To not know if I'm wasting NHS time and resources? (Pregnancy, anxiety)

[NameChangeyMcChangerson]

So, this might be a long one...

I'm 37 and a half weeks pregnant. It's been a generally fine but a bit up and down pregnancy - they were briefly mildly worried about the baby's heart, but the irregular beat resolved itself; they were then worried about slow growth, but again this has now resolved itself (as confirmed by a scan on Monday just gone). So now it could just be a 'normal' pregnancy - except that I've had a few episodes of reduced fetal movement, and am still going through stages of being very worried about them. So they still have me on CTG scans twice a week, and the consultant recommended that I'm induced at 40 weeks if I still think the movements are a concern at that point, so basically left it up to me.

The thing is, I can't work out if this is now all in my head. The couple of times I initially went into hospital with reduced movements I hadn't felt baby at all all day, but since then my fear is always that they've slowed down and reduced, but not disappeared - which is much more subjective. I've tried counting them but even that doesn't help that much because I can't always tell if I'm feeling very faint movements or not. Every time they hook me up to the CTG the baby is absolutely fine and moves normally - but I can only ever feel about half the movements the machine can measure. The baby has never had a very regular pattern, which I know is almost certainly because I have an anterior placenta, not because something is wrong.

Highly relevant here: I have a history of anxiety and depression. I had a really bad episode a few years ago that was very centred on work; I also had another low patch last year after having three (very early) miscarriages before conceiving this baby. It has always centred very highly on not being able to trust myself - when I had the work-related episode (which lasted about eight months and required medication in the end) I used to check the same piece of information over and over again but never trust I'd got it right; I'd literally get up in the night to check again. So this 'am I feeling reduced movements or not?' feels very much in this pattern; I feel like I lose a sense of what I do and don't know.

At the same time as this constant anxiety over movements, I'm also becoming really anxious over the idea that what I'm doing now is time-wasting, attention-seeking and selfish - that I'm taking resources from women who actually need them. I lie awake at night berating myself for this, and I feel so embarrassed when I go in for my CTGs - every single midwife has always been lovely to me, but I know they must be internally rolling their eyes that here I am, anxious about nothing again. Again, I recognise this as part of old anxiety patterns: it has always started as a complete loss of faith in my own abilities, but then it slips into a belief that I'm not just a stupid person but a bad one.

So, obviously, it's clear that this is at least part a mental health thing. But what do I do? I've had counselling in the past and found it helpful, but realistically I'm not going to get an appointment, let alone make meaningful progress, in 2.5 weeks. The previous coping strategy I was taught was 'And if I am right that I've got it all wrong, what are the consequences of that?' - which worked well for work, but less so for this, where both the outcomes are actually severe; I'm terrified that I'm basically (inadvertently) faking my way to unnecessary medical intervention and potentially a much worse birth, and stealing time and resources on the way, but obviously the other, all-pervading fear is that I'll say that the movements are fine, they stop monitoring and the baby dies.

Sorry for the very long post; it helps a bit to write it down, but I still just don't know what to do from here. I deliberately posted in AIBU knowing that I might get some harsh/brusque responses, and that that might be what I need - maybe I just need someone to talk some sense into me.

By the way, have namechanged as details so specific and so outing - there might be people who recognise me from other threads, which is fine but please don't out me!

I spent a fair bit of time in the ante-natal day unit when pregnant with my eldest, and some extra visits with my youngest as well. Not once did I hear a midwife say anything other than that a worried mother should come in and checked out.

All pregnant Mums feel anxious, especially the first time and especially if you have had problems in pregnancy. It pointless me saying don't worry, as you will worry. But try not to worry that you are wasting other people's time. You aren't. At 37 and a half weeks you are nearly there anyway. Getting the help you need isn't a waste of resources, same as my two complicated births weren't a waste of resources. They were what was needed at the time.

Out of interest, do you know where your plancenta is? If it is at the front (anterior) then that can stop you feeling some of the movements.

I think there are 2 separate issued her;

• You felt reduced movements and did the right thing getting checked out.
• you worry about your reaction, and lie awake worrying about wasting NHS resources. (which you haven't actually done)

You can phone Mind and talk to someone, but I really think your midwife and GP need to know you lie awake with worry.

www.mind.org.uk/information-support/guides-to-support-and-services/crisis-services/telephone-support/

Firstly , you are not waiting any time and resources.
Sorry you are having such a rough time
I hate that 'stuck' anxiety feeling when I lose all objectivity and can't work out if my thoughts are reasonable or not.

Can you ask your Midwife for a referral to the mental health midwife?

Also, as a pregnant woman you get priority for councelling/CBT services etc in my area.
Is there a local service you self refer to over the phone?

Mine usually say call back to have 1st phone appt is several weeks, but for pregnant women it's usually within a day or two, and then you go to the top of the list for whatever talking therapy is identified as appropriate in your phone appt.

It's definitely worth doing, just getting the ball rolling can really help take the pressure off.

OP, I’m rubbish at spotting patterns and honestly couldn’t have told you what the regular pattern of kicking was when I was pregnant. I was always worried (antenatal anxiety didn’t help) and couldn’t really tell you from one day to the next if what I was feeling was normal.

I’m in all other ways logical and reasonably intelligent. I just couldn’t follow this.

So get checked out if you’re worried. Don’t if your not. Don’t over stress and worry about not knowing though.

Firstly to say you aren't wasting time. If you feel as if there is a reduction in movements the advice is to be monitored. It's very hard to tell and is naturally subjective. That's why they'd rather have you in.

I think you should speak to your gp/Midwife. It's an intensely stressful period and as your techniques for coping aren't working right now it's ok to need a little more help.

I wonder if you could take the pressure of having to make a decision about induction by telling yourself you'll only think about it at a set time each day, say 10 am for 20 mins for example. If that time passes and you were busy and didn't need to then you wait till the next day. Alternatively, you could decide that you won't make the decision till you know more, say at 39 weeks? I'm not underestimating how hard this is as a technique but I've had some success with it in the past. Don't beat yourself up if it won't work for you though.

Please be kind to yourself, you don't need a good talking to or to invite harshness. You are understandably stressed, and that's ok. I hope you start to feel better

You are absolutely not wasting time if you have. Oncernd regarding movement everything tells you to seek advice of movement changes. You are doi g the right thing. They wouldn't offer you an induction if they didn't think it was a reasonable option. I was induced for the same reason. They rang me the morning of the Indiction to advise what time, I guess to fit in with other patients. Sorry for the waffle but what I am trying to say is that the change of movement is important! X

I can promise you you’re not wasting anyone’s time. No midwife would be rolling her eyes internally. Reduced movements still need checking out, not just absent movements. But if you think you’re struggling from a mental health point of view then please ask for help.

I had an anterior placenta too and had a couple of spells of reduced movements which I had checked out- always best to go in and don’t worry about the rest. You’ve only got a few weeks left so no need to talk yourself out of worrying about this- it’s normal to.
Definitely worth having a chat to GP and midwife about your anxiety and getting help/support for the early days with a new baby.

You are definitely not wasting resources! I've had 4. And had these panics and reduced movement worries with 1 and 4. With 4 I got checked about 4/5 times towards the end. Always treated with kindness and they always said that it was better to come in and realise all was good than not come in and miss something.
Turns out dc4 had a short cord and was long so basically got pretty stuck in one position and so that's why the movements were less felt.

Anxiety is pretty common but it would be good to discuss getting some support as you don't want it to overtake you. Having a newborn can also be overwhelming so if you've got some support in place now then that can help too.

Be kind to yourself.

You are definatly not wasting resourses .
I had 2 miscarriages befor finally conceving with DD and i was a nervous wreck constantly concerned.
I went in with reduced movement at 30 weeks. Stayed overnight and everything seemed ok . She did have times her heart rate dipped but they think she was laying on the chord.
Then at 32 weeks my waters went and she was delevered by C section .
My midwife always told me if your worried call them and especially for things like reduced movement to get checked out .
You would never forgive yourself if you had concerns and did nothing and the worst happened .
As a mother and woman you know your body and if somethibg doesnt feel right ypu have every right to be checked out.
At the end of the day yours and babies health come 1st.
Maybe speak to your midwife and see if there are any groups you can attend or counciling . Not necessarily befor baby arrive but for after as once baby is hear there are a whole new set of worries.

It sounds like the reduced movements aren’t really the issue, and it’s actually that you are suffering from anxiety and maybe depression? Strongly recommend phoning your community midwife and letting her know, she should refer you to the perinatal mental health service and normally pregnant women will get some support/counselling/whatever is appropriate via this. Definitely not wasting resources - the NHS is there to look after everyone, and if that’s monitoring for reduced movement, monitoring for maternal reassurance, counselling, whatever, that is totally appropriate. Why would you and your baby be any less worthy of these services than anyone else??
Really feel for you, hope you can get some support and have a more peaceful end of pregnancy/start of motherhood time.

Thank you for all the kind messages. I know you're right that I should reach out for some mental health help - I did have a counsellor that I saw (privately) before and it might be best if I go back to her since she already knows me.

I maybe didn't highlight this enough in the OP, but the thing I'm particularly worried about is the prospect of induction, which the consultant said she'd recommend (at 40 weeks) 'unless you feel that the movement issue is completely resolved by then'. This has really got me panicking as it's a decision that I just don't feel capable of making.

I think it's really hard to feel like that decision is on you, but it doesn't have to be. Contact your midwife and explain what the consultant said, she can help you work through the decision. It's horrid feeling responsibility for something you don't do qualified to deal with.

If you feel comfortable talking here, what is it about induction that has you worried, is it making the decision, or the actual induction?

I do think it would be good for your midwife to know you're suffering from anxiety and need some extra help (I'm not ruling out your previous counsellor at all either, and if that feels comfortable then get in touch). They can also help a bit more then around the birth and after.

You (and your baby) matter and it's good to reach out for help.

OP please get in touch with your midwife on Monday. Most areas have maternity mental health teams and you need to be put in contact them for extra support. If you cannot get in touch with her then you need to contact your maternity department to ask for help.

I'm actually surprised this part of your medical history wasn't noted at your booking appointment so you could be given a number/info if you needed to ask for extra help.

Also contact your former counsellor.

You aren't wasting NHS resources asking for help now as is costs less to do it now, the then if you got ill.

You are not time wasting at all. I went in numerous times for reduced movements and it all turned out to be fine but they kept telling me to come back again if it happened and that I’d done the right thing.
One midwife said - when we’re ill ourselves we first slow down a bit and then when we’re really ill we just lie on the sofa and don’t move at all. That’s a same for a baby so we need to catch it when it’s just slowing down so you’ve done the right thing.

There’s an app called kicks count that you can download I’m not sure if that will help put your mind at rest.

Everything is most probably fine but I was also told we’d rather you come in and scan you & everything’s fine than you not come in and somethings wrong! It’s their job and I’m sure they get a sense of relief too when they find out everything’s fine xxx

Hello. This sounds so tough. I can identify with you a bit. I too had 3 losses before a successful pregnancy but throughout was so anxious. Also had an anterior placenta. I feel much better now my little girl is here and the placenta was enormous, no wonder I couldn't feel much.
Do speak to your midwife. They should be able to refer you for perinatal mental health input. You're absolutely not wasting anyone's time.
Wishing you all the best. The level of responsibility for growing and protecting little people is so hard. On top of this you have the decision about induction. I hope you feel better once he/she has arrived and you've not too long to go x

Thanks again all.

My mental health was noted at booking, and I was offered an appointment with the mental health midwife. At that point I was actually feeling pretty good (up until the last few weeks I would say that my mental health had been if anything improved in pregnancy) so I declined, but I do have the number to contact her.

I don't actually have 'a midwife' at the moment - because I'm going in to the hospital twice a week for CTGs and have been having consultant appointments the last time I saw a community midwife (which was maybe five weeks ago?) she said it was a waste of my time to come to those appointments too.

I think it's the decision that scares me about induction - when they thought it would be best because of the baby's size I was scared that there was something wrong with him (and obviously I'm incredibly relieved that he's now growing well) but just accepted it as the objectively best thing to do. Now it feels so subjective. My fears are, in this order:

1. Something will happen to the baby - the labour will go badly and the baby will get distressed and be deprived of oxygen or similar. I know this is less likely.
2. The labour will be much more difficult because I was induced and will end in a life long birth injury that I will always suspect I brought on myself. I am less terrified of that - doing something that hurts the baby and having to live with that is my worst fear by a long way - but still scared, and that seems much more likely.

Oh lovely... Call that number on Monday & speak to the MH Midwifery team. They will want you to enjoy your last weeks of pregnancy with the information you need to hand to try & allay your fears.

Life long injuries with births are thankfully uncommon. I promise you they won’t induce on a whim - they’d much rather it happens naturally, so if they’re suggesting it then it’s because they feel it’s beneficial to you and/or baby.

Don’t for one minute think you’re wasting their time. They would want to err on the side of caution too.

Please talk to someone tomorrow. Your worries are common & they are there to help.

Good luck OP x

I had a similar situation during .y last pregnancy. Acute anxiety and worrying a lot about movement. I went in a couple of times to be checked and was so concerned that I was being a pain and wasting time. I was under the care of a specialist midwife who dealt with mothers with anxiety and she always reassured me to get checked if I was worried. At 31 weeks I spent the day worrying about reduced movements. I talked myself out of getting checked about 20 times through the day because I was so concerned about wasting time. By 6pm I realised I wouldn't relax without being checked and went in. They delivered him an hour later so I was absolutely right to get checked because he was in distress (he's a 13 month terror now). Please don't worry about wasting time, if you are concerned, speak to a midwife and get checked

If you are full term and things are 'favourable' there's every chance your labour will be straightforward and go well. I know many people who had inductions which were very straightforward, just a pessary or broken waters followed by a natural delivery. There is always a risk of more intervention but every labour carries this possibility and no 2 labours are the same. You could opt for continued monitoring until natural labour occurs, or you could ask at 40 weeks for a stretch and sweep to see how 'ready' things appear to be.
I'm having an induction at 38 weeks, and I feel your anxiety. I could have a section too and I find it such a daunting decision to have the responsibility for. I have to decide by Thursday.
I've had 1 induction which was horrible compared to natural delivery, but I was 34 weeks not 37 as expected and they said that the problems were due to not being ready. I had been leaking waters so it was not my decision.
I've known 3 people this year have full term inductions and they were all minimal.

I too am under the mental health midwife and would recommend you give them a call. Mine is very supportive.

Op I could have written the beginning of the post myself.

I was in/out hospital every week since week 29 As I couldn’t feel the baby cuz of his position. Sometimes I was feeling guilty, specially after being told everything was ok, but my anxiety was so bad that I’d have suffered loads if I hadn’t checked.

I was induced week 39 and my baby was born with no birth defects. In fact everything you’re worried about could happen via a natural birth as well. The problem with inductions is that they are longer normally and more painful (it took me 25h to give birth out of which 9 was with epidural) and as baby couldn’t get out I ended up in theatre with forceps (the other risk ) the closer you’re to 40 the more you reduce the interventions changes but that doesn’t mean it won’t happen like in my scenario.

The more intervention there is in labour in my opinion the less likely there will be birth consequences as you’ll be constantly monitored. However , induction is not for you if you want a home / water delivery or epidural free labour

Chances not changes

I know everyone's already reassured about not wasting anyone's time, but wanted to add -

I went in 3 times for movement changes with my first pregnancy, and worried I was wasting their time because it was always fine. The last time, I was so apologetic that the midwives were far more concerned about my worrying, and concerned that I'd be reluctant to call them again if worried - they had a real (friendly, well-meant) go at me and a follow-up phonecall to tell me that I MUST keep on going in if I felt any problems. It is NEVER a waste of time.