How often are you supposed to see the Midwife??

[sparklygothkat]

You think I would know this by now (number 4) wouldn;t you!!!??

I haven't had a full check up since 10 weeks I saw the midwife at 16 weeks and she just took my BP and listened to the baby. Had a scan at 20 weeks but didn't see anyone afterwards. Am now 24 weeks (tomorrow) and have another scan and check up next week but I am sure I should be seeing the MW more!!

[Twinklemegan]

It sounds about right I think, especially if it's not your first.

[SlightlyMadSpider]

I probably saw my community MW about 6-7 times with DD3 (and I was high risk ).

Do you not have any specialist care as a result of previous prems (am I right in thinking you have had at least 1 prem?)?

[sparklygothkat]

Am high risk though, I knwo I will be seeing the consulant every 4 weeks after next week, for scans and checkups, I also have to have steriods injections at 28 weeks

[callmeovercautious]

I thought the same but the visits soon build up closer to the end.
I think I saw her once a month until 7m (after 3m)then 2 week intervals and last 2 weeks each week. And I had complications!

[SlightlyMadSpider]

I did see consultant and spcialist MW about 6 time too I should add

[sparklygothkat]

3 premature births SMS

[SlightlyMadSpider]

Have you had any cervical measurements - I think that is a good indicator of potential prematurity (or at least thats what I was told). Is that what you are seeing consultant for?

At my hosp you see a senior MW every time you see consultant anyway so I wouldn't worry. I ddin't but then my community MW was horrid anyway so the less I saw her the better.

[sparklygothkat]

They said that they didn't think it was my cervix thats the problem I will ask again next week

[Miaou]

Off the top of my head sparkly ... once a month until 32 weeks, once a fortnight until 36 weeks, then once a week until birth. I think that's the NICE guidelines anyway. However as we all know NICE do not live in the real world and as far as I can see if you live in the south/south west you get far less m/w contact than that.

In your position I would be calling the midwife to find out what the plan is (there may not be one!) - and insist on knowing a bit more about how they plan to "manage" your pg given your history.

[SlightlyMadSpider]

It may not be. I only had 1 prem (well 2 of you count the fact that it was DTDs). For DD3 I had fortnightly cervical masurements from 18-30wks. Fortnightly vaginal swabs for infection. Fortnightly urine cultures so that a UTI didn't get missed. All bery pleasant (not!)

[sparklygothkat]

so I should have seen someone at 20 weeks (whoops) oh well.. will see baby X next week and have to see the consulant.They are better than the previous hospital I gave birth at. But I wish they would do more investigations. Its all very well giving me the steriods and the IV drugs for Group B strep, but they might be able to work out why if they did more investigations

[sparklygothkat]

I actually know my midwife, I went to school with her son... which could be embarrassing I suppose, but then again my mum's old neighbour (who I grew up knowing) actually delivered dd2 and I was fine with that.

[SlightlyMadSpider]

Sorry I disappeared - I went to bed.

The checks we get are cervical length & cervical competance. If a woman has a short cervix or shortening of the cervix they are offered another test (a swab I think) - called fetal fibronectin - which is apparently the most reliable marker of someone who is going to go into labour within 48-72hrs. I am only telling this in case you have any opportunity to discuss anything with your consultant armed with some background (although you probably have more background than me ).

At my hosp tho you only get steroids when threatening labour (which in my case was an hour before I delivered DTDs anf therefore probably too late). Although I havn't suffered recurrent premature labour like you obviously have - so those patients may get routine steroids.

When I was in hosp threatening prem labour with DD3 at 24wks though the consultant was agonising over giving me steroids. She said I could only have them once during my pregnancy and they were only really helpful if I gave birth within 5-7 days of having them. So if I had threatened labour at 28wks I would have had no steroids and no protection from the previous dose. I don't think it is all clear cut and well understood though so there are probably a lot of different protocols that exist across the country.

Having said all that I think I was lucky that my hospital is a regional centre for neonatal services and linked to that they take part in fairly major investigational studies on things like prematurity. I took part in one when I had DTDs and I know there as one going on when I was 24wks with DD3. I might just be 'lucky' because of having a hospital with a major academic interest in prematurity.

Oh and BTW I didn't have a commuity MW check at 20wks. My MW doesn't believe in seeing you 4wks either side of a scan ...

[sparklygothkat]

Thanks SMS, I will ask again about my cervix and measuring.