Consultant Care not Midwife care?? Confused

[SMummyS]

I'm 8w4d and I've just been put under consultant care due to my rather large cyst and daughter cyst on my right ovary, it's 65mm x 53mm x 48mm and has grown by 1 cm in 12 days :(

Does anyone know the difference in consultant care as I didn't think to ask the midwife his morning. I know I'm going to be scanned more and il prob have to have an elective CS. My midwife is seeing me at 15w4d to discuss the mothering side of pregnancy as the consultant will just deal with medical.

Anyone been through this ?

It just means you have to see a consultant (doctor or something) from time to time. I saw my midwife as usual, then had extra appointments to see a consultant with my 3. I was scanned alot last time, so would have a scan every 4 weeks on a Mon and then saw my consultant every 4 weeks on the Wed. to discuss the scan etc. Saw my GP/MW as normal too. Consultant did the same things as a MW visit really.

It's just about the main person in charge of your care. In your case (and in mine, with DD2), because of a couple of complications, it is the consultant who is ultimately in charge of your care during your pregnancy. You will still see the midwife in between.

It may well mean you have more appointments, and that you have to have some of them at the hospital, but it shouldn't necessarily make any difference to your birth unless their are complications later on from your cysts.

What it hopefully means is that you are getting the best care, and that the person making decisions will have all the specialist knowledge.

Hope it works out okay for you.

My sister had this and they scanned often to check size of cyst. As it didn't grow much, she was ok to give birth on the midwife led unit (ie low risk). If there had been any problems, the hospital would have liked her to give birth on the consultant led unit just in case there were any serious issues during the birth.

Don't worry about it and if it helps, write a list of questions to ask the MW when you next see her.

Thanks all of you, you've cleared it up for me. I've already started my list :) they've given me an email address if I have any non urgent questions so that may come in useful.

My first consultant appointment is after my dating scan which will be in about 3 weeks.

Oh, and also, don't be surprised if you don't actually see the consultant herself very often. Being under "consultant care" just means under the care of their clinic, and very often it's a more junior doctor who sees you, unless your situation is very serious. In my case, I saw the consultant the first time, and then never again (which I took to be a good sign !)

I'm expecting that :) it's Dr X and team lol I've seen juniors before and usually come away feeling as though everything has been covered :)

Don't be afraid to argue with them though if you don't understand/like what they're telling you. In the end, your care is your decision IYKWIM and you can insist on seeing the senior consultant if you feel it's necessary.

I mean, they are the experts but that doesn't mean you have to accept everything they tell you without question.

I have been under consultant care for all 3 of my pregnancies because I have a very large fibroid on my uterus. I saw a mixture of midwives and doctors (including the consultant). I saw the consultant more in my first pregnancy than inthe the other two.

I had the same consultant for my first two pregnancies and got on very well with her. I felt safe, listened-too, and un-patronised. She was quite happy for me to labour on the birthing-centre side of the labour ward.

The consultant I saw in my third pregnancy, however, was completely different. She tried hard to push me into a highly medicalised birth and even used scare-tactics on me. She was very interventionist, bossy, and dismissive. (Friends of mine who were under her care for elective CS loved her.). Eventually the senior midwife talked to her on my behalf and persuaded her to sign me off for midwifery-led care during my labour.

I think consultants tend to see more abnormal pregnancies and births, and are therefore more likely to be protocol-led and interventionist, whereas midwives see plenty of very ordinary pregnancies and births, and are more likely to be open to allowing the woman to trust herself and only take over control of her labour if it is meducally justified.

On the whole, I liked having the safety-net of expert medical care, but, when it comes to labour, nothing beats an experienced midwife.

I know nothing about ovarian cysts. Why does having one require CS?

Generally you don't have to have one with ovarian cysts but mine has bent the Fallopian tube up and over my uterus and is sat ontop of it. as baby and cyst are growing it's pushing up into my pelvis. I think it's more the size and position, plus even if I give birth naturally I'd be then sent for an op to remove them.

Sounds uncomfortable! Is it painful?

My fibroid at its largest was 11cm, and would quite literally swing around inside my belly as the pregnancy progressed and lifted up out of the pelvic cavity. If you imagine a clock on your belly, with noon on your bellybutton, it would swing from 7 over the top to 1. But from about 18-20w it stopped moving around. I expect that things began to get a bit snug as I expanded.

The positions of your internal bits will change as the pregnancy progresses, as different parts of the uterus grow at different rates.

Late in the pregnancies I had scans to make sure the fibroid was above the baby and not obstructing my cervix. It had absolutely no effect on my labours.

I asked whether, if I ended up with CS, they could whip the fibroid out at the same time. My consultant (the one I trusted) was reluctant. IIRC she said that there was too much risk of excessive bleeding.

Surely it would be possible to remove the cyst via keyhole surgery, once your body has recovered from pregnancy? I know that it would have been possible with my fibroid.

it is at the min, but its due to rupture in the next week, we've pinpointed a pattern :(

I can actually feel it now. Im going to wait to see what the consultant says as the information I was given was from the consultant on the gynocology ward, not that I dont trust what they said but they also told me id probably miscarry before my next scan which was 12 days away!!

They usually do the keyhole surgary to remove them but they said seen as Id be open anyway... now you've said that il definately make sure I ask that question

What a situation to be in.

It is so far out of my experience that I don't know what to say. All I know is that having a 'growth' outside the uterus may not affect your labour. This is clearly far more complex.

I hope it all goes well for you.

Thanks PrettyCandles i shall be finding out in the next 4 weeks.. slightly nervous now!