No midwife

[loop2u]

I know this is none of my business and totally up to my friend.

Not really aibu but thought I'd get more opinions here.

My good friend just told us all she's pregnant with her 4th child, happy for her.
I asked if she'd booked in with a midwife yet, She said no and that she's not this time due to bad experience with her last one. She's been looking online and women don't always have a midwife just pay for private scans for reassurance.

Is this a thing now, do women not bother with midwife's? I'd be be so worried and paranoid not getting the routine tests and checks.

I can get it. If she’s had a horrible experience I wouldn’t have the balls to do it. But my birth experience with my first purely midwife issue is was made me have a homebirth for my next to avoid that whole situation, then with my third since the homebirth tesm
was already out demanding a instant discharge unless something was actually wrong.

How does this work? Would she just rock up to give birth, or does she plan to give birth without medical care? I mean things will probably be fine..but probably wouldn't be good enough for me.

Has she seen a GP though? There’s no planned midwife visits before 16 weeks plus here if you’ve had a baby before. Gp arranges scan/ bloods etc.

Maybe it is the area I live in but I didn’t get a midwife on my last DC. i saw my doctor then four weeks later I was sent a letter with a scan date. Then after scan I had a couple of checks with the nurse a surgery. Then at 32 weeks a hospital appointment
.. then a consultant and that was it. The only midwife I saw was in the theatre. Then one who visited my home once after birth.

I can completely understand this. The NHS care with my first pregnancy made me never want to go through it again, and it took me 5 years to get past this. My second child, I had two community midwives who were a bit useless, the second of which dismissed concerns I had about my own health as me being paranoid. Both births were in the end consultant led, which ultimately meant a lot of (quite possibly unnecessary and more damaging) intervention for the first, and not being listened to/infantilised for the second. I felt out of control with both, thought the second would be better as I'd know better, but wasn't the case. For me it wasn't an option, bit I wish I could have had private care, it would have made all the difference in the world. Maybe the OPs friend had a similar experience and is scared of feeling the same again. Maybe support her to find better options for her.

Not necessarily.

My daughter had many instances of reduced movement - these were all dealt with by maternity triage and the decision to induce me was made by a consultant and not a midwife.

My son was monitored at hospital due to being small for gestational age. This was all arranged direct with the hospital.

I also have a clotting disorder and was on daily injections through pregnancy and pp. Add in recurrent pregnancy loss too.

I actually found the community midwife appointments to be of very little benefit; since I had to go to triage for scans/traces, and the hospital were the ones who managed my clotting issues too.

I didn't see my midwife with my 4th except for my very late booking. I had private tests before 14 weeks before I told the nhs. I was then consultant lead. As long as she is getting care, you don't need the midwife. I didn't need my 12 week bloods - I paid for a harmony test. I paid for a 12 and 14 week private scans with a consultant in a private hospital. It was my 4th I knew what I was doing and it avoided the stress of the triple test

@Albiboba Quite the opposite. My first ended in a placental abruption after weeks of back and forth to the EPU and Antenatal ward.

My second was much more straightforward but I was able to do all the checks at home (except iron) so the community appointments were entirely unnecessary except for that. If there had been any warning signs I'd have picked them up before any routine appointments and would have gone to antenatal baby care.

To be clear, I'm not saying that most people are like me. I suspect most people don't have the experience, knowledge or equipment to check these things themselves at home. But just trying to highlight that it's not necessarily as bad as some people are suggesting. There will be people who have the tools and skills available to equal the care given at community midwife appointments without the need to go to community midwife appointments.

As it happens I did go to all my appointments cause I didn't want to risk any negative marks on my 'record'. But other than asking about my exact iron level, they didn't tell me anything I didn't already know.

I can relate to this so hard!

With my first, I was induced and they wouldn’t believe me that I was contracting. Turns out I was having 7 moderate to strong contractions lasting between 30 seconds and 2 minutes within a 10 minute period (aka overstimulated)

With my second, I had a chest pain during my c section and they just continually pumped me with drugs as apparently it was “anxiety” because I had a high heart rate - despite the fact it was recorded on my notes that I had a high pulse. My notes also stated that I wanted to be fully informed; they wouldn’t tell me what drug I was getting except that it was “like a gin and tonic” - I still don’t know what they actually gave me! It made me vomit for 12 hours solid though.

I was definitely infantilised despite being 26 when I had my eldest and 32 when I had my youngest.

@Newname221 Exactly what I just said 😅. I was at the hospital so much with my first that I genuinely didn't need the community midwives. If there was ever an issue I went straight to hospital 🤷

With my second it was very straightforward, but I have all the equipment they have at the midwife appointments at home (so I was regularly checking urine, BP, glucose levels, fundal height etc). So really it is only the blood tests that were worth the trip. Oo, and the one time she used a Doppler so I could listen to my youngest's heartbeat 😊

@Albiboba that's why I said as long as it's done by a professional.
OP mentioned private. Not what kind of private.

Yup - once or twice per week at hospital for at least half of each of my pregnancies. Being pregnant was a full time job 😒

Funnily enough my fundal height measured up to 3cm behind with my daughter but she measured perfectly on scans, my fundal height was perfect with my son and he was measuring on the 9th centile for most of our scans. Fundal height is of limited value.

I guess it depends why you are high risk. My community midwife wasn’t equipped to deal with my risks. I needed more.

I'd be very cautious about self-monitoring at home. I've heard of cases where women have used inadequate equipment to monitor blood pressure, been unaware they were hypertensive and then sadly experience a intrauterine death. Similarly, I have heard of women who have had reduced fetal movements and used a Doppler machine bought online to self-monitor at home. This is really unsafe for a number of reasons, not least because it's really easy to confuse the maternal pulse for the fetal heart.

@Newname221 @Curiosity101

Newname221 so sorry you went through this, it's crap isn't it? I still feel so bitter about it.
I was told various 'almost certain' things about both pregnancies, especially towards the end, which actually ended up being mostly bollocks. Scared the shit out of me though (baby in immediate danger- born 5 days later after much intervention, baby is almost 11 pounds and probably needs c-section- baby 7.5 pounds no c-section) It made me very untrusting of medical professionals. I can understand why someone would withdraw from this system, especially at the moment when everything seems to be falling to pieces with the NHS.

Yup - and it’s in no way critical of anyone in the NHS! Not at all! It’s the system which is broken.

For example, I was at a high risk of an ectopic pregnancy (1:10) due to a previous ectopic. They sent me for my early scan (to rule out an ectopic) at a stand-alone scan unit staffed purely with midwives/sonographers (no doctors) - guess what? It was ectopic. I then had to get myself to the “main” hospital (which was equidistant from my house, by the way) for treatment, after being told my pregnancy was ectopic. Why would they send high risk people there?! It makes no sense.

Overall I had amazing care from the NHS but it most definitely wasn’t joined up or logical. The vast majority were excellent but there were a few who completely spoiled my experience, mainly due to formulaic procedures.

Did she say she was going to free birth or wild pregnancy? Both is legal and she seems experienced enough.

She also seems to be very well planned and organising scans and deciding things for herself. She can change her mind at anytime.

Growing a baby doesn't need a health professional. Its optional. She may choose to birth with medical professionals or she may just wing it.

Bravo to her for reducing birth trauma and making informed decisions.

@Caulidop Don't get me wrong. Someone up thread felt my opinion was quite offensive to midwives. Midwives are phenomenal - the ones I interacted with when I genuinely needed care and intervention were super stars. And I fully suspect the community midwives are the same... But...

There was a lot of cries of 'neglectful', 'awful', 'putting baby at risk' etc. And I really don't see it as black and white as that. I do think the average person should opt into antenatal care. But I can fully understand someone opting out and actually if they're purely opting out of community midwife appointments then an experienced and well informed/knowledgeable mother could theoretically provide near enough the same level of care to themselves. Because the standard antenatal appointments really are pretty basic.

And you don't often have continuity of care either which can be a big problem.

She could get an independent midwife

Exactly.

Opting out of community midwife appts = totally fine

Opting for a pregnancy and birth with absolutely no input from any health professional = definitely gives me pause.

Thank you all for your comments and advice