Exactly HOW much of a choice?!

[Anna22]

Hi everyone, I just found out I'm pregnant over the weekend
I realise I'm jumping the gun ever so slightly at not even 7 weeks pregnant yet, but I need some advice! I just moved to Leicester with my husband a few months ago and haven't had an opportunity to book in with a GP yet, instead I'm registered with a surgery in Hertfordshire which is where my parents and family live. Having found out now that I'm pregnant, I'm unsure of what to do re: antenatal care and delivery as I'd really like to deliver near my family and stay with them for a while after the birth. I also prefer the SCBU unit in Hertfordshire and as my mum suffered with pre eclampsia with all her children, It's not unlikely my baby will be born slightly premmie either.

Having said that, having to travel to and from Leicester for all my antenatal check ups and scans would be hard, and I'm not sure how a HV / community midwife would be organised afterwards? I know that you supposedly have a choice as to where to have your baby, but how much of a choice exactly?! Could I register with a GP here and confirm my preganncy, then have my check ups in Leicester before moving down to live with my family before my due date?

Thanks for the help guys... getting worried as I want to see a GP asap about this pregnancy, just in case

[madmarriedNika]

Just wrote you a reply then computer crashed!!

You should be able to have your care based at the Hertfordshire hospital even if you live in Leicester so long as a local GP consents to it. You need to get booked in with a local GP urgently- if needbe explain the reasons in detail to get an early appt- and then go through your situation in detail with him/her. As you've rightly said the fact that your Mum had pre-eclampsia does make you at a higher risk of developing it also, and therefore you should really be under consultant care at a hospital where they can devise a monitoring/management program just in case. You should really be seen by a consultant as early in pregnancy as possible.

The main issue may be if your local PCT don't want to fund the costs of your care based in a hospital in a different PCT, but usually if this is supported by your GP it shouldn't be a problem.

I had DC#2 in a hospital 1.5hrs away rather than the smaller local hospital because I wanted to be under specialist care after developing severe PE with DC#1. My GP fully supported this so it wasn't a problem at all, and my local community midwives were able to handle having 'directions' from a different hospital both during my pregnancy and post-birth (though took them a while to get used to keeping the records differently...and I had to carry my hospital records everywhere!)

It was a times hard travelling to and from the hospital, as after 20 weeks I had appointments at least every fortnight. But I have friends who live near the hospital who I could stay with or at least meet for lunch to make it less tedious. In your case you shouldn't hopefully have to have that many appointments!

Many congratulations on your pregnancy and good luck!

PS. some good pre-eclampsia links (IMO) below:
pre-eclampsia.blogspot.com
www.preeclampsia.org
pesupport.friendhood.net/index.htm

[madmouse]

Yippee, congratulations

You have the choice alright, but do you plan to travel to Hertfordshire in labour?

Not sure you should base your choice on the SCBU. SCBUs all across the country are full of the most amazing doctors and nurses (the one sin Oxford in particular are angels) and besides the largest chance is that you will not need them! You are aware that you may get pre eclampsia, so you can spot the signs early and may be able to rest/take medication. I only developed pre eclampsia when I was due.

I would say get a local midwife where you live now and get to know the hospital.

[madmarriedNika]

Yes, I second madmouse- definitely get to know your local hospital as well. Our plan had been if I remained pre-eclampsia symptom free after a certain stage of pregnancy (36 weeks I think) my care would have been transferred to the local hospital- precisely because in labour travelling a long distance is a no-no! Plus babies born at term are far less likely to need SCBU support (our local hospital didn't have a SCBU).

Both of my children have been in SCBU in two different hospitals and I honestly think all SCBUs are good, the staff are utterly amazing. So please don't worry too much about that. Plus to be honest as the SCBUs do sadly often fill up there is no guarantee a baby will get a cot in the hospital they are born in.

[Anna22]

Thanks so much for you help, and for replying.

I'll take your advice and check in with a local GP this week and book in, and discuss it then. I was mostly worried about getting a GP here and them being very strict with where I can go. I know most SCBUs are very good (I'm a neonatal nurse ) but I used to work in the unit in Watford and know the staff, and the policies they adopt there. I do think as well that because I work in NICU I've convinced myself my baby will need special care, though that hopefully won't be the case... remember I've seen very few happy, healthy births!!

I wasn't planning to drive down in labour, maybe go stay with my parents a week or so before, but I guess that doesn't marry up if it's an emergency.

Either way, I'll book in and get advice then... thanks for all your help!

[madmarriedNika]

oooh now I'm embarassed of course you know the ins and outs of SCBU!

How early on in pregnancy did your Mum develop PE out of interest? I know many don't develop it until at full term or even post delivery so hoping if you do develop it that late you'll avoid seeing SCBU from a mother's perspective- I imagine that would be very hard when you know so much about it already.

Good luck with discussing it all with a new GP

[Anna22]

Well, I only know units from a staff point of view... but it's nice to hear they're (mostly) okay from a parent's perspective also!

My mum had PE relatively late on with myself and older sister, we were both induced at 36plus weeks, but she was in hospital for a long time prior to that. With my brother (her last pg) she was in hospital on bed est for 2 months and he came 7 weeks early, so still not toooo bad.

[cyteen]

Congratulations Anna22, and also commiserations on moving to Leicester I'm in Leicester as well and just wanted to let you know that the antenatal care I've had here has been really good (am 34 weeks with first baby) - same midwife throughout, regular appointments etc.

Good luck with your pregnancy and planning your care!

[DontNeedAnything]

I respect all of your reasons for wanting to go to Hertfordshire. If it doesn't work out though I want to reassure you about the NNU at teh LRI. My DTDs spent 84 days there. The staff are fab. It is a large NNU, and I believe that is now a regional centre of excellence for the whole of the midlands.

Having said that Leicester General is a much nicer maternity unit, with a smaller NNU, but it is all part of the sme trust so the drs are shared

[madmarriedNika]

Your poor Mum, she sure went through it
I honestly believe low-dose aspirin helped delay the onset of PE in my second pregnancy (and it never became HELLP syndrome, which I'd had with DS)- there is lots of good evidence of it working well in those at high risk of developing PE. Originally it seemed to only be prescribed to women with a history of early onset (pre 32 weeks) PE but now there seems to be evidence that it is useful for all those who may have an elevated chance of developing PE- if possible I'd discuss this with an obstetrician once you see one (although ideally it has to be started when the placenta is forming, so by 12 weeks I think)

Hoping everything goes smoothly

I have much admiration for SCBU nurses