Pregnant after IVF - consultant or midwife led care? Very confused!

[GreatSoprendo]

Just home from a rather confusing 36 week appointment with MW. The MW I saw today is my new MW, as my last one has left. I asked her about their policy on induction and when I would be induced - because someone I know told me she was induced at 40+6 rather than 40+12 because hers was an IVF pregnancy (as is mine) and due to her being 38 (I'm 37).

MW told me it was my choice, and asked what my consultant thought about it when I had my last hospital appointment - to which I replied, what consultant and what hospital appointment ! Turns out, according to this MW, in my area all women who are pg after IVF are referred for consultant led care and would have appointments with a consultant to talk about early induction and presumably other stuff too. Except somehow this has never been mentioned to me and I have never been referred.

She did say its not too late and I can see a consultant now to talk it through but now I don't know what to do. My pregnancy has been fine, and my IVF was due to male factor infertility so medically my pregnancy is normal. But they offer early induction for IVF pregnancies apparently just to due to the heightened levels of anxiety amongst IVF mothers - which is a definite issue for me, but presumably induction (or even just being under the care of a consultant) would exclude me from having a midwife led delivery, birth pool etc?

Has anyone else had midwife led care and no consultant involvement after IVF? I feel a bit obliged to go for the consultant appointment now - seeing as I should have had this in the first place. Wha would you do?

I was consultant lead, I had ivf but also had a large cyst due to the fertility drugs.

I only saw the consultant twice and had some extra scans to check cyst not the baby.

On my delivery the consultant spoke to me only as I had to be consented for surgery just in case the cyst caused problems. As there were no problems the birth was completely
Midwife lead, no medical involvement due to the ivf.

I heard shortly after getting my IVF BFP that it was standard for IVFers to be consultant-led. I was horrified by this. After all I had been through, I finally wanted to be "normal". A bit of google research indicated that a lot of women felt the same and negotiated their way out of CL care at the first consultant appointment. Many other women liked the reassurance of extra appointments and scans and so were happy to stay CL. If there are no concerns about the pregnancy, it seems to really come down to personal preference.

I suppose at this point in your pregnancy, the big issue is the birth. Would you be happy to be excluded from MLU/pool etc?

Thanks for your replies. I can absolutely relate to wanting to feel 'normal' Euro after the trials of IVF! I think that's why they have really thrown me with this news today - I've been enjoying being normal! Just feeling very upset that I've found this out so late in the day, and after I had merrily been planning to have a water birth, been to visit the MLU etc

I'm tending to think I will stick with the MLU as that's what I had been assuming all along.... Going to do a bit of research and talk it through with DP.

if your pregnancy is medically normal and all is fine then I would avoid induction of labour if it is not necessary. I had consultant led care (not ivf but recurrent miscarriage) and i think the reason I was induced at term was actually more due to anxiety than any valid reason related to the baby. You end up strapped to a bed on a drip with continuous monitoring, no chance to be active, higher chance of needing epidural (which I did not get) and higher chance of failed induction leading to emergency c/s.
obviously if you need to be induced then what matters is the safe delivery of the baby. But if you don't need it I'd avoid it and go for the MLU instead

I'd go and talk to the consultant, nothing to lose. Hear what they have to say about induction and either accept it or decline it. I'm 95% sure there is a medical reason about inducing earlier for IVF, not just for anxiety. Can't remember the exact reason or stats though.....

I'm 33 weeks after IVF ICSI and no one has mentioned this to me at all at any appointments...
I saw a consultant about severe SPD and he never said anything.
Starting to worry a bit - should I have had special care?

Hi Ollibobs. I had ICSI too. Really hope my post hasn't thrown you into turmoil too! It seems to be different policies in different areas, but in mine I should apparently have been referred to a consultant. I think the medical reason for earlier induction viva is referring to is a very slight increase in still birth rates with IVF pregnancies - I will try and post a link to what I read but it basically seemed to as that although there is a slightly (and it really was tiny) increased risk of still birth, this was probably more to do with more women with underlying health issues and women who are older having IVF rather than any effect of the IVF itself.

Just cross that this has cropped up so late in the day, and only then because I asked the MW after a conversation I had with someone in a pub [shocked]

I have nothing to add about IVF but just wanted to say, just because you might become consultant led doesn't mean your 'birth plan' goes out the window.

I was consultant led with DS due to issues with DD2 but I asked specifically and found out they had wireless monitoring equipment so I could be mobile and use the pool and everything else on the midwife led unit. The info wasn't forth coming but when pushed they told me about it.

Being consultant led doesn't have to change what you want to do birth wise. Our hospital isn't high tech but they had it, yours might too.

I've just been through an ivf pregnancy. I was under consultant care the whole way through, but due to my medical history. I'm 37. The way I understand consultant care in this area is that they keep an eye on things, and do stuff if the need arises, so if everything is fine (was with me) I was planning a water birth at the consultant unit under the care of a midwife. As it was my waters went and labour didn't start so I was induced, but even so, the consultant only came in for 5 minutes to write up the prescription for the drip and the rest was midwife led.

I was automatically referred to CL care after ICSI but at around 20 weeks or so I was basically asked "so why are you here?" as all was normal. Not a word said about earlier induction. It was a second pg though, so I wonder if my previous normal delivery was taken into account. Anyway, can understand why you are cross, as obviously someone isn't aware of the hospital's own policies.

I think this was mentioned at my booking appointment but I heard nothing more about it. I thought that was because the reason I had IVF had no bearing on my pregnancy. Having said that I did see te consultant at my request a couple of times and had an appointment with him for the day after DD ended up arriving as I was very anxious about being left to go overdue as my dates were so accurate.

In my health care region ivf is not a factor that leads to consultant care. At my booking in appointment the care pathway was established by scoring me against a range of factors (illness, age, lifestyle). I am 40 and pregnant after ivf so am under consultant led care due to age not method of conception.