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Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

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Original poster

High risk obstetrics

36 replies

KitsKat · 28/06/2006 23:18

I'm wondering if anyone can give me advice on how high risk pregnancies are treated in the UK. I'm moving from the States where I see my ob every week until 12 weeks (then every 2 weeks). As I'm high risk he wants me to see an ob as soon as I arrive in the UK but I'm concerned consultants aren't as accessible there. How do I go about finding one? What's the standard course for high risk pregnancies in the UK? I'll be living in the Bournemouth/Christchurch area. Thanks

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mears · 28/06/2006 23:31

High risk pregnancies are monitored by consultant. You certainly will be referred to see consultant. If you don't mind me asking, why are you high risk? I am not sure that many high risk pregnancies need seen weekly till 12 weeks then fortnightly. US has a different approach.

Original poster

KitsKat · 29/06/2006 16:05

I'm considered high risk in the States because I had IVF, am 38 and have mild thrombophilia (tendancy to bllod clot). I'm nervous that when I get to the UK it will take me a while to get through the system and see a consultant. I have found one on the web at Bournemouth hospital and don't know whether to give his secretary a call - if that's allowed in the UK?! Yes I'm sure the States are more full on (paranoid?!) than the UK.

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expatinscotland · 29/06/2006 16:07

I hate to break this to you, I'm from the States myself, but be prepared to pay privately for your treatment. I'm not saying miracles don't occur, but on the whole, yes, you have a good way of putting it: it's more full on there.

Here, it's more than likely to be treatment rather than prevention.

expatinscotland · 29/06/2006 16:07

Here, they don't consider being 38 high risk at all unless you have complications - then you become high risk.

jabberwocky · 29/06/2006 16:13

kitskat, I am an American living in the US, but have been posting on MN for almost 2 years now. From everything that I have read, you absolutely want to go private. Americans would find the NHS a completely different world and, imo, more than a bit unsettling. You might try posting to ask about private consultants in the area where you will be moving. Or, consider staying in the US until the baby is born.

expatinscotland · 29/06/2006 16:15

I've no experience of the US system, as I have given birth to both my children here to a Scots father and was not high risk at all, but I'd have to agree w/jabberwocky unless you're the laid-back, adventurous type.

CarolinaMoose · 29/06/2006 16:17

OTOH, most British women would wonder why on earth you need to see a consultant every week of the first trimester .

You will be fine here, there are plenty of very good doctors.

Hopefully someone from the Bournemouth area will be able to recommend a private hospital/consultant (I'm assuming you can't use the NHS without paying anyway?) - or you could start another thread asking specifically about that.

expatinscotland · 29/06/2006 16:19

i think in the US, carolina, they try to prevent miscarriage, particularly in IVF patients. i don't know how they do this, b/c i never had IVF, but from what i gather, that's what the aim is.

CarolinaMoose · 29/06/2006 16:30

weird.

I don't know what happens to IVF patients here, but I've definitely heard of the fortnightly appointments thing as being routine in the States. What would you find to talk about?

expatinscotland · 29/06/2006 16:33

Dunno, both my babies are Scots. They get more scans there, too, methinks. I wound up w/more, b/c I always had things come up - like severe anaemia, the midwife couldn't find DD2, bleeding in early pregnancy, hypertension, etc. - but there they just get them more.

They get way more appointments.

When I was first pregnant w/DD1 and didn't know about MN, I went on some US boards, but I couldn't relate b/c my experience was very, very different from theirs.

kitegirl · 29/06/2006 16:51

KitsKat, I have thrombophilia (suspected, have had clots in the past), I am now 34 weeks pregnant and went private because I wanted a consultant-led birth and at 24 weeks midwife kept dismissing that there was any need for the consultant to see me and saying that I should go for a home birth... Some of my US friends have had their births here covered by their US medical insurance, perhaps this applies to you?

jabberwocky · 29/06/2006 17:57

Oh, good point! When I was in Budapest several years ago on an international business studies trip we listened to a talk given by someone who started a clinic for just this sort of thing. Would definitely be worth looking into. So, don't cancel your insurance until you know exactly what you are going to do!

mears · 29/06/2006 18:18

Gosh I am surprised and disappointed that most of you seem to think you need to go privately for high risk care
Thrombophilia is a well known condition in pregnancy as is IVF. It is the thrombophilia that makes the pregnancy high risk - many women with IVF pregnancies prefer to have low risk birth ie be mobile, no intervention, use the pool etc.
Being seen on a weekly basis is not necessary IMO and the cynic says to me that there is a link with income generation in the US rather than clinical need.
The necessary care required for high risk pregnancies is delivered free of charge on the NHS, and high risk women see a consultant.
If an NHS consultant thought you needed to be seen fortnightly, that would certainly happen. It all depends on the clinical situation. Frequent visits do not equate with high standard of care necessarily.
If you really want to be seen on a fortnightly basis during your pregnacy whether it was clinically needed or not, you would probably have to go privately and pay for it. I am not sure that a private consultant would see you more frequently than was needed either, but they are more likely too because again it is income generation.
You have to do what you feel more comfortable with KitsKat, but if you needed a certain level of care you wouldbe given that on the NHS.

mears · 29/06/2006 18:21

Sorry, meant to say if you wanted to see a consultant fortnightly when it wasn't needed clinically, you would need to go private.

Best thing to do is discuss care with the consultant when you get here. He/she will advise what they think is necessary. If it is fortnightly visits then you would get that. If they thought that wasn't necessary but you wanted that, then private care would suit you better.

mears · 29/06/2006 18:28

NHS treatment guidance

alex8 · 29/06/2006 18:39

I had a high risk pregnancy towards the end (gestational diabetes and benign intercranial hypertension) and I was seen on the NHS every week for the last 2 or so months. Each time I saw a midwife and one or more consultants.

milge · 29/06/2006 18:57

I was a "high risk", due to twins, and had to fight not to be seen every 2 weeks by a consultant on the NHS- gave in at 28 weeks and turned up every 2 weeks. If you want care when it is not medically necessary, you will need to go private in the UK - try Bupa for a list of consultants in your planned locations.

Kittypickle · 29/06/2006 19:09

Hi KitsKat. I could be wrong but I think that pregnancies deemed to be high risk in this area are seen in Poole. I'm reasonably certain that Bournemouth is for more routine pregnancies. I was deemed high risk due to my weight and my blood pressure that goes a bit dodgy during pregnancy. Actually the only time I got to see the consultant was when I went for a private sexing scan at the private hospital next door to Poole. Consultant's name is Mr Sawdy who I think excellent, very approachable. I'm sure if I felt that I had needed to see him for my antenatals I could have, but I had a lovely senior reg who I had every faith in and was very supportive. We're a slightly different area to where you are but I think that is the way it goes with high risk pregnancies. There are a few of us down here so someone else may well be along and know something I don't.

jabberwocky · 29/06/2006 22:19

kitkats, the other thing to be aware of is the post-natal situation in the hospital. there is a thread on it somewhere, but I was amazed to discover that no one seems to get a private room or send their baby to the nursery overnight - even after a c-section. Another thing to check out in the private sector.

jabberwocky · 29/06/2006 22:54

Here's the link to the other thread I mentioned.

mears · 29/06/2006 23:04

Different hospitals do different things. Single rooms areavailable wherte i work and although babies stay with their mums, midwives change nappies etc. Women who have problems are sometimes best not in single rooms so that they can be easily observed.
Nurseries are no longer used due to increase of infection,security issues and also for the fact that it is not good just to bring a baby to the mother when it needs fed. Because she has not been aroused by baby wakening, milk flow is reduced and baby does not feed so effectively. I passionately believe that bottle fed babies should not be fed by staff, but that mothers should feed them too, just like breast fed babies.

mrsdarcy · 29/06/2006 23:23

I saw my NHS consultant every fortnight until about 24 weeks.

I had a single room as well, apart from about 12 hours post-natally when there was a clinical need for me to be kept an eye on.

IME it's a good idea to get to know the consultant's secretary (find out her name and direct line as soon as you can).

Traipsing off to the hospital every fortnight is a complete pain though, and the more they look at you and prod you, the more chance of them finding something that will scare the bejasus out of you but turn out to be nothing.

Isn't thrombophilia something the NHS is perfectly capable of dealing with, anyway?

Original poster

KitsKat · 30/06/2006 01:13

Thanks everyone for all the advice! I will have private health cover in the UK so I'll look into consultants. It sounds like lots of people have had good experiences with the NHS though. To be honest healthcare costs a fortune in the States but it doesn't always buy great treatment.

OP posts:

jabberwocky · 30/06/2006 01:32

I hope it didn't sound like I was totally slamming the NHS, kk. It's just that it seems very different from what you and I are used to. The best analogy is that it is similar to the US medicaid program, although that is not a perfect comparison.

expatinscotland · 30/06/2006 09:06

I wish I'd had some help w/DD1 after her birth - forceps and loooonnnggg labour. The whole rooming in thing, especially the first night, was awful b/c I really, really needed some sleep - I'd been awake for 32 hours.

But it just wasn't to be had and that's a lot of the reason I wanted to come home straightaway w/DD2 so I could have some support to hand - my DH, SIL, ILs.

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