Delay booking with NHS until 3rd trimester

[AlexandraN]

Hi all,

I am pregnant with #2 at the moment, should be about 6 weeks (my son is 4 m.o., this is a surprise pregnancy).

I work full time, back to the office when my son was 3 weeks. The job (financial, in the City) is challenging enough now even without the need to ask for time off for the antenatal visits and annoy the boss even more. Also, I must admit I saw absolutely no value added by the midwife appointments during my 1st pregnancy.

It may sound like heresy, but with the new pregnancy I am very tempted to delay booking with the midwife until halfway through my 3rd trimester. Educated enough not to drink, smoke or use street drugs during my pregnancy, not in the risk group for sickle cell disease etc., able to check my blood pressure with the home monitor, have a doppler at home so can check the baby's heartbeat whenever I like. Of course will do all the scans & bloodwork privately (at convenient time, without three-hour queues). Presumably, it will also help the NHS overstretched budget.

Am I missing something obvious with my decision?

Scans?

How do you know what you are looking to hear on the Doppler?

Hats off to you, you must be knackered.

BaldHedgehog, I did my scans (early scan, pathology scan and some extra now and then just for reassurance) privately even with my son + a Harmony blood test. Planning to do the same this time.

Llareggub, the heartbeat can be heard from week 12+ with the home doppler, healthy reference ranges & required variation are widely quoted in the internet.

Whatever works for you.You might go and check some urine & blood samples at some point just in case.

Will you be able to pick up conditions such as gestational diabetes on your own? Those symptom-less uti that can cause complications? A baby that is growing too small / large because of a medical issue?
I would be too concerned that I wouldn't pick up on these (not being a medical professional) and wouldn't want to put them as second priority behind annoying my boss.

You must have a dating scan so growth (lung maturity etc) can be accurately checked later otherwise it will be harder to know whether to intervene. It sounds like you will do all the screening, dating and anomaly checks anyway so it is up to you. The Doppler you do yourself won't be of any use to the medical team but if you need a proper Doppler later they will do it.

I can't see a problem especially as your planning to go private for the scans and blood work.

I've personally been very dissapointed in my care, and have decided to not have a midwife till 30+ weeks if I should be lucky enough to have another. I will probably do the same as you book private scans. I know my blood group and refused the down syndrome screening as it would make no difference to me and your always going to be one in something. I'm now of the opinion overstretched community midwives are a waste of time and effort in early pregnancy as they do nothing and palm you off to the go ooh anyway.

The normal fh ranges are easy to find online. However, you are not trained to hear any deviations?

I've had all my scans privately and dipped in and out of nhs care when I've needed it.

I would also want to have regular urine dips. Can you not see a gp or request home visits?

You're fully within your rights to not do so, but just remember it is your right to be able to attend appointments. You cannot be penalised and if you are you can take them to the cleaners. BUT can I just say home dopplers, especially to the untrained ear, won't be much use.

I wouldn't advise this, but it's up to you.

Urine dips you can buy on ebay - just so you know. I don't want you risking anything x

Checking urine?

I believe as a "late booker" you might be referred to social services though.

Gp or gp ooh that should have said.

I'll also add I've started to see my gp to check on urine after my recent kidney infection. I've arranged for the practice nurse to dip my urine every fortnight feom now on to check it. My surgery gp and nurses are far better than the midwife.

Why not get a private midwife? Mine was amazing. But then I had a home birth so the cost made sense.

I thought maternal refusal to access antenatal care can result in a referral to social services but if you're having private scans etc that may not be an issue.

Given that many MWs now don't bother with the Doppler at appts I don't think that's too much of a concern.

You can do your own urine dips at home to test for sugar and protein. You can buy the strips at most larger chemists.

Overall if it comes down to a bit of inconvenience at work, I would deal with it to ensure my health and my baby's health.

Well, it is of course your decision. But if i had done this, my dc2 wouldn't be here now. Completely normal pregnancy first time around. In fact no issues with second (and I used doppler etc-and for at least a week I was listening to my won heartbeat ). Dc2 was delivered at 29 weeks by emcs with severe iugr (very small). I had loads of movements etc, nothing felt wrong. The placenta was failing.

I think you need to rethink.

How about using a private service? I'm sure they must be able to offer evening appointments.
Fwiw, the local maternity unit I used (NHS) would routinely offer evening appointments for mums who couldn't make day time appointments.

Of course I do not think I can pick up any pathologies with the home doppler. The thing is, I do not believe that the midwife can either. During my last pregnancy even no doppler machine was used by the midwife - just a hearing tube (honestly), for 10 seconds or so. Had an eclamptic seizure & emergency delivery three hours after my 38th week appointment, where I was assured everything looks great and elevated blood pressure is ok if no protein is present in urine.

The main purpose of this thread is to understand what I may be missing by not booking with the NHS. Gestational diabetes was a good pick, did not think about it, will research how it can be monitored independently.

Booking time off work will unfortunately will result in the job loss, I was already warned about this last time, do not want to take the risk. And have no holiday left to use - took all holiday for the maternity leave last December. Job loss is something I simply cannot afford now (pathetic I know).

Do you know your rights re maternity leave. Are you aware that dismissal relating to a pregnancy related reason would make it automatically unfair?

I'm going to assume that you are a very high earner in the City and that's why employment rights mean little (what matters is that no one else would employ you after a claim and you'd have to go discrimination to bust the compensation cap to make you doubly blacklisted, yes?)

Have you thought about an independent midwife? Who would come to your house evenings and weekends to fully monitor you? With a history like pre-eclampsia, do you really want not to be in the system if something goes badly wrong again?

You can get private midwives and obstetricians, even if you don't want to deliver privately. Why not see how accommodating they can be in terms of timings?

Thyroid function is another thing to watch for your list!

Why don't you just go private?

My MW has never listened to babies heart beat is this something else she "should" have done?? Anyway that's another thread.

I can see your issue about the early appointments as I was the same needing to take time off as I didn't announce it till I had to, basically when bump popped up but maternity leave is legally protected, you can't be dismissed for taking it at all!!

You can get private GPs (my local hospital does this). I would be inclined to investigate following that route, so make all the appointments at a convenient time for you (and probably close to work). If you are being monitored by a professional then it should be okay. I wouldn't want to do it myself, as even after 1 uneventful pregnancy things could crop up in the next one. And your first pregnancy wasn't uneventful was it?

I expect you will be like two women on my ward after no.3 - both fielding work calls about 6 hours after giving birth.