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A call for a change to be made to the 'no-doppler policy' at 16 week midwife check

(127 Posts)
Mythreeknights Wed 07-Aug-13 15:58:21

I've just had the most pointless 16 week midwife check ever (this is 3rd pg so I know from experience that this was completely pointless).
Other than dipstick my pee and prod me in the tummy, she did nothing, asked nothing other than "keeping well?" and wrote nothing down other than "keeping well" (seriously). It took me 25 mins to drive to the appt and 25 mins back, a total including appt time (and pre-appt waiting time) of about 1 hour, 10 mins.

She was quite defensive (obviously gets it in the ear a lot from upset pg mums), and said "but what would I do if I couldn't hear a heartbeat?" I replied, "Well, I'd hope you'd send me for a scan so they could see if I was carrying a live or dead baby". She replied "no, I'd get in trouble for that" and I said "well, I'd rather know at 16 weeks that the child had died rather than carry it around for another 4 weeks and find out at the scan".

My suggestion, if the NHS / Royal College of Midwives is so worried about not hearing heartbeats at 16 weeks, that they just send us dipstick packs, so we can dip our own pee (3 minutes), write our own notes (3 minutes) and not spend 45 minutes sitting in the car.

Anyone feel the same?

Fakebook Wed 07-Aug-13 16:00:19

I heard my baby's hb at my 16 w check up. The midwife took 5 mins to find it, but she persevered until she did.

I think it varies from area to area. I'm happy with my ante natal care at my surgery.

FruitSaladIsNotPudding Wed 07-Aug-13 16:02:31

But she's not just checking your urine. She's having a chat with you which will tell her a fair amount and she's giving you a chance to talk to her.

FoofFighter Wed 07-Aug-13 16:03:46

At my 16w app I heard the heartbeat, I got my blood results from the booking appointment, I got my pee dipped and my BP taken, appointments arranged for seeing some other people I needed to see, and any questions answered. I don't see it as a pointless exercise.

The HB was listened to with the proviso that it might not be heard due to positioning of baby and to not panic and assume the worst if they couldn't find it, and I was happy to go ahead with that agreement.

Apps don't really get any much more than that over the weeks, sorry to disappoint.

snickersnacker Wed 07-Aug-13 16:03:59

Sorry, I don't understand - did you ask her to listen to the heartbeat and did she refuse?

I can understand her reluctance, even if she was untactful. It can be hard to hear the heartbeat, and it might cause additional stress.

I can't remember the exact timing, but when I was twenty-something weeks pregnant, the midwife got the doppler out and couldn't find a heartbeat. It took her 20 minutes to find it. Luckily by that stage we could see DD moving around in my tummy so we knew she was okay, but if she had been asleep it would have been terrifying for me and the stress would have been horrendous.

Mythreeknights Wed 07-Aug-13 16:14:41

Yes - I asked if she would listen and she folded her arms and said no, it's not the policy any more (as sometimes they can't find it).

As for a chance to chat, it really wasn't. To give an example, I mentioned that I had a really dizzy spell last night (to the point that the room started spinning) but that it felt very different to a fainting episode (which I've experienced too, not in pg though). She kept going on about fainting in pregnancy, so I felt she wasn't listening at all. Or perhaps, just not understanding. I didn't warm to her at all and felt hurried and that I was being a pest asking if she'd listen to the heartbeat.

The appts are different across the country I know, and I'm glad the majority get the time taken properly with them, but my point is, in areas where it's not allowed to listen to the heartbeat, let's scrap the 16 week check and dipstick our pees at home.

mrspaddy Wed 07-Aug-13 16:15:23

I had my GP check for a heartbeat at each visit. Had a four hour wait at hospital today (35 weeks) for a quick measurement with a tape, urine check and 'are you ok?' chat.
Figure it is part and parcel of it all.
I have my own Doppler though- so glad of it.

Mythreeknights Wed 07-Aug-13 16:16:32

Oh mrspaddy I know - there's such a lot of time wasting that goes on, but at least you came away knowing all is ok. I have come away not knowing anything at all.

mejypoo Wed 07-Aug-13 16:17:56

I like going to my midwife appoints.
My 16 week one included listening to babys heartbeat which took a matter of minutes, results from previous blood test, BP taken and a general chat about how I was.

It is placed nicely in the middle from the 12 and 20 week scan for a good check up

jennimoo Wed 07-Aug-13 16:19:36

It must depend on trust (or MW) as I heard HB at 16 weeks.

BentleyBelly Wed 07-Aug-13 16:21:44

I also heard the heartbeat at my 16 week appointment. I wouldn't have minded if my midwife hadn't tried though, I am a first time mum however and I have enjoyed the regular contact with my midwife, she is lovely and I feel well looked after.

Mythreeknights Wed 07-Aug-13 16:21:49

Yes - obviously it varies across Trusts. Why is there even a variation?

jennimoo Wed 07-Aug-13 16:25:02

Are you certain it's your trust, do you know others in your area? I sometimes wonder about these 'policies' quoted by some HCPs...

BentleyBelly Wed 07-Aug-13 16:26:54

I don't get why there is variation either...everyone should be entitled to exactly the same care. I think I would be a bit pissed off after your experience today too.

Lovemyprincess4eva Wed 07-Aug-13 16:27:24

My midwife listened to the heartbeat at my 16 week check. And my friends said they had the same xx

Feelingworried67 Wed 07-Aug-13 16:28:25

I got to hear baby's heart beat at my 16week appt. I can see why most midwifes don't though!! As she STRUGGLED to find it, took her many attempts, but she; in the end, found it, I was on the verge of crying as it only gave DP and I worry!

I now see why they don't, baby is still very small and harder to find heart beat.

Just relax OP! I know it's what you look forward to, but it won't be long until your scan or until the baby is here! smile

rockybalboa Wed 07-Aug-13 16:33:41

It definitely varies from area to area as with all 3 of my pregnancies the MW has listened to the HB at 16w. They have always mentioned in passing that they are told that they don't have to do it though because it can be hard to find that early and if they don't find it it creates unnecessary stress but they've done it because they like doing it! Having said that, I think personally that so many people buy their own dopplers these days that the MWs might prefer to find the HB at the 16w scan on the basis that they know what they are doing rather than pregnant women doing their nut at home because they can't find it themselves. Or 'reassuring' themselves by hearing it when actually they are listening to their own heartbeat!

Ezza1 Wed 07-Aug-13 16:35:21

I heard heartbeat at 17 week appt with my regular midwife. However I had to see a different midwife at 26 weeks and she said "we don't listen for heartbeat this early any more, as long as you are feeling movements we don't worry"

I was a bit confused tbh. 4th pregnancy.

PumpkinPie2013 Wed 07-Aug-13 16:39:07

Sorry you were disappointed with your appointment sad

Unfortunately (although it shouldn't) I think it can depend on the trust policy and even the individual mw.

Personally I have had a really good experience so far (24 weeks with dc1). Had to see my mw at 14 weeks as had early pgp - she was really helpful and great at referring me on and giving advice. To my suprise she listened for the heartbeat and found it straight away!

However, she is a very experienced mw and I'm very tiny in build which possibly makes it easier.

Heard it again at 16 weeks and will hear it Thur when I see her. She's always on the other end of the phone as well if I have concerns and I feel really well looked after.

I do however agree with you that all women should get the standard of care I'm getting as it's unfair that some get a raw deal sad

Hopefully your 20 week scan is soon? And you will get to hear hb at 25 weeks. Good luck! X

Xiaoxiong Wed 07-Aug-13 16:40:48

Isn't the variation across trusts the whole thing about returning the NHS to local control etc? I mean, you can have policies set centrally (and therefore everyone has exactly the same care) or you can have policies set at the trust level (in which case it's a postcode lottery), but it's pretty unlikely that if you leave it up to the trusts to take decisions at a local level that every single one will make exactly the same decision.

I'm sorry you didn't hear the heartbeat at 16 weeks and it does sound to me like she was rushed and wasn't listening to you properly which must be super frustrating after a long drive and wait.

Mythreeknights Wed 07-Aug-13 16:45:06

I agree that the decision to use or not to use seems to depend on the experience / time / will of the individual midwife. This one felt hurried and I wondered whether she didn't have time to do it. I asked whether it was a cost cutting exercise (time is money and all that) and she said no. They also don't tell you the gender of the baby at the anomaly scan in my area (although on this occasion I'm happy not knowing), which is a cost cutting exercise.

I'm slim, still in normal non-mat clothes and probably a perfect candidate to get a good heartbeat instantly from...and yet she was unmoving. And I totally agree with rocky that surely it's better for a professional to have a go at listening to the HB rather than me running off now to get a doppler and having a panic attack when I can't do it myself.

VivaLeBeaver Wed 07-Aug-13 16:47:12

Nice guidelines say that midwives should not listen in to the baby's heartbeat any more. I know women find it reassuring but it tells you nothing apart from the baby is alive at that moment. Research has shown that this can sometimes be a false reassurance.

Ie; women hears the heartbeat at an appointment. Later on that day or the next day she thinks that baby isn't moving much. But rather than ring the hospital to arrange to go in for a monitoring she doesn't bother as she thinks that she's just very recently heard the heartbeat and it was ok. Honestly there is research which backs this up.

And yes where I work midwives aren't supposed to listen in. If one did at a 16 week appointment there is no way if she was unable to find the heartbeat that you'd get a scan. Scan appointments are precious due to availabilty sonographers and machines. The sonographers would refuse to scan for such a reason and the clinic manager would back them up.

So where would that leave you? Upset and worried with no reassurance and a 4 week wait for the anomaly scan.

BuntCadger Wed 07-Aug-13 16:49:28

My3 I posted on our antenatal thread too before I saw this.

My 16 w check up (I was 15w3) midwife checked blood pressure (v low), went over bloods, checked notes, talked about delayed cord clamping, she listened for heartbeat (little one swam away after a couple of seconds so she spent time refinding Zom), chatted about how I've been, discussed movements and arranged next appt for 24 weeks where she'll review anomoly scan.

Mythreeknights Wed 07-Aug-13 16:50:02

Good point viva and interesting that it's the same where you work (perhaps we are neighbours), and you back up what she said ref the scan. But I'm still in a position where I'm not getting movement anyhow so the HB would be the first sign that everything is ok until the 20 week scan when presumably I'll be feeling movement regularly. So, as it stands I'm upset, worried, with no reassurance and a 4 week wait for an anomaly scan.

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