no faith in cconsultant - can I have a different one?

[HelenHen]

I have a previous thread about this!

Wednesday I had my 36 week scan and con aappointment. She told me I have low amniotic fluid and because of my low placenta, she wants to book me in for a csection in a few days. I was confused as placenta was 100% clear at 32 week's and I didn't know it could go down again. I declined the csection as I knew I could change my mind if I wanted but I felt under pressure to agree. I asked if I could have a scan in a week to mmonitor progress and she agreed. She wanted to give me steroid shots that day anyway and I also declined. She explained that I could only birth by csection now and if I went into Labour naturally, the placenta could arupt and there'd be risk of stillbirth if they couldn't do emcs. I still declined and came away sobbing and terrified that I was doing the wrong thing.

When I came home, I looked at my notes. The growth scan notes said placenta 'clear of os'. I rang my midwife who looked at my notes, chatted to other midwives and rang the consultant. When she rang back, she said there was confusion between cons and sonographer and cons had got it wrong, placenta is fine and was now agreeing that the best plan of action is to wait a week.

I'm now getting angrier and angrier about this. Shouldn't I see her again as all the info she gave me was based on the wrong info? How am I supposed to trust any more decisions that she makes on my behalf or that she's reading my notes correctly?

I know mistakes happen and we're all human. I've made gp appointment for Monday to have heartbeat checked. Should I request another consultant or is this even possible? I know I'll calm down after the baby comes but it's really taking away from this final bit of pregnancy. I was loving it and now I feel really deflated, worried and anxious!

[Kels13]

I would definitely ask for someone else and I'd make a complaint. That's absolutely awful and could have resulted in an unnecessary csection.

[HelenHen]

Thanks kel, that's what I was thinking! People think you're stupid for not agreeing with con. Even after telling my sister the whole story, she still thinks I should wait to hear it from con instead of taking midwifes 'word' for it, even though the notes back her up. We just put so much faith in them. I've been awake since 5am still really upset and shaken over it.

Is the gp the person to ask about a new one or my midwife? I'll leave any complaining til after I've had baby but who do I take it up with then? I don't want it to go the legal route and I don't really want her getting into trouble but I can't just leave it, can I?

[redhead78]

I'm under consultant "care" and have had 4 consultant appointments so far and seen a different consultant every single time. I have no faith in what any of them say now as one of them outright contradicted what my scans show and the 3rd one I saw mis-read my notes. I have gestational diabetes and have been controlling it through diet and exercise and had already seen the diabetic nurse that day who was pleased with my progress and wrote "Blood sugars under control through diet, occasionally 7.8 - 8.6". He seemed to think that the comma was after the word occasionally and not before it and that I wasn't able to control through diet and so insisted that I went on to medication for it.
I pointed out that I was controlling them and he basically said that obviously he couldn't force me to take medication but insinuated that I'd be more or less intentionally harming my baby if I didn't. Needless to say I did not start taking the medication on his recommendation!
I now have a midwife appointment set up for a week after each consultant appointment and will double check everything the con tells me with her before I take any action/make any decisions based on their advice!

[RaRa1988]

I'd wait for the next scan so you can be absolutely sure what's going on in there and who's got it wrong... I've had loads of wrong information entered into my notes by my midwife, and it really is worrying, isn't it? I've gone through and corrected it, but thankfully none of it is anywhere near as significant as yours.

[whereisshe]

Absolutely get a second opinion, even a second scan if you can. You are the person in this situation with the most interest in your health, even the most caring and conscientious HCP will not be more interested in your good health than you are. So don't feel bad in any way about getting all the information you need to make a good decision.

Very few things that happen in pregnancy/labour are really urgent (and if they are urgent someone will tell you!) so you have time to make your decision.

[HelenHen]

Thing is the midwife really isn't wrong. The problem is not low placenta as this was confirmed by my last two scans and the consultant I saw the last time. The placenta MAY be failing and I still have low fluid so I'm in no doubt that I'm not in the clear by any means but she was basing her entire advice on the fact that my placenta is low. So the problem now is that I don't trust her and if emergency action will need to be taken, how do I know she's giving me the right advice?

It really is worrying! I'll wait and talk to gp Monday and see what he says but the only doc available is fairly junior with not much pregnancy experience! He's nice and helpful tho so I'm sure will take me seriously!

Oh redhead that's horrible too! Sometimes ya just feel like you're on a conveyor belt, eh?

[HelenHen]

Thank you whereisshe! I think that's what bothers me too is that I wasn't offered an actual apology or a chance for her to cover her arse... Maybe that's coming next Wednesday but I doubt it! You hear so many stories about cons wanting to go the surgical route cos that's what they do! It's important to not be rushed into anything unless it's an absolute Emergency!

I do love my midwife tho so that's something

[RaRa1988]

Ahhh I see. What I was getting at though is how can you be sure that what's documented in your notes is correct? Obviously you know a lot more about what's gone on than I do, but in your situation I'd want a repeat scan asap to be absolutely sure seeing as you're being told different things by different people. You'll need another scan to look at your fluid levels anyway, won't you?

Re consultant, would moving Trusts be an option for you? I did that when I was not at all satisfied with the attitude or care from the consultant at one Trust, and I'm much happier and more confident under the other Trust.

[StarsInTheNightSky]

Oh dear, that does sound like a nightmare . Have you actually spoken to your consultant again? If I were you I would speak to the hospital/maternity triage directly rather than taking the midwife's word for it. I know you trust your midwife, but it's too important an issue not to have absolute clarity on, and discussions between different HCPs can be like chinese whispers sometimes.

If you want to change consultant, you will need to ask your consultant directly, you'll have to tell her you're not happy and ask to be referred to a different consultant, as far as I'm aware she can't refuse and will have to allow you to change. It might be an idea to give the supervisor of midwives at your hospital a ring and have a chat about it first though, as often they will know which consultant is likely to suit your needs the best. It really is helpful to have a consultant whose ideas/opinions on pregnancy and birth are similar to your own. The consultant will always advise you on the safest course of action for you and baby, sometimes they are overly cautious, but better that than negligent. Often, when you start having complications, by far the safest option is surgery, hence why consultants sometimes seem surgery-happy - they only see the complicated pregnancies which are far more likely to require surgery for safety, and so they end up looking like they are biased towards surgery, if that makes sense.

One word of warning, midwives, whilst they do a great job, are not anywhere near as qualified as consultants. Discussing what your consultant has advised with a midwife can be very dangerous as they do not have the technical expertise or knowledge when it comes to complications/high risk pregnancies etc. Your consultant may have advised you to do something for multiple reasons, but your midwife may not know or realise the full extent of this and so could give very bad advice. If you are worried about what your consultant has said, and want to discuss it, please speak to another consultant and not a midwife.
I have a complicated and high risk pregnancy, and my midwife disagreed strongly with something my consultant had advised (it went against traditional pregnancy advice) and tried to persuade me to do what she thought best instead. If I'd have followed her advice our baby, and probably myself as well, would be dead now and there would have been little our hospital could doto try to save either of us. Thankfully I dismissed what she'd said as nonsense and phoned our hospital to check instead. Needless to say our consultant was absolutely furious and has now told our midwife that it is not for her to comment on my care, she takes my blood pressure, tests my wee, records the results and that is it, and she only does that so I don't have to trek over to the hospital for it.

Hope you and your baby are ok x.

[squizita]

I second what stars says.

[squizita]

...sorry pressed to early.

On a related note... from other posts, forgive me if I'm wrong, but you do seem very nervous about intervention and resist the idea that they are ever needed- there is a difference between being pro-natural and scared of intervention and I slightly sense the latter in your posts. For example you refused some steroid shots (harmless to baby) I believe?
I would be careful of, if you hear bad news re intervention, of desperately seeking that it's not true. Sometimes it is needed: and if this is the case, psychologically it's better to be prepared than think of every intervention as a 'problem'.
I just feel this because I had a friend who had interventions, she had seemed very positive pro-natural, but actually she was scared so buried her head in the sand to some extent even when warned. She was told by an ob/gyn, went to a MW (same news), went to a private midwife (told what she wanted to hear). Afterwards she had therapy due to the terror/suprise she had experienced. :(

[HelenHen]

Stars thank you for a brilliantly informative post, really appreciate it and there is plenty of information to take on board.

Squizita, you are right to an extent. I'd rather avoid intervention if possible which was why I came away to think about it regardless! And yes, as with all medical procedures, there is a big element of fear for me but I genuinely would not let the fear decide for me. I'm also pretty good at just doing what needs to be done.

I just spoke to midwife. She said it was a simple case of confusion. Sonographer said 2.5 and cons and mw took it to mean placenta but son meant fluid. Apparently cons was really upset about it and she'd like to talk to me Wednesday to apologise herself. So I think I'll wait til then cos hopefully it might mean I get better care. Otherwise mw said if I do want to switch it will just be a straight switch with no complications because of the situation. I feel a bit better now that I know it is being taken seriously!

[HelenHen]

Squizita I refused the steroids cos I didn't know they were harmless and wanted to look into it before simply agreeing. I'm glad I did now though. Thankfully my instincts were right on this occasion and all my decisions turned out to be correct. I don't presume this to mean that I know best though... Not at all! Hopefully this incident won't cloud my judgement in future.

Rara I have another scan on Wednesday thankfully so hopefully there'll be a bit more info from that. I'm fully prepared that I may have to be induced as a result or even if csection that's fine, but for the right reasons!

This is the closest hospital, I don't understand about moving trusts?

[StarsInTheNightSky]

Helen is there more than one consultant at your hospital? If you're unsure it should give a list of the obstetric consultants on the hospital website under the maternity section. Provided there is more than one consultant, you don't need to change hospitals/trusts unless you want to move to a different hospital, which given that you're 36 weeks is probably going to be a bit of a nightmare.
It is actually very easy to switch consultants, you just need to tell your current one that you aren't happy with her and want a different consultant, you don't even have to give reasons if you don't want to.

About the steroids, you don't know that your instincts were right as your hospital still haven't confirmed to you whether it was the notes or your consultant which are incorrect. Please don't gamble this - telephone the hospital and find out for sure, there's already been a mix-up and it's too important to trust third-hand relayed information from your midwife, who may also have incorrect info.

If you don't trust your consultant, please speak to a different consultant, don't just rely on a midwife/doctor/google/whatever, it's just not worth the risk and it's playing with fire.

[StarsInTheNightSky]

I should have added that my above post is not meant to sound confrontational, it just makes me very worried for you.

[HelenHen]

Oh not at all stars, you've been very helpful! There is more than one consultant but it's hard to find much info on them other than where they studied. At this stage I am happy to wait until Wednesday and speak to her (I'll still speak to go on Monday too) and then I'll follow the rest of your advice if I'm not happy! Over the weekend I won't be afraid to get straight to hospital if there's any prob.

The steroid issue was based on the presumption that I would definitely having a csection so, while they may be harmless, I'd still rather decline unless they're necessary! Obviously there's always a chance I might have a vs but now it's not the only, or even the first, option!

[StarsInTheNightSky]

Good, I'm glad it didn't come across wrong - it can be hard on a forum sometimes!

If it helps, I changed NHS trusts at 8 weeks pregnant (when I found out I was pregnant), which meant switching hospitals, I've also changed consultants within my current hospital too although I changed at 18 weeks.
Sometimes it does take a while to find the right consultant, before I changed I spoke to the supervisor of midwives and one of the maternity ward midwives at our hospital and explained the difficulties I was having with my consultant, and that I wanted to switch but wasn't sure which one to request.
They were both extremely helpful in terms of info such as "well Mr X is very good at surgery, but tends to be a bit blunt, Mrs Y is very nice and very supportive of maternal requests, Miss Z is quite business-like but knows how to get things done quickly and feels very strongly about the importance of what the mother wants" that sort of thing, and they recommended who they thought would be best for me.

It meant that I then had a consultant who's views and opinions matched mine very closely, and who has been an absolute rock through a difficult pregnancy. The first consultant I had I clashed with horribly, I wanted an ELCS due to severe previous trauma and PTSD (in a large part caused by our previous hospital, hence the change) and she was about as understanding as a roof tile and deliberately obstructive . Our new consultant is fantastic and has my absolute trust - his decisions have saved our baby's life several times already.

It is awful having any HCP involved with your pregnancy that you don't trust, it's difficult enough to make decisions without doubting whether you're even being told the right thing.
Hang in there, as you say, tell your GP about your concerns and I hope you get some more accurate info on Wednesday!

[hubbahubster]

I'd have thought the steroids were related to the need to deliver your baby early if placenta is failing or fluid is low. Neither of these things are related to the position of your placenta or your birth method – if your LO has to be delivered early, whether by CS or induction, the steroids are to help baby breathe.

Did you get an answer on whether this is likely?

[HelenHen]

Birth method will now depend on the outcome of Wednesday's scan! If things haven't improved I will be induced, possibly on the day! I'll be 37 weeks on Wednesday so no, it's unlikely baby will be premature unless it has other ideas. They normally recommend steroids up to 34 weeks so not quite sure why they were suggested anyway!

[HelenHen]

Wow stars, sounds like you had a bit of a nightmare! Glad it all worked out in the end!

[VestaCurry]

I requested (via GP) seeing a different consultant to my usual one (not for pregnancy, something else). My GP was fine about it. Ask. Hope you get it sorted.

[HelenHen]

Thanks vesta! Mw did say it wouldn't be a problem at all. It's just... What if ya switch and get someone worse? . I'll wait til Wednesday and see... It's gonna be a long 5 days!