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Brione, Rebecca
OK.
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Fiona Woollard
Ohh.
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Brione, Rebecca
OK, I can see that they started for me, so that should be good.
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Brione, Rebecca
Brilliant. Thank you. So just for the benefit of our recording. Welcome again everyone to the responses to alcohol and pregnancy Policy Focus Group. I've been over this sort of information in the consent form and the participant information sheet. But if I could just ask everyone just to confirm that they sort of consent to take part that would be super helpful. And I'm just gonna go through on the order in which you appear on my screen, which is [Participant 1] first.
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Brione, Rebecca
[Participant 1], you able to say to sort of unmute and just to confirm that you're content to take part in the basis that we've we've talked about?
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[Participant 1]
Yeah.
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Brione, Rebecca
Brilliant. Thank you, [Participant 2]?
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[Participant 2]  (Guest)
Yep, I'm happy to take part.
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Brione, Rebecca
Thank you, [Participant 2]. [Participant 3]?
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[Participant 3]
Yeah, I'm OK. I'm good to participate.
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Brione, Rebecca
Brilliant. Thank you. And then [Participant 4]?
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[Participant 4]
Yeah. OK.
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Brione, Rebecca
Brilliant. Thank you. Excellent. That's great.
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Brione, Rebecca
And and just to go over some sort of ground rules, which hopefully will make it a a sort of a safe space for everyone.
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Brione, Rebecca
And as I've already said, please keep the conversation confidential.
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Brione, Rebecca
We really want to hear from all of you. So would encourage everyone to actively participate. And please do speak one at a time. And just because that makes it much easier for us to make sure that we don't miss anything. But it makes a really big difference for the recording.
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Brione, Rebecca
And and I will try to make sure that everyone gets a fair chance to speak and hopefully with five of us, including me, that won't be too tricky. But if you think that you're being overlooked or you've got something to say and I've missed it or you want to come in on a particular point and are finding it difficult to then you know feel free to raise your hand just to interrupt if I'm speaking.
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Brione, Rebecca
And use the raised hand function, wave it, turn the camera on and wave at me. You know whatever means to make sure that I am. You know you don't miss the opportunity to speak.
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Brione, Rebecca
And equally, please say if questions aren't clear.
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Brione, Rebecca
And I would like to keep the discussion verbal rather than having a discussion here and in the chat, just because it's really difficult to moderate two conversations at once and to sort of follow everything.
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Brione, Rebecca
And and then the only other thing I particularly wanted to say was that as a group, I'm just going to ask that we all treat everyone's ideas with respect. And you know, we've got a range of experience in the room and we may well have a range of different views on different facets of what we're going to talk about. And that's brilliant. And we want to hear from everyone and for everyone to feel safe and comfortable sharing their views. So, you know, some if if there are points on which you disagree, that's absolutely fine. But it's just a case of sort of making sure that we all feelÉ
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Brione, Rebecca
ÉSafe and respected.
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Brione, Rebecca
Umm.
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Brione, Rebecca
In the room, the virtual room.
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Brione, Rebecca
So what we're going to do today is going to ask some fairly open questions about policy proposals around mandatory alcohol screening as part of routine antenatal care.
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Brione, Rebecca
The transfer of alcohol information from maternity records to Children's Health records.
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Brione, Rebecca
The potential impacts that these measures could have on relationships between midwives and patients and the potential impact they may have on professional identities of midwives.
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Brione, Rebecca
That's a lot of stuff, so it's broken down. We have four questions and one covers each of those areas and I've got some possible prompts that I can ask if we need to to get the discussion going, but I'm hoping that sort of once we get going, the discussion will sort of run itself to a large degree and I can just sort of listen in on the conversation and maybe chip in if there are particular things I want to hear more about.
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Brione, Rebecca
And and I'm planning to be fairly flexible in terms of how the discussion runs, but I'm probably going to aim to spend maybe 1520 minutes on each of the first two questions and then a little longer on on the two later ones.
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Brione, Rebecca
So and I will just wrap up at the end with just a tiny bit of sort of closing, closing, housekeeping and that sort of thing.
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Brione, Rebecca
So if everyone's happy, we can get going, but I will just pause here in case anyone does have any questions or concerns.
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Brione, Rebecca
Yep. OK. I'm gonna take silence as everything is OK, but just as I say.
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Brione, Rebecca
When it's me speaking, feel free to interrupt.
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Brione, Rebecca
I'm so first of all I'd like to ask.
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Brione, Rebecca
What you each think about mandatory alcohol screening at each antenatal contact.
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Brione, Rebecca
And as I said, I've got a couple of prompts I can ask, but I think I'm just gonna leave that as a fairly broad question to start with. So if somebody's happy to be brave and speak first, [Participant 2], I've seen you've got your hand up.
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[Participant 2] (Guest)
I'm always happy to talk. You know that. And yeah, itÕs just, uh, unnecessary for everybody is my, the short version of my, opinion on this. And there's two different there's two different paths that this needs to look at this kind of this.
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[Participant 2] (Guest)
UM, this guidance is kind of blanket guidance when actually what it needs to be is to have two different streams for for two different groups. And that's women who aren't drinking or who drank socially before pregnancy or didn't have problematic drinking before pregnancy. And then there needs to be some guidance on appropriate care and, you know, involvement and conversations when people have had problematic drinking prior to pregnancy, even if they've stopped.
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[Participant 2] (Guest)
And and those with ongoing alcohol issues. And I think the.
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[Participant 2] (Guest)
The kind of blanket approach.
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[Participant 2] (Guest)
For lots of different reasons, just doesn't really make sense to me.
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Brione, Rebecca
Thank you. What about others? What do you think?
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Brione, Rebecca
[Participant 4], can I ask? I'm picking you random. Can I ask what your views are on mandatory alcohol screening at each contact?
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Brione, Rebecca
Or [Participant 3], if, if [Participant 2]'s having a.
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Brione, Rebecca
Not able to respond right at this second.
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Brione, Rebecca
[Participant 1], do you? Do you have anything you wanted to to bring in?
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[Participant 3]
I don't have anything to say right now. OK? Yeah.
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Brione, Rebecca
OK. Ohh yeah, [Participant 3]
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Brione, Rebecca
That's right. OK.
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Brione, Rebecca
Can I ask then?
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Brione, Rebecca
If.
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Brione, Rebecca
If you work on the basis that.
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Brione, Rebecca
And that there was a.
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Brione, Rebecca
Was the proposal for mandatory alcohol screening at each contact? Are there points in the pregnancy journey? Where?
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Brione, Rebecca
And where you'd be sort of more or less comfortable.
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Brione, Rebecca
With it.
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[Participant 2] (Guest)
Do you mean like if they were going to specify different points rather than at every contact?
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Brione, Rebecca
Yes, I think so. That sort of thing.
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[Participant 2] (Guest)
Is that kind of what you're asking?
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[Participant 2] (Guest)
I'm.
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[Participant 2] (Guest)
Yeah, I suppose obviously we we we already ask at booking and that makes sense.
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[Participant 2] (Guest)
UM, I think probably asking again around 20 weeks depending on what pathway. You know people are doing.
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[Participant 2] (Guest)
And.
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[Participant 2] (Guest)
I think what you know, aside from the sort of ethics of why you need to ask something, every appointment for people for whom it's not an issue, some of the practicalities that come in from,
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[Participant 2] (Guest)
You know, actually trying to implement this is is that midwives already don't have enough time in appointments to do all the things they already need to do, UM and it this is similar to the the smoking and pregnancy guidance that came out at the end of last year from NICE, which says we now need to be doing a couple of monoxide monitoring it every appointment and we already don't have enough time to do that. And if you're going to do these, these public health interventions, these conversations need to be done in a.
00:10:00.020 --> 00:10:20.030
[Participant 2] (Guest)
You know you need to be high quality conversations. They need to be meaningful in order to be to have any point in doing them. And if you're going to give that to midwives who already don't have enough time to do the things before you're implementing these, then they're not going to have the meaning that they would or that the intention wants them to have.
00:10:21.900 --> 00:10:32.330
[Participant 2] (Guest)
So and then when you put that in the context of the the the situation in maternity services at the moment where we don't really have enough midwives and.
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[Participant 2] (Guest)
You know, having issues with retention, it's, it kind. It's basically a bit of a.
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[Participant 2] (Guest)
Feels like a bit of a poisonous stew of of situations that you're you're asking people to do something that you know, I don't see the rationale behind.
00:10:52.520 --> 00:11:06.200
[Participant 2] (Guest)
Uhm, when they don't have enough time to do it and the morale is already low and there's more and more ask. And if you're asking people to do something that they don't see the point of, then I can't really see it. It's working very well and then add in the kind of.
00:11:06.690 --> 00:11:13.520
[Participant 2] (Guest)
And feelings that the, you know, pregnant people, women might have about being asked repeatedly about their alcohol use.
00:11:14.130 --> 00:11:15.580
[Participant 2]  (Guest)
It's just gonna add to this.
00:11:15.660 --> 00:11:16.060
[Participant 2]  (Guest)
And.
00:11:17.420 --> 00:11:42.050
[Participant 2]  (Guest)
You know this feeling that they're just coming to be checked up on in a sort of Òwhat are you doing?Ó and Òare you being a good vessel?Ó rather than coming to have a check up on how they're doing and how the pregnancy is going and how you know, what's their emotional health like and how's the baby and all those things that the bits that most people come to midwifery four it just.
00:11:43.860 --> 00:11:49.070
[Participant 2]  (Guest)
There's just so many aspects about it that that kind of don't really work, I mean.
00:11:49.800 --> 00:11:51.540
[Participant 2]  (Guest)
For every appointment especially.
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[Participant 2]  (Guest)
I you know if if if this is gonna be something that we have to do, then doing it at, I don't know, once a trimester or something like that it you know that seems much more reasonable in in order to be able to manage.
00:12:05.620 --> 00:12:06.100
[Participant 2]  (Guest)
And.
00:12:08.350 --> 00:12:22.190
[Participant 2]  (Guest)
So yeah, I mean from a, from a managerial point of view, I'm then you know since this has been published, I'm having conversations with our antenatal matron about how on Earth we're actually going to make this happen, if we are, if we have to make it happen.
00:12:25.160 --> 00:12:26.870
Brione, Rebecca
Thank you. That's that's really helpful.
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[Participant 2]  (Guest)
Yes.
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Brione, Rebecca
And [Participant 3] , I can see that you were, you were typing. Do you want to come in?
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[Participant 3] 
Yeah, I was trying to ask you please put the questions on the chat. So it's, it will be much more helpful.
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Brione, Rebecca
Yeah, no problem. I can put the question in the chat so.
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Brione, Rebecca
I just let me.
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Brione, Rebecca
Let me do that.
00:13:00.370 --> 00:13:07.620
Brione, Rebecca
OK, so I've just put the the sort of main the main question in the chat and then I think.
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Brione, Rebecca
What I what I will put in is a version of the question that [Participant 2] was just speaking to, which was.
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Brione, Rebecca
About whether there were particular points during antenatal care, where.
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Brione, Rebecca
you feel more or less comfortable with?
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Brione, Rebecca
I'm asking about sort of alcohol intake at each contact.
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Brione, Rebecca
And.
00:13:32.360 --> 00:13:34.400
Brione, Rebecca
[Participant 1] , do you want to come in at this point?
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Brione, Rebecca
[Participant 3] , does that help having the questions in the chat?
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[Participant 3] 
Yeah. Yeah, it's it's, it's perfect. It's better.
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Brione, Rebecca
Yes.
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[Participant 3] 
My at my from my point of view, at some point in time, people like like the alcoholism, they sometimes take alcohol so much and then it's actually affects their finances, so.
00:14:10.550 --> 00:14:35.200
[Participant 3] 
There are some people that can't actually do without it. Yeah, so I think it's it's kind of bad and it's affects the baby. So at the end of it, I think it should be minimized and probably if possible be cut off for the sake of the baby. And then those two should also make sure they put in checks to everything about that.
00:14:41.280 --> 00:14:42.630
Brione, Rebecca
So you do you?
00:14:44.900 --> 00:14:54.570
Brione, Rebecca
Do you think that, am I understanding that that you're sort of that you are saying that sort of mandatory screening, at each sort of antenatal appointment isÉ
00:14:57.200 --> 00:15:02.470
Brione, Rebecca
Are you saying that it's a good thing for that? For those reasons, I'm I'm sort of. I don't want to put words in your mouth.
00:15:03.170 --> 00:15:05.110
Brione, Rebecca
But I just want to make sure I understand.
00:15:09.430 --> 00:15:10.760
[Participant 3] 
Yeah, definitely please.
00:15:09.730 --> 00:15:10.190
Brione, Rebecca
Yeah.
00:15:12.880 --> 00:15:13.260
[Participant 3] 
Yes.
00:15:15.320 --> 00:15:16.720
Brione, Rebecca
Good. Thank you. Thank you.
00:15:17.810 --> 00:15:18.510
Brione, Rebecca
[Participant 2]  yeah.
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[Participant 2]  (Guest)
I'm having the. Obviously I'm not now, but having been a specialist midwife looking after women with drug and alcohol problems and what always struck me that there was quite a big absence of any guidance in the sort of NICE areas like national guidance around the care that we should be providing for women with these quite specialist issues when there's you know problems with alcohol and my feeling was when I saw I saw the sort of expression of interest go out to be part of this group.
00:15:50.240 --> 00:15:50.810
[Participant 2]  (Guest)
And.
00:15:52.100 --> 00:15:54.690
[Participant 2]  (Guest)
My thoughts whether it would be much more useful.
00:15:55.540 --> 00:16:27.330
[Participant 2]  (Guest)
For me as a midwife working to have some, some guidance around what care should be provided for women that do have an alcohol problem and it seems like this is not, it feels like that should have come first before you start looking at guidance that doesn't address an issue or it seems like it's kind of maybe been, think, it's being considered or it's been decided in a way that is looking at the specific problem around you know children and identifying those with.
00:16:27.430 --> 00:16:57.340
[Participant 2]  (Guest)
With FASD and and who might have those issues and gone? OK, well, what we can do is this. And then doesn't feel like it's been considered from a, whether that actually makes sense, for the people that are going to be asking it or the people that are going to be asked it. Does that make sense? It just feels like there's already, there's not any guidance around this big the issue that does need lots of attention and does need really specialist care and so, trusts and midwives and services are left working out.
00:16:57.660 --> 00:17:02.480
[Participant 2]  (Guest)
With the evidence that they can find and, you know, historical practice, what we should be doing.
00:17:03.210 --> 00:17:11.550
[Participant 2]  (Guest)
And and then lots of time and you know, attention and and effort has been put into this guideline which doesn't really help that at all. I mean there's no.
00:17:12.300 --> 00:17:43.430
[Participant 2]  (Guest)
There's no actual, you know, information about any recommendations forÉ for tools to be used when people say that they are drinking in pregnancy. So like assessment tools or you know, how can we ask the question and in a meaningful way or in a way that is acceptable to women. It's just, telling us to ask a question and that could, you know, there might be some really good practice that comes out of that, but there might be some really unhelpful things that people do unintentionally because they're just being told to ask a question and not.
00:17:43.560 --> 00:17:44.010
[Participant 2]  (Guest)
Really.
00:17:45.380 --> 00:17:50.050
[Participant 2]  (Guest)
Being given any extra information about what's the best way to do that.
00:17:51.690 --> 00:17:52.200
[Participant 2]  (Guest)
Um.
00:17:54.090 --> 00:17:58.240
[Participant 2]  (Guest)
So it seems to be trying to meet the need of one group.
00:17:59.440 --> 00:18:05.670
[Participant 2]  (Guest)
But, you know, unintentionally or, you know, an unintended consequences, that it's gonna have potentially.
00:18:06.700 --> 00:18:09.960
[Participant 2]  (Guest)
Not helpful impact on another group.
00:18:13.060 --> 00:18:18.700
Brione, Rebecca
Thank you. Yeah. And I, I I think some of our later questions pick up on.
00:18:19.290 --> 00:18:30.060
Brione, Rebecca
..pick up on some of the some of these issues. [Participant 3]  or [Participant 1] . Do you want to add or disagree or or sort of pick up on any of?
00:18:30.880 --> 00:18:32.310
Brione, Rebecca
Any of what [Participant 2]Õs just said.
00:18:38.870 --> 00:18:41.060
[Participant 3] 
Yeah, actually you agree with what she said.
00:18:46.720 --> 00:18:48.490
Brione, Rebecca
Are you able to say a bit more about that?
00:19:08.180 --> 00:19:10.930
Brione, Rebecca
Can I ask something then which I think is?
00:19:13.050 --> 00:19:17.240
Brione, Rebecca
It's related to to what [Participant 2], to what you were just saying, but is.
00:19:18.100 --> 00:19:20.390
Brione, Rebecca
A little bit more about.
00:19:20.690 --> 00:19:42.460
Brione, Rebecca
A sort of current practice, I suppose. Which is what, what makes you ask about or particularly record alcohol intake at appointments other than booking at the moment because you mentioned that you often do, you often do. You know, you standardly do record alcohol use, take it, at booking. But you also said that there wasn't necessarily a sort of a standardized.
00:19:43.130 --> 00:19:44.900
Brione, Rebecca
Practice beyond that.
00:19:51.230 --> 00:19:51.640
[Participant 2]  (Guest)
I'm.
00:19:52.810 --> 00:19:54.970
[Participant 2]  (Guest)
Well, where, where I work.
00:19:54.980 --> 00:19:55.120
Brione, Rebecca
Yeah.
00:19:55.610 --> 00:19:56.910
[Participant 2]  (Guest)
There's Umm.
00:19:58.230 --> 00:20:28.700
[Participant 2]  (Guest)
IÕm repeating myself, and there's a a kind of practice where if you identify at that booking appointment that there are or have been any current or historical issues with alcohol, then that would take someone on to a different pathway. So they would have support from a specialist midwife or so either the specialist midwife who deals particularly with substance and alcohol use or depending on whether there were any other issues or whether you know if there was, you know, Co occurring mental health issues and.
00:20:28.780 --> 00:20:44.530
[Participant 2]  (Guest)
They were the main problem. It might be liaison between that midwife and another midwife. So actually, where there's where there's been an issue that's been identified. Then you would follow the guidance that we put together around that and you would balance up asking.
00:20:44.900 --> 00:21:14.820
[Participant 2]  (Guest)
..versus not wanting to put the person off coming to those appointments because they're gonna feel monitored. So it's a, it's a very delicate balance and we would always have conversations with social workers where they might want us to do that every visit. And we'd say actually, if it looks like that the woman isn't coming to her appointments because she wants, she's not wanting to answer that question and that'sÉ The main point of maternity care is to provide antenatal care. It's not to.
00:21:15.260 --> 00:21:44.290
[Participant 2]  (Guest)
Monitor people's alcohol use. It's not to be a social worker. So we would always then bring it back around to what do we need to do in order to make sure this woman feels safe to come to her appointments and we can listen in to the baby's heart rate and we can check her blood pressure and we can do the things that we know will make a difference to the outcome of of, you know, of her pregnancy and all those things. So again, that that means it just depends on the person. And if somebody has told us at booking that they (a) have never drunk.
00:21:45.310 --> 00:22:16.420
[Participant 2]  (Guest)
Obviously, some cultures and religious religions, those people never drink or people said Ohh I would drink socially, but I stopped, you know, before I was pregnant or when I found out I was pregnant. Then, clinically, for me there's no rationale or no indication to need to ask that in a repeated way because, and you know, unless somebody came to an appointment and seemed like they might be under the influence of alcohol, in which case, I might say, I might ask the question, but I, you know, I haven't had that happen.
00:22:16.520 --> 00:22:20.410
[Participant 2]  (Guest)
For somebody who we didn't already know that there was a an issue with alcohol, so.
00:22:21.120 --> 00:22:21.730
[Participant 2]  (Guest)
Um.
00:22:22.760 --> 00:22:30.900
[Participant 2]  (Guest)
You know the, the whole point of everything that we do, we're supposed to have a rationale for for what we do, and to understand what that is.
00:22:31.510 --> 00:22:40.310
[Participant 2]  (Guest)
Um. So that's what I wouldn't do it unless there was a reason to ask the question. And that's, you know, that's my understanding of common practice where I work, at the very least.
00:22:42.510 --> 00:22:43.300
Brione, Rebecca
Thank you.
00:22:43.920 --> 00:22:49.390
Brione, Rebecca
And [Participant 3]  Or [Participant 1]. Is that your experience as well?
00:23:05.640 --> 00:23:07.550
Brione, Rebecca
I think if, if you if.
00:23:08.490 --> 00:23:16.290
Brione, Rebecca
If neither, if nobody wants to add any more to this question, then we might move on to the next one. But I'm conscious of just that. Haven't heard from everybody, so.
00:23:16.930 --> 00:23:32.210
Brione, Rebecca
Um. If there are other points that you'd like to bring up at this point to do with sort of your general views about mandatory alcohol screening. I'd really, I'd really love to hear them and would really welcome hearing them now.
00:23:46.210 --> 00:23:49.920
Brione, Rebecca
OK. If anything does come up that you think is more relevant?
00:23:49.680 --> 00:23:56.920
[Participant 3] 
Ohh personally I don't have any experience like that so I don't know. I don't have any suggestions actually.
00:23:58.450 --> 00:24:00.560
Brione, Rebecca
Do you have experience fromÉ
00:24:01.840 --> 00:24:04.290
Brione, Rebecca
Caring for women who you for
00:24:05.210 --> 00:24:05.940
Brione, Rebecca
who perhaps
00:24:06.990 --> 00:24:09.960
Brione, Rebecca
Don't drink or drink socially that
00:24:11.190 --> 00:24:13.060
Brione, Rebecca
 that you'd like to bring in?
00:24:32.390 --> 00:24:36.030
Brione, Rebecca
[Participant 1] , was there anything you wanted to add before we move on?
00:24:44.950 --> 00:24:55.310
Brione, Rebecca
OK. Well, if there are things that come up, we can always come back to this. So this is sort of supposed to be a discussion rather than, you know. So we can take it where it needs to go.
00:24:56.110 --> 00:24:56.610
Brione, Rebecca
Umm.
00:24:57.390 --> 00:25:18.420
Brione, Rebecca
So the second question I wanted to ask, which I will put in the in the chat in a second, but I cannot copy paste and talk at the same time. Is what you think about the idea of routinely transferring information on alcohol intake from maternity records to the to the child's health records.
00:25:26.740 --> 00:25:27.520
[Participant 2]  (Guest)
I'm happy to go.
00:25:28.320 --> 00:25:30.730
[Participant 2]  (Guest)
first, unless someone else can say something.
00:25:32.450 --> 00:25:37.390
[Participant 2]  (Guest)
This this one feels. I feel like I'm a little bit more on the fence about this one.
00:25:38.010 --> 00:25:46.470
[Participant 2]  (Guest)
Umm, because there's lots of information that we that we do copy on to the to the, the neonatal records about.
00:25:47.470 --> 00:26:07.000
[Participant 2]  (Guest)
Uh, mothers. But again, I don't really see the point if there hasn't been an issue. I think having robust ways for when there is an issue for that information to be on the record so that that you know that maybe that child can be appropriately assessed and and you know those needs can be met that makes sense to me, but it just.
00:26:10.290 --> 00:26:19.860
[Participant 2]  (Guest)
It just. I don't see what the point is if there hasn't been, apart from to confirm there hasn't been. So I guess it's maybe it's about helping make a diagnosis diagnosis of exclusion.
00:26:20.500 --> 00:26:21.190
[Participant 2]  (Guest)
UM.
00:26:22.890 --> 00:26:33.880
[Participant 2]  (Guest)
But it feels less contentious to me. But then I, you know, that's that's my view, not of being somebody thinking about it from my own personal, not my pregnancy point of view, as a sort of health professional, point of view.
00:26:35.790 --> 00:26:36.760
[Participant 2]  (Guest)
It definitely doesn't.
00:26:37.390 --> 00:26:38.240
[Participant 2]  (Guest)
Feel.
00:26:40.930 --> 00:26:48.700
[Participant 2]  (Guest)
It's one of the bits of the the the quality standard that doesn't bother me as much as some of the other ones.
00:26:52.710 --> 00:26:56.100
Brione, Rebecca
[Participant 1]  or [Participant 3] , do you want to come in?
00:27:10.030 --> 00:27:12.720
[Participant 3] 
Personally, I don't think it's actually.
00:27:13.980 --> 00:27:14.120
[Participant 3] 
And. [Distortion Ð voice is breaking up]
00:27:17.420 --> 00:27:17.710
[Participant 3] 
Hey.
00:27:21.840 --> 00:27:22.470
[Participant 3] 
Yeah.
00:27:29.100 --> 00:27:29.540
Brione, Rebecca
I'm.
00:27:29.280 --> 00:27:31.610
[Participant 3] 
That's good for for.
00:27:33.190 --> 00:27:35.570
[Participant 3] 
Yeah, of course.
00:27:36.730 --> 00:27:37.670
[Participant 3] 
And it's actually.
00:27:41.890 --> 00:27:45.910
Brione, Rebecca
I'm really sorry, [Participant 3] . You were breaking up. Could you say that again, please?
00:28:10.360 --> 00:28:18.820
Brione, Rebecca
Sorry, [Participant 3] , I just put in the chat. Umm, but I couldn't hear. Your connection wasn't very good. Do you mind saying that again please?
00:28:35.260 --> 00:28:38.080
Brione, Rebecca
[Participant 3], I might come back to you in a second, [Participant 1] .
00:28:38.730 --> 00:28:41.090
Brione, Rebecca
What about you? What's what are your views on this?
00:28:56.400 --> 00:29:01.030
Brione, Rebecca
Sorry, [Participant 3] , I don't like if you can hear me. Are you able to repeat what you said?
00:29:13.840 --> 00:29:17.990
Brione, Rebecca
I'll ask again in a second, because I really would like to hear it.
00:29:19.510 --> 00:29:19.750
Brione, Rebecca
But.
00:29:21.990 --> 00:29:28.340
Brione, Rebecca
[Participant 2] , can I ask something to follow up from what you said and I will also put this in the chat for everyone.
00:29:29.880 --> 00:29:33.180
Brione, Rebecca
I I'd be interested in hearing more about your views on.
00:29:33.640 --> 00:29:35.330
Brione, Rebecca
on whether.
00:29:36.010 --> 00:29:43.420
Brione, Rebecca
If transfer of information was introduced, whether it should be mandatory or voluntary, sort of based around some form of consent.
00:29:49.810 --> 00:30:01.620
[Participant 2]  (Guest)
There this is. This is where it gets really interesting in terms of what information a child has a right to and then which you know, I think this is like a.
00:29:50.210 --> 00:29:50.720

[Participant 2]  (Guest)
It's something that we just make assumptions that it's OK to just any information about the mother for that to be shared.
00:30:10.690 --> 00:30:25.640
[Participant 2]  (Guest)
On the child's records and I I I yeah, I don't know what the I don't know what the ultimate answer is. But I mean it feels like when, when something is really important and potentially gonna impact on that child's life, then I think that's something that's important to share.
00:30:26.100 --> 00:30:26.920
[Participant 2]  (Guest)
Uhm.
00:30:28.300 --> 00:30:34.100
[Participant 2]  (Guest)
If that's gonna make a difference to the care that a child needs and receives, thenÉ.
00:30:35.530 --> 00:30:47.600
[Participant 2]  (Guest)
Then it feels like less of a question. It feels like, well, that seems like it, yes, that should be done. But again, it comes back to this two, there's two different groups and you can't you can't make blanket.
00:30:48.970 --> 00:30:51.620
[Participant 2]  (Guest)
You know suggestions or you know
00:30:52.420 --> 00:31:08.430
[Participant 2]  (Guest)
give blanket guidance for groups that where the outcome the potential impacts and consequences are very, very, very different. As in you know with somebody who didn't have a problem with alcohol, wasn't drinking during pregnancy or drinking a way that was really not a problem.
00:31:08.870 --> 00:31:16.440
[Participant 2]  (Guest)
And then again, either that doesn't, that's not necessary information and and you know we are.
00:31:17.140 --> 00:31:25.200
[Participant 2]  (Guest)
You know, we're supposed to be sharing only information that is a need to know, and therefore that would be the situation where I would say.
00:31:26.320 --> 00:31:43.960
[Participant 2]  (Guest)
Yes, we should be asking people, or ideally, it shouldn't. Information shouldn't really be shared unless it's necessary information and it doesn't fall into that category in my mind, unless there is an issue for then you know what I was saying before that there's potential impact on that, on the child.
00:31:46.490 --> 00:31:53.240
Brione, Rebecca
So, are there circumstances where you think it should be mandatory is that, am I, am I understanding that correctly?
00:31:53.770 --> 00:32:08.180
[Participant 2]  (Guest)
And I guess it's it's less of a, I don't know whether it doesn't necessarily. I feel like it needs to come into a into a conversation about what's mandatory and not mandatory. It almost feels like what's clinically necessary.
00:32:08.800 --> 00:32:09.550
[Participant 2]  (Guest)
UM.
00:32:10.730 --> 00:32:18.650
[Participant 2]  (Guest)
And kind of feels like what already happens. So when information is important enough that the it's needed for the baby's care, then that information is.
00:32:19.820 --> 00:32:38.030
[Participant 2]  (Guest)
To my, in my experience, you know, put on the baby's records. It's shared with the clinicians that are caring for that baby. There's always plans put in place and everything. So it kind of almost feels like that's already in place. I don't know what exactly.
00:32:39.380 --> 00:32:52.800
[Participant 2]  (Guest)
They mean about the, you know, transferring it onto the child's records. Because I, you know what I'm talking about is the clinical records that we hold on that person. And, you know, on that, that child in the in the hospital. So,
00:32:53.750 --> 00:32:59.600
[Participant 2]  (Guest)
Presumably they mean, I don't know, putting it on the spine or the GP record or something, but again.
00:33:01.050 --> 00:33:11.580
[Participant 2]  (Guest)
That kind of feels like that would already be there, because if there were concerns about alcohol and that would be shared with the GP, that would be shared with the health visitor because we are already.
00:33:13.670 --> 00:33:17.140
[Participant 2]  (Guest)
Usually aware of these babies and and their care needs. So.
00:33:18.220 --> 00:33:23.350
[Participant 2]  (Guest)
It doesn't. It almost feels like the conversation now is about whether we should.
00:33:24.480 --> 00:33:29.500
[Participant 2]  (Guest)
Mandatory mandatorily share you know that this person.
00:33:30.720 --> 00:33:36.720
[Participant 2]  (Guest)
Said, you know, at their booking point, I used to drink a glass of wine with dinner on a Friday.
00:33:37.400 --> 00:33:40.450
[Participant 2]  (Guest)
Umm. And we have to share that information which.
00:33:41.590 --> 00:33:45.930
[Participant 2]  (Guest)
Is pointless. And it's not relevant clinical information.
00:33:47.110 --> 00:33:49.120
[Participant 2]  (Guest)
Does that make sense? It kind of just feels like.
00:33:51.190 --> 00:33:53.560
[Participant 2]  (Guest)
Umm yeah.
00:33:54.840 --> 00:34:16.510
Brione, Rebecca
It, it does make sense, I would like I, [Participant 1] , I could see that you were that you were typing. So I'd really like to come to you in just a second. Can I just ask one clarificatory question [Participant 2], which might just be my ignorance. But when you say it would go on things like the clinical notes and maybe be available to the GP or the health visitor is that.

00:34:17.840 --> 00:34:23.420
Brione, Rebecca
That is that different to what would be and say the child's red book, if the red books still exist. I know it used to.
00:34:24.650 --> 00:34:31.990
Brione, Rebecca
In terms of the the sort of child health record that the parent carries. And I'm sorry, that's a really stupid question, but.
00:34:28.000 --> 00:34:28.330
[Participant 2]  (Guest)
Umm.
00:34:31.470 --> 00:34:41.960
[Participant 2]  (Guest)
No, no, no, it's not at all. It's not at all. So yeah, the Redbook does still exist. We have E- Redbook as well as physical red books these days. So I think there is a there is going to be movement to most of that being.
00:34:32.070 --> 00:34:32.440
Brione, Rebecca
OK.
00:34:42.660 --> 00:34:51.110
[Participant 2]  (Guest)
Uh on the cloud or whatever it's looking like. But yeah, So what? When I'm talking about the clinical records, I'm thinking more like, you know, in a.
00:34:51.790 --> 00:35:23.580
[Participant 2]  (Guest)
A summary of a woman's birth. You would have some information about her antenatal period, where there any complications for the birth, you know postnatally, and if somebody has an alcohol problem and they've been under specialist care for that, then that would be included in that information. And that then gets transferred to the GP. So because they have the sort of long term follow up with the, and with the health visitor as well, they get the same information and then the GP obviously manages their own records. The health visitors have their own records that they would write about that baby as well.
00:35:23.970 --> 00:35:32.250
[Participant 2]  (Guest)
And I don't think that routinely, in the Redbook currently, there would be anywhere that you would put something like this.
00:35:32.670 --> 00:35:36.300
[Participant 2]  (Guest)
UM and I don't know whether that is the plan.
00:35:39.330 --> 00:35:41.380
[Participant 2]  (Guest)
I'm just trying to think if there's anywhere else.
00:35:43.420 --> 00:35:57.310
[Participant 2]  (Guest)
So it's probably more the professional facing records. Obviously families can access themselves if they if they want to. But yeah, rather than information that parent is carrying around or accessing.
00:35:59.550 --> 00:36:00.710
Brione, Rebecca
That's really helpful.
00:36:01.500 --> 00:36:10.230
Brione, Rebecca
Slightly concerningly I can now see that we've also lost [Participant 1] , who is clearly been trying to type. Ohh, there we go. I think she's hopefully coming back in.
00:36:06.840 --> 00:36:07.650
[Participant 2]  (Guest)
Ohh no.
00:36:13.590 --> 00:36:15.070
Brione, Rebecca
Bear with us and we'll just.
00:36:15.820 --> 00:36:17.390
Brione, Rebecca
Because I'm quite keen to bring her in.
00:36:19.590 --> 00:36:20.860
Brione, Rebecca
Hi, [Participant 1] .
00:36:23.220 --> 00:36:24.320
Brione, Rebecca
Are you able to hear?
00:36:31.630 --> 00:36:33.920
Brione, Rebecca
I, [Participant 1] , I could see that you, ohh sorry.
00:36:37.300 --> 00:36:38.470
[Participant 1] 
I think it.
00:36:49.050 --> 00:36:56.220
Brione, Rebecca
Hi [Participant 1] . I could. I could see you were trying to type or that you were typing 
00:36:57.870 --> 00:37:15.310
Brione, Rebecca
What? What did what would you like to bring in? I I hope that we didn't miss any messages. I can see the full chat, but I couldn't see that anything came up. Um. what? What are your views on routine transfer of information from the maternity records to the child's health, child's health records.
00:37:24.620 --> 00:37:25.280
[Participant 1] 
Actually I was.
00:37:25.380 --> 00:37:25.760
Brione, Rebecca
Ohh.
00:37:26.490 --> 00:37:32.410
[Participant 1] 
That we transfer information should be mandatory. That's what I was trying to type in.
00:37:33.240 --> 00:37:33.770
[Participant 1] 
Thank you.
00:37:34.430 --> 00:37:36.940
Brione, Rebecca
Sorry, you were saying that it should be mandatory, was that?
00:37:42.870 --> 00:37:43.610
[Participant 1] 
Yeah.
00:37:46.210 --> 00:37:50.410
Brione, Rebecca
And do you think that that should be the case in all cases?
00:37:58.390 --> 00:38:01.590
[Participant 1] 
Actually, I think it's be in more circumstances.
00:38:04.870 --> 00:38:14.000
Brione, Rebecca
Can you say a little bit about the circumstances where you, sorry, you think in all circumstances are in some circumstances I just realized I might have misheard.
00:38:19.640 --> 00:38:20.440
[Participant 1] 
I think it will.
00:38:25.030 --> 00:38:25.510
Brione, Rebecca
In all?
00:38:26.890 --> 00:38:27.590
[Participant 1] 
Yeah.
00:38:27.770 --> 00:38:29.270
Brione, Rebecca
Right. OK. Thank you.
00:38:31.320 --> 00:38:33.760
Brione, Rebecca
And you think it should be mandatory rather than voluntary?
00:38:36.940 --> 00:38:38.890
[Participant 1] 
Yeah, it should be mandatory, yeah.
00:38:39.500 --> 00:38:47.340
Brione, Rebecca
Thank you. Sorry, I just wanted to make sure that it that it was, it was clear there was a little bit of breaking up when you were first speaking for me.
00:38:49.580 --> 00:38:51.300
Brione, Rebecca
OK, that was really helpful.
00:38:53.800 --> 00:39:03.930
Brione, Rebecca
I think I'm minded to move on to the next question, but is there anything else that [Participant 2]  or [Participant 1]  you'd like to say on this before we do?
00:39:09.130 --> 00:39:16.210
Brione, Rebecca
No? I will take silence and hopefully [Participant 3]  will be able to rejoin. I wonder if she's having connectivity issues.
00:39:16.940 --> 00:39:24.670
Brione, Rebecca
And because I didn't, I don't know if either of you did did, but I'm afraid I didn't hear what she said before, so I'm hoping she will be able to rejoin us.
00:39:25.720 --> 00:39:26.220
Brione, Rebecca
I'm.
00:39:27.020 --> 00:39:29.970
Brione, Rebecca
OK. So the third question that I wanted to ask about.
00:39:30.530 --> 00:39:56.480
Brione, Rebecca
And was whether you think that the proposals either for mandatory screening or for screening and transfer of information to child's health records could have any impact on your relationship with your patients. And I think from what you've, what we've sort of talked about already, that there might be different different aspects of this, thatÉ
00:39:58.140 --> 00:40:03.110
Brione, Rebecca
Éwe want to discuss in different ways, but I think I'll start with that broad, broad question.
00:40:08.900 --> 00:40:10.880
[Participant 2]  (Guest)
Just wondering. [Participant 1] wants to go first.

Brione, Rebecca
[Participant 1], do you want to come in first this time?
00:40:29.290 --> 00:40:34.010
Brione, Rebecca
[Participant 2], if you want to, if you want to come in, then [Participant 1],, just come in when youÕre ready.
00:40:34.840 --> 00:40:37.180
Brione, Rebecca
Uh, yeah, come in. Come in when you're ready.
00:40:37.560 --> 00:40:41.050
[Participant 2]  (Guest)
Sure. I mean, one of the things that feels like it.
00:40:41.740 --> 00:40:49.390
[Participant 2]  (Guest)
Is really important in what we're movingÉ trying to move towards in maternity care, is just trying to offer more culturally appropriate care.
00:40:50.270 --> 00:41:09.510
[Participant 2]  (Guest)
And and that means paying attention to the person in front of you and hearing about their culture and then tailoring your care. That's sort of obvious. But that, that's one of the reasons that I think asking somebody who's told you they don't drink for religious reasons.
00:41:10.210 --> 00:41:26.350
[Participant 2]  (Guest)
At every time you see them, how you know whether they've drink any alcohol since you saw them last or whatever it is that we're gonna be saying it, even if it's something that we are supposed to do, that might feel to the person like they're, you're not paying attention.
00:41:27.310 --> 00:41:27.790
[Participant 2]  (Guest)
And.
00:41:28.600 --> 00:41:36.110
[Participant 2]  (Guest)
It might feel like you're giving them culturally inappropriate care, because if you know somebody has never drunk alcohol for religious reasons.
00:41:37.040 --> 00:41:43.060
[Participant 2]  (Guest)
Then why are you asking the question? So, UM, what we get into is a.
00:41:44.560 --> 00:41:53.640
[Participant 2]  (Guest)
Midwifery by rote kind of situation where you like. ÒOh, I'm just. The computer says I have to ask you this question. So I'm asking you this question.Ó and actually that's.
00:41:54.300 --> 00:42:02.110
[Participant 2]  (Guest)
Time and even if it's one question, that's precious time that you could be having a conversation about something that means something to the person thatÕs sat in front of you.
00:42:04.760 --> 00:42:05.360
[Participant 2]  (Guest)
So.
00:42:06.300 --> 00:42:12.180
[Participant 2]  (Guest)
I think there is potential for that to be an issue. Again, I think the issue of.
00:42:12.930 --> 00:42:14.740
[Participant 2]  (Guest)
People feeling trusted.
00:42:15.560 --> 00:42:16.190
[Participant 2]  (Guest)
So.
00:42:17.450 --> 00:42:22.460
[Participant 2]  (Guest)
If I say to my midwife that I stopped drinking when I knew I became pregnant.
00:42:23.240 --> 00:42:32.810
[Participant 2]  (Guest)
And then they asked me about whether I've drunk anything at every time they see me, I might think, actually, this midwife doesn't trust that I'm not drinking the, you know, thinking.
00:42:33.760 --> 00:42:43.140
[Participant 2]  (Guest)
They don't trust that I'm not doing this thing, which I know to be harmful to babies and blah blah, blah, so I feel like there's the potential impact in that sense.
00:42:43.870 --> 00:42:52.800
[Participant 2]  (Guest)
Umm, there's a potential impact on on that relationship depending on how you ask that question as well and whether that's done in a.
00:42:54.160 --> 00:42:55.330
[Participant 2]  (Guest)
In a way.
00:42:56.390 --> 00:43:14.580
[Participant 2]  (Guest)
Like if I say ohh I I just have to ask you this question. It's a silly question but I have to ask it so I'm asking it then that you know that kind of makes that reduces the issues probably around not understanding why the questions being asked if it doesn't need to be asked but then maybe that might cause some.
00:43:16.050 --> 00:43:19.290
[Participant 2]  (Guest)
You know, a sort of degradation and trust in the system like.
00:43:20.700 --> 00:43:26.190
[Participant 2]  (Guest)
If this, this health professionals is being made to do things that they don't think they should need to do.
00:43:26.970 --> 00:43:39.180
[Participant 2]  (Guest)
Then what other things is the system going to, to suggest or do that don't need doing? Um. If that makes sense, I just think there's a lot of potential pitfalls.
00:43:42.130 --> 00:43:45.080
[Participant 2]  (Guest)
And and again another of them that I mentioned before is aboutÉ.
00:43:47.040 --> 00:43:52.430
[Participant 2]  (Guest)
It's the the autonomy of midwives to decide who needs what kind of care and when.
00:43:54.640 --> 00:43:55.160
[Participant 2]  (Guest)
Umm.
00:43:56.470 --> 00:43:56.850
[Participant 2]  (Guest)
Yeah.
00:43:58.410 --> 00:44:03.260
Brione, Rebecca
Thank you. And do you think there are any particular pros toÉ
00:44:04.220 --> 00:44:05.260
Brione, Rebecca
To the proposals?
00:44:07.990 --> 00:44:33.800
[Participant 2]  (Guest)
I this is a I, I imagine this, is not necessarily what I think would be happening, but I imagine whoever thought this of this as an idea one of the things they might think was a pro would be actually you might have more of a a relationship is built up over time and then that person who does have an issue with alcohol or is continuing to drink but doesn't feel confident to say it yet at some point they then disclose that.
00:44:36.610 --> 00:44:43.410
[Participant 2]  (Guest)
Which in theory I suppose is true. That depends on lots of things, though that a that you're getting some continuity of care which as we know is.
00:44:44.110 --> 00:44:48.300
[Participant 2]  (Guest)
Still a work in progress in a very large way.
00:44:49.520 --> 00:44:51.340
[Participant 2]  (Guest)
And that the person.
00:44:52.230 --> 00:45:01.000
[Participant 2]  (Guest)
You know, is asking it in a way the midwife is asking it in a way that that would engender the kind of trusting, you know, disclosure. UM.
00:45:01.810 --> 00:45:10.960
[Participant 2]  (Guest)
So I guess that there's a, there's a, you know, infinitesimally small number of women for whom that might that might be the case. I don't.
00:45:11.830 --> 00:45:13.600
[Participant 2]  (Guest)
Really think that.
00:45:14.290 --> 00:45:17.200
[Participant 2]  (Guest)
It's very likely, but I suppose it is a.
00:45:18.250 --> 00:45:19.040
[Participant 2]  (Guest)
Potential.
00:45:20.480 --> 00:45:21.320
[Participant 2]  (Guest)
Potential thing.
00:45:24.960 --> 00:45:27.240
[Participant 2]  (Guest)
I can't really think of anything else that
00:45:28.540 --> 00:45:31.780
[Participant 2]  (Guest)
Éfeels positive about it because it just does feel like a waste of everyone's time.
00:45:33.010 --> 00:45:34.070
[Participant 2]  (Guest)
More than anything else.
00:45:36.630 --> 00:45:39.090
Brione, Rebecca
Thank you, [Participant 1] . What do you think?
00:45:49.420 --> 00:45:52.540
Brione, Rebecca
Oh dear, we've lost [Participant 1]  again. Hopefully she'll be back in a second.
00:45:53.340 --> 00:45:53.750
Brione, Rebecca
Umm.
00:45:55.050 --> 00:46:04.800
Brione, Rebecca
I'm really keen to hear what she says. If you if you don't mind bearing with me, [Participant 2] , I will just sit tight for a second. Have a quick drink of my mint tea.
00:46:06.010 --> 00:46:08.200
Brione, Rebecca
And just to see if [Participant 1] is able to rejoin us.
00:46:20.930 --> 00:46:25.180
Brione, Rebecca
Hi, [Participant 1]. Are you you back with us and able to hear?
00:46:43.050 --> 00:46:45.430
Brione, Rebecca
Hi [Participant 1], are you able to hear us? Ohh yeah, sorry.
00:46:45.910 --> 00:46:47.360
[Participant 1] 
Yes, I can hear you now.
00:46:47.800 --> 00:46:49.010
Brione, Rebecca
Excellent. Thank you.
00:46:49.630 --> 00:46:55.020
Brione, Rebecca
And I'd, I'd love to hear your views on, you know.
00:46:55.940 --> 00:46:56.760
Brione, Rebecca
How you think?
00:46:57.560 --> 00:47:02.820
Brione, Rebecca
What impact do you think the proposals would have on, on your relationships with your, with your patients?
00:47:32.340 --> 00:47:41.670
Brione, Rebecca
Do you have any views on the particular sort of pros or cons of the proposal in relation to your relationship with patients?
00:48:00.210 --> 00:48:02.780
Brione, Rebecca
I might ask one follow up and and.
00:48:03.580 --> 00:48:05.030
Brione, Rebecca
[Participant 2] and I might come to you.
00:48:06.330 --> 00:48:15.140
Brione, Rebecca
Just cause you might feel that you've answered this and what you've already said, in which case that's fine, but I just wondered if you felt that there was a difference.
00:48:16.560 --> 00:48:18.680
Brione, Rebecca
A difference between the sort of impact of.
00:48:19.760 --> 00:48:31.350
Brione, Rebecca
Just doing the screening, just asking about alcohol intake or the screening plus the transfer and if you feel like you've answered that already, then just say that's absolutely fine.
00:48:38.460 --> 00:48:38.830
[Participant 2]  (Guest)
Ah.
00:48:41.610 --> 00:48:48.060
[Participant 2]  (Guest)
I feel like my views are probably similar for either and you know, or both.
00:48:50.290 --> 00:48:51.880
[Participant 2]  (Guest)
I don't know whether we're.
00:48:53.710 --> 00:49:06.390
[Participant 2]  (Guest)
Particularly checking in with people about what information is already transferred over to the child. Records don't know if that's a conversation we have in a, you know, in a in a big way anyway.
00:49:06.910 --> 00:49:16.370
[Participant 2]  (Guest)
And but it feels like if that's then something that you're getting into and you're having a conversation about, you know, it, it almost smells like.
00:49:16.710 --> 00:49:26.620
[Participant 2]  (Guest)
And echoes of anything you say may be used against you in a court of, you know, like the police would say to you when they're interviewing you. So you know we.
00:49:27.980 --> 00:49:38.900
[Participant 2]  (Guest)
Any information you share with us about your alcohol use will be transferred to your health records, so and it. The thought of having that conversation with somebody just feels again like.
00:49:39.540 --> 00:49:40.310
[Participant 2]  (Guest)
Umm.
00:49:42.030 --> 00:49:44.290
[Participant 2]  (Guest)
Not something I would be.
00:49:45.000 --> 00:49:51.120
[Participant 2]  (Guest)
Relishing and doing because again, I'd be in the situation where I say for most people that.
00:49:51.910 --> 00:50:08.600
[Participant 2]  (Guest)
Wouldn't be necessary or relevant. UM and where, where I was working with someone who, where it was necessary and relevant, I would have had that the conversation would be based around a clinical.
00:50:09.850 --> 00:50:17.790
[Participant 2]  (Guest)
Conversation around the impact of alcohol and pregnancy when that use is at a certain level or there's a problem with alcohol and that would be.
00:50:18.840 --> 00:50:27.190
[Participant 2]  (Guest)
You know, and that I would be having a conversation about needing to share certain bits of information to make sure that they got the support that they needed and their baby got the care they needed. So.
00:50:29.940 --> 00:50:33.790
[Participant 2]  (Guest)
Where there is where it's relevant, those conversations do take place already.
00:50:34.470 --> 00:50:47.390
[Participant 2]  (Guest)
And it's just it. I feel like it is coming back to that same thing. It's just that issue of feel like I only want to do things that I can see and understand and rationalize.
00:50:48.200 --> 00:50:50.140
[Participant 2]  (Guest)
Doing basically.
00:50:50.690 --> 00:50:50.990
Brione, Rebecca
Umm.
00:50:51.990 --> 00:50:52.760
Brione, Rebecca
No, thank you.
00:50:53.790 --> 00:50:55.210
Brione, Rebecca
[Participant 1] , do you want to come in?
00:51:17.480 --> 00:51:21.340
Brione, Rebecca
[Participant 1] , I'll come back to you again in a second. I've just, so one..
00:51:22.240 --> 00:51:27.470
Brione, Rebecca
..additional thing that struck me when you were speaking [Participant 2] . So you said about sort of.
00:51:29.650 --> 00:51:31.460
Brione, Rebecca
Bringing it up with.
00:51:32.250 --> 00:51:33.940
Brione, Rebecca
With patients and.
00:51:35.550 --> 00:51:48.260
Brione, Rebecca
Having that particular conversation about what's transferred onto the child's health record in relation to alcohol, but you also sort of said that there was potentially some ambiguity in what information is already.
00:51:48.970 --> 00:51:53.850
Brione, Rebecca
Currently transferred in different situations and I guess.
00:51:55.590 --> 00:51:58.540
Brione, Rebecca
I'm just wondering if you have any sort of broader thoughts about?
00:52:01.410 --> 00:52:07.010
Brione, Rebecca
Sorry this was not a pre drafted prompt as you can probably tell, but broader thoughts about.
00:52:08.840 --> 00:52:10.710
Brione, Rebecca
Whether there's particular?
00:52:11.590 --> 00:52:20.740
Brione, Rebecca
Pros and cons in sort of singling out alcohol or anything else for discussion about what gets transferred if there is actually.
00:52:21.510 --> 00:52:27.610
Brione, Rebecca
More nuance and ambiguity and what gets transferred, in particular in particular situations anyway.
00:52:28.390 --> 00:52:29.250
Brione, Rebecca
Does that make sense?
00:52:29.910 --> 00:52:34.900
[Participant 2]  (Guest)
I think so. Yeah. I mean it does. It does kind of bring that.
00:52:36.140 --> 00:52:41.110
[Participant 2]  (Guest)
Kind of that thought up as well. Yeah, it it kind of for me it means.
00:52:42.330 --> 00:52:46.940
[Participant 2]  (Guest)
It doesn't make sense to to start discussing discussing one issue.
00:52:47.830 --> 00:52:50.910
[Participant 2]  (Guest)
And singling out alcohol use as an issue because.
00:52:51.840 --> 00:52:52.520
[Participant 2]  (Guest)
Um.
00:52:53.280 --> 00:53:05.710
[Participant 2]  (Guest)
Because there's there's lots of things. There's lots of things that we kind of monitor for and that we know can harm fetuses in utero, that we would do public health and interventions for, like smoking and pregnancy.
00:53:06.150 --> 00:53:09.750
[Participant 2]  (Guest)
And who? You know the, the testing for.
00:53:10.910 --> 00:53:22.970
[Participant 2]  (Guest)
Infectious diseases in pregnancy that can be passed on to fetuses in utero and like various things. So if you're going to start having conversations about.
00:53:23.940 --> 00:53:28.520
[Participant 2]  (Guest)
One you probably need to do the same conversation about all of them.
00:53:29.350 --> 00:53:30.040
[Participant 2]  (Guest)
And.
00:53:32.560 --> 00:53:45.670
[Participant 2]  (Guest)
And I don't know, you know, having some sort of standardised, you know, document that shows the woman what information is going to be sent in through to her child's health records.
00:53:48.110 --> 00:53:49.030
[Participant 2]  (Guest)
Rather than just.
00:53:49.780 --> 00:53:53.380
[Participant 2]  (Guest)
And making a particular point out out of 1 issue.
00:53:54.020 --> 00:54:01.540
[Participant 2]  (Guest)
And particularly because you know, you know, it seems to me that problematic drinking and pregnancy is a lot less.
00:54:02.090 --> 00:54:05.080
[Participant 2]  (Guest)
prevalent than smoking in pregnancy.
00:54:07.400 --> 00:54:07.830
[Participant 2]  (Guest)
And.
00:54:09.320 --> 00:54:10.430
[Participant 2]  (Guest)
The same kind of.
00:54:12.340 --> 00:54:25.490
[Participant 2]  (Guest)
We suppose that is kind of the same thing is happening for that, but it just I have the same thoughts about about the screening for for smoking when you know that someone isnÕt a smoker and it just.
00:54:27.740 --> 00:54:32.960
[Participant 2]  (Guest)
I don't know if I've answered your question, Rebecca. Maybe you want to ask again what's so I can check.
00:54:33.560 --> 00:54:39.850
Brione, Rebecca
No, I think I think you, I think you have, I think you have that was really helpful. Thank you.
00:54:40.730 --> 00:54:41.180
Brione, Rebecca
Um.
00:54:41.860 --> 00:54:51.740
Brione, Rebecca
[Participant 1], would you like to come in on on this more broadly sort of anything, anything you'd like to add about the sort of proposals and their impact on relationships with patients?
00:55:04.250 --> 00:55:09.200
Brione, Rebecca
I'm just gonna put a little note in the chat because I'm just a little bit concerned as to whether [Participant 1] can hear us.
00:55:44.940 --> 00:55:48.000
Brione, Rebecca
Speaking, I think what we might do is just.
00:55:48.880 --> 00:56:06.560
Brione, Rebecca
We might move on to the to the 4th question, but then we can always, we can always do a little bit more of a sort of broader discussion towards the end if there are points that we've missed and or if anyone who's lost connectivity is able to rejoin us. The joys of online working!
00:56:07.360 --> 00:56:07.910
Brione, Rebecca
And.
00:56:09.140 --> 00:56:13.310
Brione, Rebecca
So the the 4th question which I will again put in the chat in just a second.
00:56:13.890 --> 00:56:17.140
Brione, Rebecca
is is a related one so.
00:56:18.680 --> 00:56:34.430
Brione, Rebecca
It's what I like to ask is whether carrying out mandatory screening and doing the transfer of information, whether it would change the way you view your professional identity and role so much more of a question about how you.
00:56:35.400 --> 00:56:41.970
Brione, Rebecca
See yourselves and how you see your identity and and and your role in your work.
00:56:46.700 --> 00:56:52.600
[Participant 2]  (Guest)
I feel like probably I've given clues to to my thoughts around this, I just.
00:56:54.760 --> 00:57:03.070
[Participant 2]  (Guest)
You know, I've talked about my practice as a specialist midwife looking after people who did did have, you know, alcohol problems and actually.
00:57:03.940 --> 00:57:05.190
[Participant 2]  (Guest)
There's great.
00:57:07.700 --> 00:57:36.770
[Participant 2]  (Guest)
Umm, what's the word? I'm trying to think ofÉ reward in in being able to offer care that is meaningful and personalized and, you know, really tailored to the person and what is going, what I believe is going to help them the most and actually on lots of occasions that was not asking this question or not doing maybe having a conversation but not doing a test or.
00:57:37.150 --> 00:57:37.510
[Participant 2]  (Guest)
You know.
00:57:39.120 --> 00:57:48.160
[Participant 2]  (Guest)
Concentrating on the general antenatal care that that person needed in order to make them feel safe and comfortable and.
00:57:49.760 --> 00:57:52.910
[Participant 2]  (Guest)
I think as midwives we really value the.
00:57:54.570 --> 00:57:59.660
[Participant 2]  (Guest)
The the space that we have with women to make them feel cared for.
00:58:00.520 --> 00:58:00.980
[Participant 2]  (Guest)
And.
00:58:02.470 --> 00:58:06.570
[Participant 2]  (Guest)
What this feels like it feels like it's impinging on my.
00:58:07.390 --> 00:58:08.840
[Participant 2]  (Guest)
Clinical judgment.
00:58:09.760 --> 00:58:10.420
[Participant 2]  (Guest)
And.
00:58:11.200 --> 00:58:14.870
[Participant 2]  (Guest)
Ability to, you know, like if you don't follow guidelines.
00:58:16.340 --> 00:58:16.990
[Participant 2]  (Guest)
Then.
00:58:17.870 --> 00:58:28.420
[Participant 2]  (Guest)
I mean there should be. There should always be the, you know, you should have the autonomy to be able to, you know, back up your rationale for doing or not doing something. But there is a especially with the the climate of.
00:58:29.900 --> 00:58:42.850
[Participant 2]  (Guest)
Needing to follow guidelines to demonstrate safety when there have been lots of, you know, bad things going on, it feels like there is going to be less and less room for midwives to feel the ability to do that or to have the confidence to do that.
00:58:45.190 --> 00:59:01.420
[Participant 2]  (Guest)
And you might just have, you might end up with a situation where everyone is practicing defensively, doing exactly what they've been told to do to the letter, whether they feel that it's necessary or not, or feel that's meaningful or not, or agree with it or not in a quite fundamental way.
00:59:01.920 --> 00:59:03.150
[Participant 2]  (Guest)
And and.
00:59:04.380 --> 00:59:05.890
[Participant 2]  (Guest)
The that kind of.
00:59:07.150 --> 00:59:14.540
[Participant 2]  (Guest)
Independence and autonomy is a really is a very specific midwifery thing that I think we all feel.
00:59:15.660 --> 00:59:21.230
[Participant 2]  (Guest)
Usually very proud of and it's a very meaningful thing. So you know potentially.
00:59:23.020 --> 00:59:42.030
[Participant 2]  (Guest)
It does. It would have an effect. It's a bit like the the, you know, the outcry and the upset of being made to assess people's right to receive maternity care under, you know, without being charged. You know, we're not border guards and I'm not, you know, the police and I'm not.
00:59:44.210 --> 00:59:48.960
[Participant 2]  (Guest)
All of those other things, and it it feels like there's that there are tasks.
00:59:51.210 --> 00:59:51.950
[Participant 2]  (Guest)
That feel.
00:59:53.350 --> 01:00:04.470
[Participant 2]  (Guest)
Not necessarily unrelated. It's not unrelated, but when you're being told to do something that you don't understand the need for, you don't see the rationale for then.
01:00:05.190 --> 01:00:06.640
[Participant 2]  (Guest)
It feels more like a.
01:00:08.060 --> 01:00:09.310
[Participant 2]  (Guest)
A midwifery robot
01:00:10.600 --> 01:00:11.640
[Participant 2]  (Guest)
Kind of situation. You know?
01:00:14.660 --> 01:00:15.310
Brione, Rebecca
Thank you.
01:00:16.290 --> 01:00:18.730
Brione, Rebecca
[Participant 1] , what are your views on this?
01:00:40.630 --> 01:00:42.050
[Participant 1] 
[indistinguishable] takeover..
01:00:44.040 --> 01:00:56.840
[Participant 1] 
Mandatory screening is important and it doesn't change your professional view or role because it will help you to maybe know the risks in.
01:00:58.300 --> 01:01:01.620
[Participant 1] 
You know, during the childbirth, you know, something like that.
01:01:10.110 --> 01:01:11.580
Brione, Rebecca
So do you.
01:01:13.930 --> 01:01:16.660
Brione, Rebecca
Do you see it as having sort of particular?
01:01:17.600 --> 01:01:20.770
Brione, Rebecca
Particular pros rather than particular cons or.
01:01:24.580 --> 01:01:25.540
[Participant 1] 
Sorry I didnÕt get it.
01:01:26.250 --> 01:01:36.350
Brione, Rebecca
Sorry, I said. Do you? So do you think it having of it has having particular benefits rather than particular cons is for your sort of professional role?
01:01:49.900 --> 01:01:57.010
Brione, Rebecca
Sorry, I didn't. I don't know if you just said something then [Participant 1], I didn't. I didn't catch it. I'm struggling a little bit with the connection, I think.
01:02:00.570 --> 01:02:04.410
Brione, Rebecca
Are you able to say just a little bit more about about how you?
01:02:05.320 --> 01:02:06.670
Brione, Rebecca
Sort of think it..
01:02:08.600 --> 01:02:14.670
Brione, Rebecca
How? How you how you think it influences how you view your your professional identity? Cause I'd really like to hear more.
01:02:37.800 --> 01:02:41.270
Brione, Rebecca
[Participant 2] and can I ask you a a a follow up to something that you said?
01:02:41.770 --> 01:02:42.130
01:02:41.970 --> 01:02:44.670
Brione, Rebecca
Umm, which was thatÉ
01:02:46.230 --> 01:02:55.840
Brione, Rebecca
I think I. So you mentioned earlier about working in specialist in specialist roles. I wondered whether theÉ
01:02:56.630 --> 01:03:00.620
Brione, Rebecca
The views that you shared just now, whether you think they hold for.
01:03:03.220 --> 01:03:15.060
Brione, Rebecca
All midwifery roles all sort of, you know, antenatal, different formats in which antenatal care are provided or whether you were thinking particularly from a specialist perspective.
01:03:16.420 --> 01:03:19.320
[Participant 2]  (Guest)
Umm, no, I don't necessarily. I think it's.
01:03:20.570 --> 01:03:23.060
[Participant 2]  (Guest)
Generalizable so.
01:03:23.900 --> 01:03:41.670
[Participant 2]  (Guest)
You know, even now I will occasionally caseload clients and I would you know, I would feel the same thing. I think sometimes you know, maybe particularly early in your career if you're a newly qualified midwife and you were out doing antenatal care, you might find some comfort in having.
01:03:42.650 --> 01:03:46.180
[Participant 2]  (Guest)
Much, much more detailed guidance about what it is you're supposed to do.
01:03:48.740 --> 01:04:00.420
[Participant 2]  (Guest)
But that's not necessarily meaning that that having such a prescribed way of doing things is something that should be mandatory. It might just be a matter of confidence and UM.
01:04:01.380 --> 01:04:06.350
[Participant 2]  (Guest)
And under the competence and kind of making sure people have got the right support rather than.
01:04:07.760 --> 01:04:10.630
[Participant 2]  (Guest)
Then just telling people exactly what they should.
01:04:12.350 --> 01:04:25.010
[Participant 2]  (Guest)
Ask about each particular issue and you know how people should do assessments for additional needs because that's, you know, that's fairly well prescribed anyway by by booking appointments certainly.
01:04:25.690 --> 01:04:26.280
[Participant 2]  (Guest)
And.
01:04:28.800 --> 01:04:31.050
[Participant 2]  (Guest)
So I feel like it's probably the same.
01:04:31.860 --> 01:04:35.590
[Participant 2]  (Guest)
My view would be it would be the same. I mean I just I think that.
01:04:37.010 --> 01:04:38.920
[Participant 2]  (Guest)
Midwives doing antenatal care.
01:04:39.620 --> 01:04:43.580
[Participant 2]  (Guest)
Uh. Covering so many things. Like it's such a broad.
01:04:45.330 --> 01:04:54.820
[Participant 2]  (Guest)
You kind of just, you're doing an assessment to exclude lots and lots and lots and lots and lots and lots of different issues that could potentially be occurring and actually.
01:04:55.340 --> 01:04:55.990
[Participant 2]  (Guest)
And.
01:04:58.660 --> 01:05:02.830
[Participant 2]  (Guest)
Social problems or, you know, things that fall into that psychosocial.
01:05:03.310 --> 01:05:33.440
[Participant 2]  (Guest)
Umm Sphere  are are a big part of that, but I don't think necessarily asking a question about alcohol use at every appointment is the best way of finding out what the issues are and and how to deal with them that a better way of doing that is to have, you know, practitioners who are confident in opening a conversation about that person's life and how they are. And then if they are not doing OK, then what's going on and how are they coping with stress and actually then.
01:05:33.720 --> 01:05:42.810
[Participant 2]  (Guest)
Then if there is an issue with alcohol that might come up and that that, you know, people are having more wine on a Friday than they thought they would be, or you know, there's.
01:05:44.260 --> 01:05:45.740
[Participant 2]  (Guest)
It's just because you're not.
01:05:46.730 --> 01:05:52.000
[Participant 2]  (Guest)
Asking every appointment about someone's alcohol use doesn't mean that you wouldn't find out that there was a problem if there was a problem.
01:05:52.900 --> 01:05:54.370
[Participant 2]  (Guest)
I think that's what I'm trying to say.
01:05:56.160 --> 01:05:57.350
Brione, Rebecca
Thank you. Thank you.
01:05:56.380 --> 01:05:56.710
[Participant 2]  (Guest)
ItÉ
01:05:57.740 --> 01:06:01.730
[Participant 2]  (Guest)
Seems like a blunt tool for something that is not easily.
01:06:03.200 --> 01:06:03.770
[Participant 2]  (Guest)
Umm.
01:06:04.900 --> 01:06:09.510
[Participant 2]  (Guest)
A simple a simple fix or something that isn't simple to find out about or fix.
01:06:10.990 --> 01:06:11.540
[Participant 2]  (Guest)
Basically.
01:06:12.330 --> 01:06:12.810
Brione, Rebecca
Thank you.
01:06:14.940 --> 01:06:19.010
Brione, Rebecca
[Participant 1] , do you have more that you'd like to add or different views that you'd like to share?
01:06:43.570 --> 01:06:52.960
Brione, Rebecca
I suppose one thing that that I've sort of picked up from the range of comments in the last hour or so is.
01:06:54.160 --> 01:07:03.010
Brione, Rebecca
Sort of possible tensions between the aims behind screening and transfer and the sort of.
01:07:03.810 --> 01:07:05.040
Brione, Rebecca
And the midwifery role.
01:07:05.580 --> 01:07:07.310
Brione, Rebecca
Umm and.
01:07:08.650 --> 01:07:13.890
Brione, Rebecca
Some people might see that these tensions are there and some people might not feel that these tensions are there and.
01:07:17.420 --> 01:07:20.060
Brione, Rebecca
I wanted whether I mean I think.
01:07:20.890 --> 01:07:31.250
Brione, Rebecca
[Participant 1] , you've met. You've alluded to it a little bit in terms and I think you've spoken about your views on this too, but I wondered if there was anything more that anyone wanted to say.
01:07:32.200 --> 01:07:32.870
Brione, Rebecca
About that.
01:07:42.340 --> 01:07:43.230
[Participant 2]  (Guest)
I I wonder.
01:07:44.030 --> 01:07:44.840
[Participant 2]  (Guest)
Whether.
01:07:46.710 --> 01:07:49.110
[Participant 2]  (Guest)
People's own personal views on.
01:07:49.820 --> 01:07:54.540
[Participant 2]  (Guest)
Alcohol use or substance use or, you know, addiction.
01:07:55.430 --> 01:07:56.790
[Participant 2]  (Guest)
Might have.
01:07:57.870 --> 01:08:01.380
[Participant 2]  (Guest)
And the, you know, the reasons that those things exist for some women.
01:08:03.160 --> 01:08:09.270
[Participant 2]  (Guest)
Maybe that would affect how you know how people see the the policy. You know, if you.
01:08:10.080 --> 01:08:13.210
[Participant 2]  (Guest)
Think of addiction as a sort of.
01:08:14.440 --> 01:08:18.820
[Participant 2]  (Guest)
Personal failure or something that somebody is doing wrong. Then actually I can see that you would think.
01:08:19.560 --> 01:08:27.590
[Participant 2]  (Guest)
That this is a good, we need to keep an eye on, this is a really big impact potentially on children. If mothers drink your pregnancy and we really need to.
01:08:29.140 --> 01:08:33.620
[Participant 2]  (Guest)
You know, I don't know if you're if you're focused on the rights of the.
01:08:34.530 --> 01:08:39.850
[Participant 2]  (Guest)
Fetus or the child that isn't in existence yet because it's a fetus, then maybe.
01:08:40.830 --> 01:08:42.940
[Participant 2]  (Guest)
This makes more sense. UM.
01:08:44.390 --> 01:08:57.900
[Participant 2]  (Guest)
But the the kind of the angle that I think of addiction is very much a trauma informed view of understanding this is a coping mechanism that actually can be quite effective with helping people deal with very difficult situations.
01:08:59.420 --> 01:09:05.710
[Participant 2]  (Guest)
Umm. And so it feels more like needing to identify where support is needed.
01:09:06.610 --> 01:09:09.080
[Participant 2]  (Guest)
And understanding that the best way of doing that is not.
01:09:10.040 --> 01:09:10.680
[Participant 2]  (Guest)
Asking.
01:09:12.540 --> 01:09:16.890
[Participant 2]  (Guest)
A question by rote every time you see someone. And I think.
01:09:18.230 --> 01:09:20.040
[Participant 2]  (Guest)
That may be those, those kind of.
01:09:20.810 --> 01:09:23.740
[Participant 2]  (Guest)
Differences in how you understand alcohol use.
01:09:26.990 --> 01:09:29.140
[Participant 2]  (Guest)
and mental health issues and you know.
01:09:30.030 --> 01:09:33.240
[Participant 2]  (Guest)
People's ways of dealing with stress or people's.
01:09:35.180 --> 01:09:38.010
[Participant 2]  (Guest)
You know, attitudes towards those things might have an effect on.
01:09:39.420 --> 01:09:43.380
[Participant 2]  (Guest)
The attitudes towards the, you know, the things that are being proposed.
01:09:44.730 --> 01:09:45.290
[Participant 2]  (Guest)
I think.
01:09:46.960 --> 01:09:47.800
Brione, Rebecca
OK. Thank you.
01:09:49.900 --> 01:09:51.730
[Participant 2]  (Guest)
And also sorry.
01:09:50.080 --> 01:09:51.210
Brione, Rebecca
[Participant 1] , sorry.
01:09:52.270 --> 01:09:54.400
[Participant 2]  (Guest)
And and also you know the.
01:09:55.960 --> 01:09:57.030
[Participant 2]  (Guest)
The kind of.
01:09:58.570 --> 01:10:02.600
[Participant 2]  (Guest)
Whether you're coming at health care from a very much.
01:10:04.130 --> 01:10:17.890
[Participant 2]  (Guest)
The hierarchy of who's who's in charge and needing to do what and it feels like a a partnership of care where the person that is caring for the and the person who's being cared for are coming together to.
01:10:18.690 --> 01:10:23.940
[Participant 2]  (Guest)
To to have discussions and to work out what the most important things are and work out what their needs are.
01:10:25.270 --> 01:10:27.150
[Participant 2]  (Guest)
Does that negate the kind of?
01:10:27.990 --> 01:10:28.640
[Participant 2]  (Guest)
Need.
01:10:29.520 --> 01:10:49.200
[Participant 2]  (Guest)
It seems like a very much like, Òwell, I've got these things that I need to check up on what you're doing and then I need to tell you whether you're doing it wrong or right. And then you need to listen to me and do what I say.Ó And that feels like a very old, old fashioned, hopefully old fashioned way of of it doesn't necessarily fit with what I would hope is the.
01:10:50.840 --> 01:11:01.270
[Participant 2]  (Guest)
You know the current state or what I would want to be the current state of midwifery in the future state of of the relationship between the you know, the client and the caregiver.
01:11:06.300 --> 01:11:06.910
Brione, Rebecca
Thank you.
01:11:09.240 --> 01:11:13.310
Brione, Rebecca
[Participant 1] , are there other things, other things that you would like to to say or to add?
01:11:34.310 --> 01:11:53.230
Brione, Rebecca
Fiona, this is really unfair of me because I didn't pre warn you that I was gonna ask you this, but I know that sometimes if you're sitting in and listening in, it's easy to think of something that you you think you that you would have asked if you were running it and that didn't get asked are there are there additional things you would like to ask?
01:11:57.600 --> 01:12:02.390
Fiona Woollard
I'm not, I'm not actually sure I. I have to say, I haven't been.
01:12:03.370 --> 01:12:14.720
Fiona Woollard
Fully listening in to the extent that I'm I'm a I've been kind of checking whether there are any. Anybody who wanted to come in or whether there were any.
01:12:16.780 --> 01:12:23.400
Fiona Woollard
Uh technical problems, but I haven't actually been kind of following this discussion, I'm afraid.
01:12:23.710 --> 01:12:28.940
Brione, Rebecca
That, that's fair enough. Sorry, that was really unfair of me. IÕm just conscious that sort of when you're trying to.
01:12:29.560 --> 01:12:40.380
Brione, Rebecca
Keep an eye on work out what's going on. Sometimes it's it's easy to come out of it and then go. I wish I'd ask this so it at least if there's not anything that's obviously burning that I've.
01:12:41.590 --> 01:12:43.300
Brione, Rebecca
Failed to ask about.
01:12:44.470 --> 01:12:48.190
Brione, Rebecca
I don't think there is. According to the the topic guide that I'd written.
01:12:49.100 --> 01:12:49.430
Brione, Rebecca
And.
01:12:50.180 --> 01:12:51.890
Brione, Rebecca
Are there any sort of?
01:12:53.420 --> 01:13:01.990
Brione, Rebecca
Final points that [Participant 1]  or [Participant 2]  either either of you would like to make or things you'd like to say that I haven't asked about.
01:13:07.700 --> 01:13:09.070
[Participant 2]  (Guest)
I think one of them.
01:13:08.030 --> 01:13:08.420
01:13:10.320 --> 01:13:10.690
[Participant 2]  (Guest)
This is.
01:13:11.920 --> 01:13:17.360
[Participant 2]  (Guest)
Probably something I need to do for myself as well and started doing and is actually trying to find out.
01:13:12.210 --> 01:13:12.680

01:13:19.200 --> 01:13:28.160
[Participant 2]  (Guest)
Who was on the, who suggested. And who? You know. What input there was into the, you know, into the suggestion for this.
01:13:28.700 --> 01:13:30.630
[Participant 2]  (Guest)
And and.
01:13:32.640 --> 01:13:38.840
[Participant 2]  (Guest)
Yeah. Whether any of that was midwifery inputs, it does feel like something that was not.
01:13:40.080 --> 01:13:44.400
[Participant 2]  (Guest)
I think the thing for me with this is I can see where the intentions are, I can see.
01:13:45.860 --> 01:14:08.750
[Participant 2]  (Guest)
And I think it feels strongly that the the babies who are exposed to alcohol really do deserve the best care, and it's sometimes hard for them to, you know, they get misdiagnosed or it's not taking them into account. So there's lots of potential benefits from the intention. And I just think that's some of it. Some of the way of going about this is just wrong. It's not gonna.
01:14:09.770 --> 01:14:12.800
[Participant 2]  (Guest)
It's not going to do what people are hoping it would do.
01:14:13.490 --> 01:14:16.010
[Participant 2]  (Guest)
And so it just seems a little bit.
01:14:18.350 --> 01:14:19.740
[Participant 2]  (Guest)
Not considered.
01:14:21.710 --> 01:14:22.360
[Participant 2]  (Guest)
Basically.
01:14:23.610 --> 01:14:24.080
[Participant 2]  (Guest)
And.
01:14:27.200 --> 01:14:28.470
[Participant 2]  (Guest)
Yeah, I think that's it.
01:14:29.770 --> 01:14:30.420
Brione, Rebecca
Thank you.
01:14:32.130 --> 01:14:39.610
Brione, Rebecca
[Participant 1] , I'm conscious. I haven't heard lots from you. Are there points that you'd like to bring in things you wanted to say earlier?
01:14:58.330 --> 01:15:23.640
Brione, Rebecca
Then actually [Participant 2] and I have one, one more question. [Participant 1] , please feel free to chip in as well on this, which is again possibly a clarificatory question for me. But just to make sure that I've understood, you spoke earlier about information being recorded and transferred where it's clinically relevant onto the child's health records. And would that information
01:15:25.200 --> 01:15:29.390
Brione, Rebecca
Follow a child. If they didn't end up living with their birth parents.
01:15:30.160 --> 01:15:32.410
Brione, Rebecca
in your in your sort of.
01:15:34.200 --> 01:15:36.470
Brione, Rebecca
In your understanding and your experience in practice.
01:15:37.580 --> 01:15:40.230
[Participant 2]  (Guest)
And yeah, and I suppose.
01:15:39.010 --> 01:15:39.660
Brione, Rebecca
Yeah.
01:15:41.060 --> 01:15:48.890
[Participant 2]  (Guest)
Think you know where alcohol is a serious issue. There's there are, you know, it's one of the reasons why it is less likely that a baby is gonna remain.
01:15:50.120 --> 01:15:58.890
[Participant 2]  (Guest)
With birth parents and so that information definitely would go because in that kind of situation.
01:16:01.070 --> 01:16:02.040
[Participant 2]  (Guest)
Social care.
01:16:02.690 --> 01:16:28.940
[Participant 2]  (Guest)
Processes and child protection processors would mean if a baby wasn't in its mother's care, and became a looked after child or adopted. Or, you know, in a special guardianship order, then there's processes like child protection, medicals and actually there's forms that, I've just filled out a couple last week, around.
01:16:29.590 --> 01:16:48.620
[Participant 2]  (Guest)
Giving information about pregnancy and birth for babies who are being adopted so and one of the questions that's asked in those forms is about drug and alcohol use in pregnancy, smoking and pregnancy. Any other medications used so in in those circumstances, it definitely would. And probably, you know like.
01:16:49.520 --> 01:16:50.350
[Participant 2]  (Guest)
Be.
01:16:51.590 --> 01:16:56.800
[Participant 2]  (Guest)
There's those children would be getting more assessments that we're looking specifically at that kind of stuff.
01:16:57.630 --> 01:17:00.350
[Participant 2]  (Guest)
I would have thought. Does that answer the question?
01:17:00.730 --> 01:17:02.020
Brione, Rebecca
Yes, it does. Yes, thank you.
01:17:01.390 --> 01:17:01.580
[Participant 2]  (Guest)
Yeah.
01:17:02.800 --> 01:17:06.090
Brione, Rebecca
[Participant 1]  is is. Is there anything you would like to add?
01:17:17.970 --> 01:17:22.820
Brione, Rebecca
Any sort of final final points that you wish you'd said before we finish?
01:17:24.450 --> 01:17:25.140
[Participant 2]  (Guest)
I don't think so.
01:17:25.830 --> 01:17:26.130
Brione, Rebecca
Right.
01:17:27.490 --> 01:17:33.540
Brione, Rebecca
Well, in that case, thank you so much. I really appreciate everyone's time and I'm sorry that we lost a couple of people en route.
01:17:33.660 --> 01:17:55.450
Brione, Rebecca
And Monday, I guess we'll be back to doing these things fully in person, but I found that a really interesting and really useful discussion. So thank you. Just to reiterate, we will be downloading the automatically generated transcript and Fiona will then correct it against the recording and we'll make sure there's no identifying information in there.
01:17:56.160 --> 01:18:26.130
Brione, Rebecca
And and then only at that point would it be shared with with Rachel, the other member of the research team, and and I for for sort of further analysis, if you want to see a copy of the corrected transcript, or indeed if you want copies of any papers, briefing notes, anything like that, that we produce as as a result of this project as a whole, then please email Fiona on the address that you've already got, which is on the participant information sheet. And she will be able to.
01:18:26.210 --> 01:18:56.490
Brione, Rebecca
Manage all of that, and then as they're taken of our thanks, we will be emailing a love to shop voucher and to yeah to say thank you very much for your time and your input and your thought and and all of the you know, all of the really sort of thoughtful input that we've had today because we do know how busy everybody is. But if you have any problems with the voucher which I haven't come across often, but I have once or twice very specific circumstances being able to help people with problems. So if you do have any problems with the voucher, let us know.
01:18:57.230 --> 01:19:00.450
Brione, Rebecca
I'm feeling yeah.
01:18:58.630 --> 01:19:00.080
Fiona Woollard
Can I say one thing?
01:19:00.730 --> 01:19:22.220
Fiona Woollard
So I just wanted to note that we're also intending to deposit the transcript with the identifying information removed and make it available publicly that that was on the participant information form. But I just wanted to make sure people were aware of that.
01:19:09.340 --> 01:19:09.690
Brione, Rebecca
Oh yes.
01:19:23.450 --> 01:19:24.420
[Participant 2]  (Guest)
Yeah, I saw that.
01:19:23.780 --> 01:19:24.560
Fiona Woollard
So it be.
01:19:25.280 --> 01:19:26.230
Fiona Woollard
That's great.
01:19:29.460 --> 01:19:37.480
Fiona Woollard
And and and I want to add my thanks to you both for participating and thank you to Rebecca for running it.
01:19:38.610 --> 01:19:39.880
[Participant 2]  (Guest)
Pleasure, thank you.
01:19:39.580 --> 01:19:48.060
Brione, Rebecca
The thing thank you very much. Thanks everyone for your time. And then yeah, hope you have a really great rest of the day. Fiona, should we just stay on the call for a second?
01:19:48.520 --> 01:19:50.310
Fiona Woollard
Sounds good. Sounds good.
01:19:49.890 --> 01:19:53.360
Brione, Rebecca
OK, excellent. Thanks very much. Goodbye.
01:19:50.740 --> 01:19:53.250
[Participant 2]  (Guest)
Alright. Thank you sweetie. Bye.
01:19:54.480 --> 01:19:56.710
Fiona Woollard
I'm just going to work out how to stop the recording.
01:19:56.550 --> 01:19:57.000
Brione, Rebecca
Yeah.