Help! 36 weeks, want to change hospitals but high risk. Anyone done this???

[Aubergenie]

I?d like some advice please as I?m feeling really anxious and trapped. It?s a bit long so please bear with me.

I am 36 weeks +2. I?ve been having my antenatal care at my local hospital (no midwife at GP) but was not planning on having the baby there as I was booked into a lovely midwife-led birthing centre. However, I?ve just found out that I?m not allowed to have my baby there as I have recently fallen into a high risk category due to raised ALT levels (no itching, bile acids fine). Anyway, I am now in a cycle of regular monitoring twice a week at the hospital and they are assuming that I will have the baby there. I have been told that I will be continuously monitored during labour, which I don?t like the idea of but will obviously go with if it?s necessary.

The problem is that my hospital doesn?t have a good reputation. Added to this, from conversations I?ve had with them today it sounds like the labour would be extremely medicalised (stay on the bed, no eating etc) which is exactly what I didn?t want. I would prefer to go to another hospital in my area, which seems to be more progressive about moving around during labour etc, even when being monitored. Had the whole birthing centre thing progressed, I would have been automatically registered with this hospital and gone there in the case of an emergency but because the centre refused to register me, I haven?t been registered at the hospital either. Now I?m really worried about being stuck at the original hospital.

Can I change hospitals at this stage given that I need regular monitoring/consultant appointments etc? Has anyone ever transferred in these circumstances? I?m in London if that makes any difference.

bump

have to be quick as can hear dd starting to yell, but I don't see why you shouldnt tbh.

HOWEVER you will undoubtedly have to fight for it and go prepared with a very good reason not to go to the one you are currently booked in at. most health care professionals (kind of understandably) will want to keep things the way they are, easy for them and they already know your history iyswim

i changed when I was 20 weeks due to similar reasons to you and I had to really persuade.

glad i did in the end tho as every woman from my ante natal class who went to this particular hospital ended up having emergency caeserean

best of luck x

have to be quick as can hear dd starting to yell, but I don't see why you shouldnt tbh.

HOWEVER you will undoubtedly have to fight for it and go prepared with a very good reason not to go to the one you are currently booked in at. most health care professionals (kind of understandably) will want to keep things the way they are, easy for them and they already know your history iyswim

i changed when I was 20 weeks due to similar reasons to you and I had to really persuade.

glad i did in the end tho as every woman from my ante natal class who went to this particular hospital ended up having emergency caeserean

best of luck x

have to be quick as can hear dd starting to yell, but I don't see why you shouldnt tbh.

HOWEVER you will undoubtedly have to fight for it and go prepared with a very good reason not to go to the one you are currently booked in at. most health care professionals (kind of understandably) will want to keep things the way they are, easy for them and they already know your history iyswim

i changed when I was 20 weeks due to similar reasons to you and I had to really persuade.

glad i did in the end tho as every woman from my ante natal class who went to this particular hospital ended up having emergency caeserean

best of luck x

Sorry you feel this way- can't be fun. Before you go to all the palaver of shifting, are you completely sure about the difference in policy between the hospitals? Because if it is not a written down policy then it might be just up to the different staff on shift? And did you talk to them in detail about what you wanted, and that you would be so unhappy about their policy that you would shift hospitals to avoid it? And are you absolutely certain that the other hospital will give you what you want, given you are high risk?

Also, you might not want to get too carried away necessarily about the reputation of a hospital. I have heard bad stories about the "good" hospitals, and good stories about "bad" hospitals IFSWIM. It depends so much on individual circumstances and the staff on on your shift.

I was monitored a lot in my labour too, and very grateful for it as it kept my DD safe. I surprised myself by not particularly wanting to move around in labour- just parked meself on all fours on the bed and got on with it. And I had no earthly wish to eat. This after planning a hippy water birth. The things you think will be really important might not actually be that important when you're in the thick of things. That isn't meant to sound patronising, hope it doesn't come across like that.

whoops. internet slow and i am being impatient

I agree wilkos - I am going to have to move fast. What reasons did you give you your new hospital to persuade them.

Domesticslattern - No, I'm not 100% sure that this is the policy in the new hospital, but when I went for the tour they talked about how important it is that the woman is comfortable, they encourage women to give birth standing up, how you can bring aromatherapy products and other things from home etc etc. Plus other people I know have given birth there recently and had good experiences. I didn't get any of that from this hospital when I went to look round.

It's also generally considered a much better hospital, rated as ?excellent? for quality of care from the Healthcare Commission. I asked about the original hopital here on Mumsnet a while ago and the responses were overwhelmingly negative which scared me before I found out about all the intervention.

I'm finding it really hard to make a decision and feel a bit overwhelmed. Obviously I have no idea whether I'll want to move about or eat or anything, but I do feel like it's all being taken out of my control. But I'm sure you're right about it being down to who you get on the day.

Hi Aubergenie, was in a different situation to yours but changed hospital at 12 weeks. I asked my doctor to write a strong refferal letter and it worked. Some hospitals also do self-referral. What you could do, is ring the antenatal clinic annonumously (Spelling?!) in the hospital you want (once you're sure of course) and ask if they do self-referal. If so you can enquire about how etc.

Also depends if the hospital is within your 'area'.... doctors are supposed to give you a choice of where to give birth, so if there is another one in the area that you would prefer then speak to your GP as they may be able to help you.

I changed at week 38 due to the fact that the delivery suite didn't have air conditioning and it was a very hot summer (2006)

Changed via my midwife who made all the arrangements.

If I could change for a superficial reason can't see why you can't for better reasons!

Thanks 1sttimer80. I will check the self referral thing. Good idea!

ilovemydog - what did they do with all the notes you must have had at that stage? I've got quite a folder full and obviously I need to make sure that they are up to date with my condition at whichever hospital I end up at.

Not sure - I did go to the day assessment unit at new hospital due to a kidney problem and they said they would get notes, but had my own yellow book which seemed to suffice.

Just call the delivery suite and say you want to have your baby there and what is the process.

I mean, women just show up going into labor. You're at least giving them a bit of notice...

Which hospital are you booked into? I had both my dc and just wondered if I could give you any reassurance about the one you are booked into.

I had all my AN care on the south coast where I lived. DS was due just before Christmas, we had planned to visit my sister just after he was born in the Midlands for Christmas. He was very late, we still went, with all our stuff, came home 10 days later with our new bundle. My sister phoned ahead to her local hospital before we left to check it would be OK. The reply she got was it doesn't matter where you are in the world, if the babys coming the hospital will deliver it. Admitedly I was not high risk.

Hi Aubergine, I think you might need to sit down and have a serious talk with someone at your current hospital first. I remember you have suspected OC - but with no itching and bile acids fine, do they still suspect OC? If not, what else are they diagnosing? Why exactly do they want you to have continuous monitoring? If there is a very good reason, chances are the "good" hospital might want you to do exactly the same thing. If not a very good reason, you may be able to discuss birthing options with current hospital. Probably also a good idea to try and discuss with "good" hospital before trying to move there, just to check what they would do given your circumstances. Sorry have to advice on how to go about this as I have never done it! But it seems a good idea to have all the necessary info before deciding which would be the best one to go to.

Switching hospitals when you are high risk shouldn't really be a problem in itself, as plenty of women swtich from small local hospitals to big regional ones when they become high risk. All the info the hospital needs should be in your blue notes (or whatever colour yours are!) that you carry with you.

Have no advice

Hi Liege, You're right it was suspected OC. Just had the latest bile acid results back and they are fine - 2.5. The're still talking OC (but not early induction unless things change) and have booked me for a liver scan which is next week so hopefully things will be a little clearer then. ALTs were 80 at the last test. When they talked about continuous monitoring, they said it was because the baby was at a higher risk of passing meconium and getting into difficulties. My feeling was that they were quite inflexible about movement, but I suppose it depends who you get on the day and I could perhaps negotiate with them. You are right, the other hospital may well want me to do exactly the same, and I do need to talk to them, but the impression I get based on talking to people who have been to both is that I would be less likely to feel under time pressure to go to CS for example if things were progressing slowly etc etc at the other hospital, and I am concerned that things may not progress very quickly if I am hooked up to a machine and not able to move around. Does that make sense?

Oh yes definitely makes sense, I would feel exactly the same. Hope you can manage to get to talk to people at the new hospital. Good luck with the liver scan - I had one of those at 31 weeks, it was done by two youngish women who wanted to spend ages looking at the baby so I got a really lovely scan of ds! Hope all goes well.

Message withdrawn

I think I'll get the liver scan done so things are a bit clearer and approach the other hospital. Even if they say the same thing, I think it's possible that it could be a better experience.

pruners - Thanks for your message. I know in the cold light of day that I can refuse continous monitoring, but I'm worried that once things get underway we won't feel a confident in refusing inteventions and might get bullied into things we don't want, simply because we don't know any better! I know that makes us sound a bit useless, but a friend's baby died because of meconium going into his lungs so I am very conscious of not doing something that would put my baby at risk so I could see myself being talked into it when it might not be necessary. Does anyone know if there is anywhere I can find further information/research about the implications of having/not having the monitoring and risks to the baby? If it is something I can have a proper conversation with the (whichever) hospital beforehand I might feel more confident. Perhaps they would agree to monitoring for a certain amount of time every hour, for example. The other thing I thought about was perhaps trying to hire a doula who could act as a sort of advocate for us and to try to avoid things spiralling out of control.

Luckywinner - Sorry I just realised I hadn't answered your question. I'm booked into Newham General. There's been a lot of publicity about how dirty it was (and this came up in a previous thread about it) I think it's been cleaned up a lot recently so it's not as bad as it was, but there are lots of other things that still don't sound so good.

any chance you could book a Doula...that might help you "fight" your corner...

3andnomore - That's exactly what I've just been thinking! I was worried that DP might feel pushed out but I've chatted to him and he's fine with anything that makes me feel better.