Missing antenatal appointments?

[CheNina]

First pregnancy. I had appointments at 9 weeks, 12 week scan, 15 weeks, 20 week scan, 25 weeks, 30 weeks, and my next antenatal appointment isn't until 37 weeks.

I didn't have a 28 week appointment. There was a mix up and my midwife didn't actually turn up to my 25 week appointment so had to rearrange. She said there was no point in me going to the next one as it was so soon so just made me a 30 week appt. This resulted in me not having 28 week bloods and had they not realised this in the hospital I wouldn't have had them until my 30 week appointment.

Looks like I haven't been booked in for a 35 week appointment either, so if I go in to labour at 37 weeks I don't have seen my midwife for 7 weeks. I thought midwife was meant to see you at 35 weeks?

AIBU to think this is unacceptable?

But the consultant just does a scan and a urine test. They don't talk about the birth, or any other symptoms I'm having. They're there to talk about my baby's growth. It's all very scary and not a routine appointment. These are meant to be done alongside my normal midwife appointments, not instead of surely?

@Tartsamazeballs I've just been seeing a consultant who only discusses what is on the scan. They do a urine test and bp too. They don't normal midwife stuff however like talking about birth plan and that kind of stuff...

I've had two consultant appointments and on both occasions they've replaced the midwife appointment due at that time. All the health checks midwife would carry out are done by consultant and I've also raised any worries be discussed with them. I've seen a nurse to take blood etc before seeing consultant so chatted to them too.

Here, birth plan us done at around 35 weeks. If you're worried, get in touch with your midwife and ask to see her to talk about birth plan etc.

@CatchingBabies I do have consultant appointments booked in during this time, but my consultant appointments are entirely different to midwife. They don't go through anything to do with birth, or how I'm feeling, my anxiety issues etc. They just look at the scan and send me home.

It sounds like you are being well looked after to me? I think if you are feeling anxious or want to discuss the birth then mention it to the consultant? If there is a problem with your pregnant re growth etc then the consultant is far better placed to answer questions than the midwife?

The consultants don't have time. I asked about my birth plan and they told me that my community midwife would do it with me. When I see the consultant it is part of a clinic, not an appointment so they have very little time. Tried contacting my midwife but she's on holiday.

When I had consultant led care some years ago, I saw the hospital midwife at the same appointment.

@Ceilingrose there's a midwife who does bp and a urine test but she literally comes in at the beginning of the appt then sits in with the consultant on the computer. Doesn't talk to me etc.

Then you are receiving the care you should, the consultant appointment is instead of the midwife one. Otherwise they would be doubling up doing the exact same checks which is completely pointless! It’s too early to discuss a birth plan yet that will be done later and in terms of mental health / other concerns that should be being discussed with the consultant, they should also be talking to you the same as the midwife would. If there is anything you wish to talk about then just tell them next time you see them.

There should be a contact number in your notes for the head midwife.
I would give them a call to discuss your concerns.
Let them know you are not being seen as the schedule advises, that you have tried to discuss it with your MW but she is on holiday, and that you would like to see someone else if at all possible, or at the very least, be booked in for the next MW review you are due.

So out of curiosity when would you do a birth plan catching?

@CheNina what you describe sounds like fairly standard practice, certainly where I work.

Your needs are being met by the midwife/consultant at the hospital from a medical point of view. However your personal/mental/psychological needs, such as general well-being, birth plans, feeding methods etc will be better met by your community midwife.
You don't necessarily need all the 'standard' midwife appointments, but certainly you should have enough that you feel reassured and feel you have been able to discuss your needs properly. This also allows you to build a relationship with the person/people who will provide your PN care when you have the baby.

If your were someone I was meeting in a work capacity, my advise to you would be to contact the community office/community manager who will be able to direct you to another person who can provide your care other than your current midwife. If may be that there is another midwife that covers the same/similar area as to where you live, but she may work from a different GPs/children's centre.
You do not have to raise a formal complaint to change midwives, but certainly making contact to ask to change will highlight to them that their clearly is a problem with service at the moment that needs addressing.

To be honest your consult appointment sounds like why would happen with the midwife. They just check BP and urine not much else. Mine never discussed my birth plan. Call your booking hospital and ask about maybe seeing a midwife for an extra appointment if you’re anxious

Thanks @babycatcher411 - I was just concerned that I'm 36 weeks and haven't discussed birthing options, birth plan, issues with my anxiety, symptoms I've been having etc and when I've raised certain things I've been told it'll be discussed in my next community midwife appointment. I'll raise it at some point today when I get a quiet moment to give them a call!

Every area/trust works differently.

I was under consultant care last time for physical issues.

No way would I have expected my routine MW care to be delivered by them.

I saw her separately, as scheduled.

The consultant team do not have the time or resources to discuss birth plans, MH etc or refer you on to other teams such as physio or MH MW.

They are also specialists in their own area, and the MW in theirs. So unless you choose to opt out of some appts yourself, they should be offered.

Good luck with your call!

At 36/40 I would expect you to be doing/discussing a birth plan around about now.

I'll be doing it at 37+3 when I'm booked in. The consultants have concerns and are talking about induction etc (my midwife knows this) so baby could be early. Hence where my anxiety re not having had many MW appointments is probably stemming from.

I can understand your anxiety, that is cutting it a bit fine if you're likely to be induced earlier. I would definitely mention this when you call in. Even if you just have one appointment soonish with another midwife, whilst your midwife is away, to cover your birth plan, you can then continue with your normal midwife after if that's acceptable.

OP I was consultant led and so was a friend of mine both very recently but not in the same hospitals.

If you are consultant led your consultant decides your individual schedule of appointments and you don't go off the NHS website.

The consultant should have gone through your appointment schedule and told you how often you need to see someone and who you should see when. If they have not ask them.

I suggest if you wish to ask your consultant or one of the doctors they manage you see something then simply ask them. If they cannot answer you depending on the hospital they will get a hospital midwife to.

In my case I saw a consultant, GP or community midwife every 10 days. I also saw hospital midwives but these tended to be when I also had a consultant's appointment. My friend saw someone every week.

My birth plan discussion couldn't happen until I attended antenatal classes and so the midwives - both hospital and community - checked when I was taking classes and what classes. The community midwife then took 2 minutes to go through my plan at 36 weeks. It was basically due to being consultant led you know what you can and can't have.

I would do a birth plan at 36 weeks. I didn’t think you were that far along yet, if you’re care is consultant led and you’re having growth scans and possible early induction? then really it’s should be the consultant discussing birth options with you as they clearly have a plan they would like to follow

Is it your first baby? You probably should have seen her a bit more than you have.

I'm on my third and I've had my booking appointment, 16 weeks, 28 weeks and 34 weeks. Apart from scans that's it. Different midwife each time too

I will also point out that consultants are quite capable of discussing birth plans, mental health problems etc. and are also capable of making physio referrals etc. not sure why people think they can’t. Not having enough time / being too busy is really not an excuse and is the exact same for the midwife. You need to raise this with your consultant, there is little point in a midwife sitting and doing a birth plan with you, talking about waterbirth, signs of labour etc. if your consultant has concerns and wants to induce early as that’s going to impact hugely on what’s available to you in labour so they need to be discussing with you what your options are and what their plan is.

I don’t ever remember discussing birth options etc with a midwife. What exactly is it you want to talk about?

Have you done antenatal classes as these normally cover those sort of questions

What you’re getting sounds fine. It’s on you I believe to ask or make more appointments if you need them. If you are anxious about it all then bring it up and explain that it needs discussed and now. If they are thinking of induction then maybe a birth plan isn’t a great idea. I don’t mean this in a nasty way but they rarely go to plan and even you may change your mind. Have an idea in your head of what you want and make it known. Be aware that things may need to change for yours and the baby’s safety. With induction there isn’t much need for a plan, you have to sit on the bed while being monitored and can’t really move around much (that was my experience anyway) I did move myself once the pushing stage came, was I fuck giving birth on my back. Ended up needing to be on my back towards the end though lol. I’d ring up and make an appointment basically, if you are worried and want to talk through some fears, even book a double appointment so it isn’t so rushed.