Pregnancy after loss - Consultant , not what I expected... Feeling let down(46 Posts)
Don't really know why I'm writing this to be honest, I think I just feel a little confused and let down (possibly) by my first encounter with a consultant.
Back story -
In May last year my partner and I lost our little boy Edward at 38+2, he was sadly stillborn. We decided against a post mortem as we didn't like the thought of our son being poked and prodded. We were happy for the placenta to be analysed and for both myself and my DP to be tested for whatever they thought necessary.
Anyway, nothing much was found, the only thing to note was that the placenta was far smaller than they would have expected and it was assumed that this was the cause of Edward's death as it could no longer support him any more.
We were advised that any future pregnancies would be monitored by a consultant and midwife, I'd have many more scans and watched very closely, etc.
Fast forward to today, I have just returned from my first consultant appointment - I am currently 14+5 weeks pregnant with our second child.
The lady I saw was not the person I was told I would be seeing, (this didn't transpire until later) she was a registrar working under the consultant. I wouldn't have minded this, however when I asked her whether I would see her for my next appointments she replied:
"No, I'm not Miss DrYouShouldHaveSeen. You will most likely see someone different each time."
Now the thought of this fills me with great dread (although this particular woman was awful), having to repeat my circumstances over and over is pretty distressing when you've lost your child.
I was (rightly or wrongly) under the impression that I would see the same consultant throughout, at least for continuity of care(?!)
We sat down, she started flicking through my pregnancy booklet.
"So, why are you here? Ah, you had a baby last year at 38 weeks, is that why you're here?"
I looked at her a little gobsmacked, especially since it is written all over my notes that our baby was stillborn.
I replied, "Yes, but he was stillborn. That's why I'm here."
She muttered under her breath; "oh, sorry".
Insensitive to say the least.
I asked the consultant if the placenta would be measured this time (I was told on multiple occasions by various medical professionals that this would be the case after we lost Edward).
"No. It's impossible to do that."
At this point I started to cry. I asked her how they would know that the same wasn't happening this time - obviously I'm super paranoid that something terrible will happen with this pregnancy.
She gave me a crumpled hard hand towel to wipe my face, (luckily I was prepared with my own tissues).
She said that I would have more scans this time and they would monitor the growth of the baby, etc. Her response made me feel as though I was being an inconvenience, firstly for crying and secondly for asking a question.
We talked about scans, starting at 28 weeks. I asked her if I would have any more between now and 20 weeks (I have had two reassurance scans earlier on in the pregnancy, just for my peace of mind more than anything). Her reply:
"No. This is it." nothing like "it depends how you feel" or "If you're worried we can fit you in".
She asked if she could listen to the baby with the doppler. I said "Yes please, I've been really worried as it's such a long wait to see someone between the 12 and 20 week scans. It's really quite scary not knowing if everything is ok." (In reality I've been afraid for the last week that something terrible has happened to this baby too). She didn't bother replying.
I did have more questions but she made me feel that uncomfortable I didn't bother asking them. I figured I'd just wait until the next appointment and hopefully I'd get someone nicer.
Long story and rant... I guess I just expected something a little different? I thought that perhaps the consultant would be a bit more understanding or have some compassion.
She didn't even say goodbye to me as I left.
All I know is that I now feel worse than before.
Not once did she ask how I was during the appointment. Even if she had I don't think she would have given a shit.
The "mental health and wellbeing discussed" box in my notes was obviously left un-ticked.
I just wanted to say I'm so sorry about your experience and the tragic loss of your child
I have experienced several medical professionals on this pregnancy journey who appear to need a compassion transplant. I have had to make a complaint about a midwife (I have not had any losses but I am anxious about it, and he was patronising, dismissive and utterly flippant about the possibility of losing the pregnancy, telling me with a condescending smile that I just needed to accept that baby could die at any moment). I've also had two snappy and "business-like" sonographers who were fine in circumstances where it was good news, but I remarked to my DH that they would be the last people from whom I would want to hear bad news.
I don't know whether it's that these people deal with babies every day such that they just don't care about each individual baby, but I have been surprised at the poor bedside manner, I would have thought it was especially crucial in this sphere of medicine. If they don't care, it would be nice if they pretended to! It's so hard being pregnant and anxious about the precious bundle you are carrying only to be treated so coldly by medical professionals. Perhaps you could specifically ask not to see this woman again and hope the others are nicer?
I'm sorry for your loss.
Most 1st world countries offer a 3rd trimester scan at which only the placenta is really looked at - you should definitely be getting scans of the placenta starting at the beginning of the 3rd trimester.
I moved from the UK to Germany during my second pregnancy and my obstetrician could not believe the NHS care I told him about and called it third world. It's from the start of the 3rd trimester that monitoring placental function becomes essential. It does sound as if you will probably get those, but your registrar sounds clueless and lacking humanity.
I’m sorry for your loss and going through such a distressing experience.
I went through pregnancy after loss last year. The reason for the loss at 21 weeks was an issue with my cervix that was likely to reoccur in any future pregnancy and the consultant indicated that there were measures that would be taken to prevent another loss, which gave me the confidence to try again. However once I was pregnant, I really had to fight my corner. Most HCPs that I encountered were very blasé about the problem reoccurring, and I went to my GP with high levels of anxiety because I was not being taken seriously and her letter to the consultant kick started a better level of care. I have also been in a situation when I was called into a room with a registrar working under the consultant, but said I would wait to see the consultant himself (I knew he was there for the same clinic).
I was referred to maternity mental health services and saw them early in my pregnancy - then they made a follow up appointment for 32 weeks, which was ludicrous given my concerns were around premature birth! As it happened my anxiety radar was right and the problem reoccurred, and I gave birth at 24 weeks (DD is now home, happy and healthy).
I was given false reassurance throughout my pregnancy, but had to take control during my pregnancy and escalate as needed. I got the direct phone/email of the consultants secretary somehow, and that helped with getting answers to questions.
I was also referred to a specialist unit for monitoring and the advantage was a dedicated midwife. Now she was one of the biggest causes of my anxiety as she clearly didn’t believe that it was anything other than bad luck that caused my loss - however as the pregnancy progressed and the consultant agreed a care plan, I turned her into an ally for getting the extra scans that I needed.
My local SANDS has a pregnancy after loss group, if there is one in your area, I highly recommend them for support.
She sounded awful, salt in the wounds. So sorry for this and your loss.
Have you got a consistent midwife or a sympathetic GP? There are lots of excuses they could come up with for extra scans (I had a monthly growth scan even though I had no diabetes, but because they seemed sure I would get it. A friend who'd had a miscarriage with her first pregnancy was sort of prompted by her GP into getting an early scan which was really to stop her worrying). Talk to your midwife or GP to say you've found this appointment very distressing. Your mental health and well being is important during this pregnancy even if this hard faced woman couldn't see it.
Can you bear to contact PALS with this story? This is terrible and I’m so sorry you went through it.
Thank you all for your replies. I'm just typing out a complaint letter as we speak to the hospital.
Sorry, Jenijena - what is PALS?
So sorry for your loss.
The nhs, wonderful as it is, is not good at handling anxiety in pregnancy.
In particular while doctors may know loads about medicine, they can sometimes be pretty rubbish at bedside manner.
So things that may help:
First up at consultants clinics the way many work is that a consultant works with a group of registrars to run through a large list of patients. They simply take each patient in the order they come up. However, if you want to speak to a specific consultant you can often agree to wait until that person comes free. Make sure and request this with reception when you arrive.
Another thing you can consider is to make an appointment with a supervisor of midwives (head midwife... name may have changed), and talk through how your care can be modified to meet your needs. Mine also offered to sit in on consultants appointments with me to handhold. I also was able to meet with her to debrief appointments afterwards. They are great at managing the relationship with consultants where necessary.
Good luck and I hope things proceed a bit more smoothly from here.
The patient [cant remember what the a stabda for] liaison service. It’s provably where your complaint will go first but I confess I don’t know a huge amount about it.
Make a complaint about your care - that ensures they sit up and take notice the next time. <bitter experience>
I’m so sorry for your loss. I had a stillborn baby at 41+3 and was incredibly nervous the second time around. We did ask for the post-mortem but no cause was found.
HCPs not reading the notes was one of the things that caused a lot of pain and heartache in subsequent pregnancies. I had to repeat myself again and again.
I had no issues with my consultant (because we had complained about my care during the stillbirth and she was the senior doctor from neighbouring hospital who had been charged with reviewing my notes), but they didn’t start my extra scans until 28 weeks either. I think it’s standard.
She sounds very lacking in natural empathy and in training that tells HCPs how to handle these situations. I would complain about her manner.
I'm so sorry for your loss and the awful care you have had.
Not the same situation at all but I have a high risk pregnancy after some fairly risky complications last time and I have seen a different Dr each time. I honestly felt my care last time, when I was low risk, was far better as at least I had some continuity of care and the midwives I saw seemed more professional. I also have had to repeat my story each time and they never seem to understand as it's quite complicated so I go away feeling as if I haven't been cared for well. I really hope things improve for you and you have a safe and complication free pregnancy.
I’m so sorry for your loss. I’m also a member of a local SANDS group after my daughter died shortly after birth and I agree that finding one and asking for further advice on there might be beneficial.
Do complain via PALs and ask for continuity of care and everything else that you are looking for. I really hope you are able to get the proper support you need and everything goes smoothly for you in this pregnancy.
I'm sorry for your loss but I think you were expecting a little much. The NHS is hugely stretched right now. Pregnancies with actual diagnosed problems rarely get to see a consultant at every appointment. Yours are all just reassurance appointments really. It sounds like you wanted someone to manage your anxiety rather than do the medical checks which is what the dr did. She might not have the best bedside manner but if checked your baby do you care? I'd rather have someone professional and good then someone lovely and caring who is just planting you. I don't think its fair to complain about a DR fro not handing you a soft tissue.
@bookhelp I do not think it is unreasonable for a doctor to quickly check notes and work out if a bereavement is the cause of the patient in front of them today. It will not be unusual, surely, in an obgyn appointment?
@BookHelpPlease have you experienced you a stillbirth or neonatal death? Your comment seems shockingly insensitive and from my experience (and yes, I have had a baby die) subsequent pregnancies are considered high risk and are consultant led. Any issue with the placenta is something that can and should be monitored.
This person sounds horrific. You should complain and say you do not wish to see her again. I don't think it's always possible to see the same doctor each time as consultants don't always work every day. She was so insensitive she needs to be pulled aside and told to shape up. Other people have called the NHS worse than third world. And I am sick of it being held up as some sort of beacon for the world where in reality it is sometimes extremely poor indeed.
I am so sorry that Edward died. So sorry that you had an unpleasant experience today. I would be inclined to Google the pals email address of your hospital and write an email to the consultant you were expecting to see. Ask about how many more appointments that you would prefer to see her in person and have continuity of care. Ask the questions that you didn't today. Very reasonable to say you didn't ask them today as you were very upset that your notes hadn't been read prior to your appointment and you were upset having to explain about Edward when you want to feel positive about this pregnancy.
Say you were told that your placenta would be monitored and are very worried to be told today this won't happen
in my experience emails via pals get very prompt, thorough replies. As they are monitored and leave a paper trail.
I hope you get some reassurance and can enjoy your pregnancy
sending a very big hug. so many emotions. Such a tough time.
I have been placed under consultant care because my baby died. As I said in the original post, the placenta was not sufficient for my baby to survive to full term. They do not know why this happened and so they wish to monitor this pregnancy and baby's development closely.
I have been told that any further pregnancies WILL be viewed as high risk because of this. That is a diagnosed problem. I didn't ask to be put under consultant care because I wanted my head patted.
I'm not asking for my hand to be held, I'm asking for help so the baby doesn't suffer the same fate as my last and a bit of compassion is not difficult. Equally it doesn't take any extra time to not be an arsehole to someone. Doesn't cost the NHS anything either.
I said I didn't know what to expect from the appointment. Clearly from other reactions my treatment was shit.
Yes she used a doppler. She didn't check the health or wellbeing of the mother of the baby though - surely that's important too?
I don't know your circumstances, I can only assume you haven't been unfortunate enough to be in a similar sort of position.
bookhelp I think this might be one of those threads where if you can't say any nice then shut up. Now jog on. The op is consultant led for a reason and her appointments aren't just for reassurance. They are there to reduce the chance of the same thing happening as well.
Op are you seeing a midwife as well? If you don't feel up to formal complaint by PALS maybe mention it to them?
I am so sorry for the loss of your baby boy.
I was under the consultant for both my pregnancies. At each appointment, I would see the midwife first, and would tell her I needed to see Mr X and no-one else. She would put a post it on my notes, and therefore a random registrar would not see me. On the couple of occasions they did, they would call him anyway, as my case was very complex. Did you see a midwife first at the clinic? As I think they might be your route for more compassionate care.
Also, due to fears over both my babies, I had a scan pretty much every time I saw him at the clinic, and I had more formal growth scans and additional scans where they checked the blood flow through the placenta.
This service is available and most definitely should be for you. You need to try and see the consultant and no-one else.
In addition, I have a friend who sufffered a tragic loss and I am pretty sure she had the care of a specialist midwife throughout her subsequent pregnancies. I am shocked if this is no longer available.
I wish you all the very best.
You could be describing the Doctor I saw at my first consultant appointment in my second pregnancy. Our first daughter died due to a cluster of things, placenta issues, infection and a chromosome issue that meant we had the undergo genetic testing to see if it came from us (it didn't). She was born at 20 weeks.
Like yourself, we didn't see our consultant at first, we saw the registrar and she was just awful. She hadn't read any of our notes so we had to explain why we were there, I had questions that were just dismissed out of hand, she kept on forgetting that I had been pregnant before, I asked for a special sticker that I knew the hospital did to be put on my file so that staff would know this was a pregnancy after loss and she wouldn't do it as my loss was before 24 weeks, she was just awful. No bedside manner at all. I left the appointment that was supposed to be for reassurance in pieces.
What we found invaluable for us was our bereavement midwife. I told her what happened and she fixed all of it, the rest of my appointments were with my actual consultant, I had regular scans throughout and was offered extra monitoring toward the end. I got the sticker and she made sure that the Dr in question was informed what the stickers were actually for. She came to important scans, visited me at home, even came to the meeting to schedule my c section and took me on a tour of the theatre. She was a star. Do you have access to anything like that service?
I am so very sorry for your loss.
bookhelp The OP has a very good reason for feeling anxious and needing continuity of care.
LittleBelina - I am seeing my midwife as per usual routine. I have only seen her once up to now and I'm due to see her again in 2 weeks, I will be just over 16 weeks then. I have the same midwife that I had during my first pregnancy. I will definitely be mentioning this to her when I see her.
CoperCabana - I didn't see a MW today at all. I had my BP done and urine dipstick by (what I assume was) a nurse but she didn't do anything more than that.
DeadButDelicious - I don't have a sticker on my notes - I think I might ask for one, it may make things a little easier. I honestly don't know what services I have available to me. I naively thought that I would just see the same consultant and they would know what happened previously and have a structured plan for this time around. I didn't even know that I might not be seen by the consultant today - maybe I shouldn't have assumed.
I did see a consultant after Edward died and she was lovely . I might ask if I can see her again. I just feel quite lost now when I was hoping this would have given me more direction.
Hi Jen. It was the person who did the urine dipstick and BP that I assumed to be a midwife who would write the note on my notes.
It's a difficult one as I have no idea who I would want to see. Aside from the one consultant I saw last year, I haven't had any contact with any consultants etc so I don't really know anyone yet.
I'd just like a nice person who seems like they care!
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