first time being pregnant on NHS...what to expect

[lynn1]

For my first baby we were on private healthcare and are no longer. I'm only a few weeks pg and am waiting for my 1st booking in appt.. Being my first time on the NHS, I have a few questions. My 1st birth was a c-section. I would think that after 1 c/s, it would be assumed that you'd have another. Is this normally the case?
I've also heard that in general, midwives are generally very pushy about breastfeeding. Wondering what your experience was?
Thanks for any guidance.

Not sure about the c section, think it would vary from consultant to consultant, and your reasons for asking for one. I had an nhs section, and am having another one, because of a traumatic first birth.

Had excellent care, apart from one monstrous hypo (I'm diabetic) when the nurse on duty saw me crawling along the wall mumbling about sugar and vaguely suggested a turkey sandwich...Apart from that, which was mainly my fault, tip top. I'm in Devon.

Can't rememeber about breastfeeding - think they generally think it's a good idea, I had to give up after a couple of months with mastitis. Mainly I remember it hurting and stuffing cabbage leaves down my bra!

That's not a massively helpful reply is it? Hoefully someone else will be more use.

I'm really delighted with the level of care that I've had thus far (nearly 30 weeks) from the NHS. I'm with the homebirth team, so just went to the hospital for the booking in appointment and for all appointments since they've seen me at home. I've also been along to some of their weekly coffee mornings to meet all of the homebirth midwives, which is a great service to offer as you feel like you've met all the MW's, whoever's on duty when you go into labour.

They haven't mentioned BF to me yet, so certainly no pushiness here, though I'd love to BF.

Congratulations and good luck

Thanks, I'm really glad to hear positive experiences. I think the negative stories are fewer, they probably just stand out more. Appreciate your feedback.

I had good care, though I rarely saw the same midwife twice.

I have a friend who had a C-section first time, and her midwives want her to try for a natural birth this time, though she's not too keen. I think if you pushed for it though you could get a second.

I always wanted to breastfeed, so I can't really say if they were pushy - more that they were very supportive, and I wouldn't have been able to without the brilliant help of midwives in the days after the birth.

As it is your 2nd you'll have mainly midwife care and v few appointments if you are low risk. This is my care schedule but I'm hoping for 2nd homebirth... I imagine that if you go for csec there will be consultant appts and the 38&40 wk checks would be irrelevant.

Booking in, 12 wk scan, 16 wk check (mw), 20 wk scan, 28 wk check (mw), 34 wk check (mw), 38 wk check (GP), 40 wk check (mw).

Given my experience is limited to community midwife care (which has been great - they came out on Xmas day to deliver DD1) I can't help with the other q's!

I appreciate the detailed info on appointments. It still surprises me how few appointments there are, having come from the US system (antenatal care) and transferring to private care in the UK near the end of my last pregnancy. Doesn't really bother me- I guess if they actually find a problem you'd be watched more closely, one could hope. Thank you for your helpful reply.

Depends which hospital you are assigned to. I have excellent ante-natal care at the Chelsea & Westminster but I am high risk.

Expect your blood test results to be lost. Expect to have to find out everything for yourself, so try and remember what you were given before as if you don't ask for the information - you won't get it. Although I will say that the midwives seem fairly pleasant but don't expect them to get to know you at all - don't even expect them to remember you after a few appointments, as they won't.

Im not at all familiar with NHS either and pregnancy has been my very first experience of any of it.

So far I think (hope) everything is ok. I haven't been very proactive about asking questions etc and as a result I havent heard anything back in regards to test results and have no paperwork/maternity records etc. Am not too sure how to go about finding these out as I dont really know which department/phone number to ring but will ask my GP at my next schedeuled appointment about these.

So my advise would be to clarify everything and ask lots of questions about test results, contact numbers, when you will receive paperwork etc. You need to be very proactive it seems.

I had an really good experience.

I think the MW will probably encourage you to try for a natural birth but if you have good reason to specifically want section they as far as I'm aware they are accomodating.

Birthing experiences are just like everything else in life... your likely to be online writing about it if it was bad than if it was good, hence why you tend to find loads of horror stories and not many good ones.

tebbles just ring your GP about your notes and results, if they dont have them then they will direct you to someone who has.

I come from US and even though I did not have antenatal care there before I can surely tell that your pregnancy with NHS is going to be a totally different experience. I would perhaps balance out with some private providers if possible to make your experience less stressful.
I think may be if you are under consultant care your experience will be different from mine. So far I have pretty normal uneventful pregnancy with midwife team at a hospital.
I so far found most midwifes in my hospital are lovely but some are downright rude with no client relation skills. They don't take time to explain anything, you have to REALLY ask and that makes the whole experience scary and unpredictable because there is no trust relationship with the provider. It does not help that I see different midwife every time either.
Both of my scan experiences were not very informational so I had to get 2 private scans for reassurance.

At 34 week appointment I was told that the hospital is booked and I should not come back until 40 weeks. It was overbooked with quote on quote more sick women and there is no space for me with my normal pregnancy. I demanded another appointment and did not leave until I was in the schedule at 37+ weeks.
I was pretty upset for a while and scared to have a baby at that hospital because I was not sure that they will have time for me when the delivery comes, but than I spoke to one of the midwifes during my visit there and she reassured me that everything will be OK and they will take a good care of me when the time comes.

If I could describe my antenatal care with NHS so far with one word I would say INCONSISTENCY. I really hope that you will good care but if I could make a suggestion is to go there with open mind and no expectations.

Congrats and good luck!

With a previous C-section you probably get to see the consultant at the 20 week scan appointment to start discussing options for the next birth.

I had mine yesterday, and he was very supportive of my decision to go for a repeat section (and gave me a date, as I could show that I've done my homework and made an informed decision), but he would have been also supportive if I had wanted a VBAC, he just wanted to make sure that I've looked at all the options.

I guess what kind of care and level of support you get will differ from trust to trust, and from consultant to consultant, and midwife to midwife, so it's not really a NHS vs private sector experience, but a trust specific one, I guess.

I'm really happy with the care I've been receiving both when I had my daughter and in this pregnancy.

As for breastfeeding, my midwife recommended an antenatal breastfeeding workshop in my first pregnancy, and a support group and I'm very glad she did. I didn't feel pushed but felt that the decision was down to me, but it was good to get support when I needed it (especially with a slow weight gainer, for which my GP tried to push me to 'topping up' with formula).

I'm having a great experience with the NHS, and the midwives in my area have a fantastic reputation. I don't actually know anyone who has had anything other than NHS care with their babies, and although some have had difficult moments with individuals, most have been happy with their care overall.

The only part of it that I would love to be able to do privately would be post-natal. I've heard horror stories about most post-natal wards locally, and am hoping for a homebirth (which also ensures that the community midwives that I've been seeing and getting to know would deliver the baby) to avoid it. If I go to hospital, I would love to be able to spend a few quid on some silver service private room stuff!

I've no complaints about the NHS care I've had- everyone has been lovely, the facilities have been great and no problems like test results getting lost etc. I am the sort of person that prefers to be left alone unless I'm worried though, so I had no problem with going weeks without seeing a MW in the early days.

I always wanted to BF too so can't really say if the MW were pushy or not.

The first HV I had was lovely but my new one is crap.

I haven't ever had private medical care, so can't compare, but I have had 3 pregnancies which were all 'high risk' on the NHS. My experience is that often they are a bit stretched and so if you are low-risk you don't have that many appointments. However, if (like myself) you have more problems they look after you very well. I had weekly appointments (alternately with the same midwife at the GP surgery and with the diabetic clinic). When things got hairy they became very attentive, put me in HDU room and observing me every fifteen minutes. When I got better and was due to leave HDU room (which was on labour ward) there have been nights when there were a lot of births where I have been hard pressed to get anyone to come in and help me! I was told to buzz when I had expressed milk for my ds in NICU - I did and after 2 hours of being ignored and told they would do it later I staggered there myself (day after C section).

Breastfeeding support is terrible. If you want that, although some places are good most places are not great although they do talk the talk (seem too stretched really). If you are intent on bottlefeeding they will probably just ask which brand you wish to use and leave you to it. Post C-section bottlefeeding ladies had their babies taken to the nurses station for a few hours to give them some sleep, whereas breastfeeding ones were told they could take them for a few minutes but if they cried they would have to return them (obviously) for feeding. However, help with feeding was not given very much as they were 'too busy'.
I had an Emergency CS with DS but was encouraged to go for a VBAC with DD as they seemed to want to get their CS rates down. I think if you've had one before you usually have the right to request one though. I did because of all my other complications meaning it would probably end with one anyway and wanting it at least on my terms.

Hope that helps. Good luck and congratulations!

This is the 2nd child with the NHS. I found with my DS who is now 5yrs they were absolutley fab. I had my DS at north staffs hospital they were great. I found the first scan a bit sterile and a bit rude but the rest was great. My midwife was lovley and the midwives were so nice on the ward and everywhere. This time around im 28 weeks I have moved to Rugby when I was about 16 weeks. I have found the scans to be so nice and the ladies I have spoken to are lovley and tell you everything. But on the down side I have not yet met my midwife she is ill or away. I keep seeing different ones. I went to hospital new years eve thinking labour had started was very worried I went to Warwick hospital they were lovley and the midwife was fab. But when I got there she said none of my results had been filled in and they could not find my results on the system. So I had an appt at the surgery that Wed and asked the midwife if she could fill in the results (as the lady at the hospital had told me to) and she could not find them anywhere. So had them re took I found her ok but a bit abrupt and they have always stated how busy they are and how pushed for appts they are. I found the receptionist a bit off as well. I have worked in the NHS and private hospitals in the pathology labs and have worked in haematology and microbiology and have found the standard in a NHS hospital better than private as they deal with a high volume of samples. The thing is if your private you will get results quicker and explained to you better as your paying for it. But what people dont know is that if the private hospital fails you get shipped to NHS anyways. So say your there for an op on your leg and something goes wrong and you private hospital does not provide emergancy care you will get taken to a NHS hospital anyway. Private hospitals are better as regards to infection control and the footfall is not as much as a NHS hospital there are not as many visitors or patients and yes you get results explained to you and quicker and the rooms are very nice indeed. NHS doctors work in Private hospitals as well. {smile}

It can be inconsistent, because there is such pressure on the system. So you won't generally see the same midwife, but lots of different ones, and you need to make sure that they are up to speed with your information each time. You can't afford to be passive, so ask and ask to make sure you get all the information you need. It can all seem a bit ad hoc, and your surroundings won't generally be particularly swish.

However, I think the NHS does work well. My experience has been that problems or emergencies were handled very well (an illness that meant I had to be admitted overnight, my induction when DS stopped moving, a relative's hetero-ectopic pregnancy etc) and that the standard of care was good.

My experience of ante-natal care in 2 different cities is, on the whole, positive. I was under consultant care for the first and high-risk consultant care for the second.

I had a very bad post-natal ward experience, which led to my daughter's illness not being picked up in time, and, tragically her death. This is because there was no consistency on the PN ward.

My ante-natal care after DD death has been faultless. The whole team looking after me have been alert (perhaps overly-cautious but that is good). They will make sure that baby will be well cared for on the PN ward.

Eldritch made a v good point about not being passive. Do make a noise if you are worried about anything.

I've had a pretty positive experience so far, I'm low risk so there doesn't appear to be much for them to do though! My inital booking and scan appointment was very prompt, and I've found most of the midwives that I've seen very helpful.

From reading about other people's experiences a lot does seem to depend on where you are and which hospital you go to.

I'm high risk (nearly 40 and with a kidney problem), with DC1.

I'd say the care I've had on the NHS, so far, is excellent, bar some of the admin, ie chasing to confirm appointment times and some long waits in the waiting room.

From memory I've had - booking scan, anomaly scan (inc Dopplr), and will have 28 week scan and 34 week scan. Also 2 x GTT tests, 2 x midwife appointments and at least 6 appointments with both an obstetrician and renal consultant. I've contacted the midwife (and seen same day) once myself, with a worry that turned out to be nothing.

Hope you have a similarly good experience.

I am low risk but under shared care (consultant and midwife) due to a bad tear last time and will be having an ELCS.

For a second baby with a previous section I would think it most likely that you will be under shared care too.

My experience has always been positive, I see the same midwife each time and I have been more than happy with the care I have received so far, but the focus is very much on ensuring the baby is healthy and that the overal care experience may not be as focussed on reassurance as you are used to.

As far as I remember I have had appointments at 8 weeks, 12 weeks (scan only), 16 weeks, 20 weeks (scan followed by consultant appointment, 25 weeks (optional, I didn't bother as was fine), 28 weeks, 31 weeks, 34 weeks, 36 weeks (consultant appointment to book CS), 38 weeks and will be having the CS at 39 weeks.

If you would like more involvement or are anxious it may be worth booking 1 or more private scans (I had a nuchal scan at 13 weeks and a bonding scan at 26 weeks)