physio staff this twice and was ignored.

- I do not want further treatment as I should not have to come to Patient Opinion to get offered it. I am making my own arrangements for my care at my own cost as I have no faith in the physio department anymore, especially so after this response.

Thanks for your time and I hope the next person with SPD gets treated with care and respect, and with an approach that understands how completely debilitating, crippling and disabling it is to live with this condition. I now can't do anything unassisted, I can't look after my toddler on my own and I am medicated and in pain 24 hours a day.

Response from Louise Ewing, Patient Relations Manager, NHS Fife

picture of Louise Ewing

Dear SJC1983

Sorry the response offered has only served to further aggravate you, it was definitely not the intention. I would not begin to pretend to understand how debilitating your condition is and apologise wholeheartedly that I failed to recognise that and respond in a compassionate manner. I will take time with colleagues to reflect on the response; however the situation you describe is concerning and I wondered if you would consider chatting this through with me. If so please contact me directly on 01592 648153. In the meantime I will make sure that your further post is shared.

Thank you for taking the time to respond


Louise Ewing

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