Confused and disappointed

[SlightlySuperiorPeasant]

I'm under consultant-led care for my second pregnancy as I had pre-eclampsia first time round and DS was a low birth weight baby. I'm now 31 weeks and this pregnancy is completely normal - no pre-eclampsia, fundal measurements perfect, growth scans all within normal parameters etc.

I've just seen the consultant this morning for a routine appointment and been told that I can't have a home birth, I can't use the midwife-led birthing unit (right next to the delivery suite), I can't use the birthing pool and the recommendation is that I am continuously monitored throughout labour. I asked why, when this pregnancy is textbook, and got told that it is still high risk because DS was 'smaller than we expected' last time round.

I'm a bit confused and really disappointed. Everyone knew from 30 weeks onwards that DS was going to be a small baby, it wasn't a surprise to anyone. All measurements this time round have been perfect and if they continue to be perfect and I don't develop problems in the next few weeks then why would DC2 be LBW?

I really don't want to have continuous monitoring through labour. I know I can refuse this but I don't want it written all over my notes (which it has been) so that I'm constantly having to battle with the midwives and doctors when I'm in labour.

The consultant did say that I can refuse all the recommendations and have an unplanned homebirth if I want to, but I don't want that extreme either!

I've been trying not to panic about labour this time round because DS's birth was awful and I've been telling myself that this time will be different, but it seems like it's going to be a re-run for absolutely no reason.

Do I have any options between accepting all the recommendations or none?

I think this sounds like you need a chat with your MW? She will be a bit less clinical maybe, and might be able to offer some good practical advice?

I did talk to the MW after the first appointment with the consultant (less doom and gloom than this one but ruled out home birth straightaway) and she said that this consultant is notorious for going for the most clinical route on offer. Maybe I'll ask to be seen by a different consultant and see what they think.

You CAN have a homebirth - they can't stop you. They can advise against it - but ultimately the decision is yours, and your midwives have a duty of care to support you x

PE can be life-threatening, without symptoms - and you are more at risk this tome, having had it before.

I'd personally take the professionals advice.

I could have a homebirth but I don't really want one. If something were to go wrong, I don't know how I could live with myself. I asked because I am so anxious to avoid a re-run of last time but I would have been much happier in the MLU (which they can refuse access to and now have done), which is through a set of double-doors to the delivery suite but with a more relaxed atmosphere. I'm really disappointed that the consultant has ruled that out but I knew that was a possibility. What I'm really not happy with is the recommendation for continuous monitoring. I feel like I'm being pushed into a very medicalised birth and don't really understand why.

The consultant isn't worried about PE, the concern is that I could have 'another unexpectedly small baby' who will be vulnerable during labour and delivery. I don't agree that DS was unexpectedly small and don't understand why they would think DC2 would be.

they can't force you to be continually monitored, it's your choice. you can try insisting on a mobile monitor or ask to be regularly monitored instead. i am in a similar position for different reasons, i don't want a medically managed birth and will be refusing CFM but i have spoken to my midwife and have her support, in fact her suprevisor is talking to my consultant on my behalf which i hope will make a world of difference.

my advice would be to do your homework, look into the risks and speak to your midwife then you can make an infomred decision. i think the bottom line is that they can refuse to let you use the pool etc but they can't force you to have CFM or any other medical intervention that you don't want. Consultants tend to be a bit too nervous sometimes when there have been past complications, your midwife should have a more relaxed and supportive approach.

good luck

Thanks hzgreen. I spent some time today looking at the NICE guidelines on when a woman should labour in the delivery suite and other hospital trusts' policies on using a birthing pool and CFM (I've requested a copy of my local hospital's policy on maternal care). I don't meet any of the increased risk warnings or contraindications so I feel more confident in pushing this.

If I end up with CFM or lots of intervention then that is luck of the draw, but I don't want a highly medicalised birth to be the starting point when it seems so completely unnecessary.

good call with the maternal care policy slightly!i think the more you know about your own situation and your rightts the more likely you are to get their cooperation rather than just going along with the medical routines.

how assertive is your birth partner, i believe mine will be key in giving me the best chance for a vbac because on the day i don't really feel i'll be strong enough to keep fighting for what i want. also adreniline slows down the birth process so i don't want to be arguing my case while trying to have a relaxed natural birth!