Consultant Led

[babynelly2010]

Does anyone know what makes you high risk to go under consultant care?
I had my first 2 at birthing centres and under MW care. My second baby was huge and had low sugar at birth. I was huge during pregnancy but they MWs ignored me each time when I said that the belly was way to big. DS was born weighting 2 pounds more than DD who was a normal sized baby. He got stuck as he was coming out funny but all was OK with him at the end. However I had split tummy muscles and needed a brace to walk during the first few days, I also got some prolapsing in the pelvic region.
I do not wan't to be under midwife care I prefer to be under consultant care. I am also over 35 years old but I think that does not matter anymore. Anyone under consultant led and for what reasons? Who do I ask to be under consultant GP or MW? Can I just request that?

[LyndaNotLinda]

Yo can't ask to be under consultant care - it's only if your pregnancy is high risk.

[Thataintnoetchasketch]

I was consultant led due to having Graves' disease and needing my thyroid monitored closely. There would need to be a clinical reason to be red pathway.

[FuzzyOwl]

Over 40 years of a BMI of over 30. Otherwise certain medical conditions, previous c section or a issue in your last pregnancy. Lots of consultant led care consists of seeing a registrar once and then being signed back to midwife led care.

If you aren't happy with your midwife, then change so that you come under another one.

[Out2pasture]

Question, If you go private can you not choose consultant care?

[hopeful31yrs]

I chose consultant led and just stated my reasons - you have good reasons in that you had complications related to a bigger baby and you're quite in your right to ask. Incidentally are you being monitored for gestational diabetes in this pregnancy?

[Jodie1982]

I have a Degenerative condition and arthritis in my spine. High BMI. Always suffered terrible SPD which leads to induction. Plus always make 10pounder babies. And PTSD. This is my 6th pregnancy and 1st time High Risk.

[ohidoliketobe]

Currently 36 weeks with DC 2 and have been alternating between midwife and consultant throughout. First referred to consultant for previous post partum haemorrhage, but it was deemed a low bleed (under 1.5 litres ) so back to midwife. Then over again due to hyperemesis and allergic reaction to sickness medication. Got that under control and back to midwife led care, only to be transferred back due to suspected IUGR! Most recent scans have started to shown a steady growth pattern and if the one I have next week correlates I will back to midwife led.

I'd rather be midwife led, and luckily all appointments and even the two birth centres are in the same place so the current uncertainty isn't too much of an issue

[Jodie1982]

ohidoliketobe excuse my dumbness but what is IUGR? TIA

[readingrainbow]

I'm technically consultant led due to a previous c-section, big babies, age and a weight just barely over 30BMI (literally, like 30.1, heh). I saw her once, she went over all the information I'd given during my booking in appointment, and said she wouldn't see me again unless a problem cropped up. It was a bit of a waste of time, really. Midwives are more than capable of handling most pregnancies and deliveries, even ones that tick a few "high risk" boxes.

[LyndaNotLinda]

hopeful - you must be a high risk pregnancy to be under a consultant - you can't just 'choose' it in the NHS. Of course the OP is perfectly within her rights to ask. Incidentally, AFAIK you can't give birth in a birthing centre unless it's MW-led.

Out2pasture - yes you can. It costs more. Obviously! I was under the care of the consultant who supervised the birth of Kate Middleton's children but he also works in the NHS.

[Hoppinggreen]

When I had DD ( now 11) my GP looked after all pg women along with the MW at The Practise, I also had a named Consultant - I suppose this would have been called Consultant led. When had DS 7 they were moving more to being Mw led as our local hospital had closed the maternity unit and just had a MW led birth centre. My GP asks which I preferred but suggested that due to a retained placenta last time she suggested I be under the hospital in our next town and have a Consultant there. I took this option despite being less than 5 minutes from the MW led unit so I suppose I actually did get to choose

[Mybugslife]

I'm consultant led because my son had multiple congenital abnormalities without a diagnosis. And my daughter was born pre term at 34 weeks.
My ex-SIL (who is still one of my besties) was consultant led because of a high bmi. There's loads of reasons why but you will only be consultant led if you are classed as high risk. If your worried talk to your mw at your next appointment xx

[iwillbemrsminty]

I'm consultant led because DP has one kidney, a heart murmur and my mum is diabetic and my thyroid levels are borderline. I didn't get a choice I was just told straight away by my midwife. Didn't know at the time of booking in but having twins which also puts me at higher risk!

[Whatsername17]

I'm under consultant care for previous hypertension and my mum, maternal aunts and maternal grandma all having had blood clots and/or PE. I'm healthy. Nonsmoker, BMI is right in the middle of healthy range etc. Previous birth was difficult but very well managed. I only saw the consultant once when he said 'you have one hour to push this baby out or I'm intervening'. I got her out in an hour and five minutes! Other than that I just had a couple of extra midwife appointment a (where she repeatedly missed my high blood pressure) and an extra blood test. This time, so far, it's the same. I've got a low lying placenta this time so need to wait and see if that changes things.

[44PumpLane]

I'm consultant led due to having twins.

[Haresonthemountain]

I'm consultant lead this time because my daughter was small. Saw the midwife at booking in but every other checkup and growth scan is with the consultant (now 19 weeks). My brain is a bit foggy but I think that after the initial appointment with the consultant they decided whether to send me back to the midwife or keep me consultant lead. No one picked up on my daughters weight until right at the very end when they decided to induce me (even though I started off measuring small and the gap got bigger and bigger) which is maybe why they want to watch it this time? I would have thought you could request an initial appointment with the consultant as you rightly have concerns, then they can decide where to go from there?

[ChatEnOeuf]

I'll be consultant-led due to previous spinal surgery and a previous stillbirth.

Be aware that even if you are consultant-led, you will still see a midwife for your regular check-ups. Depending on how big your last baby was (and given their low sugars), they may offer you a GTT and maybe a growth scan.

[MoonriseKingdom]

I think you are best to bring these issues up at the booking appointment with your midwife. They would usually decide at this point if someone has indications for referral to a consultant (ie is high risk). You mentioned your baby getting stuck - was this shoulder dystocia? (ie an emergency) - this may be a reason for consultant led care and certainly may preclude you from delivery in a MW led unit.

Regardless of who is in overall charge of your care you should discuss whether further monitoring is needed (eg should you have a growth scan later in pregnancy, should you be tested for diabetes?).

[Iloveapplepie]

I am
Consultant care due to previous strep b and gynaecology problems

[April241]

I'm consultant led as having twins. Before finding out we had twins I was referred to a consultant to talk about my asthma and if it was controlled (it is) so they'd have signed me back to the midwives however once we found out it was twins we were referred to a different specialist.

In my area at least you're only consultant led if there's a clinical reason,you can't request it. Would you be happy to be in a midwife led area with consultants around incase there are difficulties? My local hospital is a CMU but the hospital I'm delivering at has consultants. Just means you'll be midwife led but have doctors to hand if needed.

[SauvignonPlonker]

having read through your OP, I am wondering if you had Gestational Diabetes in your previous pregnancy. It can be characterised by larger babies & shoulder dystocia (baby getting stuck at birth).

In subsequent pregnancies, I would be asking for screening for GDM. If positive, you would be managed under consultant led care in a high risk clinic.