Antenatal care

[Cookie51]

Is it just me or does anyone else find the UK's attitude of "everything's normal until something goes wrong" quite strange. I'm over 40 and had an early miscarriage a few months ago. Then recently after a positive pregnancy test I went to the doctor, had a very short consultation, had to ask to have a blood test and never received the results until I asked for them at reception. Was told that HCG and progesterone were normal for 5-6 weeks pregnant but my research reveals progesterone is on the high side. Why doesn't the doctor have the courtesy to phone me and explain what the results mean, even if her opinion was that the levels were in the normal range? Throughout my last pregnancy (at 39) I never saw a doctor (told it wasn't necessary), received "booking" appointment very late and had to chase for the screening tests to be done on time. Throughout pregnancy and the birth itself I felt like I received the minimum level of care - with the higher risks and concerns of an older mother I really expected better of the NHS.

Doctors and nurses are pressed for time. If you want to educate yourself about a topic, the internet is great for that, but it's not for healthcare professionals to talk you through every aspect of a procedure if the results are normal.

Whilst I understand what you are saying, I agree with OP that doctors don't have the time to call everyone to say that results are normal. It would be an issue if they didn't call you if there was a problem. Also, the lab based their judgement according to their standards of "normal". An early MC is not considered to make a person high risk. I didn't have my booking apt till the day of my 12 week scan. It didn't bother me one bit. I have miscarried twice and so it so I was happy to have it later in case it happened again.

I can't fault the ante-natal care I have received by the NHS (in two different cities). I am high risk 2nd time around and am v grateful to have access to brilliant care. I know this not everyone's experience!

If you can afford it, you can pay for private ante-natal care (scans and tests and consultant appointments), you should get quicker results and more individual attention that way. I think as others have said it's normal to get the 'minimum level of care' on the NHS if you're considered low risk and everything is progressing normally, that's just how the NHS works.

I have friends in the US and what you are asking for is basically what they get. They get 30 min appointments every 2 weeks that include a scan and all manner of measurements and examinations. The obstetrician (who they see at each appointment) will spend time explaining everything in minute detail but will also get cross with them if they have put on too much weight, or the baby is growing too quickly/slowly etc. It is a very paternalistic view of medicine. The doctor knows best and is the only one who can advise you. They also pay through the nose for this.

Here in the UK, we get a much more hands off approach and I think that is fine for most people. I don't see that having an internal exam every 2 weeks is necessary. I would get very cross if I was weighed all the time and told off if I moved off some spurious curve. I think the "everythings fine until it isn't" approach is great. Why make things more complicated than they need to be?

I completely agree with you, Cookie51. Neither my husband, not I are Brits, and although we have been living in the UK for a decade, we just can't stand this "have a cup of tea and everything will be ok" attitude. We decided to go privately to get a better care. So far, I am pleased with my consultant and the quality of care. It costs a fortune, and in any other developed world country insurance would cover this, but not here which is amazing... Wishing you a good delivery!

I am really struggling with this too.

I am high risk, after my last (twin) pregnancy resulted in one stllbirth and one premature emergency caesarian delivery.

I am 12 weeks pregnant, and had the second half of my booking appointment today with the midwife. She was trying to persuade me to have a home birth. I quote "no, it's not as safe, but it is much nicer. Ummmm... one of my babies has already died (due in part to lacking NHS care). I am not taking gambles with this one for the hell of it, thank you very much, so stop trying to persuade me. If I do try for VBAC (50% chance of success) I cannot have a water birth as they will insist on full-time monitoring. Is this even possible with a home birth?

When I told her about my PTSD (after the stillbirth, she wrote in my notes "post natal depression". I corrected her, she insisted "oh, it's the same thing". No it bloody well isn't, and if a fricking midwife doesn't know that, what hope do we have?

I also told her about a couple of things that have been concerning me. Apparently if my period-like pains carry on much longer, it might be an idea to get checked over and you can use and over-the-counter medicine for thrush. Not according to NHS direct, you can't.

Sorry, enough whingeing about me. Basically, I totally agree. After everything went so desperately wrong last time, I really wish they would try harder this time.

Thanks I really appreciate all your comments but I'm surprised by some of the responses.

What I'm getting at is, not all midwives are necessarily qualified or experienced enough to pick up on complications or reassure someone with particular issues or concerns.

When I went into labour with my daughter, I went from nothing to fast contractions and a great deal of pain in next to no time (severe pain in the middle of my back) but was sent home by a very young midwife - well I refused to go so they shoved me in a side room, gave me pethidine and ignored me until the next morning. The next day it took until about 5pm before any of the midwives figured out my baby was facing the wrong way (I forget the technical term, I don't mean breach). By this time I'd had 2 doses of pethidine and they figured the next option was an epidural but it took 3 hours to an anaesthetist, by this time my baby was in trouble.... OK alls well that ends well but I can't help thinking that with better attention, the problem could have been identified earlier and either a Caesarian may not have been necessary or else the need for one could have been established earlier and gone more smoothly - I saw no-one except midwives until the anaethetist arrived nearly 24 hours after I arrived at the hospital.

I understand in other countries even if you have an uncomplicated preganancy you are examined by a doctor and scanned on arrival at hospital. If there isn't the resources to do this in the NHS then something is seriously wrong - even an uncomplicated pregnancy can become complicated at the last minute so assuming all is ok is putting people's lives at risk, in my opinion!

Cookie - I responded back in Dec. Reading your new post, I do totally sympathise with what you are saying. An awful lot of responsibility is put in the hands of inexperienced/junior midwives. I can't help feeling that had even one midwife spotted my baby was very poorly after birth, she might have a fighting chance of being here today.

Sadly, one needs to have experienced a disaster before getting the care that ALL pregnant women deserve.

Yep... NHS... hm well so far in my opinion... it sucks... NO costumer service, no structure, everyone goes on a different rampage....
I am sorry, I know some people think NHS is the best in the world and its free but its not the best and of course it coasts loads to tax payers...
I order for healthcare to be great it has to be provided privately that is why it is so good in America and private care in UK is also pretty good.
40 is not a low risk pregnancy, any pregnancy after 35 can turn high risk at any moment that is why extra monitoring should be done for women over the age of 35. Not informing about the test results is not acceptable, I don't care how busy the doctors and nurses are, they have admin to support and make these calls.
Sorry, for making strong statements but I had my share of bad experiences with NHS...

sorry costs :)

That is exactly how I feel, Babynelly. Not from America, but from Belgium, now living in Germany.
I get increasingly shocked at stories here, and also the attitudes of patients who accept the state of the NHS. No, it is no excuse that test results are not communicated unless they are abnormal. In Belgium also you get regular scans (from 6 weeks to the very end!) and tests, tests, tests and more tests. To check you blood sugar, hormones, just name it. And more if you request. Standard puctions for people over 35, I think.
Even if you are low risk (or equivalent) (which means have had three births and pregnancies without any problems whatsoever), you get your ultrasounds, from 6 weeks, your tests naturally, only your regular doctor's visits are a bit less frequent. And that depends very much on the doctor, there are not a lot of them who do actually do that.
Births, I think, are usually monitored, but they are not so bothered about you staying on a bed for it. I'm always a bit confused why monitoring should be done on a bed, at any rate.
You do receive advice extensively if you want to breast feed. I have never heard of anyone's baby being formula fed, apart from in the 80s when I was born. No matter how badly it goes. And of course there is not a lot of milk after the first feed. That's why in Belgian hospitals, the give baby sugar water from a bottle, in order to get it over its hunger while they give mum time to get her supply up. Two days that lasts I think, not sure. If mums stop afterwards, it will be because they want it, not because of some midwife who wanted to get the baby calm (admittedly, it must be hard with five crying hungry babaies in one ward during the night.).

I find it shocking that you should be a doctor yourself almost to really be able to judge in some cases.

few, got it off my chest.

Must admit I did think I would be monitored more than the average already had kids mum to be, as I have high bp and had it before pregnancy... but tbh they don't seem to care. One midwife at the hospital said I must get seen asap at 12 weeks by the consultant, who then cancelled it until my 20 week scan.

Gp is better, she said if I wasn't going to be seen so often, to go to her and she would check it.

If every pregnancy is different, I can't see how they can say oh you only need x amount of check ups because you have already had them.

I can see why they don't tell you results unless there is any need to worry though.

And MrManager the internet is not a good place to go if you need educating always. how many scare stories and unproven idea's are on it? Left to the internet nobody would have the flu jab, tests wouldn't be done, because someone stumbled on a web site that said you didn't need them you could sit and chant and everything would go well!

....the best thing I found yesterday was on a well known site, you shouldn't use heartburn remedies!!! Because it doesn't cure the cause so you shouldn't need to alleviate the symptoms. And the same goes for milk or yoghurt. And its all caused by eating sugar. nothing to do with things relaxing and letting acid back up. So next time I can't sleep for burning acid I will just put up with it and tell myself off for bringing it on myself.

Can't blame GPs/ midwives etc though or the NHS. Can blame the totally inept pathetic government that are happy to make the cuts even if it means lives are lost. less people, more money for the government to send to everyone else.

My last word on this subject - healthcare doesn't have to be private to be good. My sister-in-law has described the care she received when she had 4 children in Ireland, totally different to the UK!

Their health service is also stretched and has suffered cuts recently but somehow the approach seems vastly different.

Well... healthcare does not have to be private to be good, it is true, however, NHS is very inconsistent and its good for some while it is terrible to others. What makes private healthcare good is that it provides you with choices, if your provider shows to be no good, you just change them. I am currently stuck with a same GP who is operating out medieval dirty looking office and I dread the day I have to go there. I usually have to do my own research and have to provide her with ideas because on most occasions she pretty much has none. Likely so far I did not have to go there that much. I have no other choice in my area. After my baby is born I plan to take an health insurance policy for our family, because a thought of taking my child to that place is terrifying. It's just unfortunate that if you choose to pay for private health to get a dicent care you pay for healthcare twice, once through taxes and then out pocket through insurance or direct...

babynelly2010 - you are right, my comment was a bit idealistic really, based on what we would hope and expect for the NHS after we have paid our taxes for all these years!!

My experience of the local GP practice is very similar to yours; although they have recently refurbished and extended the building, the same offhand attitude usually applies to most of the support staff and some of the doctors. When I was first pregnant this time the doctor insisted I was 4 weeks pregnant when I was actually 6 weeks, and that was a woman! Today I had a flu jab and asked advice about the jab I had to have privately for my 2 year old, I was told it's not their problem because they didn't do it!!!

Good luck with the research for the private healthcare for your family, make sure you check exactly what is excluded you know what insurance companies are like!