Hospital not providing atenatal appointments

[Zahrah5]

Guys

Im starting to have nightmare about MW appts at my hospital.

Anytime I goo see the midwife and she tells me to book for next appointment in X weeks time according to the NHS schedule the receptionist tells me there is no slot free until X+ y weeks.

Here is the schedule from my notes:
16w
25w
28w
31w
34w
36w
38w
40w
I had problems to book my 16 weeks which happened when I was 18w.
After my 25w appts my 28w appt was scheduled for when I will be 30w, so eesentially missing the 28w one.

I have tried to go the clinic to inquire whether they had any cancellations and could take me earlier but they said no. So i made a fuss last time about the 28w appt and got to head of clinic. She told me they are full and if I want I can go to have my appt at my GP. I dont want that, Iam not sure if they have doppler and are skilled in this, such as determining fetal position.
She was able to arrange for MW to see me on that day, so that became my 28w appt and the original booked slot I will use for 31w.


I know they will not be able to give next appt at 34 w and possibly not even the 36w.
So I need advice what to do in this situation. I have already made a mess and got seen. But I can not do it every time, it is very stressful.

It can not be only at this clinic me who has this problem?

[sleepybee]

I see the midwife at my GP surgery is this not what they meant by going to your GP? I'd check this out

When I see my midwife she books the next appointment there and then. Most of mine have been a few days to a week ahead of schedule - my 32 weeks one I'll only be 30+4 for example

[jmojo]

A couple of weeks either way largely doesn't make much difference unless you are needing anti d at 28 wks. What is important is that you are being seen regularly and the growth and your progress is being monitored. (I say this as an ex midwife) so don't let it stress you out too much. The baby's position is only really relevant from 36 weeks when if the baby is breech then you will be referred to the consultant clinic to dee a doctor re ?turning (ECV), ?mode of delivery. If the head isn't engaging or the baby is oblique this also will be watched too after 36 weeks (but most babies do the right thing and engage) and they will want to see you not send you to your GP.

Here is an idea of roughly what to expect so you can decide how much you want to push for an appointment exactly at the guideline gestation.

For mums of normal singleton pregnancies with no complications this is what usually happens (it can vary slightly)

16w routine check quad test bloods for those having it (you can see GP if not).
25w routine check could be GP, if there were problems with scan you should have already been referred to Cons/MW for this check as appropriate.
28w Bloods for GP/ GTT (for those requiring it or those at hosp where they do routine mini gtt) Hb check. Anti D for Rh -ve mums. I think whooping cough vaccine is recommended now after 28 wks (but GP usually does it) Some hospitals do a blood group and antibody screen now too. This appt should be at 26-28 wks if at all possible if GTT being done or Anti d needed. Otherwise it could be a bit more flexible if all well.
31w GP or mw is fine, so long as any blood results followed up (you should be able to ring MW for them).
34w Gp/MW fine too but starting to look at fetal position so if your GP isn't into Obstetrics maybe go to mw. Hb check. (pre delivery to make sure have time to treat it if on low side before you deliver).
36w mw/gp position check becomes significant. Discuss birth plan if not done already (you should have done any antenatal classes by now or be under going them at this time, so you should have info for doing birth plan if you wish to do one)
38w routine check, discuss any concerns re delivery, mw (if worried) Gp if no birth questions.
40w Discuss going over due and what will happen, make 41 week apt for sweep. See mw here.

(at 41 wks membrane/cervix sweep and book date for induction at 40+10/12/14 depending on hospital policy for induction. It depends on the hospital as some book induction at 40 weeks.)

Sorry it is long but sometimes info can help with your decision making.

[blowinahoolie]

For all antenatal appointments I have to attend the GP surgery to see a midwife there. My first one will be at 16 weeks, but that's up to me to arrange this. The hospital don't get involved. Is that maybe what is meant OP?

[bonzo77]

I had this problem in my first pregnancy. My gp did the appointments instead. She did have a Doppler and was much more thorough than the hospital midwives. She suspected a serious problem at I think around 32 weeks. She got me seen by the hospital consultant the same day. The consultant confirmed that the problem was potentially serious but had been picked up well before any harm. She also said that my GP had been very switched on to send me in. I honestly think that the fob-you-off midwives would have missed it.

[Zahrah5]

Thanks


To clarify, my GP doesnt offer appointments with midwife, they refer all patients to hospital.
The hospital I am now is different NHS trust than i live or where GP is so even hospital community midwives will not visit me, etc not sure if that matters.

I do not care if I am seen at exact gestation weeks but as mjojo noted above I care that I am seen regularly. Mostly I am concerned about protein in urine and growth of the baby. Listening to heartbeat is reassuring too. I can check my blood pressure at home.

On feb 5 My hospital was only able to offer next available appt at March 12 what is 5 weeks wait time.
According to schedule we are to be seen in third trimester every 3 weeks and after 34 weeks every 2 weeks.
So I dont think 5 weeks gap means being seen regularly.

[jmojo]

It shouldn't matter if your GP is the same hospital district or not (although it may mean they can't access any blood tests done at the hosp as it will be a different system. Check if there is a GP at your surgery that specialises in gynae and obs, it may not be your regular one but it at least provides an alternative. If more women felt confident in their GP's maternity care then more would see the GP at certain weeks and it would free up hosp apts. It isn't the women's fault at all, it is a confidence issue in the care they are offered, and I totally understand it. (I am pregnant just now!)

Do they let you book more that 1 apt in advance? I used to do that for some of my women who had to fit apts around work/childcare etc, to make sure they got them at a convenient time. I know some clinics don't let you. Sounds like your clinic just doesn't have enough apts for the volume of women they have.

The only thing I can say is write a letter of complaint explaining when you got your apts, the struggle you had. I know it sounds blah, but believe it or not the hospital has to pay attention to these letters, and actually you may find that the poor antenatal clinic midwives who are trying to see all these (frustrated) women may be saying the same thing to their management. You can bet the poor receptionist who has to take all the complaints will be. Sometimes it takes quite a few letters from different women before the midwives can action it with the hospital board and make a change. I only speak from experience. You may not see the change immediately, but you may next time you are pregnant.

Anyway I totally sympathise with your frustration. I hope you can figure something out.

[jmojo]

Oh and the letter should go to the Director of midwifery and the Hospital Chairman!

[bonzo77]

Op I was and am Again in the same situation. Booked at a hospital in a different area, no access to community midwives before the birth (I will have them after the birth). There is no midwife at my GP. As as said before, my gp herself offered me everything the hospital MW could have including blood and urine tests, blood pressure measuring and listening to baby heart beat. When I needed extra scans and ctg she got me to the maternity day unit at my hospital exactly as the MW at the hospital would have done. I agree that it's pretty crap the hospital are so busy that they cannot see you, but it's proably beyond their control. You will get the care you need. Are you in London? Maternity services are sooo over stretched.

[beth1987]

Most midwife appointments I have had involve dipping urine, checking blood pressure, listening to heartbeat and measuring bump. I would assume these would be transferable skills from other procedures they do every day. Would rather see a GP than have late appointment especially if you can pick a GP.