Rubella immunity

[Kwini]

Hi there,

DP and I are planning to start TTC in three months. I received the measles, mumps and rubella vaccination in 1996, when I was 14 (no idea why, but the health records are definitely there - it may have been because I was travelling that year). Does this mean that I should still be tested for rubella before TTC this year?

I did ask my doctor a whiel ago then if there were any health checks I needed in advance of TTC, and she only really stressed the need for folic acid - no mention of vaccines, etc. But I see that the NHS and other sites recommend that women planning to TTC should be tested for rubella as a matter of course...

I'll definitely ask my doctor this week, regardless, but would be interested to hear MNers thoughts in the meanime.

Thanks in advance!

Is there anything else my doc should be testing for at this stage?

Your immunity after having the jab cannot be confirmed until 3 months later. It is ok to conceive a month after the jab without danger of the vaccine harming the baby but you won't know for sure if you are immune at this point.

kwini, as my situation was so long ago I have no idea what kind of advice/tests GPs should now be giving to people prior to conception. I'm sufficiently sceptical to think that the NHS wouldn't encourage anything beyond the very basic advice because they fear they could get swamped by requests for rubella immunity or other tests. (Or maybe some GPs don't know what would be reasonable because they're swamped with so many targets to reach.)

I usually don't visit this area of MN (I tend to hit the 'last hour' or 'last 15 minutes' link and see if there's anything that interests me) but maybe there is a check-list that TTC-ers have already produced which could be bumped from time to time (much as the Home Edders do).

Grr. Just phoned my doctor and was told that they don't do blood tests! There are five or six docs at this surgery plus a couple of nurses - but apparently you have to go into hospital to have blood taken?? Is this normal over here?

No that isn't normal. Ask for an appointment with a GP then you can discuss this. He/she will then ask you to make an appointment with the phlebotomist or nurse at the surgery for the test to be done. GP has to authorise it so best to speak with them first.

You probably spoke to a receptionist

Our GP's don't do blood tests, we have to go to the local cottage hospital where they have a blood clinic, but we need authorisation from the doctor first.

Yes, mears, I spoke to a receptionist. She was insistent that there's no one at the surgery who can do blood tests. Bizarre...

Ah, well, am seeing doc on Thurs. Looks as if I'll have to be referred for a blood test at local hospital - it just gets easier, eh? ;)

it's not bizarre kwini - it's normal where I live.

Sorry, bruffin - don't know what a cottage hospital is. I'm in London. 'Bizarre' only in my experience - here and in N. America - that a surgery with half a dozen doctors and several nurses there's no one who can take blood

Well I didn't realise there were GP surgeries that couldn't/wouldn't take blood. I do think that is ridiculous.

My surgery does have a nurse (or nurses) who will take blood samples. Some surgeries may be too small or not have sufficient staff to take blood.

Taking blood samples is best done by someone who does a lot of them - I suspect that many GPs don't have much experience. In our local hospital (a district general hospital) blood samples are taken by phlebotomists, and that's all they do. They are specifically trained and sufficiently experienced they could probably get blood out of a stone. Also, they are good at getting blood out of tiny veins, and out of patients who are terrified.

kwini, the term "a cottage hospital" used to refer to a very small hospital in rural areas where the patients were looked after by the local GP. More complicated problems would have been sent to the nearest city hospital.

These days a small local hospital is usually linked to a district general hospital. There is such a "cottage"-type hospital linked to our district general hospital. Amongst other things, it has a minor injuries unit, day surgery for fairly routine procedures, outpatients department (the consultants travel from the DGH), some rehabilitation in-patient wards, and a small midwife-led delivery unit. There are probably no such hospitals in the London area, as these small hospitals are relatively costly to maintain, partly because they are small and often housed in very old buildings, and partly because in such a population-dense area such as London it makes sense to focus hospital health-care in specific locations.

Getting back to kwini's original concerns: there seem to be gaps in the advice given to people who ask the sensible questions prior to TTC but don't get a sensible answer. From kwini's experience, which sadly I doubt is unique, there should be some standards about advice/tests for those who want to prepare for the best outcome.

I know that Mumsnet is pushing for best practice in the care of miscarriages, so maybe this is a good forum for putting together good practice for people prior to conception.

(I would also love it if Mumsnetter could push for best practice for women approaching the menopause - when I asked my GP for advice about that all I got were some leaflets published by HRT companies.)

Mears - my surgery also. You get an envelope with attahced plastic pouch to take to your choice of blood letter in the district. It has the docs intructions on it, and the phleb takes accordingly, you pick up results at the surgery in due course.

And Kwini, there's nothing like a phlebotomist for taking fuss free bloods, they are in & out before you've passed the time of day. I do recommend this approach.

agree catinthehat

Our "cottage" hospital has blood clinics 4 days a week, you just turn up and take a ticket. They have 3 or 4 people taking bloods and it is over in seconds.

"And Kwini, there's nothing like a phlebotomist for taking fuss free bloods, they are in & out before you've passed the time of day."

Woohoo! That's exactly what I want

Thanks again for all your responses. I agree, uglymugly, that there really should be a forum for people who are just pre-TTC. I'm all for trying for a 'happy accident', but the rubella test is a perfect example of the kind of thing I'd be worried about having missed...

(apparently you can also check for anaemia and toxoplasmosis immunity pre-TTC - not sure about these, though, although we do have a cat...)

Saw my doc today - as expected, she was very low key about the risks of rubella for someone of my age and cited the number of accidental pregnancies that didn't involve pre-TTC testing which turn out just fine.

But she did agree to give me a reference for a blood test, so I toddled off and had it done at the local hospital then and there...

...and survived! One small step, and all that

People like your doctor annoy me. Your age has nothing to do with the risk. And she obviously hasn't read the NHS guidelines. She should be delighted to have a patient who is being sensible about her health and that of her future babies.

Congratulations on getting the blood test done.

Rubella is an odd virus because it's not always in the community. It comes around in epidemics every 5 or so years.

My mother didn't get it until after she had 3 children and I was 13 by then. She gave it to all of us.

Uglymugly, I was sorely tempted to point out that the NHS guidelines explicitly advise testing for immunity...but didn't. Probably should have, as I left feeling that she must think I'm a totaly worrywart.

She did say that the virus comes in waves, bruffin - she actually predicted that by 2020 we'll be seeing lots more babies being born with rubella-related problems because there are now so many more kids who didn't have the MMR (thanks to fears of autism and other side-effects, etc). Once they start having children, the implications could be pretty serious...

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