When to change hospitals

[Sparklies]

I require an ELCS (baby can't come out any other way!) with this pregnancy, my third baby.

I had preterm labour with my other two - one came 36w6d, and the other I had PTL at 34 weeks which stopped but ultimately led to an emergency c-section at 35w5d. I doubt I'll get an ELCS before 38 weeks but as you can guess I'm pretty concerned I won't get near that date!

I'm currently booked in at my horrid local hospital, who I hold at least partially responsible for the problems with my second and subsequent and future pregnancies due to their mistakes. Many people I know who have delivered there have similar horror stories to tell. I'm booked in there because the community midwives are lovely and the consultants are.. satisfactory and it's only 10 minutes away. This is a huge issue considering I have really bad SPD (I'm only 21 weeks and had to use the Tesco mobility scooter yesterday to do my shopping already..) and limited childcare so appointments have to be nearby for most of the pregnancy.

I don't want to deliver at this hospital again if I can help it, so I am intending to swap to another for the birth. The one I will probably go for is around 20-25 minutes away compared to 10 minutes for the local one.

Questions:

1. Do I have to give a reason? I feel bad for offending my consultants who have been fine but their hospital maternity unit sucks the big one in general, is ridiculously overcrowded thanks to other local maternity unit closures, and as for the postnatal care.. let's not even go there

1. How long does it take to swap hospitals? Best and worst case scenarios! What happens if I go into labour whilst midway changing?

1. If I go into labour, I need a c-section pretty quick (permanent abdominal cervical stitch could mean uterine rupture) - if I call an ambulance where will they take me? The local "potential deathtrap" hospital (7 mins blue lights), or the place I have switched to? (15-20 mins blue lights)

1. Totally subjective, but when do you reckon I should start this process? I presume I ask my GP..

Thanks everyone!!

I changed midwife and GP part way through my pregnancy because I moved house, but kept the same hospital, as it was approx the same distance as the other possible hospital I could have gone to.

When I did this, I phoned GP and let them know as well as my old midwife (who actually recommended my new MW).

Slightly different to your situation, but I found it very easy to switch.

My new MW is attached to a different hospital to where I will go for delivery, but if and when I have to call an ambulance, I've been told that I can ask for it to take me to the right hospital, as it's where my care is managed.

Hope that helps a little!

If I were you, I'd call my GP and chat through the process and then talk to your consultants.

Thanks Crystalline!

That's a big relief you can ask the ambulance to take you to the right hospital.. especially as I'm pretty sure I may well end up with an emergency situation. I'm at home with my two preschool children on my own most days so I just know what the law of sod would dictate.. and waiting for a taxi that might not bother showing up for 30 minutes in those circumstances (if DH was at home he would drive me obviously) would be less than ideal.

I'm seeing my GP again in a few weeks so I'll have a chat with them about it then!

Will they/should they admit you to hospital at 35/37 weeks of going into natural labour is that immenantly dangerous?

It seems unlikely they would - it's not a condition like vasa previa where the baby has to be out within minutes. Part of my issue is that I had a precipitous labour with my first but not with my second so who knows what might happen!

It's more like I need to get there within an hour or so which is enough time to get to hospital via car or ambulance. But not public transport or waiting for a potentially flaky taxi.

With two preschool DCs at home and a DH that works full time, hospital bedrest would be inconvenient to say the least, but I'd do it if necessary.. I did with DD2 for different reasons at various points.

I changed hospitals at 18 weeks in my 2nd pregnancy.

I went to my GP who faxed the new hospital and within about 3 days I had a letter inviting me for a booking in appointment later that week!plus a scan a couple of days later.

I didn't need a reason but the Dr (and midwife) did ask why but out of curiosity I think.

With my 1st I tried for a home birth and was told if I needed an ambulance I would have to go to the local hospital (which is where I had her in the end).I think because if you call 999 the ambulance comes from the local place.

Good luck

Thanks Mumcah. Interesting it was so quick.. I will bear that in mind.

I had been feeling a bit guilty about swapping as the registrars had been nice at my local dangerous hospital, but I saw the consultant yesterday and he did not listen to anything I said and only seemed interested in his own opinion of how he thought things should be (I'm high risk * 3 or 4 and very well-researched so this kind of thing really pisses me off!) so I have few qualms about jumping ship now!

Interesting about the ambulance - contradicts another poster! Maybe it's a regional thing.

I think 999 ambulance calls are supposed to take you to the nearest unit - you need to check it out in advance or you may not end up where you want to be

I have a friend who works for the ambulance service both as a dispatcher and a call taker, and with my last pregnancy she told me that they try to take you to the hospital you are booked with so long as it is not too far away, unless the baby is literally coming out (which in my case would not happen as the baby cannot get out!) However it is always at the discretion of the crew at the time.. if they're super busy they may just go to the nearest unit but if it's quiet, they might be more willing to oblige. So maybe that accounts for some of it.

Having never had to test what she said (I was ironically at the hospital for an unrelated appointment for DC1 when my pre-term labour started with DC2!) I wondered what other people's experiences were!

I changed hospitals at about 26 weeks as we moved house. I found a new GP and they did all the rest. Had a letter several days later from my new hospital..very easy..!

You can self-refer without going via your GP, a friend of mine did this online as she wasn't moving but didn't like the hospital.

Only annoying thing is you have to have bloods taken again..but hey that's not much really.

Good Luck x

Thanks Highlandgirl that's very reassuring! Interesting that you can do it online.. heh.

I will need my bloods taken at 28 weeks anyway so might well try and move then to save duplication!

PS - to everyone else, I just asked my ambulance service friend again (it has been 2.5 years and my memory is fuzzy!) and she confirmed pretty much what I said in my previous comment. That they'll take a patient to anywhere they are booked in London (or the outskirts) so long as the baby isn't actually popping out or some other really dire emergency. No mention of "at the crew's discretion" which is reassuring! After all it is probably ultimately safer to deliver at the hospital where they know you and have all your history to hand.