Is this normal/ok or should I kick up a fuss?

[SometimesUnsure]

33+2 Pregant. Baby 90th+ percentile (I'm normally 5ft 2", size 6-8). Pelvic Girdle Pain started in the first trimester and was on crutches and using other supports from the second trimester. I've been off work for at least the last 6 weeks. Due to mobility concerns midwives are currently saying to induce by week 39. They want to leave it as close as possible to 39 weeks for brain development but have said that if needed they can induce from 37 weeks. Second baby, first baby was straightforward, vaginal birth.

The hospital team want to refer me back to the community midwife team as everything else is fine. They said my next appointment would be at 36 weeks to sort out birth preferences, book in next appointment/potentially induction date/go over general queries or expectations etc.

Problem is community midwife team don't have an appointment during week 36 so I've been given an appointment the following week when I will be 37+5. Should I be insistent on an appointment sooner, even if its back at the hospital rather than the community team? 37 weeks seems very late especially when there hasn't been any discussion re birth or feeding preferences. I meet with anaesthetics which may need discussion too (concerning maternal family history with epidurals).

AIBU to expect an appointment sooner or should I just trust the NHS on this one?

I absolutely would kick up a fuss imho. The maternity care over the past few years has drastically gone downhill and so you really need to advocate for yourself as much as possible.
I'd look at hypnobirthing (the calm birth school) - there's a lot there about inductions and when/whether they're necessary which I found brilliant and very informative. It's very much backed by science and statistics

Sorry that you’ve had a bit of a rough time. I would personally speak to NHS and move the date forward if possible, even if that meant going to a different hospital to have that appointment. I agree that nearly 38 weeks is too late. My friends baby was 90+ centile and she was also a size 8 and he had shoulder dyscosia. I would absolutely push for a 36 week app x

Adding to my comment I also feel like you should be getting regular scans. Seems a bit off to me x

It's a long time since mine and my friends dc were born, but I don't remember any essential discussion about feeding before birth, especially for number 2, just a 'how are you planning to feed' and 'have you got everything you need to feed'.

I would heavily advocate for an earlier appointment though.

I would also suggest pushing for an earlier appointment. I had terrible pelvic girdle pain too, and I was just left until I went into labour myself (with my second child) they estimated he would be around 8lb, he was 9lb7oz and after he was born i literally couldnt close my legs properly because it felt like my pelvis was going to snap!! I would absolutely advocate for yourself at this point, especially as you yourself are smaller too. Honestly half the time unless you push they just leave you to it, I wish I'd been more vocal I really struggled. (All was ok a few weeks after his birth not to scare you!). Hope you manage to get sorted x

Do you have a specific plan in mind? Do you have access to your app where your birthing plan can be written?

If you do have access to it (was Badger Notes in Scotland) then you can update birthing plan and feeding preferences in there.

In all honesty I completed this with my first AND discussed with community midwives and NONE of it happened (emergency section) So just went with the flow that time and they got baby here safe.

Message your midwife and say you would rather the appointment was earlier and see if they can accommodate you.

edited to say my 2nd pregnancy I required extra scans for baby as measuring off the charts, baby arrived 6lb 15oz (not the 10lb baby they anticipated)

As someone who has had 3 big babies, I hope you get the care that you need and care givers who can give you every confidence that you can deliver this baby.

I had two complicated pregnancies and was under the hospital and community midwife teams. Hospital team were great, community team didn’t know one end of a Doppler from the other, and so - disclaimer - this may colour my advice.

I think I’d get back in touch with the hospital team, explain the situation with appointments and ask their advice. I’d emphasise that it may be simpler if you’re monitored by the hospital as there’s currently no capacity in the community system and, ultimately, they’ll be making the decision about inducing anyway.

Hi, sorry you are in so much pain, must be incredibly challenging with another to care for also.

as regards care, NICE guidance states that you should be seen at 36/40, I only deviate from this if seeing a consultant instead or if the woman is on holiday for example, and in that situation I would see at 35 & 37 instead.

as regards birth & feeding preferences, we don’t do this for subsequent pregnancies unless there is a specific reason, an example would be a prev LSCS for breech presentation and now wishing to VBAC for example. Most women find it unnecessary second or more time around.

in respect of risk of shoulder dystocia, your risk is no different to anyone else from what you have disclosed, obviously I don’t know your full medical hx so it wouldn’t be proper for me to say anything more.

I would suggest asking if it’s possible to have an appt with a different community midwife to your usual one, I realise this defeats continuity of carer, which is the gold standard, but unfortunately midwives are thin on the ground and most of us are doing our best.

They have expressed concerns about the shoulders. I had my previous baby in a different part of the UK and found the way the teams were organised and the amount of information much better. Obviously some of that was first baby vs second baby but I still find it off that there's so little when they aren't sure about some info. They know there may be concerns with painkillers and if they can use an epidural. I didn't need one the last time so they don't have much to go on. I find it odd they don't want to discuss things ahead of time!

I had an extra scan at 32 weeks but that was out of concern for something else. My midwife did ask about it at the previous appointment when she had done a measurement though. She also wanted to check I'd had glucose testing done or she was referring me for that (I had the glucose results that week). No more scans planned.

Thanks for sharing your experience. I totally understand what you mean. I feel very similar. Trying to do all the exercises, keeping active, following physio advice but its not easy going. Oddly I'm not overly worried about the birth itself, I think so many people manage. I'm just concerned about the big gap when the midwife had brought up possibly being induced as early as 37 weeks!

Did you get a physio referral to help with the PGP? You could be fast tracked again.

Plan is loose (as it was with my first) but I think I'd just like a bit more information on what might be best with the pelvic girdle pain as there's different information available online and women I've spoken to have had different experiences. There's concern about using epidurals so I suppose I want that really, really clear. I won't know more about it until I have an appointment specifically about that soon.

I'm cautious re size as well. My first was meant to be a small baby and was average. Again know so many people where baby weight estimates and baby weight at arrival were very different. Guess I'd rather just be prepared mentally!

Yes. I've been in and out of physio. They've been a great help and seen me promptly. The midwife did say I might need a referral to them again actually about if a c section might be needed so I must follow up with that too!

Yes. I've been in and out of physio. They've been a great help and seen me promptly. The midwife did say I might need a referral to them again actually about if a c section might be needed so I must follow up with that too!

If I was you I’d push to speak to a consultant regarding this and also push for a 36 week meeting and scan. This all seems way too late to leave until almost 38 weeks

Good luck OP, advocate for yourself xx

What’s the concern re epidurals? That appointment sounds like it’s more important (because it could have more implications that just whether an epidural for labour is sensible). I’d definitely be wanting to at least know an anaesthetist had thought about various different plans for you if it is a real issue. (Doi:anaesthetist)

A family history of allergies leading to temporary partial paralysis from the shoulders down lasting a few days. Really rare and in both previous generations 😬 Only 2 in my generation have given birth and neither of us needed one. The consultant the last time around actually rang my mother at 10pm to try figure it out. Conclusion was statistically it should be fine but avoid if at all possible. I wasn't filled with confidence from their confusion and uncertainty. Different part of the UK now though so I assume they want to do their own research and make an informed decision!

My maternity care was shocking I have babies with growth restrictions history of preterm birth and cervical incompetence and I didn't see a midwife beyond 22 weeks twice they didn't have me down for the appointments they made so I told them not to bother after that and just seen my consultant

Birthed 7 babies myself and all were very different, inductions, natural, planned sections, straight forward pregnancies, high risk pregnancies, over 10lb babies and also twins. In my experience, I would not accept a later appointment and insist on an appointment 37 weeks as per the request from the hospital team. In all my pregnancies never have I discussed feeding plans etc nor have I discussed birthing plans etc apart from my last c section but that was because it was extremely high risk due to previous section scar tissue and placenta previa amounts other things and that birthing plan was actually just all the consultants and the required teams discussing their plans etc. Also they really are not accurate weight predictions and percentiles I was told all mine were going to be very small and had to go for growth scans, one they said was gunna be about 5lb she was well over 10lb born. My twins were estimated 2lb and 2lb 2 they were born at 37 weeks at 7lb 10 and 7lb 2 😂. So I wouldn’t worry too much plus I have to be 100% honest my over 10lber was by far the most easiest labour and quickest. Also I am 5ft 3 and usually a size 4-6. Had all mine at either 40weeks or 37 weeks although last one was section at 36 weeks. No nicu.

As for the epidural and your own personal circumstances I defo would be bringing the appointment forward and insist it’s at the hospital to discuss it in more detail with them. The community midwife team don’t usually discuss in the detail you will require. They will prob refer you to the hospital team and due to the appointment being late you will be cutting it fine. However, if you are being booked in for induction, you will be able to actually speak to the anaesthetist on duty before induction starts but that will also depend on what’s going on that day including emergencies

Good luck