To think this wasn't an insulting thing to say to a doctor at all?

[MissusWrex]

I was discharged from hospital yesterday.

As a bit of background I have had a number of miscarriages, one quite late on which had to do with problems with my placenta.

I wasn't really happy with my discharge and felt I still had a lot of unanswered questions and concerns (ward doctor just told the midwife outside it was ok for me to go, didn't come in to explain everything. The midwife was newish I think and tried but didn't know any of my history and didn't know much for certain.

So I've sent this email to my consultant (nightmare to get on the phone) I haven't slept or ate since my discharge, just feel incredibly anxious and to be honest would rather just get him out where he can be looked after! I'm 34 1/2 weeks.

My friend said it sounded like I was second guessing professionals and they would probably get the hump with my. I thought I was just expressing my concerns but am a bit worried now.

I'll paste it here with details taken out. What do you think?

'Dear Consultant,

My name is Miss Wrex and I'm one of your Ante Natal clinic patients.

I was discharged from ward (number) yesterday afternoon but have been feeling very anxious since, though I'm not sure if this is due to previous history or if I am right to be.

I was admitted on Wednesday night with a very hard and uncomfortable stomach (it stayed rock hard for a quite a few hours, did not get softer at any point during this period), pain behind my cessation scar and back cramps.

Ctg monitors were fine, baby's heartbeat was fine and he was moving as usual.

Yesterday I was discharged after having a scan in the afternoon that showed there was a good blood flow through my umbilical cord but that the baby has now got static growth (AC measurement). I've had a first dose of steroids and will be coming back for a second dose this afternoon. Also I was told I'd have ctg monitors twice a week and anc every two weeks (? I think that's the right way around!).

The thing is I can't shake the feeling something is wrong and have become very anxious. This is mainly because the first doctor I spoke to on triage mentioned that sometime if the is a problem with the placenta that it can cause the hard stomach (this has happened a couple of times since but only stayed hard for between an hour/ 2 hours since) which was identified as a possible cause with my late miscarriage and that I would have a Doppler scan to check the placenta. Which I haven't had. He also said that because I'd had a previous bleed behind my placenta that it could possibly happen again so they would keep me in to check.

Also since late morning yesterday I have noticed a big reduction in baby's movements. I was put on a ctg monitor yesterday evening and his heart beat was ok and he had four movements on the monitor so they said it was ok. He usually has between 20/30 movement on the monitors and each time when he has his active periods through the day or night, I used to find it reassuring he was so active!

This has dropped to between 8 that I've managed to count so far since leaving yesterday afternoon. Is this still enough or should I be concerned that it's not at all like his usually patterns for the last two months? He moved a total of 12 times yesterday that I could feel when it usually would be much more than this. Could a hard stomach have anything to do with this or mean I can't feel him as well as previously?

I apologise for all the questions but I didn't get much chance to speak to a doctor before I left and am unsure if I'm being over anxious because of previous losses or am right to feel something is wrong. I'm just so very worried about anything happening to him while he is in there.

Thank you,

Miss Wrex'

Just go back - don't delay.

Really glad you're going back in and hope everything is ok. Don't get fobbed off until you have a full explanation you understand and are happy with. Yes they're health care professionals but they are human and humans make mistakes.

I think the letter helps you express your feelings, and it's definitely not rude or "second guessing", but I agree with everyone that asserting yourself in person is what you need to do now.

The very best of luck.

I agree with the others saying that you should go back and get checked if you have reduced movement.

Sorry to hear of your previous losses It's completely understandable that you would be more anxious this time. The doctors should be trying to reassure you - not being dismissive of your concerns

They are meant to take mother's instinct in to consideration, not just dismiss your concerns. Definitely give them a call and go back today.

Your friend isn't being helpful. You wrote politely and sensibly, which is admirable in the circumstances.

I know from experience how silly and humiliated midwives can make you feel if they minimise your worries, but now more than ever is the time to be a bit bolshy. I'm not saying to go to the hospital shouting and bawling and making demands, but be confident (fake it if you have to) and politely and repeatedly ask to be taken seriously. Any eye-rolling or huffing and puffing from midwives is small-fry. You're not there to impress them, so just shake it off. Instinct is so important when you're pregnant - get checked out if and when you feel it's needed.

Lots of luck

BTW

I'm fairly assertive, and worked as a HCP for years, but it's amazing how easily some NCP can make you feel small and silly for expressing your concerns in pregnancy/ after childbirth.

Your letter is fine and you were right to send it. I think you need to go back in though as well.
I don't think your over anxious either, your not but doctors like to think that's the case don't tell you are anxious as they will dismiss your concerns.

X post fracking

I'm glad you are going back in. Please don't leave until you feel happier with the situation. It really is OK to ask for a second opinion when you are there and to ask to see a consultant (might not necessarily be your consultant). Don't worry about being rude (which you absolutely weren't in your email, it was great), this is your sons life, if you need to bruise the ego of a couple of doctors to get answers then so be it.

I agrre with others, the email is fine and I would have sent it! I agree you need to be monitored!

Go back as everyone has said but... It is normal for movements to reduce towards the end as there's less space. So it may be indicative of nothing but a nice big baby.
But with your history you take no chances.

From 32 weeks the movements should be roughly the same though according to Kicks Count www.facebook.com/kickscount/posts/10153433016108016:0

I think you should go back in and get the reduced movements checked out. You know your body and your baby. My consultant advised me to drink ice cold water and to lie down for a while and baby should start moving.

I think you are right to send the email. I would not apologise for asking questions or raising concerns. Just because a person is s professional does not mean their decisions can not be questioned/clarified. But I think it's terrible you were sent home without reassurance.

Agree with others, fine to email, fine to want to be seen again with reduced movements. When I was pg with DD I ended up going in on Boxing Day as I had reduced movements. Midwife very carefully checked me out and asked a few questions. She came to the conclusion that it was because I'd eaten so much at Christmas poor baby was a bit squished and sluggish because of all the food.

I was completely , but even then she said she would much rather I came in having eaten too much than stayed at home when I was worried there was something wrong.

And DD was fine. Hope everything works out well for you.

You may be worrying unessesarily but you ARE worried. Stress and anxiety can can have a very real effect on the body so I echo what others have said, go back. Send the email/ letter and go back.

Email is fine. They have done a Doppler scan though (that's what looking at the blood flow in the umbilical cord is!)
Go back in if baby isn't moving.

Reduced movements you need to go in! Send the letter of you want.

I think there are two separate issues going on here.
1, you are unhappy with the way you were discharged
2, you have currently got reduced fetal movements.

regarding the second, I think that an email isn't the way forward. Its an urgent problem that needs investigating now, not next week. Ring the maternity unit and get assessed again.

The first is more difficult to answer, as none of us were there and don't know the other side of the story. What I do know is that the doctor would have discharged you according to the information he/she had available, and it sounds like that information didn't include anything that was worrying. If that information was incorrect, then that is another matter and an email may be the right way to help resolve it.

Thank you again I am on my way back, lovely midwife on the phone was very reassuring that I wasn't being a pain. Unfortunately it's a bit of a drive to the hospital but should be there in ten minutes.

I have been told I'm ridiculously over polite (asd) so no fear of me ranting and raving.

I didn't realise that was a Doppler, oops! I'd have what I thought were dopplers with my dr and it was a red/blue light show when they were looking around. This was like a pulse line on the bottom of the screen after she'd measured a bit of cord.

I'll mention that I was wrong about that to consultant.

I can't see anything wrong with your letter, it's quite apologetic and is basically asking for more information because you didn't get the opportunity to ask before. The consultant would have to be very thin-skinned indeed to take offence (they might, of course, but that wouldn't be your fault). Does your friend have a tendency to defer to authority figures as a general rule?

Sensible health-care professionals would rather be challenged than have something go wrong as a result of some clue that might have been missed or incorrectly interpreted in the light of your history; and let's face it, however comprehensive their notes, only you know all the details as it's your history. As said above, it's probably fine, but if there's any chance it isn't, now is the best time to get it checked out. If all is well then great, no harm done.

Cross post, glad you're getting looked at again and that they're being nice about it, as they jolly well should.

Your email is absolutely perfect. You are 100% right to document your concerns. If anything, it's too nice. . There is NO WAY on earth anyone could take offence to it.

You are completely right to be going back in, and you must continue to be insistent. There can be a lot of inconsistency with anti natal care, so be as forceful as you need to be.

From your post and your comments, you seem a very gentle and kind person so I very much doubt any reasonable person could ever take offence.

Very good luck xxxx

I don't see anything wrong in your email (I am a doctor but not an obstetrician) but unless your doctor has said you can email him/her I don't think it is a good way of getting hold of them and I glad you are on your way back in.

For example I don't necessarily check my emails every day. Or I might be on holiday or away from my desk for hours. You wouldn't know that and an emergency might be unfolding for you while you are waiting for me to respond. Most doctors don't encourage emails from patients except in specific circumstances for this reason.

There is nothing wrong with your email. Your friend was being unhelpful. Good you're going back in. I had placenta problems in my first pregnancy. I must have gone to the hospital four times in the week before he was born with reduced movements. Don't be afraid about bugging the professionals. Good luck.