to wonder why the UK is so far behind with ante-natal care?

[hairbrushbedhair]

Just that really. The UK doesn't seem to test or worry about things that other countries take more seriously. I know we have a NHS and it's down to cost probably, so it's likely I am BU

I think I would have noticed.

This is a topic close to my heart. My friend is a nurse at a children's hospital and has just lost a child to chicken pox. We don't vaccinate against this and we should. My friend had a still born boy due to CMV. My antenatal care was shocking until I went private and some serious problems were flagged up which probably saved my DSs life. Just because the NHS is 'free' doesn't mean we should only look at it through rose tinted glasses.

I live in a place with 3 midwives to cover a whole city. I registered for midwifery care at 5 weeks pregnant, they contacted me at 37 weeks pregnant to tell me they had a midwife starting in a couple weeks who could give me care. The UK isn't behind in many respects, the ward I stayed on after having my DS was pretty awful though. At least with him I could have had a water birth with a midwife. No option of that over here. It's doctor led and you have to lay on your back with feet in stirrups

Gin not necessarily. They could have done the test when you were in labour. They use a swab and could have take a sample from a glove they examined you with. Honestly it is such a simple test I can't believe anyone would turn it down. I have had them done 4 times there was more than a 4 week time period between my first swab and delivery. Second swab when I was pregnant with DD I didn't even feel. The doctor started to tell me what she was doing and I told I would prefer not to know!

Also you do realize that they think between 10-30% of mothers test positive at delivery and the rate of serious infection in the child is 2 or 3 per 1000 and higher for the mother. I would take the test and move on. When it came to the baby it was a non invasive test IMO with the Qtip on long stick being inserted. Given all the other manual checks they do during labour to check progress I don't consider it invasive at all! I have no idea how anyone would know if they fall into a low risk category. Just because you never had a UTI during your pregnancy doesn't mean you are low risk. You are still very much at risk.

Pirate I too am shocked that they don't vaccinate against chicken pox in the UK. Both of my kids are vaccinated. DS had a reaction to the vaccine and the specialist said it was a darn good thing he got the vaccine as it's these kids with reactions to the vaccine that really suffer when they get chicken pox. He was an older man and said that as a specialist he had seen far too many children die from chicken pox before the vaccine was made routine.

insertwittyusername Where the heck are you living? Just want to know if case they want to transfer DH! I can't imagine having to deliver with feet in stirrups.

With the US comparison you have to take into account the level of socioeconomic inequality and deprivation. Once you take that into account, the maternity care system performs well in terms of outcomes.

not Medicare, that is for retirees

Just to clarify further, Medicare is for people 65 and over. Many people on Medicare are still working. I am one of them. You may still have some employer funded insurance, but most people 65 plus who are still working will have some, or all, of their insurance through Medicare coverage.

Also if you are on Medicare and your kids are at school and under 26 they too are covered under Medicare under the new rules. Couple of recent grads are in this position.

My sil had a delivery in USA with high level insurance and checks a plenty- they still went to regular delivery and not section even though her placenta was blocking the exit... Here that would be high risk and monitored

Yes they will do that. I had preclampsia and they induced me. I was closely monitored and right next to the operating rooms. The hospital I delivered at has 4 operating theaters for CSs and there is always one available, one being made ready and two in use. They promote vaginal births here more than you would think.

I just gave birth in Sweden - maternity care here is amazing.

I think the nhs is under massive strain. I work in clinical research so when I lived in the uk iworked closely with the Nhs. The actual clinical staff (who are generally great) are hampered by a system under great pressure financially and political. There's a distinct lack of joined up care, not enough time and not enough money.

Here we had, as a matter of routine, a named midwife, amazing medical care, and everything was joined up. Own room after delivery, extra bed for dh. Little kitchen opposite where you could get a snack or a cuppa 24/7. you can stay for as long as you need, everything is in the same place. Midwives on call 24/7, never left longer than a minute or so of you needed help. Before we left I'd seen midwives, nurses, physio etc.
I contrast that with the experiences uk family and friends have had - postnatal wards that were overcrowded, hot, dirty. Other people's husbands and families inches from them at vulnerable times. One friend was assaulted by a man on a postnatal ward. There is often one bathroom to share with visitors etc. Grim.

The room we had wasn't posh or flash, but the difference was the staffing levels and organisation. Staff weren't run off their feet and seem to have the time and resources they need, so they can spend half an hour with you as needed to establish feeding etc.

One critical difference is that it's not entirely free. Dh paid about 30 quid a night to be in with me. I was charged a small fee per overnight too. I know the free at the point of contact thing is a real shibboleth but I honestly think that a small token fee per visit is a good thing.

Anyway, I'm a convert to the Swedish system. I'm glad I didn't give birth back in the uk!

I'd move to Sweden just for that if it were possible skiptonlass it sounds like a dream!

The UK does seem a bit slack. Lack of screening for Group B. It seems like women don't really get weighed or given much advice about weight gain either....?

Not that I am blaming the medical staff--they are under a lot of pressure due to rising birthrates and population.

newstatesman I was only ever weighed on booking. I don't know if it's necessary to weigh people though? I would have thought making women paranoid about their weight isn't a good thing

Charting weight gain is extremely important. When I was first identified as being at risk of preeclampsia it was because the doctor looked at my chart showing my weight gain during the pregnancy. There were two periods that were two weeks each where I gained 11lbs between the two periods. It was flagged and I came in for weekly check ups. I did end up with preeclampsia but it was all managed which enabled me to be relaxed about it. The doctor later told me they were also very concerned about gestational diabetes.

Also, during pregnancy you should be watching your weight. It is not good to gain too much. I started this latest pregnancy just into the obese category. I am weighing myself daily as a motivation tool to keep eating my veggies and not eat chocolate or other calorific carbs. I really do not want to end up with GD and being in the obese band at the start of my pregnancy does increase the risk. It has also made me realize that I need to get this excess weight off. If I can limit my weight gain to less than 20lbs during this pregnancy I will be super happy.

want but they can check for preeclampsia with urine and blood pressure.

It just seems like an additional thing to worry about. I just ate normally and gained about 18lbs. Unless you're massively under eating or overeating does it really matter?

I just think unless it's extreme either way it's not as big an issue as testing for group B strep for example.

Urine tests don't always pick up preeclampsia. The urine tests were not picking up any issues and I had weekly blood tests that also showed no issues apart from anemia.

Oh and how did you know you only gained 18lbs if you were only weighed once? I am weighed on a medically approved scale at every appointment. What if your scale as off and you really gained 25lbs or 30lbs?

They need to start routine gbs testing.
You do get testing for hiv rubella and rhesus factors.
I would categorise nhs care as disorganised.
They change even known due dates which is ridiculous and cant help with things like risk of stillbirth.
I have pcos - no offer of the glucose tolerance test
Hypothyrodism- no consultant care at my hospital. In fact i went hyer and no dr even saw the results.
No weighing i think except for downs screen.
Hopefully they will move to the blood test for this as it should be soo much more accurate, quicker etc. and save money and lives on needless amnios.
I did have an early scan both times (ivf). But completely see this can cause lots of anxiety if you are unsure of dates.
However it is puzzling with tge technology that we go by where the mw feels the baby is ie breech etc. when they cant be 100%.
The tape measure can be out dd1 was below average fundal height but 7lb odd, dd2 was maybe average but 8 and a half pounds. So could easily have been in range and 10lb or more.
Agree with pp about the apts not being convenient for work. They only book consecutively so you couldnt get the last one of the day.
Once i had apt at eye hosp same day and even then they wouldnt book later so i had to risk not getting an apt.
With a second dc the apts were far apart at the end i think 40 and 42w. So not giving apt for a sweep till then. I just delayed 40w one so i could get a sweep.
I was worried that an induction would keep getting delayed due to low priority.
Littlle things over the 9m start to add up.

want so if blood and urine both missed it how did it get picked up at all? You can't diagnose it from weight gain.

And because I never had to buy maternity clothes and was in my own dresses 6 days after birth. So I'm pretty sure I didn't gain 30lbs.

I'd have felt it was obsessive and intrusive to be weighed at every appointment. I'm capable of weighing myself.

I'm not capable of GBS testing, ultrasound scanning and so on

I had wonderful antenatal care with my second baby. I live in South London and had access to the Oakwood midwives who were fantastic. All my antenatal appointments were at my house and I had a team of three midwives who did antenatal care, delivered the baby and my post natal care. And at Kings hospital I had 3 scans and the harmony test. I was really impressed (but enough to have a third :))

This is the first link I hit when googling:

www.mayoclinic.org/diseases-conditions/preeclampsia/basics/tests-diagnosis/con-20031644

They looked at the whole picture because observing me they saw extremely swollen hands and feet (I went up 3 shoe sizes), I had blurred vision and I had splitting headaches that would not budge with Tylenol. What the doctor identified was that I have low blood pressure so when they were reading me at 135/90 that was high for me. My regular blood pressure is 90/60 at most. It has been known to be lower.

Weight gain is one of the indicators too and in my case it was the indicator that first caught the attention of the doctor.

want so you had lots of symptoms not just weight gain. I have low blood pressure too and had a pre e scare when it went to 120/90.

I understand it's an indicator but as there are others I think it would cause more worry than help

Exactly, it is an indicator of a couple of potential issues and costs nothing to monitor if you are coming in anyway. Its just as bad as the Strep B test. It takes 2 seconds to do the test and costs next to nothing. Weighing costs nothing and quite frankly I think it is lazy to have a scale there and not use it when there is a clear benefit to the measurement helping identify any potential issues in the minority of women that are affected.

No it isn't just as bad, the implications aren't often as severe. It should be offered perhaps but I think you're underestimating how unnerving some people would find it.

Like I said I'd have found it intimidating, like it was being implied that I couldn't weigh myself or didn't know how to eat properly