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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?

MacaYoniandCheese Wed 07-Aug-13 16:51:51

Just for informational purposes, I live in Canada and we have a check at 18 weeks, where they listen for the heartbeat as a matter of course. With DC3, they couldn't find it and I had to wait an agonizing weekend for an ultrasound to make sure he was OK (he was).

Just to say, I can understand why they have the 16 week no-Doppler policy and yes, perhaps arrangements could be made for those who have to travel/miss work for an appointment at this stage.

VivaLeBeaver Wed 07-Aug-13 16:52:08

Did you not have a 12 week/dating scan?

VivaLeBeaver Wed 07-Aug-13 16:53:36

I can understand been worried, but you'd be more worried if the midwife hadn't been able to find the heartbeat and then hadn't been able to offer you a scan.

badguider Wed 07-Aug-13 16:54:41

Where are you having these appointments that is a 45min drive away?
Mine are at my gp which is a two minute walk from my house. If you're with a gp far from home then I think you have to accept the journey might not always seem worth it.

Mythreeknights Wed 07-Aug-13 16:57:46

Viva yes, of course I had a 12 week dating scan, what has that got to do with the price of tea in China?
Bad you must live in a town, I live in the country - the GP clinic happens to be 25 mins away by car. I accept that, but I'd rather not make a journey if it's going to be completely pointless.

badguider Wed 07-Aug-13 16:58:47

And as far as I can tell the appts are mainly bp and pee which are the two pre-eclampsia indicators.

badguider Wed 07-Aug-13 17:00:59

You don't mention bp. If she didn't take your bp I'd really question that!
(And I doubt they'd trust us to self-monitor bp even though you can)

ExtremeCouponQueen Wed 07-Aug-13 17:03:34

My MWs do the Doppler at 16 weeks. i think it's important.

Mythreeknights Wed 07-Aug-13 17:04:08

She did do BP (although the electronic monitor broke - apparently 'only happens to her') and that is normal, so that is helpful I guess!

VivaLeBeaver Wed 07-Aug-13 17:05:29

It's just that you said if you'd heard the hb today it would have been the first sign that everything was ok.

Therefore I thought maybe you hadn't had a 12 week scan. But you have, surely that was a sign that everything was ok.

ExtremeCouponQueen Wed 07-Aug-13 17:09:09

viva that was 4 weeks ago for the OP though. i wouldn't feel very reassured if there was no checking to see if baby was live from 12 weeks to 20 weeks. alot can happen from 12 weeks to 16 week.s

Mythreeknights Wed 07-Aug-13 17:14:39

Absolutely extreme, that's my position - at 12 weeks I had a wonderful scan, saw the baby, brilliant. But my next opportunity is at 20 weeks to get any professional confirmation that all is ok. I feel that's a bit shitty and I am inclined to borrow a doppler, then risk freaking out when I can't find the HB. It seems silly not to do the HB in some areas when they will in most others.

VivaLeBeaver Wed 07-Aug-13 17:16:17

Which kind of proves the point that a Doppler or even a scan is only reassuring on the day (or even at the time) that its done. So if you hear the hb today, why would you still be reassured next week or even tomorrow?

Saying that seeing the hb on scan is reassuring. Having seen that and coupled with no bleeding/pain it's very unlikely that anything has gone wrong between that scan and 16 weeks.

Mythreeknights Wed 07-Aug-13 17:17:54

Thanks viva I know the chances are that ALL is well, I just feel robbed that on a day when 99% of women hear the HB and have that instant feeling of reassurance, I haven't.

VivaLeBeaver Wed 07-Aug-13 17:32:33

I hope the next few weeks whizz by and you're having your scan and feeling movements soon.

posybunchof Wed 07-Aug-13 17:54:31

My main concern at all my appts, having had PE in a previous pregnancy, has been to have my BP and urine checked. My great-grandmother died of PE, purely because ante-natal care was so crap back then. It's such an important thing to monitor.

I am not sure a dipstick and home monitor would be suitable for everyone, so I can definitely see the point of a standard 16 week check. Plus women have other concerns during this time; SPD, HG etc. At the 12 and 20 week scans, you see the baby, but you don't get a health check yourself, and so to go from the booking appt to the post-20 week scan appt with no midwife appt would be too long imo.

Sorry you didn't get to hear the heartbeat tho (I did, but fwiw was told she might not find it), and 45 minutes does sound a long way to go for five mins. Unfortunately that prob won't change - I'm 39 weeks and my appt this week was still very brief. And your midwife does sound a bit dismissive about your fainting etc. Maybe your GP would be more helpful? Just a thought but you can buy dopplers for home-use, and you could always pay for a private scan?

Anyway, your 20 week scan will be here before you know it - I also hope the time whizzes for you! xx

Bodicea Wed 07-Aug-13 18:10:28

Vic is right.

You don't need to check for the heartbeat at 16 weeks. I am a sonographer and as long as the scan was normal at 12 weeks the chances of babies heart stopping before 20 week scan are extremely low. I fact in my 6 years of scanning I have never once scanned someone at a routine 20 weeks scan and not found a heart beat.
So it is pretty pointless checking the heartbeat at 16 weeks to be honest. All it does is panic expectant mothers if the midwife struggles to find it - as it can be pretty difficult especially if they have a large bmi. Then sonographers scan slots would wasted on unnessesary scans for reassurance.
Sorry buts that's just how it is. There aren't that many sonographers and we are constantly being asked to do extras on top of our working lists. We have to prioritise the urgent things first.

VinegarDrinker Wed 07-Aug-13 18:21:14

As Viva says, NICE guidelines are not to listen to the heartbeat at all at any routine appointments, regardless of gestation.

Many MWs and Drs do check, but this is against NICE guidelines.

www.nice.org.uk/usingguidance/donotdorecommendations/detail.jsp?action=details&dndid=216

Tiredemma Wed 07-Aug-13 18:27:33

I have only had the Doppler at my very first MW apt and that was only because we didn't have clue how pregnant I was - both MW's had a feel around my tummy and deduced that I must have been "about 24 weeks" (this was where I almost fell off the bed)- They then got the Doppler as they felt that any heartbeat under 20 weeks would be hard to find.

I had it once more at 32 weeks (two weeks ago) and that was only for the student midwifes benefit - the main midwife said that they don't tend to do it anymore and will only use it if specifically requested my mum-to-be.

midori1999 Wed 07-Aug-13 19:03:39

I have had a midwife try and listen in at 16 weeks and that was in a pregnancy where there was already a problem. Despite me being pregnant with twins, she couldn't find either heartbeat and went off to find a midwife to scan me. (my antenatal appointments then were at a midwife led unit and midwives did the 12 week scan and consultants had portable scanners in each room too and scanned at all appointments) Her colleagues were very clearly unimpressed with her and had I not been able to have the scan I would have been very worried, whereas I would have been disappointed if she didn't try and find the heartbeat, but not so worried.

I'm not really sure what it is you want OP? As you say you could have just dipped your urine and filled out your notes at home, but then you wouldn't have heard the heartbeat either. confused Plus, it's unlikely you'd be able to take your own blood pressure at home, which is important.

I'm sorry that you're worried but as someone who is scanned regularly and seen weekly by a consultant, I can assure you, it really does only reassure you for that day sadly. Hopefully the time between now and your 20 week scan will go quickly. Alternative, you could always pay for a private scan to reassure yourself?

Mamabear12 Wed 07-Aug-13 19:03:54

I insisted on hearing heartbeat and midwife said most likely she won't be able to find one. But I insisted anyway, she went ahead and did it....found the heartbeat in a few seconds! I think for some it might be difficult and some easier...so midwives prefer not to scare if she can't find it. If you insist however, they usually try. Just explain you will not freak if she can't find. I like going to my midwife appointments, even if it's just to chat, check blood pressure and pee on stick. It's important to keep getting monitored and if you have any concerns or questions be able to ask.

ShadowMeltingInTheSun Wed 07-Aug-13 23:53:28

My midwife did a doppler test at the 16 week appointment, I didn't realise that this wasn't standard practice.

Having said that, she also did a doppler test at my last appointment - at 30 weeks - and it took her a good 5 minutes to find the babies heartbeat (Baby wasn't where she thought it was - anterior placenta was making it hard to figure baby's position out). So I can sort of see why they might be reluctant to do them at routine earlier appointments.

ouryve Wed 07-Aug-13 23:59:38

But there's not that much needs doing with a normal, healthy pregnancy.

I only had the heartbeat listened to at 17 weeks with DS1 because I'd had yet another heavy bleed (3rd that pregnancy) and rather than a doppler, the midwife listened with her trumpet thingy.

Much as you would have found a doppler reassuring, some mums to be would find it invasive - no idea how well founded it is, but there's some people who are concerned that dopplers and even ultrasound scans are potentially harmful to baby and should only be used if of benefit to baby, rather than mother.

ItsNotUnusualToBe Thu 08-Aug-13 00:05:39

On my third pregnancy my midwife couldn't find my baby's heartbeat at the 16 week checkup. She immediately sent me to EPU for a scan with a wonderful and compassionate woman who had to tell me that my baby had died at 11 weeks 6 days - one day after I'd had my dating scan.

My very lovely midwife said in all her years, only once had she failed to find a heartbeat at 16 weeks. She knew pretty much straight away.

I'm very much in favour of the midwife checking for a heartbeat at 16 weeks.

(Nb two wonderful sons later, I will never forget how supportive those two women were during those three pregnancies. Well done Glangwili hospital )

RugBugs Thu 08-Aug-13 00:09:55

My 16wk appt was the first time I actually got to meet my midwife (high risk pgs are booked in at hospital) so it was important from my point of view.

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