Anyone else had their pregnancy classified as high risk just because you had PND previously?

[wompoopigeon]

I recently went for my booking in appointment, and the MW saw that my GP had noted on the referral letter that I had had PND after my first child. While it wasn't much fun at the time, that was three years ago and I have been fine since. It was, compared to some, mild - treated with group psychotherapy, no meds or in-patient stays or anything like that, no concern about the baby's safety or anything.
The MW pulls a face, asks if I want to be referred to social services and insists at great length that I am classified as a high risk, consultant-led pregnancy, with my first consultant appointment at 12 weeks. I have not the faintest what I am going to say to him or why she was so incredibly insistent. Actually I feel really pissed off about the whole thing, and wish I had said no when the GP asked if she could disclose it.
Anyone able to share any experiences of how previous PND was dealt with in subsequent pregnancies? It all seems so ... heavy handed.

I had this with my dd! I had pnd with ds1 & ds2, but this was really to do with my situation at the time as my xh was physically & mentally abusive.

Actually it was my gp who got me "down-graded" as she's known and treated me for many years, and knows all about my previous situation.

This time, I mentioned it when asked but the mw wasn't bothered as I was fine with dd.

I don't know if this helps (my situation is slightly different...). I've suffered with pre-natal depression this pregnancy (my first). My community midwife was a bit worried that this would classify my as high risk and so I wouldn't be able to use my local midwife-led unit.

However, this local unit has a specialist mental health midwife and she plonked me down in front of the consultant and got him to write in my notes "Is not high risk, can use MLU, no further consultant appointments needed".

Could this be your tactic with your consultant appointment? Get him/her to agree that you're not high risk, and refer you back to MW-led care?

It does seem incredibly heavy-handed though, all that has been lined up for me post-natally is an early visit from the Health Visitor so that I know who will be turning up on my doorstep.

Hope it works out for you.

Yes and I'm a bit at sea with it. I've been referred to consultant care instead of midwife purely and simply because of PND, it's written clear as day on my notes.

I haven't seen anyone other than MW yet so not really sure what this means in practical terms.

Hi Gwen, I too had PND after DD and am pg again. I can understand how hp's would like/need to know for after the baby is born, which is the approach my MW is taking, but surely the 'high risk' should refer to medical issues. I don't think your consultant is going to be knocking on your door after the birth to check how you are coping! I'm sure the consultant will agree that you are not medically high risk and I would maybe go down that route with the MW - emphasise the medical side of things.

Does seem very heavy handed. I had severe PND after my twins and was medicated for 2 years.

I talked to my MW at my booking in and she seemed relatively unconcerned, I guess the HV will just keep an extra close eye on me after the birth...

I am classified as high risk but only as I'm on Clexane (injectable blood thinner). Even then she hummed and hawed about whether to put "high risk" so I'm pretty sure the PND didn't come into it...

I'd actually argue that I'm at less risk from developing PND this time becuase I know all the things to do/ not to do to help myself (eg making sure I sleep whenever I can, accepting help etc). Even if I do develop it I know the signs and would seek help immediately... The thought of SS being involved would concern me a bit TBH although I hope someone would come on here and say that's completely unfounded.

Good luck with it...

I ended up being referred to a psychiatrist early on in case I needed meds, but he was happy that I wanted counselling instead. My CMW reassured me that, even if I ended up being referred to the community psychiatric nurses, Social Services would NOT be involved.

Does your hospital or Trust have a specialist mental health midwife? It may be worth finding out and getting a referral to her as they are a bit more clued up. Mine has been amazing, and is now my main contact at the unit.

I was diagnosed with PND after having my 1st it was never mentioned with my 2nd (3 years later) and it hasn't been mentioned with this one.

I am Consultant led and classd as high risk for this pregnancy but it is nothing to do with the PND.

You may find the Consultant will give you more information and explain it better or they may even remove the risk etc. See how the first appointment goes and hopefully it will all become clearer then.

Congratulations on the pregnancy and Good luck for 12 week appointment.

Thanks all for the helpful replies, and glad to see that some others have found that it wasn't mentioned in second pregnancies. I feel like I am totally wasting the consultant's time. In fact, the MW was so bizarrely insistent about classifying me as high risk that I wonder whether the trust has some kind of target for high risk births and so she wanted to add me to the statistics.

I was thinking of cancelling the consultant appointment but now I think I will just very firmly and sanely (!) ask him to remove the high risk status as Daisybell suggests, as I am very keen to give birth in a MW-led birth centre. Whether he can remove the "PND" word which the MW scrawled in thick black pen on the front of my yellow notes remains to be seen.

I don't think that they do have a mental-health MW but god knows they could do with some sensitivity training.

Like outhere I feel at much less risk of developing PND this time round- have more support organised already for a start- and I honestly wish it had never been mentioned until I reached the HV stage. The MW even tried to enter it into the system as "psychiatric problems" until I leaned over and corrected her (she was stuck trying to spell psychiatric so I had a long time to notice what she was trying to type!). Really interested to know what happens to others like Gwen- and experiences of any others of course. Thanks so much.

I had mild/moderate PND with my daughter. I didn't even mention it at my MW booking - it wasn't something I wanted scrawled on my notes and I didn't really want to talk about it. I can't see its relevant anyway - it's not as if it was really severe or that I felt depressed during pregnancy. I was classified low risk. Can't you just refuse to go and see the consultant?

That's interesting brettgirl. I didn't raise it at the booking in appointment but it was there in the referral letter which is why the MW zoomed in on it.
I'd like to refuse the consultant's appt- indeed it is a total PITA as it was organised for me on the only day of the week I have no childcare. The MW trilled at me to take DD along; FGS like I am going to discuss my (historical) mental health problems with a 3.5 year old listening.
I really wish I had been less up front about PND and then I wouldn't be in this ridiculous situation.

I had another thought - can you go to the supervisor of midwives and ask her opinion? Apart from the risk factor the social services comment is frankly bizarre. It doesnt sound like she handled well it at all. That level of 'sensitivity' could be really damaging to someone who was depressed. At the very least ring the hospital and rearrange the appointment for a time you can get someone to look after your daughter. The MW expecting her to sit there while you discuss how hard you found it after she was born defies belief.

Similarly to Daisy I had pre natal depression with DD2. The extra care I received was; HV visit monthly during pg to check how I was coping with DC1&2, early sweep (40 weeks) and further sweep every 3 days (if I'd needed) to try to prevent an induced labour as I was very anxious about having one and a phone assessment by the mental health midwife.

They do seem to be being very heavy handed here, if you're not happy to see a consultant then you can refuse a referral. Also worth seeing GP again to inform them how your MW reacted, so they're prepared when you turn down consultant care.

Thanks, this is all very helpful food for thought.
I think I will rearrange the consultant appointment. I worry that if I turn it down then it'll appear as a red flag and I'll get more grief.
No one has ever ever mentioned social services before and I can tell you it sends shivers down your spine. I am happily married, professional job, own flat, good health, happy child, blah blah blah blah- the idea that my family could be referred to social services just because three years ago I was a bit miserable... You'd honestly think that they had bigger things to worry about.