to think that I should be fed up with my antenatal consultants?

[Nikkittta]

At the 20 week scan, baby was seen to have an echogenic bowel. It was stressful and awful and thankfully we have ruled out infection, cystic fibrosis and chromosomal problems. The bowel is now normal and has been for weeks. Initially the consultant said she would like me to give birth in a hospital. I thought fine, of course, as the baby still had an echogenic bowel. I have had three growth scans since and twice they said that as long as the bowel looks normal, then they see no reason for me to be in a hospital as there's no evidence to say there's anything wrong with my baby. I had another growth scan today and I've seen a different consultant who has now said she thinks I should give birth in hospital. She couldn't give me a good reason for it other than 'just in case'. I phoned he MLU I wanted to go to and they told me a couple of weeks ago that they see no issue as long as the growth is ok, and that would be the case anyway regardless of the echogenic bowel. The consultant today wrote to the MLU confirming that it is ok and advising against a MLU birth. I see no reason why though, and am scared the MLU will just follow the lead of the consultant.

I've been told so many things and could cry because I feel so out of control and that opinion changes based on who I am speaking to.

How can I fix this and get a straight answer from someone? Because right now I don't know what to do.

Anyone?

Bumping one last time :)

Sounds really stressful OP.

I think I would request an appointment with the supervisor of midwives to have this properly discussed and explained.

Apple thank you - do you know how I would go about finding out who that is? Come the day of the birth I don't know whether I should be going to hospital or MLU...

Is the MLU attached to the hospital or is it separate?
I’d say, if it’s in the hospital, you’ll be fine as you’ll be close enough the delivery suite should you need extra assistance. If the MLU is an ambulance ride away, I wouldn’t risk it.
That said, I’m overly cautious and I was moved from a MLU to the delivery suite with my first but it was literally across the corridor so it was overly stressful.
Someone else might be able to give you some better information than me though x

Is your MLU in the same premises as the delivery ward? Where I live, this is the case, so you simply have to go up 2 floors in a lift, should need arise.

If not and you’re looking at having to travel in an ambulance across the city you live in to get from one to the other should “just in case” become reality - I would listen to the consultants recommendations.

Certainly they could have explained things to you better but I really don’t see giving birth as something that should be built up to be “a perfect experience” as such and women need to be more flexible when the reality is their baby’s health could be at risk.

It's not attached to a hospital, but I'm low risk and my baby is healthy. I'm midwife led and no longer seeing a consultant. If it's a case of being cautious just because they want to, not based on any concern, wouldn't there be a case to not send any women to these MLUs?

It's really not a case of building up a perfect experience. It's just a case of liking he MLU, wanting to try a water birth (they don't have pools at the hospital) and the fact that they are the best rated delivery suite in this (very large) area. I would absolutely give birth in hospital if I felt my baby was at risk.

The doctor has assessed your risk and had recommrnd you give birth in hospital to be on "the safe side".

They don't make that recommendation to be awkward, but because they think it's the right thing to do.

The most important thing is that baby arrives safely in a place where the medically trained staff feel they can best meet any needs the baby might have.

The birth is a very small part of the parenting journey.

I'm all for doing your own research and exploring your options but the doctors make these recommendations for a reason.

Saying that, I would never dream of electing to give birth in a MLU. I'd want to have access to all monitoring, interventions and pain relief, so I'm a bit biased.

The likelihood is that your baby is absolutely fine, but ultrasound scans are not 100% foolproof, so they are being cautious.

Things I would ask:
What is the monitoring available for the potential bowel issue on MLU and delivery ward?
How quick is the transfer time?
Will pediatrician be at MLU and delivery ward as soon as you've given birth?

What is it on the MLU that you'd miss out on? Could you have that in the hospital?

Also, are you going to find it more stressful if you have to transfer?

I agree with Semper, ultimately what you want is the birth that is best for your baby.

I would personally go with the consultant in terms of advice.

"Just in case" would be a good enough reason for me.
The most important part is the safe delivery of a healthy baby.
The medical staff are there to provide life saving support if needed, not to rob you of a good birthing experience

Their job is to advise you. In their opinion, a hospital birth is safest.

What you do with that advice is up to you, but they aren't going to lie.

If a consultant told me to give birth in a hospital, I would give birth in a hospital. Why take the risk?

I don't think you're getting any straight answers as until the baby is born they can't be 100pc sure everything will be OK. That's true for any baby bur more so if any potential issues have been spotted. I mean they can't even tell size of babies from scans with any accuracy. And different consultants will have a different perception if the admittedly tiny risk is worth it.

I think it depends on -
What the chances of a problem are. I'd press the consultant on this
If there is a problem how much worse would it be if you have to be blue lighted to hospital - is a delay in treatment going to make baby a bit worse or is it life threatening
How far is the distance between mlu and hospital
How many people routinely get transferred from mlu to hospital.

In my case all was low risk, I went to mlu and got blue lighted to hospital. 2 out of 5 people starting at the mlu near me end up giving birth at the hospital anyway so you've got a 40pc chance to start with. In my experience any hint of any issue and they don't want you there

Also my mlu was only 10 min away...most uncomfortable 10 min of my life, ambulances are not built for comfort and contracting as you're going over bumps is not fun. Laboring in the water was good pain relief though

I too would need more information than 'just in case'. What is the worst case scenario for your situation? How would being in an MLU impact on it? Etc. And why are two consultants saying different things? Is consultant 2 saying consultant 1 is wrong or has something changed?

Ime there is a lot of arse covering in the health sector. I changed consultants once to get the birth I wanted. 2nd consultant didn't see my issue as a problem at all in terms of where/how to deliver.

I had a hospital birth due to induction and it was fine. Lovely room and no need to be moved as needed some extra help. I mostly had my eyes shut but the decor was as nice as the birth suite.

I had thought I wanted a water birth but what I wanted was my baby to be delivered safely and thats what happened but next time I'd have an epidural, gas and air only does so much.

There is no bowel issue now. The bowel issue is gone. The ONLY other risk is that the baby could have restricted growth, but I am having extra growth scans and if baby was too small or came early they wouldn't accept me at MLU anyway.

All consultants have told me it's fine, the MLU said they see this commonly and deliver babies who have had echogenic bowels every month, and it's just this one consultant who wants me to give birth in hospital because 'you never know when there might be something wrong' - it's not even related to the echogenic bowel, she just thinks that babies should be born in hospitals and that scans don't show everything, so there could be something wrong I have no idea about.

Surely if this is her reasoning then nobody should give birth in an MLU or have a home birth?

Maybe I'm not trusting enough of this consultant but the majority of people have told me it is fine to go to MLU, and only one has told me no base on what seems to be nothing...

*based

The consultant may have a perfectly good reason for wanting you to deliver In the hospital. And that is absolutely fair enough.
But they should communicate this to you.
Unfortunately so many consultant obstetricians treat women as if they have no rights and no ability to make up their own mind.

If it was any other medical procedure and they wanted you to have it done I’m a certain place, you would been given a rationale as to why.

Some obstetricians are a complete law unto themselves and dictators. You only had to watch the Victoria Derbyshire programme about elective c sections the other week to see just how so many of them ignore regulations and the wishes of women they care for.

Anyway that’s enough of my rant.
I would advise you to request an appointment with a supervisor of midwives at the hospital and find out why.
If they have a good rationale and can give you a reason why it would be safer for you to deliver in hospital, and why they consider you higher risk than most women who use the mlu, I’d probably follow the advice and go to hospital. If it’s a case of one consultants personal beliefs and preferences with no sound reason or evidence that you are any higher risk than any other women who would use mlu, then I would challenge this and request another consultant opinion.

Good luck and don’t be kept in the dark about decisions around your own birth.
Also you could always contact birthrights for more advice.

@Upandaway0 you explained that so much better than me! Thank you.

I have zero qualms with giving birth in a hospital if the safety of me or my baby depends on it. I just would like to be told 'I want you to give birth in hospital because of a b and c' not 'oh just in case something happens, you never know' ...

I think I’d err on the side of caution in your shoes. How far away is the MLU from the hospital?

@SunnySkiesSleepsintheMorning it's about 9 miles away I think.

I understand erring on the side of caution but I just don't know what it is they want me to be cautious about. I want to know what they might think is wrong with me or my baby. I can't accept them telling me that they are sure everything is absolutely fine but then telling me they aren't happy for me to be out of hospital. I'm so anxious about it. How am I supposed to sleep at night and believe that everything is okay when they're telling me that I can't go to MLU? I feel like there's something they're not telling me. I feel out of the loop and like I have no choice in anything.

I would never ever put my baby at risk but I also don't want to give birth in a failing hospital over a fantastic MLU 'just in case'.

I think this is a communication issue. Either there is good reason for you to be cautious and give birth in hospital but the consultant did not explain it to you, or there is no particular reason and the consultant did not listen to you. I am not sure what the solution is, will you be seeing the consultant again? Can you see someone else?

If the consultant had concerns about a specific issue then rest assured that they would tell you. It is not in anybody’s interest to keep you ‘out of the loop’.

As a midwife I would consider your pregnancy not to be low risk at this point due to the fact you are having growth scans. The consultant is recommending you give birth in hospital due to your increased risk factors during the pregnancy, as this would be the safest place for you and your baby.

Having said this, you absolutely do have a choice in the care you receive and if you decided against medical advice that you wanted to go ahead and deliver on an MLU then that is a decision you make knowing the risks.

Do you have anymore appts with the consultant? If so I would raise your concerns and ask them to clarify the reasons for the advice you have been given.