A call for a change to be made to the 'no-doppler policy' at 16 week midwife check

[Mythreeknights]

I've just had the most pointless 16 week midwife check ever (this is 3rd pg so I know from experience that this was completely pointless).
Other than dipstick my pee and prod me in the tummy, she did nothing, asked nothing other than "keeping well?" and wrote nothing down other than "keeping well" (seriously). It took me 25 mins to drive to the appt and 25 mins back, a total including appt time (and pre-appt waiting time) of about 1 hour, 10 mins.

She was quite defensive (obviously gets it in the ear a lot from upset pg mums), and said "but what would I do if I couldn't hear a heartbeat?" I replied, "Well, I'd hope you'd send me for a scan so they could see if I was carrying a live or dead baby". She replied "no, I'd get in trouble for that" and I said "well, I'd rather know at 16 weeks that the child had died rather than carry it around for another 4 weeks and find out at the scan".

My suggestion, if the NHS / Royal College of Midwives is so worried about not hearing heartbeats at 16 weeks, that they just send us dipstick packs, so we can dip our own pee (3 minutes), write our own notes (3 minutes) and not spend 45 minutes sitting in the car.

Anyone feel the same?

[posybunchof]

But isn't that the point that your GP friends made though...?That as there is a chance that it won't be found at 16 weeks because it is too early (as in poor jacquelines's case), so unnecessarily stresses out mothers, but sending someone for a reassurance scan would be over-stretching already pressed sonographers.

When I went for a mini-scan (one of those mobile scanners) at the day unit for poss breech, I did think, why don't midwives have those in their offices - money is the reason of course, but if they were able to whip those out for a quick check in the event of uncertainty...

It does sound though like you have got a midwife who maybe doesn't suit you (or other women by the sound of it!). It's such a shame you have so far to drive to find any midwife and that the one you have you don't 'click' with.

[Mythreeknights]

Well quite. The resources should be made available instantly in situations like yours.

[JaquelineHyde]

They couldn't find the HB at my 16 week scan.

They booked me in for another appointment in a week so that they could try again.

I got told if they couldn't find it at the next appointment I would be sent for an emergency scan

It was without doubt one of the worst weeks of my life.

They found the HB at my next appointment, but I honestly wish they hadn't bothered looking for it because what is the point if you then do nothing about it for another week anyway

[Mythreeknights]

letmefly what a horrid situation, I am so sorry you lost a baby and I am so pleased that you went on to have a successful fourth pregnancy (and that the 16 week midwife had a heart).

I have since spoken to a gp friend and a midwife friend, both of whom know the midwife in question with my situation. It was interesting what they said, basically that I'm not the first person to find her manner appalling and that its very much 'her way or no way'. People have moved to other tactics to avoid seeing her. But, apparently she is experienced and her professional judgement is great, so it's a toss up between sacrificing the human approach and the ball ache of going for check ups even further away. As for my astonishment that she wouldn't listen in, they both agreed that 'it causes more stress than manageable when they can't hear a heartbeat', that 'sonographers are already over stretched and do not appreciate having to scan healthy mothers who have been worked into a false state of stress'. But still, I think it's crazy that some mws are happy to do it and some are not, and come on, if so many people can find a baby hb on their own with no experience using a Doppler as early as 11 weeks I find it impossible to understand how an experienced mw cannot. I am still for bringing back the doppler at 16 weeks nationwide.

[badguider]

Scotland doesn't use NICE or not always - certainly not for drug decisions anyway..

In Scotland the following organisations perform a similar function to NICE:
The NHS Quality Improvement for Scotland carries out technology appraisals
The Scottish Intercollegiate Guidelines Network (SIGN) provides clinical guidelines
The Scottish Medicines Consortium (SMC) gives immediate advice on new medicines when they become available

[sanityisamyth]

I had a midwife appointment at 17+2. She tested my urine and listened to mini-me's heartbeat (150 bpm). All seemed normal so I was very happy with that. I'm assuming it varies between areas.

[posybunchof]

Well I am getting v confused but the poster who posted with the NICE guidelines suggests it is not policy but that most midwives do it anyway. Which suggests that the OP is just unlucky having a midwife who said no.

[FoofFighter]

Or rather it's supposed to be policy I meant... I heard mine too, and am in Scotland.

[Fakebook]

With dd I was oblivious to anything bad happening. I didn't even know what a miscarriage was because I'd never thought about one. With DS, after 4 mc's I was very anxious and bought a Doppler and heard his hb everyday from week 11 to 40. Every single day.
This time I've only listened in twice and luckily, her movements are very regular so I'm not anxious at all.

If you really need the reassurance, then I'd buy a Doppler and use it at home. But be warned, you need to fiddle around a lot until you hear a hb and sometimes you may need "reassurance" at 2 or 3am when you can't feel baby move and you'll find the battery dead or something. This causes more grief than good. (Personal experience).

[TobyLerone]

The fact that many of us have heard the HB at our 16 week appointments would say otherwise.

[FoofFighter]

But it is policy pretty much across the whole of the UK isn't it, if the NICE guidelines say it?
Nothing to do with being in Scotland at all.

[apprenticemamma]

Are the home Dopplers any good? which would peeps recommend?

[posybunchof]

"I wouldn't mind so much if it was policy across the whole of the uk not to use a Doppler at 16 weeks."

The link posted by someone else though said NICE actually don't recommend dopplers at any appointment though. So I don't think you are missing out because of your area, just midwife preference?

I really would get a doppler (does your DH have to agree?!) if you need that much reassurance. It didn't cross my mind I wasn't pregnant between my 12 and 20 week scan (as eccentrica is right, it isn't fairly common for babies to die after 12 weeks, as the sonographer who posted earlier also confirmed) but I can understand why some people need more certainty.

[eccentrica]

letmefly I'm really sorry to hear that I do agree that they should listen at 16 weeks.

OP this is the Doppler I got - there are lots of them going second hand on Ebay too

www.ebay.co.uk/itm/161035484583

I was 16 weeks when I bought it and it sometimes took a few mins to find it. Am now 19 weeks and it's much easier and quicker. However, I've never not been able to find it with the Doppler. Just takes a bit of practice and a bit of hunting at first.

I got it because I thought I might not feel movements til after 20 weeks, as with my daughter, and I couldn't bear to wait that long. It has made pregnancy a much less anxious experience for me.

The main warning I've read is not to use it in later pregnancy instead of counting movements, as that can be falsely reassuring. So once I start feeling proper regular movements, I'm going to sell mine on.

[letmeflyfarawayfromhere]

My MW listened for the h&b at 16 weeks with all my first three babies. Babies 1 and 2 - found it with no problem. When it came to baby 3, she couldn't find it; she did reassure me that this was not unusual at 16 weeks but it was worrying.

Luckily, I was referred for a scan the following morning, squeezed into a probably overstretched EPU clinic as the first patient. The baby had died at around 14 weeks.

With baby 4 (a year later) it was hideously stressful going for that 16 week appointment. When I finally got there, the MW told me that the new policy was not to listen for the hb. I am sorry to say I cried until she gave in .

I accept it can be tricky at 16 weeks but really for the small number of us for whom something has gone wrong after 12 weeks, is it really acceptable to leave it until 20 weeks? Would it really have been better for me to have gone for the anomaly scan to be told it had been over for weeks, that it was now too late for an ERPC and that I would have to go through giving birth to a baby that had died six weeks earlier? I don't get it.

[OddBoots]

I know you're feeling let down but if she palpated your uterus she would have been making sure it is the right size for your dates, if it wasn't then she would have sent you for a scan.

As your uterus is the right size for your dates then that in itself is a very good sign that things are going well.

It's not an absolute but as Viva says, even a heard heartbeat isn't a promise that all will be well at 20 weeks, there's a lot we can't have control of.

[islingtongirl]

*when it isn't

[islingtongirl]

Just to add I am in central london and heartbeat wasn't checked at my 16 week appointment, was told policy not to anymore as cant always be picked up and causes mum's more stress etc why it isn't, similar to other people's experiences. Yes I was a bit disappointed but somehow managed to wait until 20 week scan and then hb has been checked at every appointment since, even at GP.

[QuietNinjaTardis]

I heard the heartbeat at my 16 week scan. My midwife said she wasn't supposed to but as I had been suffering from hyperemesis and had to have blood taken to check my iron and she knew I hated needles she did it as a treat. Said she had been a midwife long enough that she could ignore the rules a bit.

[MaryKatharine]

I also have a home Doppler and along with the newborn breathing alarm is the best peace of mind equipment ever.
We have never had a problem picking up the heartbeat. Also your heartbeat is unlikely to be 158bpm. I think baby's heartbeat is very distinctive from mum's.

[eccentrica]

I wouldn't tell the midwife!

incidentally I've had anterior placenta both times, first pregnancy felt almost nothing til about 23 weeks, but this time have felt from 17 weeks, don't know why

[ShadowMeltingInTheSun]

DH got a doppler when I was pregnant with DS, and he got a huge lecture from the midwife when he mentioned this to her.

Apparently it's fairly common for untrained people to have problems finding baby on their home doppler, and then panic and call the midwives at the hospital.
Midwife said that they recommended keeping an eye on baby movements instead, although I know 16 weeks would be very early to be able to feel anything - I've had anterior placentas for both pregnancies, and never felt any baby kicks before 20 weeks with DC2 (took longer than 20 weeks in first pregnancy) because of that.

[eccentrica]

tell your DP it's a piece of cake :-) I've been finding it since 16weeks and, while I'm not massive, I'm not super slim either so i do have some excess weight on my belly.

I'm on my phone but when I get on laptop I'll post you a link to the one I got. I use it twice a day and it's really changed things for me, wish I'd had it in previous pregnancy!

j find scans/hb checks only stay reassuring for about a week and then I start worrying again, or something happens like my daughter jumping on my belly! its great to be able to check at home

[Mythreeknights]

You are right eccentria but dh worries we won't be able to use it properly so I have to convince him too! Would have been so much simpler if the mw had done it, I would have been relaxed up to my twenty week scan.

[eccentrica]

it is not 'fairly common' for babies to die between 12 and 20 weeks. the overall risk of miscarriage in second trimester is 0.5% so lower if you have no risk factors e.g. previous mc, etc.

I'm currently 19w and get terrible pregnancy anxiety which is why I recommend getting your own Doppler. if they hadn't found the heartbeat you wouldn't have accepted it, you would have demanded a scan as you said in your op.