Choosing a hospital miles away - am I insane?

[PavlovtheForgetfulCat]

I am having some issues with my local hospital where it has automatically be assumed I would be giving birth to my 2nd child. The main issues are around exactly how busy and overworked they are, and the fact that I have had to wait until now to even hear from them about my first consultant appt, which I was meant to have at 20 wks, or tied in with my scan which I had at 19wks. I am now 21 weeks, and today I have been notified that I will see a consultant at 26 weeks, as they are so busy. They are understaffed and overworked according to a midwife who I spoke to when chasing appts and it is not inspiring confidence.

At a time when I should be having more care than normal, I am in fact receiving less as community midwife said no appt with her needed until 26 wks as I was having consulant appt at 20wks, ante-natal clinic told me I did not need to make an earlier community midwife appt as despite delays I would see someone by 23 wks (luckily i ignored both of them and made one for 23 weeks anyway just in case).

I am worried beyond beleif (well about everything, this is probably just another irrational fear) that given that this number of people who are swamping their system are all going to give birth at the same time, they are going to be as snowed under when I go into labour - what if there is no space in labour ward? what if they are too busy for proper care? When DD was born I had very hands on staff, but it was very quiet that day.

Can I, or rather should I, try to have my child at a local community hospital, which is about 45 min drive away, but will be quieter and has a good reputation. There is another one which is a good hosp but until I talk to nurse friend do not know if it has maternity ward there.

Should I ask for this to be a consideration, who do I ask, midwife? consultant? Is it too late to get a space now I am 20 weeks? What do I need to consider when thinking about not going to my nearest hospital which is the local emergency dept too?

I am worried that it is too late. Not to change my mind, as I never decided on Derriford, I was sort of directed that way for the consultant and it was only recently that it occured to me I am allowed to choose the hospital I give birth in.

[choufleur]

if you look on www.drfosterhealth.co.uk/ you can check out stats on various hospitals and see which near you have maternity wards.

you can change you're mind whenever you like (well i'm pretty certain about that anyway). I switched hospitals at about 24 weeks as I had pretty much the same concerns as you. received appalling ante-natal care. luckily for me the other hospital was about the same distance away.

[PavlovtheForgetfulCat]

The distances here are about 20 mins with no traffic to the local hosp, 45 mins in traffic.

45 mins with no traffic to furthest hosp we are considering, probably up to 1hr30mins with traffic/roadworks/accident . Or if DH is driving, 30 mins

[PavlovtheForgetfulCat]

Sorry, I meant to say, and forgot with my pg addled brain, thanks for that link, I will go check it out.

[suwoo]

The hospital I have chosen to have my second and third babies at is 45 minutes away in no traffic. There are two others nearer. The only hassle I have is that they come under different boroughs, so all the notes and midwife bits and bobs are different, which causes the midwives some hassle.

Other than that, no biggie.

[PavlovtheForgetfulCat]

Ah I have just come across a potential problem.

Given that I am supposed to be consultant led, but so far am not. Do I have to chose a consultant led hospital, or can I opt out of that and go for midwife led? Would that be foolish? The hospitals I am considering are midwife led community hospitals.

I am thinking of just trying to see whether I can push for a home birth regardless of what I am advised, and if there is an emergency I can go to local hosp, and if all is ok which is should be, I will be at home, where it is not busy.

[Lulumama]

my instinct would be to go for a home birth?

why are you consultant led this time?

[PavlovtheForgetfulCat]

2 reasons
1 DDs growth slowed down when I was around 28 wks pg, and by 34 wks had stopped completely. I was going to be induced at 38 wks but she arrived on her own 2 days before induction date, love that she is! They did not ever find out why she was small, born at 5lbs, but she was perfectly healthy apart from a little jaundice and slight sugar issues for 24hours (common in low bw babies apparantly). Last time I was not 'allowed' a home birth as they did not know why DD was not growing and needed to monitor her internally while I was in labour (as it happens the midwife did not do this, but held on to a monitor on my belly so I could stay on all fours for most of it!), they said this monitoring will need to take place again and cannot be done at home.

1. I had a retained placenta, and had to have it manually removed, again no identifiable cause, allow placenta was apparantly small and broke up quite quickly. It took a long time to remove manually as not in one peice by the time they operated, and they were concerned about hemorrage at the time. Apparantly, there is a higher risk of this occuring again so I cannot be at home.

But, my opinion is, it appears that I get consultant care immediately if there is a problem, just not before the problem occurs, so if I give birth at home, or at a community hospital, I can be transferred to hospital if needed very quickly.

I would love a home birth, dh is worried about that.

[PavlovtheForgetfulCat]

the time between DD being born, and placenta being removed was at least 2 hours, so that would be plenty of time to let me deliver it naturally and then if not within an hour, whizz me to the hosp.

[jabberwocky]

I had ds2 at a hospital that was an hour away as I did not feel comfortable with the ones that were closer. Everything went fine. I would go with your instincts.

[Lulumama]

with regards to (1) ,are there any signs of IUGR this time? and with regards to (2) did you have the injection for the placenta or a physiological 3rd stage?

[PavlovtheForgetfulCat]

1. none at this stage, but DD was a good mid-weight at 20wk scan, as this baby is, it was a little later that weight and fundal height stopped adding up, so scans were upped and growth was visably slower.

1. I need to read my notes, but I recall oxytocin (i think) being administered, as the person putting it in could not get the canula or whatever it was into the vein in my hand, so put it in my elbow crease which I was upset about as it made it more awkard to hold DD. My bf who is a nurse and present with us said that the oxytocin was not going on properly or something, trouble with my veins? But I know it was not done immediately as I had wanted to do it on my own, however cannot recall how long I waited. I do know that I did not have the op for a good while after waiting for the placenta to come out of its own accord.

I also vaguely recall, but cannot swear the accuracy or details of this, but think it is relevant - I think the cord had been pulled to speed up the expelling of the placenta, as I remember my friend saying the cord snapped as it was very brittle, and came away from placenta easily - that could only have happened, if I guess this correctly, if the cord was touched in the first place, and I have heard from other people that this can impact on an placenta not being passed out naturally?

I personally think that what happened with DD was just a mixture of circumstance, just what happened (placenta) and DD was just small as I am small, DH is small and thats how she was meant to be, rather than some major medical drama that needs to be monitored (as clearly appears the case with the hosp as they are not rushing an appt through ).

[happyjules]

Hi there,
I can't offer advice on your situation with regards to being consultant led or not. However, I have twice chosen to travel significantly further to deliver my daughters, both times at MLU's as opposed to large hospitals. The journeys have been uncomfortable but most defiantely worth it, and yes I would do it that way again (hopefully one day). Good luck.

[PavlovtheForgetfulCat]

thank you