Antenatal care in pregnancy after stillbirth & recurrent mc

[BipBippadotta]

I hope it's all right to post here - I thought I'd be more likely to get informed & compassionate responses here than in the pregnancy section, but happy to move if it doesn't feel appropriate.

I'm currently 11 weeks pregnant, after a full-term stillbirth & several miscarriages, and am incredibly anxious.

I have my booking appointment with a midwife on Tuesday. Because of my age & obstetric history I'm likely to be considered high risk & offered extra monitoring, but I'm unclear of what this means in practice. I'd be really interested to know what others' experiences are of high risk care after multiple losses, particularly late losses - how much extra monitoring did you get, and at what point in the pregnancy? Did you have consultant-led care? Did you see the same person for each antenatal appointment? If you had a planned c section, was the doctor who performed it someone you had met before & was somewhat familiar with your history?

If anyone has an experience to share, I'd be really grateful! Thanks so much.

Anyone?

Nothing to add but wanted to say congratulations. After all you've been through I hope your pregnancy and birth is lovely and easy.

Hi Bip are you on the Angels and rainbows group on FB? Set up by some lovely mums netters. I am sorry for all you've been through. PALS - pregnancy after a third trimester loss is good too, and a very active group.

I had a stillbirth two years ago and have just had another baby. I also had an early MC after my stillbirth.

I am afraid my answer won't be totally helpful as we opted to go private in central London (I'm not in London) for antenatal care and the birth - planned C at 37 weeks. However, I still attended my local hospital for monitoring. I went in quite frequently with worries and niggles (eg baby not moving much, pains) and eventually - at about 33 weeks - this became a scheduled 2-3 times weekly appointment, where I would just sit on the monitor.

No one at that hospital was familiar with my history and I kept having to repeat it, which was distressing. And when I did, hardly anyone had the decency to say 'I'm sorry'. It was upsetting. But main thing was they were always happy to see me and offer reassurance. For that I was grateful.

I am very scared of hospitals and pregnancy, pregnant people too - lots of mental trauma, as I'm sure you can relate. For this reason, I always took headphones and relaxing music to hospital- so I could zone out and be in my own little world while I was waiting or sat on monitor.

I booked regular private Doppler scans at the fetal medicine centre with prof Nicolaides - THE expert in stillbirths.

I was on cyclogest and high dose folic acid throughout. I have also heard a lot of people in our situation go on baby aspirin, but this wasn't advised with me.

I attended a sands pregnancy and parenting after a loss group, which was so helpful

Hope that helps and good luck to you, it's a tough experience but the reward at the end makes it worth all the tears and panic

Thanks so much ColdToast - I'm very sorry about your losses, and pleased and relieved to hear about the birth of your new baby.

We're thinking of going privately as well, as I ended up feeling so brutalised by the NHS during my first pregnancy and labour when my daughter died. Like you I am scared rigid of hospitals, pregnancy, pregnant people, babies (particularly newborns, which you see a lot of in maternity unit waiting areas). I'm really having to fight the urge to pretend this isn't happening and not go to any appointments at all.

I'm on baby aspirin & lots of folate. My daughter died because of a cord accident and it really alarms me that they don't routinely do Doppler scans in the NHS, so I will be going privately for those if I get to that stage.

I think I'm feeling a bit too fucked up still to go to a SANDS group, but am considering going back into therapy for a bit as I'm not in a good frame of mind about this pregnancy at all.

Thanks so much for sharinng your experience - and thanks for your kind thoughts too, Nomad.

Hi Bip - what a truly shitty time you've had. I'm so sorry.
First, you will automatically be consultant-led by dint of being high risk. How that actually translates in terms of your care might vary, but you will definitely have a meeting or two with a consultant sometime during your 2nd or 3rd tri.
A lot depends on your trust tbh - how busy they are, whether or not they're understaffed. Unless you're out in the sticks, you're unlikely to consistently see the same midwife. BUT an important thing to remember is that you have autonomy here - I appreciate that might be hard to feel, given what you've gone through, but you are the ultimate boss of your own care. So if you want something and feel it would help you, don't be afraid to shout loud and push for it if you have to. So if you want to see the same midwife throughout, tell them that, ask if there's any way that can happen - mws are usually rota'ed, so it might be that they can shift your appts a little bit out of the normal schddule so that you can see the same person. Likewise, with extra monitoring etc, ask for what you want - with your history, any mw with an ounce of compassion should be willing to go above and beyond to help put your mind at ease. Midwives are there to safeguard your mental health, not just the physical, so remind them of that if they look like they're going to kick up a fuss re extra monitoring etc. Personally if I were you, I'd be pushing for a free pass to go in for foetal monitoring as often as you feel you need to, as well as regular scans (say 4-weekly from 16w). It might help to have a plan of what you'd like, to give you a start point to work from.
I had 3 MC and had an extra scan at 24w with my last pregnancy to check dopplers (I think - blood flow to the uterus & baby), so again, something to push for if its not offered routinely in your trust.
Try and develop the mindset of being a partner in your care - don't agree to anything you're not comfortable with, and don't let HCPs fob you off if you really feel you want something (elective C-sec for example). There is always, always scope for negotiation.
It might also help to have someone who knows what you want, so they can advocate for you if you don't feel mentally or emotionally up to it at any point. A lot depends on your HCPs - some are fantastic, some are crap. Fingers crossed for you for a fantastic one, but don't put up with a crap one if you get landed with them.
Really, really hope for you that this pregnancy is the one that all works out. With my last pg I was so beaten down I spent the first 20 weeks just waiting for it all to go wrong. I'd sit in the scan waiting room with my heart pounding like I'd just run a marathon. And I haven't gone through half of what you have. But we made it through in the end, despite a lot of stress. I coped by pretending it wasn't happening - DH and I barely spoke about the pregnancy for pretty much the whole first trimester, and not much after that. I didn't bond with the baby at all during pregnancy as I couldnt shake myself out of the mindset that he would die. I worried and fretted right up until he was born. But it worked out in the end, I bonded with him fine once he was out, and the stress during pg doesn't seem to have affected him. And I never ever forget how lucky I am - I've been on the wrong side of the statistics (the 2% who MC after seeing a heartbeat, for example) and it's fucking shit. I never take what I have for granted and I am thankful every day.
Sorry this is so long and rambly. I am by no means an expert AT ALL, but I know a little bit around antenatal care, requirements of HCPs, and your rights as a service user, so feel free to pm me if you ever need to for whatever reason.
Very very best of luck for this pregnancy. Will be thinking of you.

Thanks FourForYou - I am so sorry to hear about your losses but glad to hear you had no trouble bonding with your son when he finally arrived.

Looks like I may have got ahead of myself in thinking about antenatal care, unfortunately - had a private scan yesterday that put me at 11+5 and showed the baby had an umbilical hernia which should really have resolved by 11 weeks. If it hangs around later it tends to be associated with chromosomal problems. So I'm off to the Fetal Medicine Centre tomorrow for CVS & am preparing for the worst. Ugh.

Oh bloody hell, sounds like you can't catch a break. So hope it all works out ok for you, very very best of luck. I know the thoughts of random internet strangers are meaningless, but you're in mine

Oh gosh, keeping everything crossed for you- what a horrible time. You're in good hands at the FMC, presumably you'll see the professor (I know he is only in on Wednesdays) and I just hope he has good news for you. Be prepared for a bit of a wait - up to 3 hours on busy days! So sorry you're going through this now, on top of everything else

Yep, I'm bringing a good book for the wait. I do feel somewhat comforted to know I'll be in good hands with the FMC.

I am very very sorry to read about the things you are going through.
Just wanted to say it is brave (in the best possible way) of you to look for information and help. Keep looking and make sure you get all the help you need (as was written before). You should not have to go private as you have got reasons enough to demand any and all the NHS has to offer. NICE guidelines can help a lot as they say very clearly that it is your pregnancy and you should be supported to decide what is best for you and your little family.

Thinking of you today Bip - hope all goes as well as can be x

Thanks very much. Feeling eerily calm about it - nothing I can do, and at least I know the drill if it goes wrong.

I'm really sorry to hear that bip.

We lost dd2 to a chromosome disorder. Saw fmc in our subsequent pregnancy with ds who were brilliant but he died at 14 weeks. It's really hard loosing another after a late loss or stillbirth.

Keeping everything crossed for you

Meant to update - went for Nuchal scan at the FMC and there was no sign of the hernia after 40 mins' searching. They said I was low risk & no CVS needed. Phew!

So now it's just a wait for my appointment letters from the hospital and I'll find out what my care's likely to look like. Thanks for all your support & suggestions.

And Kitty it's good to hear from you. I hope you are doing all right & I think of you often.

Bip that is really good news! Best of luck getting through all the milestones, and fingers crossed you have the most boring pregnancy ever :)

I had a mc, fertility treatment, a termination for t21 and finally ICSI before my successful pregnsncy with DS.
I had a fetal medicine consultant and saw her at 7,9, 12, 16, 20, 24 and 30 weeks. It would have been 34 and 36 as well but we moved house.
She scanned me herself every time.
I saw my GP midwife regularly as well.
Very best wishes to you

What brilliant news bip. The tough thing is knowing how bad things can go once you've lost a baby. So tough.

That's very sweet of you. I'm ok-ish. Been good for ages but hit a bit of a tough time atm. It happens. Fingers crossed for a very dull and uneventful rest of your pregnancy

Bip - meant to reply to this yesterday to say, amazing news! So very pleased for you and wishing you absolutely all the best with everything - and fingers crossed for excellent HCPs that make you feel better, not worse.