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?

You already said if she couldn't find the heartbeat that you would expect a scan. My local EPU was double booked all week this week already. Where do they fit the extra people in?
It isn't an exact science. The baby is still small at 16 weeks. There's a good chance the heartbeat might be hard to find.
Believe me, I understand PG anxiety. Im 9 weeks PG after a previous MC and my sister lost her DD at term.
But as others have said, its very rare for things to go wrong at this stage. You just need to try not to worry.

You could always buy your own Doppler and drive yourself mad with worry in the comfort of your own home....

Perversely, my MW listened for the heartbeat at my 12 week appointment, gleefully telling me that she may not hear anything (knowing full well that I had had two previous miscarriages ). I didn't have the emotional strentgh to ask her not to, and hate to think what state I would have been in iof she hadn't found anything.

Buuuut, personally, I think that an experienced MW should be able to find a HB using a doppler at 16 weeks.

Congratulations Saggy

And another thing; most of my MW appointments were of the "wait around for not much time spent" category, but all my pregnancies were very straightforward. My SIL, on the other hand, had terrible problems that were only picked up via a routine MW appointment. She was more than happy for all the travelling back and forth as it meant her baby's genetic problem was anticipated well in advance of the birth thanks to an on the ball midwife who picked it up at a routine appointment.

Aaaaaand, the MW service, like all aspects of the NHS, is at breaking point. MW's really do do their best.

I had a similar experience as you OP.

MW refused to listen for hb, it was my second pregnancy and I hadnt felt baby move, I felt DD move at 13 weeks so I was anxious about it yet she still refused. The doppler was lying on the table between us the whole time.

a colleague had her 16 week check @ 2 weeks before me and got to hear the hb. she lives about 2 miles from me different LA, gave birth at the same hospital.

I left the appt and ordered a doppler and heard hb myself 5 days later.

I think everyone should be entitled to the same care.

Horrible midwife !

I know they have rules to abide by and if they bend the rules once etc etc but I just do not understand the logic in allowing a pregnant woman to leave an appt with anxieties which could be alleviated.

I had already had an early scan at 8 weeks due to HG and was having a thoroughly shitty pregnancy.

It was a very stressful time.

oh and congrats OP I hope the rest of your pregnancy goes well and you get to hear hb soon.

DS is now 10mo and a bundle of energy

Maybe you should be glad that it was a nice simple appointment for you but there are lots of women this won't of been the case - referrals need to be made, BP monitored, blood test results discussed, scan results discussed and discussion re: further testing. Medication checked & started.

YABU thinking that every woman is the same as you and that there is no point in anyone having the 16 week check. Just be glad you had no issues and be grateful for the healthcare you receive free on the NHS

When I went for my appt at 10 weeks with ds1 mw whipped the Doppler out and could hear hb. Defo before my scan. This time round I realise that she is a bit of a maverick!. My mw said the policy is not before 16 weeks bc of reasons u describe. So may differ regionally but also individually .

In Scotland we don't even get a 16 week appt. it's 12 week scan, 20 week scan then midwife appt at 22 weeks.

10 weeks is really early to try and even locate a HB- how can the MW be sure it wasn't your heartbeat that you heard?

I'm glad they don't listen to the hb at 16 weeks any more. My 16 week appointment was a terrifying 20 minute search for a heartbeat, followed by an emergency scan referral. Turned out my LO was incredibly high up for 16 weeks but honestly, I would have much preferred they didn't look for the hb.

Straightfoward mw appointments can sometimes feel a bit disappointing, but as other posters have said, it means you're having a straightforward pregnancy. There are plenty of people who don't and the 16 week appointment is a vital step in identifying those for whom there may be complications emerging.

The other thing I would say is that it's up to you to make sure you get the most out of these appointments. Go armed with questions (written down if necessary), ask for clarification if you're not happy with the answers, and don't leave until you've discussed everything you want to.

Congratulations, Saggy! That's excellent news

I think the major issue for you is the travelling time. That's your 'fault' for living in the country, surely? (I mean that in terms of your personal responsibility/choice rather than the NHS or any individual HCP.)

With DD1 at 28 weeks I had to go for a half hour trace at the local Antenatal unit because the midwife had heard a couple of decelerations. She said it was probably just the baby pulling on the cord. All was fine but that was the worst hour or so of that pregnancy as I cried at my sister's and all the way to the hospital. DH and I resolved never to buy a personal heartbeat monitor as we'd be checking all the time and worrying that we couldn't interpret the sounds properly.
As pp have said, remember that it won't be such a straightforward appointment for many women. Try to relax and enjoy your pregnancy rather than stressing over everything. You'll be feeling movements within a few weeks. If pregnancy taught me one thing it was patience!

books - that's not true for first time mums in Lothian. We all had an appt between 16 and 18 weeks where our booking blood results are given and 12wk scan results discussed.

Because of my age I went to the hospital for my 16 week check and the doctor there listened to the heart beat - took a moment or two but she got it and it was strong.

As this is my first pregnancy and I am totally clueless I had no idea I would be able to hear the baby's heartbeat. I am so glad I did though - that was the point where I finally felt like I had a baby inside of me. I had had the 12 week scan (and one at 8 weeks as I had bleeding) but they didn't seem real - the heartbeat did.

I don't care what the NICE guidelines are I think if many women are given the opportunity to hear the heartbeat at 16 weeks then that should be available for all women. I understand the OP's disappointment and upset at being denied this.

I had my 16 week appt with my MW last Thursday.

I wasn't very ok.

i had suffered a threatened MC 9 days earlier, (blood everywhere) and had spent a night on a drip in hospital. I had tried to ring the MW on the way to A&E but she wasn't answering her phone. I had left a text message, but got no reply.

I had had a scan the morning i left the hospital, and baby was ok. Oblivious even, thank God.

MW: Oh - you must have so worried. But if the gynea couldn't explain it then i can't be expected to. No, no listening in to HB today. (this muttered with her back to me - i didn't even twig what she was on about till i was handed my notes back to leave) Urine's ok, BP's ok. 20 week scan was booked ages ago. That's it. questions?

Me should i be feeling baby move?

She - hmmm, some people do .... See you at 28 weeks - bye.

10 mins.

She won't see me now for 12 weeks.

sigh. i dunno - i just hoped for more from her.

I had a scan at every antenatal appt, whether it was with midwife, gp, or consultant. Just a quick scan, so they could see heart beating, baby moving etc, not lke the big scan at 12 and 20 weeks.

Was really shocked when I read on mumsnet how unusual that is. I was very pleased with my antenatal care, it was very attentive, and all forms of physical and mental health issues were covered.

treacle are you in the UK? It's extremely rare for GPs and MWs to be trained and experienced in antenatal scanning.

It's also rare for GP surgeries to even own an ultrasound scanner!

I've just come back from an emergency appointment with my midwife at 14 weeks due to a small, old bleed yesterday. They said there was no way they would check for the heartbeat and they don't offer it until 26 weeks! My older children are 13 and 10 and I distinctly remember hearing their heartbeats at the same GP practise at 14-16 weeks.
Saying that, the doctor and MW have been fantastic over the last two days and I know I would have gone into a panic if they hadn't found a heartbeat.

It's a tricky one. It depends whether you see listening for hb as a clinical test or as something nice for mum.

If its a clinical test then the very basics of any test is that a) you should have a clear idea if what it is you want to find out and b) you are going to do something with the results and c) it's predictive or useful. Listening for a hb in that basis means that I must be able to refer for a scan or something else if I can't find it. Otherwise it's a useless clinical test and shouldn't have been performed. Listening for a hb isn't predictive or useful as explained above so it should be discounted on that basis anyway.

Where I work I can refer for a scan at 16 weeks if I can't find a heartbeat. So I do listen. I do not listen before then, not even at 15w6d, as I can't do anything if I can't find it.

If listening for a hb is just something nice for mum then we can't expect to spend NHS money on scans etc if we can't find it. I feel this leaves mums in a really scary position. S I always treat it is a clinical test, only listen when I would expect to find it I.e. after 16 weeks and have recourse if I don't. Really obese women are seen by the consultant at 16 weeks anyway so I don't have that to contend with which makes it even trickier.

Some hospitals will be strict on nice guidelines (where it suits them) and I've heard of listening in been a disciplinary issue for midwives. So if I worked at such a trust I wouldn't do it in a million years, knowing there was a good chance that it would be spotted in an audit and I'd get a bollocking/file note.