37 weeks and still waiting for planned c section consultation?

[Faerieel]

I'm FTM 37 weeks pregnant and have been asking for a planned c section since week 28 of pregnancy, due to baby being 99th percentile and I'm a very small person with a family history of emergency c sections and babies getting stuck due to small pelvises. (It's happened to 4 of my cousins who are all bigger than me and whose babies were smaller at birth than mine is estimated to be at 36 weeks.)

I'm currently under the care of one hospital but due to traumatic experiences there in the past (lumbar puncture given without anaesthesia leading to permanent nerve damage as Dr did it in wrong place the first two tries) I've been asking to be transferred to another hospital since 20 weeks. My midwife agreed to this and said she was sorting it, but every appointment I've had in the past 17 weeks since she has kept saying this and it still hasn't happened. I am also staying with my MIL until baby is born so it would make sense to be at her local hospital and not ours anyway.

I ended up going to my old hospital at my 36 week scan and asked again to be referred (have asked GP and hospital multiple times too over this pregnancy and new hospital said I couldn't self refer) which they said they would do there and then for me and I should get a phonecall within the next couple of days from new hospital inviting me for a consultation. As I was also told this at 32 week scan I wasn't hopeful but kept my phone on me. As expected, no phonecall.

I'm now 37 weeks pregnant and rang up the new hospital asking if they even had my notes yet and when I could expect a phonecall about the planned c section consultation, and they said they haven't had anything from midwife, GP, or old hospital at all regarding this and that it's now very late to be scheduling a planned c section. They also said there was nothing they could do for now so to ring back on Monday to speak to someone else.

Has anyone got any advice? I really don't know what to do at this point and as my midwife all along has been telling me she thinks I should just attempt to push him out I feel like she has done her best to give me no choice in the matter. I was only 6st10 before pregnancy and baby is already 7lbs so don't feel safe doing this and the doctors at the hospital agreed despite also not helping me schedule a consultation. I just really don't know what to do at this point and I feel like crying all the time when I think about it.

Oh gosh so sorry to hear you've been passed from pillar to post like this.
I would get back in touch with your midwife on Monday and firmly reinforce that you need the referral to be pushed through to chosen hospital. Also contact the chosen hospital again on Monday using the same number you did before and explain the situation again to hopefully someone that can help (I know you shouldn't have to be doing any of this). If you can't get anywhere doing this, the chosen hospital should have a PALS department or Patient Experience team that you could contact who may be able to help escalate your situation to someone who can sort it out and get you in with a consultant.
I hope you don't end up going into labour as this is not what you want but if you do, as it's first baby it is not likely to be super quick, get straight onto the maternity triage line if you experience contractions and tell them that you are in the process of obtaining an elective section date and that you need to come in now. As long as they haven't got an emergency in theatre they should do your section before you get to a stage of pushing and baby getting stuck. This is obviously scary and I don't want things to get to this point for you but just letting you know you can request a section even in labour as long as things have not progressed beyond a certain point. I am a recovery nurse on a delivery suite and this happens sometimes with ladies that are booked for planned sections and end up going into labour themselves... they come in quick and get their section.
Make sure you have a birth plan in your notes, did your midwife go through one at 36 week appt? Your midwife cannot give you no choice in the matter, as hard as it is you have to tell her that you want a c section and you have every right to one. Can you take your DP or MIL with you to appointments to help advocate for you?

Really hope you can get this sorted, if you need any further help then feel free to PM me x

Thank you for replying, it means a lot. I've rang my midwife this morning and got told she'll speak about it at our appointment tomorrow but if they've not got my transfer now then it's too late for her to sort it now and I'll just have to give birth at Cumberland, where she also won't help me get a consultant for a c section. Apparently I've never told her about wanting to be in Newcastle instead of Carlisle despite it being in my notes for months.

As she was so unhelpful I rang Newcastle myself to see if there was anything I could do but they said it had been left too late by my midwife and if I wanted to file a complaint I could but there was little chance of me being transferred at this point in time. They also said it wasn't something I could do myself at all so if the hospital or midwives wouldn't help me then the best thing I could do is just book in with the original hospital and hope my care was better than previous times when they've done things like forgotten to give me anaesthetic etc.

I feel very disheartened at this as I've found pregnancy very difficult so far with severe joint pain since month 5 and multiple fainting episodes for which I've been given no help when I've asked for it, even being sent home without being looked at or monitored when I fainted and hit my head at work at 6 months pregnant. My mum thinks it's because I'm only 22 and small so look even younger, people don't take me seriously. I dunno. Hopefully everyone else has a better experience than I have had, because I really wouldn't wish this on anyone x

Can you contact birthrights today and ask for their help? So sorry you're going through this. I'm 37+5 so can only imagine how stressed you're feeling 😔

www.birthrights.org.uk/

I would raise merry hell at your appointment tomorrow. Go in with a printed list of dates you’ve requested the transfer and the section and point out that it’s not too late on your account: you raised it at X weeks, again at X weeks, etc, and she hasn’t made the request.

I’ve had shocking care this pregnancy but things dramatically improved once official complaints were made, in writing, and I refused to let matters drop. Your midwife has really shafted you here.

Yes as pp have said, contact birth rights and go in with your dates and times of requests made.

I would also contact the PALS department of your NHS trust in carlisle that your midwifery team is under, they will be able to help you form a complaint.
In this complaint highlight how the NICE guidelines have not been adhered to by failing to refer you to an obstetrician in a timely fashion to discuss a c section and that a professional is obliged to refer to an obstetrician to discuss elcs for maternal request. If the PALS department can help you get that to a maternity matron urgently, they may be able to get you in and seen by a consultant to get it organised. I know it won't be in the hospital that you feel more comfortable with, but if the team there are aware of your traumatic experiences had previously, then hopefully they can allay your fears and make sure you feel more in control.

This whole thing is an absolute shit storm and I hope your midwife is held to account for her lack of care. Reinforce to all professionals you speak to the impact this has had on your mental health.

Feel free to PM me if you need any further help x

www.nice.org.uk/guidance/ng192/chapter/Recommendations#planned-caesarean-birth

I would contact PALS, you should be able to find the email address on the hospital website

Slightly skimming over the point of where/how you plan to give birth, you should be flagged up to the obstetric anaesthetists if you’ve had a nerve injury from a lumbar puncture as a spinal injection, which is what would normally be used for obstetric anaesthesia, is a lumbar puncture. They may need to think a bit about whether that’s feasible or best avoided if you do choose/need to go to theatre for anything. May be worth checking that the midwives have done that. HTH.

Get a complaint into pals asap. You can ring up and make it. They will (hopefully) support you to get the appointments you need.

i had to put a complaint into pals as couldn’t get the appointments I needed and kept seeing diff dr / consultants who kept telling me different things. Care improved massively post complaint.

I'm so sorry you're having to go through this 💐

As others have said, absolutely put in a complaint to pals as soon as possible. Make sure it's in writing to numerous people, including your midwife that you only consent to having an elective section.

Can you call gynae admissions at the hospital? These are usually the people who schedule sections. If you are able to, could you rock up at the hospital today / tomorrow after your appointment and basically refuse to leave until you have a date and time sorted? In all likelihood, you'll have another 3/4 weeks before you actually go into labour as a FTM but that isn't the case for everyone of course and you could start contracting any minute from now.

That's so stressful for you. I hope you get it sorted out soon.

This should have been done a long time before now. I think I had mine at 28wks and it was all signed off and the papers put in with my notes. There is usually a consultant on site once a month I was told so. They try and do it around 30wks but could be between 28-32 weeks.

Definitely put in a complaint asap although might not help you now. You need to be very assertive at your next appointment. Say ur making a complaint and this is causing you unnecessary stress and anxiety. You have a right to choose and you've they've just fobbed u off for months, terrible care.

I really feel for you I can't imagine how much stress this is cashing you. I hope you get it sorted.

Can you take someone with you to your appointment who can be assertive on your behalf? I’m not saying you haven’t been so far but sometimes having someone else there who is willing to very forcefully back you up does put the wind up them and hold them more accountable. This absolutely shouldn’t have happened and I’m a believer that where there’s a will there’s a way, I’m sure there’s a way of sorting this from your midwives side. It might mean more work for her but at this stage it’s the least she can do.

Thank you to everyone who replied, I took my MIL to the appointment with us and she helped me speak to my midwife. Luckily there was also a student midwife there who knew how the procedures for referrals worked so she actually managed to get me referred. My midwife still insisted it wasn't their job but the other midwife told her otherwise.

After the student midwife sent the forms off and rang the RVI for me to see what she could do, I'm now booked in for a consultation at 39+3 weeks which is the soonest they could manage, although the hospital did say that the section would likely be scheduled pretty soon after this as due to Baby's projected size they'd want him out at his due date at the latest.

The maternity unit there also told me they would make sure I could have my section regardless of whether I make it to this appointment/my due date or he comes before. And although they couldn't get me another checkup with a midwife before my due date due to waiting times I can ring 24/7 with anything even if it's just a question which has made me feel loads better.

Overall this has somehow managed to get fixed as much as possible, mainly thanks to the student midwife, and I'm so relieved that even though it's not as smooth as I would have hoped I do now have a plan in place at my hospital of choice for my birth of choice.

I would file a complaint with your local Healthwatch as well as PALS as you've been really let down by so many professionals along the way. Healthwatch are independent and follow trends in complaints so is much more useful to future mums than just an internal complaint. I'm so glad the student midwife has stepped in! I hope all goes well for you.

This is a tremendously good update, well done! When all the dust has settled I’d encourage you to submit a formal complaint against the original midwife, regardless that you got your section in the end, as she clearly and deliberately tried to prevent it.

Hello @Faerieel , so good that you had finally got what you needed and wanted! How did your c section go? X

@SoInLuv unfortunately I didn't get my c section when it came to it! Baby was 38 weeks and 9lbs3oz, but my midwife did not transfer my notes properly and Cumbria don't give you paper copies. I told the midwives at the hospital at the time details such as baby's predicted weight/size, my weight, and all medications etc Ive ever taken but ultimately they couldn't access my records as Cumbria had actually lost my medical record so lied about sending it.

The birth was quick, 4 hours start to finish, and unfortunately I couldn't have painkillers until after he was born and I'd had all my stitches. The birth was as good as it could have been though in the circumstances and I'd recommend the RVI in Newcastle to anyone thinking about giving birth there, they went above and beyond after the birth to look after me and baby and even filed a complaint with Cumberland Infirmary on my behalf.

Oh @Faerieel, what an experience you had...well done, it's good it went okay in the end and 4 hours for a 1st baby is quick. I can't believe that Cumbria had lied about sending your records, how unprofessional.
Also, I can't imagine how someone petite/tije like you could have a 9 pounds something baby- I can't imagine if/how painful it must uave been pushing him out? Gosh, I hope he slipped out smoothly.
Congrats!