to expect my midwife to explain my appointments?

[BigMama99]

I've had a letter in the post today following my blood tests last week for a Consultant led appointment at an ante-natal clinic. I have no idea if this is routine, why I have this appointment, what the appointment is for etc. It just came in the post. I literally just says 'please attend for an appointment with the consultant team at the ante-natal clinic'

It's for 20 days time exactly at which point I will be 17 weeks.

AIBU to be completely stressing regarding not knowing what this appointment is for? I've never had a baby before and am not going to sleep tonight as I'm so scared my blood tests have come back and this is what this appointment is in regards to. It seems like a lifetime to wait until tomorrow to call them.

Sorry if I seem a little neurotic however after three miscarriages I don't seem to be coping with pregnancy very well...

I don’t know if you’re in Scotland or not as I know stuff is often done slightly differently either side of the border but I had a list of the routine appts on the inside cover of my notes.

I’m sure there is a routine appt where bloods are taken around 14-18 weeks then you get your 20 week scan. You’d think I’d know the score after giving birth to 3 babies!

It's more likely to be a routine appointment if you've had a letter with a long lead time on appointment. It's difficult to say why they'd send this without knowing your detailed medical history. It could well be because of the 3 consecutive miscarriages, it could be something else.

Try not to worry. If it was urgent they'd have you in far more quickly -
If it were a concern with your bloods, you would likely have a phone call and/or an appointment very quickly. They certainly wouldn't leave it for 20 days before dealing with any issue from bloods.

Your midwife may not even be aware that an appoint has been made for you, this is dependent on how their system works - it may be a central booking service that have made your appointment based on information provided from your booking appointment.

She's also likely to have a large amount of women on her caseload and it could have slipped her mind or she may have attempted to contact you to explain and not got through for many reasons - these are just a few reasons why she may not have been in touch with you.
She won't know there's an issue or confusion unless you flag it to her and ask for clarification.

Contacting PALS won't get you any rapid response. Your best bet is to contact the community midwife directly tomorrow and if you can't get through to her, try the community team office or antenatal clinic. The numbers should be provided on your notes (or clinic / community midwives available via hospital switch board).

The only way to get an answer is to ask directly.

When is your quadruple test? Sounds like it might be around the same time as this consultant appointment?

It could just be something as simple as the midwife ticked the wrong box and put consultant led rather than midwife led.

Hi OP please try not to worry, if it was anything serious they would have asked you in urgently or called you. Easier said than done though I know! I had a letter for a consultant visit and called my midwife who looked into it - no one could actually tell me why or who'd arranged it so it got cancelled. They said it may have been automatic as I'd declined some of the screening tests (as I'd already had them done privately - not because I didn't want them at all). I had a consultant appointment later on as well as due to some issues with my first birth they wanted to assess whether I was suitable for the MLU . Hopefully it will be something routine for you as well

I got invited to similar after my 12 week scan and blood tests with dd2. I called the hospital reception to find out why and they were baffled too and it was an error. Give the number a call tomorrow and ask. If it was anything serious the appt would be sooner and most likely you would have had a phonecall.

Thanks Gilligan's

I'm less afraid to ask about things now but frequently surprised at how little communication there is. I guess a lot of it is down to how pushed for time maternity services are (six hour wait in triage today after I'd been seen for medicine to come from hospital pharmacy because they didn't want to give me a prescription to take away. It was grim!)

You guys do an amazing job though!

When my bloods came back “iffy” they called me and asked me to go in the next day so I agree with pps that if it was urgent they would have called. I’m not medical but also suspect it’s to do with your miscarriages (so sorry about them 💐). I think Gilligan has explained the process beautifully (I wish she’d been my midwife!). Pregnancy can be stressful, both of mine ramped up my anxiety, people always told me to try and enjoy it, but I couldn’t relax. I hope all is well and the rest of your pregnancy is as stress free as possible.

Midwife here. Sorry she didn't explain it better to you. At the trust I work at they would send you for a consultant appointment due to the previous miscarriages, you would then get an appt to have a chat with the doctor who would no doubt decide to continue with midwifery led care, unless there was a good reason to make another appointment due to the nature of the previous miscarriages, ie. late miscarriages and therefore possible cervical stitch. It's nothing to worry about, but I agree it would be nice to know ahead of time!

You don't have any notes? No booklet with numbers to ring, or charts on baby's size, advice about movements? That's really surprising, I know all trusts are different but I thought this was standard. Did they give you anything at your 12 week scan that documented how big the baby was, how many weeks you were etc?

I'm also pregnant after three miscarriages, and had to see the consultant because of this (though not until 26 weeks). They did explain this to me, but I have found the communication to be generally pretty crap - I'm still currently consultant-led (for a reason unrelated to the miscarriages) and they've been terrible at explaining who I should see when. I feel like the whole system seems to assume I know what they're talking about when they're saying things that are pretty meaningless to me!

If it’s anything urgent then you’d get a phone call (what happens here anyhow).
Sounds like you are similar length along to me (i’m 14+5). Also my first pregnancy.
So far I’ve had:

• booking in appointment
• NT scan at 12 weeks & blood tests
• got my next appointment with midwife next week (where I presume I will be getting results of my blood tests (HIV/syphilis/hepatitis etc), downs results were sent by post. They said i’d only get a phone call if it came out high risk.
• 20 week scan due in June (got given the date & time by hospital when I was having first scan

If you aren’t sure of anything then discuss with your midwife. Mine is really good and says to phone her with any problems/questions. My notes are all paper based though not electronic, and I got several leaflets about screening tests, an outline of approximate dates of scans and midwife appointments and an actual pregnancy book etc.

I’m being seen completely by the same community midwife, not seen GP/consultant at all. I’m guessing your previous history with miscarriages has let you to being more consultant led?

I don't understand why you are blaming the midwife here. she doesn't send out the letters. they are generic letters from the admin team, i've never had a letter explain what an appointment is for for anything medical. unless it was a scan or something you need to prep for.

In my area everyone sees a consultant at some point, even those with straight forward pregnancies. If it was anything worrying they'd contact you well before 20 days.

nothisispatrick here we don't get given our notes to keep until the 20 week scan.

They will you usually call you and speak to you if there is any bad or worrying news.... they would not just send a letter. So if you only have a letter then presume it is a routine thing.
Different areas have a different set up over appointments and tests sometimes so it can be hard to know what is going on and often midwives can assume that you do know!
They should go through it all with you but often they dont think to if it is what is to them a routine thing.
So basically what im saying is that even though its annoying that she hasnt run through it with you properly I wouldnt get super worried about there being anything wrong because if there was then it certainly WOULD be told to you directly over the phone or in person and not just left to you to work out.

And agree with some pp that I did not get given physical notes with a list of appointments on until I was 20 weeks. That is the case in some areas.

I was called into the hospital at 17 weeks, completely separate to the midwife, because I'd previously had an abnormal smear test and had some biopsies taken so they needed to measure my cervix to double check it wasn't going to be a high risk pregnancy. Could it be that?

Your midwife isn't the one sending these letters. Communications during pregnancy (and in fact after the birth) come from a confusing array of departments within the NHS and outside it -- it's not organised, it's not joined up, and your midwife probably won't have a clue what it is. It may just be that your multiple miscarriages have flagged you up for extra care/checks. You can refuse if you don't feel it's clinically necessary, but it might give you extra reassurance.

The midwife might be able to help with a list of the routine appointments, though -- I had a sheet printed out at the back of my notes that I could refer to (although even this didn't have 'extra' things in it like consultant appointments that resulted from risk factors etc).

I had loads of extra scans and the glucose tolerance test simple because of being a bit fat. To be honest, next time I would refuse. Lots of sonographers tutting over what a huge baby I could theoretically have, and how I ought to have an induction, and ouch -- had a perfectly lovely little 8 pounder with no pain relief in a birth pool at home!

PS you can decline being consultant-led and ask to return to midwife-led care if you prefer it. It's a option, not something you are forced to do.

Don't panic. It will be something utterly routine. IME consultants are a bit better at explaining things than midwives too so you should get more what you're expecting. They're not scary, I promise - they actually tend to be really nice! They are also pretty busy so if it turns out you don't need/want to be consultant led they are usually happy to discuss this and very happy to discharge you provided there are no major issues.

If you're not getting on with your midwife, you can ask for another one. But I do find this is pretty standard under midwifery care in the UK, it's quite haphazard seeming (it's not really, it works fine, but I agree with what PP said about different departments) and they tend to assume that you will be OK and you do have to push a bit more if you want more information. However I've never met a midwife who wasn't happy to answer questions! Just ask her at the end of each appointment what to expect next time :)

The admin letters from my hospital were dreadful for just giving a time and location without explaining what the appointment was for. Turned out they even booked me an appointment to discuss scan results before the appointment for the scan The clinic secretaries were very good at sorting it out when you phoned!

Fwiw, my contact with consultants was triggered by a bit of history from my booking in appointment and I was transferred back triggered midwife care after seeing them.

Also, the one time I had a blood test and it did flag up a problem - low iron - I had a phone call from my GP as soon as she got the results to tell me they were issuing a prescription rather than a letter calling me in for an appointment in the future.

@BigMama99 - I feel exactly the same. First baby, high risk and with a hospital that has fantastic reviews where I am. I went in expecting I'd be talked through my appointments, procedures explained, friendly/reassuring staff would be on hand to answer my questions, etc. I've had such a weird experience so far- like you, I get booked in for something which isn't explained, eg. a glucose test at 24 weeks which the consultant queried saying it should be taking place at 28 weeks as that was the ideal time it should happen. I mentioned my concerns in passing to the head midwife but will mention it again when I attend an appointment later today. The only explanation I can offer is that they're thin on the ground and rushed off their feet but so am I in my profession but I would never make a diagnosis/statement and run!

@Nothisispatrick it is all online and I can't access it.

@TheOriginalEmu I don't think anyone is blaming the midwife, but more pointing out that she should have explained what appointments I would be having. I have no idea and would've thought that was standard practice from a midwife.

It's most likely a standard appointment to confirm you're fit for midwife led prenatal care. You may get another one closer to your due date. All about ticking off red tape.

I feel your pain with the lack of notes! I'm the same and it's my first baby and I don't have a clue what is happening at all.

If your in Scotland and trying to use that ‘Badger-net’ online notes thing.....good luck.
I’d say you’ve been flagged due to previous miscarriages and they’ve put you on the red pathway. You’ll probably get extra scans. Midwife should have explained.
If it was something serious from bloods they would get you in ASAP.