How do I change consultant/ get a second opinion at 37 weeks?

[tattycoram]

I finally saw a consultant last week - previous delivery was of a big baby with forceps and damage etc etc.

This baby is looking big, but not quite as big (prob about 10ibs on delivery - I know that ultrasounds aren't reliable, but still, likely to be bigger than average)

He is keen on the idea of induction, which I don't want - given that it is not recommended by NICE and is associated with forceps deliveries - the last thing I want is another forceps delivery of a big baby.

So, I had thought I would choose between an ELCS (which is still on offer) or natural labour but the more I think about it I don't want to have that conversation with him becauser I just don't trust his judgement. My final appointment in which I draw up a birth plan is next week.

Is it possible to see another consultant? How do i go about it? My midwife is adamant that he is the one assigned to my area, but I am not happy about it.

Any ideas?

In fact, any ideas/reflections on any of the above would be appreciated as I'm getting really stressed about it now.

I'm worried that if I go into labour natrually feeling this stressed it will all go wrong anyway, so perhaps I should have ELCS and be done, but my instinct is that it isn't necessary

I would ask your MW again - if you are not happy with the care you recieve you should be able to ask for a second opinion surely?

You could ring his secretary and say you want another opinion and will he please refer you on to his colleagues. They can't really refuse that.

Is there a consultant midwife at your hospital?
You culd make an appointment to see them.
Selina

I think there might be - could she sign off my birthplan tho if I did want an ELCS?

The thing that confuses me most is that my midwife is insistent that i do want a section, as was teh first registrar I saw, both saying that another vb could cause more damage, but the consultant didnt seem that bothered about htat. But no one has looked at my sodding notes from last time

You can ask to see the consultant MW in addition to a consultant - it doesn't have to be either/or.

Given your MW's comments to date and your gestation I'd be inclined to go straight to the people you want to talk to, and ideally see the consultant MW first.

Fingers crossed things go more smoothly for you this time round :)

I think your plan of action should be to arrange an appointment with the consultant midwife/head of midwifery and your consultant and make it clear you wish to have a copy of your previous labour and delivery notes there too. Go through the notes and see what might have been done differently and if there is anything which may have happened last time which can be avoided this time. You can then be sure in your own mind that a section is/isn't right for you. For example, if you were labouring for a long time, with an epidural, on your back and were simply too exhausted to push baby out, that is potentially avoidable this time. However, if you laboured well, got to fully with baby in a good position, pushed like a woman possessed but still couldn't push baby out I may be inclined to think you had an unusual pelvis shape.
Good luck.

I changed consultant at 37 weeks to get a second opinion. My midwife made the calls for me and got me an appointment with the 'new' one.

Thank you - I'm seeing the midwife tomorrow so I will talk to her about hte consultant midwife then, that sounds like a good idea

I hope you are able to put your mind at rest after your appointment yesterday. I am nearly 37 weeks and suffering from terrible SPD which my physiotherapist has advised a natural birth will aggravate, I asked yesterday to discuss a C-section with a consultant and was told that I could not have an appointment as all clinics were suspended due to being 'chock-a-block'. I was then told that I would have to wait until I have gone into labour and then ask to discuss my birth options on the delivery ward with a consultant. I am extremely stressed and anxious about this and feel like I am being kept in limbo unable to plan the birth I want. Does anyone have any advise about what I should do next? I am so worried about this I am not sleeping! I just know that my wishes will be ignored on the day as I will not be in much of a position to talk things through in a constructive manner...

Oh you poor thing, that is not right. I think you really need to make a fuss. Could you ring the head of your midwifery team? Or the consultant's secretary, or possibly PALS (patient liaison)? AFAIK they have to keep some appointments free for emergencies.

I hope someone who knows the system will be along and able to help. Perhaps start a new thread which might get more attention?

I know just how you feel, I'm not sleeping either. My midwife yesterday wouldnt refer me to the consultant midwife because doctors had made the original decision about episiotomy or not - so essentially she was saying it wasn't their responsibility. I am so angry about it, typically I accepted it while I was in there but when I got out realised that actually my birth had been managed by midwives until the forceps come out and I want to talk this birth through with a midwife (unless I do go for ELCS obviously). Anyway, they/'re supposed to work in partnership

My DH is talking to the head of our local midwifery team to get a second consultant opinion. I normally fight all my battles myself but tbh I just can't face it anymore and given that I have to do all the rest of giving birth I think fair enough that he battles for me. Would your DP/DH put in a few calls for you funnymummy if you don't feel up to it?

funnymummy thats really poor, if it was me I would put on my determined face and ask again for an appointment and if the answer is still no say you want a consultant to ring you or you will go and sit there until someone agrees to see you, I know it's hard to fight your battles when you're pregnant (i am 38+5) but it's an awful lot harder to fight them when you are in labour.

Failing the above ring the PALS people and complain (I understand they are usually pretty good) and see what they suggest?

Tattycoram & Hevster - Thank you both so much for your replies, it is just good to know that I am not alone in thinking that this is wrong. I will try your suggestions and see if it gets me anywhere.

I'm sorry to hear about your situation Tattycoram, it seems so unfair having all this extra stress piled on at a time when you should feel reassured and ready for the challenges ahead!! I really hope you manage to get the outcome you are hoping for!

What about asking your GP? My GP told me I had the right to have a second opinion. Otherwise you could go private - you would probably get an appointment quickly but obviously have to pay. My private consultant then wrote a letter to the NHS consultant giving his advice on what he perceived the risks were and best plan of action and made kind of clear in a nice way that if this was ignored without good reason and things would go badly wrong as a result he might be sued, was all very stressful but it did work in the end.

Funnymummy - when I asked my original consultant for a second opinion Iwas told I wouldn't be able to get one as it was too busy (christmas week) - my midwife insisted that she should be allowed to phone another consultant anyway and lo and behold I got an appointment the following week.

funnymummy, do persevere. I've now got the head of our local midwifery team trying to get me an appointment with a midwife consultant. I do think it is possible, even though I know the last thing you feel like doing is putting energy into fighting.

Hope you're feeling okay x