First antenatal apt 6 weeks away!

[Teaandcake90]

Hi all,

Recently found out I’m pregnant for the first time and used the online self referral to refer myself to antenatal services at my local hospital on Monday.

It’s now Friday and no one has contacted me but yesterday I got a slightly dodgy looking email with the initials of the trust and a link to activate my account.

I signed up to their online portal and saw there was an antenatal appointment booked for me for 21 November. This is more than 6 weeks after I submitted the referral (6 weeks yesterday).

AIBU to expect to be seen within a couple of weeks?

I think this is pretty standard

Actually op I agree with you and in many countries they do offer early appointments as standard for the reasons you state (USA for example).

There are loads of medical matters where people could just look up the info online but we offer appointments.

It is true, OP. All three of my midwives confirmed this.

They want you booked in so they can plan workloads, have appointments sorted, etc. If you book face to face they will often give you a leaflet about nutrition etc in pregnancy.

However, as at least 20% of early pregnancies end in spontaneous miscarriage, there’s no point making appointments for women only 4-8 weeks pregnant. It would be a huge waste of resources and time.

Unfortunately there just isn’t the availability to see everyone before the booking appt, and as another poster has said (and my midwife also mentioned to me) sadly 1 in 4 pregnancies end before they make it to 12 weeks so having first appointment 8-10 weeks is more practical.

First appointment wasn't till 13 weeks, told too late for dating scan so no point. I booked in at 4 weeks.

It would be a colossal waste of NHS resources to see everyone before the 8-10 week booking appointment for the sole purpose of telling them to take folic acid/not smoke etc. there is ample information available on the NHS website!

Your comment about being middle class and educated is quite offensive, the vast majority of working class or less well educated women would also be able to use google to access the information.

Yes, that sounds about right. I think I had first appointments 8-10 weeks and then scan at 12 weeks. My midwife was quite booked up so I don’t think she would have had short notice appointments available.

Folic acid is important and they usually recommend you start a few months before TTC. If you are already pregnant unexpectedly (and of course many women have unplanned pregnancies, as you say) and haven’t taken any and don’t Google pregnancy information once you find out you are then I’m not sure there’s much anybody can do.

OP thank goodness for this thread. I am working class and until now I had no idea I could Google things to find out information. What a revelation!

All info is on the NHS website and it’s the opposite in terms of time. I don’t want to see people until 10 weeks so they don’t see people who will go on to have miscarriages.

It’s quite normal. There’s not really anything to be done in the early days. You’re very much in nature’s hands and tbh even later in pregnancy and child birth nature is definitely in the driving seat

8-10 weeks is normal for the booking in appointment. Unless you have specific concerns or complications. There's really not much to do before then anyway. Lots of pregnancies sadly end in the first few weeks. You don't really need a midwife to tell you to take vitamins and not drink do you?

This. It sounds awful but it’s true. I went to A&E for bleeding at 6 weeks (the day I found out!) and was sent to the EPAU the next day for an early scan. All was fine but they basically sent me away saying while all is ok now, if anything does happen there’s not much they can do this early anyway. I asked if I needed to see my midwife sooner than my booking in and again they said no it would make no difference. My pregnancy was unplanned so I wasn’t taking any folic acid, pre-natal vitamins etc so I basically walked into a pharmacy and said “what do I need to take?”. I avoided caffeine and alcohol as obviously knew not to have those, didn’t smoke anyway, but other foods I had a quick Google and a lot of it was common sense (no rare steaks, raw fish etc).

Congratulations and good luck OP!

I haven’t said the majority of working class or less well educated women can’t google. Most people in this thread obviously haven’t worked in health or social care. There are many, many people who won’t do this for various reasons. People from a more disadvantaged background face more barriers to accessing information and health care. Around 10% of pregnant women in the UK smoke. It’s wild that you think every pregnant woman is diligently scouring the NHS website for dietary advice and queueing up in boots to buy folic acid without any advice or support.

It is true, sadly.

They used to do an earlier appointment, but it turned out to be rather wasteful, as a lot of the pregnancies didn't proceed.

Statistically, your chances of something going wrong drop the closer to 12 weeks you get, and then continue to drop afterwards. The screening tests need to be done at 12 weeks, so they scan you then. They do your first midwife appointment anywhere between 10 - 12 weeks in most places, a couple do 8 weeks. They ask you to self-refer earlier so that they can manage wait lists and reduce the chances of people missing the window for screening, should they want it.

It might be worth looking up the "usual' contact during pregnancy, I don't know anyone who wasn't quite surprised by how hands-off the NHS is. You'll probably see a midwife at 10 weeks, and then at around 16 weeks, and then 24 and 32 weeks. You'll then see them weekly from 39 weeks until you give birth, usually. You have two scans, 12 and 20 weeks, unless you need growth scans later on.

For second pregnancies, you're seen even less.

They do leave the rest to you - the midwife will tell you about folic acid at 10 weeks, but they do expect you to know about vitamins/caffeine/alcohol etc, or to look it up.

10 weeks is pretty standard where I am. Its got later and later every pregnancy I have had.

2017 - booking appointment was 6 weeks (no information bar last period date was needed pre appointment - all done through the doctors)
2020 - booking appointment was 8 weeks (little information - last period date, were you trying or surprise, dad's details, number pregnancy etc) Done via a call to the midwife team
2021/2 - booking appointment was 10 weeks (rather a lot of information on the post referral email was needed - pretty much filling in the notes booklet before you got to the appointment). Done via an email to the central team then they sent a link to fill out everything.

I have always pointed you to look at the NHS information about folic acid and what not to do/eat etc from the referral contact though. Whether that be from the initial call or a email back.
Covid really changed the way midwife care was given where I am and although the initial booking appointment is later, the information give at first contact is huge now. The email I had after my 2022 baby had more information than I knew what to do with.

But your experience in working in social care is, I think, skewing your expectations in the opposite direction. Bluntly, the NHS can't afford to start antenatal care of everyone very early, or right from the moment someone discovers they're pregnant, in order to scoop up a minority of non-coping or vulnerable women from disadvantaged backgrounds who may neasily be able to access healthcare information.

A leaflet about nutrition is a bit late 11 weeks in though. The NHS website says it’s important to see a midwife as early as possible so isn’t true that they actively don’t want to see people early due to miscarriage, even if an individual midwife has told you that. Of course there’s a high risk of miscarriage, but the first 12 weeks are a critical time for a healthy pregnancy. It’s more likely to be a lack of resources and available appointments to fit people in earlier rather than that they don’t think there is any point seeing you.

I don’t see how it’s any different to the average GP appointment, many of which are about minor ailments.

I imagine the number of women who don't know these things, but do know they're pregnant very early and will listen to a midwife is miniscule.

It also wouldn’t actually use up any extra resources to hold the appointment earlier. It’s the same number of appointments but timed differently.

You don’t need to search high and low and read hundreds of academic articles. When you register your pregnancy if you call up to register they should signpost you to the NHS page and links, and typically mention starting folic acid if you aren’t taking it already.

If you register your pregnancy online then there are links on those pages with that same information.

You’re really not giving people enough credit here. You don’t need to be university educated, middle class, a high earner or a genius to look on the NHS website (which you’d be on if you were searching on how to register a pregnancy) and all of the information you need is right there in one easy to find place.

It’s not unreasonable at all for hospitals to expect people to take that very simple step prior to the booking appointment.

4 pregnancies over the course of the last 18 years and I have never seen a midwife before 10 weeks. It's standard practice. Wait until your next pregnancy when they don't want to see you at all between 12 and 26 weeks! That was a shocker!

If you hadn't had much contact with health services previously it may feel a surprise. However maternity services physically cannot give an appointment to every single woman who has a positive pregnancy test. It's difficult enough to get support or advice when miscarrying.

Folic acid is most important in the very first few weeks, before a lot of women even know they are pregnant. An appointment at 8 weeks pregnant wouldn't change this.

They offer a lot more appointments and tests in America because it's all chargeable.

It would be more appointments. How many pregnancies are lost before 8 weeks?? All those are appointment spaces.