Hospital emergency dilemma - long!

[Sparklies]

I'm currently nearly 33 weeks with DC3, with a history of delivering early (36w6d, 35w5d). In fact I had PTL at 34 weeks with DC2 which stopped, but not before my hindwaters ruptured.

Anyway, contractions have been picking up of late - for instance this afternoon I've been having fairly uncomfortable ones a reasonably regular 8 minutes apart. I'm fairly sure it's not labour, especially as they're now more irregular and 10-12 minutes apart but there's going to come a time when I'm not sure.

Here's my dilemma. I get my antenatal care from Hospital A, which is 10 minutes drive away. I had DC1 at Hospital A and do not trust the doctors/staff there as they have screwed up with me repeatedly in the past causing permanent issues. It's not a hospital with a great reputation generally either. But as far as Hospital A is concerned, I am delivering (via completely medically necessary ELCS - baby cannot escape any other way) there.

However, I am actually intending to deliver at Hospital B, which is 1-2 hours away depending on time of day. I am booked in there for my ELCS with the same consultant who did surgery on me earlier in the pregnancy, as I trust him. This baby probably owes him his life. If baby wants to come sooner, I am still welcome to have an EMCS there.. so long as I can get there safely.

Hospital A do not know about my Hospital B plans and I don't intend telling them because for all I know they might boot me off the books, including off the midwife books, leaving me with a 1-2 hour trek across London on public transport with SPD for each antenatal appointment.

And anyway, if I went into precipitous labour as I did with DC1, I would need to deliver at Hospital A as it's closest because there's a real risk of uterine rupture if I leave things too long. So I'd rather stay on their books with my notes active and available to hand until the baby is safely out.

If it's clear it's Real Labour and not precipitous then it's obvious what I should do - head over to Hospital B.

But what if it's just non-labour contractions and I don't know for sure but it's worrying enough to warrant monitoring? I don't want to make the huge journey over to Hospital B for what could be dozens of false alarms. Especially as I'm not booked in there antenatally. While obviously my consultant is totally fine with the c-section (he offered, in fact - I didn't even suggest it) the labour ward might be less than pleased at this interloper.

However, if I went to Hospital A, what if they decided it WAS real labour and arranged the c-section then and there? I can hardly say "That's great guys, I'm off some place better!" and leg it to Hospital B, can I? Especially if by the time they've determined it's real labour I'm probably in a bad way. Pretty daft to leave a "perfectly good hospital" (not my choice of words!) for another one two hours away in those circumstances, right?

Of course I'm probably overthinking it and when I go into labour it'll be obvious but I just don't know. I've been in denial both times I've gone into real labour, especially as I have a hugely irritable uterus just anyway, so I don't trust myself to spot the real thing any more!

Not really sure what I'm asking actually, but any thoughts on this, including what you might do in my situation, very welcome!

Thanks for reading my essay

I think you should go back to consultant at hospital2 to confirm at what point he wants you. A message vis his secretary is probably best way to do this.

I'm pg with my 5th, and have a similar history to you, with prem rupture of membranes/hind waters and prem deliveries. (Though mine are born vaginally) Even with my 4th I wasn't sure that labour was really labour for quite some time. I had to go in 3 times for ruptured hind waters and suspected labour... rather embarrassing on my 4th baby so then stayed at home for too long when it eventually was the real thing and only just made it. It was important for me that my actual real consultant saw me, given my history, on those occasions.

It may be that the consultant would rather you did transfer your antenatal care to his hospital/him directly at this stage, and it would almost certainly be worth putting up with the longer journeys.

Just an additional that I'd be thinking about; which hospital has better SCBU facilities?

Sparklies I've been hoping to bump in to you! Really glad you're 33 weeks now :)

I agree with checkmate re the Scbu too. Which is the best ?

Checkmate - Thanks for your thoughts, I think you are right. He did tell me to come in if it felt like it might be labour, but I can't remember if he mentioned how many contractions/hour etc it might be. For the last almost 12 hours I've been having 6-10 an hour and I'm pretty sure it's not labour despite having PTL at 34 weeks last time because they're not regular nor super painful, just uncomfortable. So it would be useful to know what he thinks I should do in that sort of situation and after all it's probably best he knows things might kick off. I have his email address which I've used before so that makes things easier especially as I hate hate hate talking on the phone.

Daft, isn't it, how even after having a few children we still can't be sure! Every pregnancy is different which probably doesn't help. I can just see myself doing what you did with your fourth though - that's very me!!

I am pretty sure the hospital further away has the better SCBU although I really would hate to trust my baby to the local one.. ugh. Heh, just checked - Hospital B wipes the floor with Hospital A (local).. it even has a NICU and about three times the number of cots. There's a surprise, not.

Hi WorzselMummage - how are you? :)