1st consultant appointment

[SellyMevs]

Hi all,

I'm 14+4 with my first pregnancy and I've been deemed high risk so will be having consultant led care. I've got my 1st appointment next week and I have no idea what to expect.

I have a heart condition, I've been treated for SVT previously and tend to have an abnormally high heart rate. I also have a clotting disorder and I am at an increased risk of haemorrhage.

Will the consultant want to discuss my birth options? I guess I'm trying to second guess what decision will be made about my care. My heart problem means I tire easily, become very short of breath and can have a very low blood pressure. The clotting disorder means I require transplants etc if surgery is undertaken.

I've resigned myself to the fact I have little control over the situation and will do what's best for me and the baby but I can't help wondering! Any questions I should remember to ask?

TIA

Not in quite the same position but i'm consultant led and am shnizzin myself about the first appointment. My last pregnancy was low risk so i can't even compare cause i was midwife led then.

I know how you feel cause you just feel like you're surrendering all control over the pregnancy and labour.

I would clarify what kind of birth they have in mind .... but ive known women still be allowed to give birth in a birth centre under midwife led care.

Sorry... i wasn't much help, was i?!

Hi Selly - I'm under consultant care due to having two chronic conditions, one of which is being a history of SVT and general tacchycardia. I was on Beta Blockers prior to pregnancy but came of them prior to TTC as nobody could guarantee me about birth defects.

I'm having an elective C-section due to both my conditions but my cardiologist said that just having SVT/arrhythmias is not on its own a reason to have a c-sec. It may well be that with your clotting disorder it is safer for you to have a CS....is that what you are expecting or wanting?

I originally wanted a water birth, but consultant led care wins you a place in the delivery unit upstairs in my local hospital.

I've not taken beta blockers since before I conceived. I don't want a c section unless they deem it necessary. But at the same time, I don't want to become so unwell during labour that find the whole experience traumatic. I have M.E. as well so this can compound the tiredness. I suppose I just have to hang on and see what the recommendations are!

I wish I'd realised how my health would be affected during pregnancy. . Ordinarily my conditions are considered to be benign and a bit of an inconvenience. I asked my GP last year about TTC and my health and his advice was just to stop the pill when ready and crack on. I'm not sure that really prepared me for this!

Your consultant will certainly have an opinion but ultimately they can't make you do anything you don't want to do so it should be a discussion not instruction. It may also be too early to decide, they may suggest waiting to see how the pregnancy goes.

Your consultant will do all of the usual tests your MW does first. They might offer you extra scans if they think it necessary. They will discuss your medical conditions with you, but don't be surprised if they wait until a later appointment before discussing birth plans in too much detail.

My Cardiologist warned me how the pregnancy might affect my heart and explained that I may end up back on Beta Blockers if my heart struggled to cope with the extra workload. I was fine until I hit about 19 weeks when my heart rate started climbing, I started having palpitations again and the odd dizzy spell. My Obstetrician checked my pulse and I was having missed beats and an erratic rhythm and so was re-commenced on my Beta Blockers. I was put on the lowest dose possible and my symptoms improved almost instantly, I felt so much better in myself. From 24 weeks gestation I had 4 weekly growth scans as issues with the heart, including arrhythmias and high blood pressure can affect the baby's growth so they like to keep an eye on this - I've had no issues though and baby is huge I would have had these monthly scans whether I was on Beta Blockers or not so you may find you get the same treatment.

its really important you say that you feel a bit out of control with this pregnancy beacause of your health. i say that because there will be decisions you can make and ways to bring that control back to you. one of the things thats a really good thing to ask is how does have this impact on my pregnancy and birth? although it might seem early to be thinking about birth now, it might well be that its the earlier the better (unsure on this one) so that you have more time to get used to it and consider whats best and safest for both of you.

Hi everyone - just an update for you.

Saw the obstetrician yesterday and they have a plan for me. It's been decided that Plan A is for a vaginal delivery. This is the safest option for my bleeding disorder as it is the lowest risk of haemorrhage. I will be induced, and given 2 drugs to help my blood clot. I will also need a platelet transfusion. To combat the heart issue... I will be given an early epidural (providing the anaesthetist is happy I'm stable enough) and this should prevent my heart rate rising unnecessarily and hopefully keep that under control. They will also have a specified Plan B if an EMCS is required. They also won't be using forceps or using anything that could risk injuring the baby, as the genetics are not fully understood about how the bleeding disorder is inherited, except that it does run through families. So they are determined to reduce the risks until the baby can be tested for the disorder.

I'm relieved that they have obviously done their research and thought of every eventuality. I'll be seen again at 28 weeks to start to finalise the plans. I'm a little disappointed as it's not the birth I had envisaged. But I can live with a little disappointment if it means I can have a healthy baby and the safest delivery for me!