When Should I be Having Appointments?

[NellyNoodle1]

Hi All,

I'm 19 weeks pregnant and so far I have only seen the midwife once and been to my 12 week scan. Last time I saw the midwife was 31st March - I was told I am to be consultant led as I have a number of problems including hypermobility and I have to take steroids for my eyes (and I have fibroids as found on the scan) to name a few. It has taken me 3 weeks to track down my next scan appointment and an appointment with a consultant after calling every day as no one was coming back to me - apparently they can't find my referral so either it was never sent or it was lost en-route. I've just looked on the NHS site and it says I should have had a midwife appointment at 16 weeks - would this still be the case if I am seeing the consultant? I know it should be a case of just calling and finding out but I really can't get hold of anyone and I can't spend all day at work on the phone. I will be 21 weeks when I next go to the hospital. I don't know if I should just chill out a bit or if I should burst into tears like I feel like doing! Advice please. Thanks.

That doesn't sound right to me. I'm 7.5 weeks and by the end of this week I'll have had two midwife apps and one doctors. An app with the consultant isn't the same as with the midwife.

The first was a general where we filled out form and I was given a specialist referral, the second to take bloods and find out about referral and to liase with my doctors notes incase we missed anything in initial assessment. You should have had that after your consultant.

Have you not been given the name of two midwives you can keep calling? I know it's hard to keep calling, I teach full time and it's a real chore for me to, but you have to put yourself before work and keep pestering them. If that doesn't work ring the hospital and ask to make a complaint.

Next time you ring them say the stress of it is really getting you down and effecting your mental health. I really hope things work out for you :)

Didn't want to read and run. I would call your midwife to make sure that you don't need to see her (I'm consultant led atm) but I had to arrange my 16 week appointment ended up being nearly 18 due to bank holidays and her only doing one clinic a week. If you ask she should be able to reassure you and be able to contact the consultant to make sure appointments are in place. Mine did when a registrar booked an appointment at 2 weeks after baby born instead of 4 week return. Chill as much as you can and call.the midwife in the morning and check. Hope this helpd

Were you given a folder for your notes? I think they differ slightly in each area but mine had a care pathway saying when I would see a midwife. There are more appointments for first pregnancies.

I think I had bloods taken at 16 weeks so this could be an important one. Call your community team and do the whole "I don't seem to have written down my next appointment" spiel.

Thanks for replies - I had blood tests after the scans at 12/13 weeks and that was the last contact I've had - I know it seems really defeatist but I can't seem to just call the midwife - I have a slot between 9am-9.30am to ring - the answer machine is always on at these times and last time I called and left a message I was called back 5 days later to say my midwife was away and to call the hospital - then the three weeks of calling started. I can leave a message again tomorrow but I will probably be at my next scan by the time I get a reply - also my hospital isn't the same area as my midwife so they said they don't hear much off them. I just didn't want to be a nuisance for no need - there is no appointment in my notes.

I would if your having this much trouble get in touch with midwives at the hospital, tell them how much stress this is causin you are not sure what is going on.

Are you sure there isn't a list in your notes of typical appointments for a first pregnancy? Mine had a page near the front that listed typical appointments for consultant led, as well as midwife led pregnancies.

Also I would contact the supervisor of midwives at your hospital and complain about this. Maybe you can change midwife teams?

This is what NICE says about normal pregnancies:

www.nice.org.uk/nicemedia/live/11947/40110/40110.pdf

There is a list of midwife appointment schedule in the NHS website
www.nhs.uk/Conditions/pregnancy-and-baby/Pages/antenatal-appointment-schedule.aspx

But they won't book them in for you , you call the surgery they work out of and make an appointment. Try contacting the general appointments line if the midwife doesn't answer ? I just call the surgery and make an appointment to see the midwife, I don't have to call her. You might have better chance then!

Thats not right chuck, im also consultant led care and from 12wks ive had appointments 2wks apart nd the odd ones bein a month apart, but ive had midwife appointments ojnce a month too, andnow having regular growth scans. Babys fine its just me lol stupid kidneys -.- i would chase them up and put in a complaint with the nhs take the matter further, cus if anything was to happen to you or babber due to their neglegance, you have more than enough ground to sue! Especially as youve already been chasing things up! Hope you get somehwere soon x

"Thats not right chuck, im also consultant led care and from 12wks ive had appointments 2wks apart nd the odd ones bein a month apart, but ive had midwife appointments ojnce a month too, and now having regular growth scans."

That's not necessarily what the OP needs, much like donkle's experiences of 3 appt before 8 weeks being highly unusual. They are not automatically being negligent!

I am also consultant led and don't see them before 24 weeks, which midwife care before then. To get midwife appointments here, you phone your GP surgery to make an appointment on the afternoon she's there. Have you tried phoning your surgery?

I had a 16 week check up, but tbh it wasn't hugely detailed. The ones you need are 12 and 20, in terms of in depth checks. I would recommend using PALS if you're confused or it is hard to get hold of appointments - I did this when a computer error meant I had no scans booked (I am high risk) at 28 and 30 weeks, they sorted it and phoned me with appointments (I used them as the same computer error was playing havoc with the phones to the clinic too!).

Oh and as Dino says, several of my appointments are local MW ones, a few are hospital ones. This seems normal these days.

I am 18 weeks and consultant led.

Mine so far have gone..
9 week - midwife
13 week - scan
15 week consultant
16 week - midwife

My next midwife appointment is 28 weeks.
As squizita said - my 16 week appointment was pretty basic. It lasted about five minutes and they asked me how I was feeling and checked my blood pressure and I went on my way. So you haven't missed much but the point is you have missed an appointment and you need to raise this with them.

I wasnt saying its what she needed but just letting her know my experience -.- so she could have some idea of how things work etc. like all your other experiences. X

And i never said they were being neglegant....i said if SOMETHING was to happen....get some glasses! And read what i type properly -.- ffs!....

Generally speaking you will/should see your midwife every 4 weeks from booking in. Once you get to about 36 weeks the appointments become every 2 weeks. I can't speak for consultant led care as I didn't have it, but I would have thought they don't come into the picture until later in your pregnancy.

You do need to book the appointments yourself though, I always booked my next appointment the day after my last one as they tended to book up quickly.

Actually all women in my area have 2 appointments by 8 weeks, so I'm really not that unusual - it's given in our notes and appointments are allocated. I've only had 3 due to a ectopic scare and exploded cyst.The first an initial assessment lasting an hour, the second for compulsory bloods and to merge documents from doctor surgeries.

I did suggest this seemed a bit much and was told it's the national service framework. So basically when you're pregnant you should see a medical profressional, be it midwife or otherwise twice before your 12 week scan.

I also take steroids for underlying autoimmune problems and have health issues, more the reason to have more than one app by 19 weeks. Due to my steroid use I will have more midwife appointments in the long run. My steroids are also only topical. However, unlike yourself my midwife did make this clear to me.

I hope I don't come across as moany to other contributors but I am sticking my ground on this one. I certainly am not 'highly unusual', given your health issues and ongoing medication 1 appointment by week 19 isn't ok. Neither is constantly ringing and not getting through, that's not ok at all. I won't even mention the lost referral. On top of that the stress and time consumption of answer less phone calls on your part is inappropriate.

Moreover, the fact that you're this confused means someone hasn't actually sat you down as said 'right this is what's happening', which when you actually have no idea is what you need. That right there is called patient centered care, the basis of our nhs system.

I really hope you have had some better luck and managed to get through to someone today or that your consultant has been clearer with you x

I'm consultant led and so far I've had a booking in appointment at around 7 weeks, dating scan at 12 weeks along with first consultant appointment directly after the scan. Then I had my 16 week appointment with the community mw. That was basic bp check and urine and a listen in which was the first time I heard my baby's hb. I then had 20 week scan, again followed after by seeing the consultant. From there my appointments have differed from the norm as our baby has a cleft lip so we've had additional scans and appointments but up to the 20 week point I believe I followed the normal routine appointments. I do have to make my own mw appointments though and just make sure I check in my notes when these should be x

The norm where I am is that someone sees you every four weeks, whether that's a scan at the hospital or a midwife at the GP's. So 12 week scan, 16 week midwife, 20 week scan, 24 week midwife and more midwife appointments from there. I've had growth scans in both my last pgs plus consultant appointments so have seen the midwife in between. It's been down to me to make the actual appointments though.

So far at 18+4 I've had and will be having following apps

10w - booking in app
12w - scan
17w - MW check, bp, hb and weight. Consultant and next MW app given
19w - 20 week scan
24w - MW app
28w - scan
32w - scan and consultant app

This is as far as I can go. My MW has booked all my apps. The only one I had to book was the first one.

FWIW it isn't always the case the consultant is seen at the end. For me, the risk reduces week on week so I was seen more frequently at the start and now have more mW care.

Consultant led here, and private scans to 12 weeks.

Day 1 - went to GP for medication I need to take when pregnant
8 weeks - NHS booking in appointment
10+5 - private viability scan for Harmony blood test
12+5 - private Nuchal/bloods and Harmony test result and scan
17 weeks - first consultant appt, at which I also saw a midwife for 2 minutes
21 weeks - NHS '20 week' scan

Future already booked in
23 weeks - consultant appointment for Doppler scan
24 weeks - GTT (boo)
28 weeks - growth scan
32 weeks - grown scan
36 weeks - grown scan

My consultant appointments are booked one ahead only, so I won't find out about the next one until after the 23 week one. I'm guessing I'll see a midwife at that point too for the same 2 minutes as I had last time. Who knows. It all feels quite random.

Firstly, boogles, calm down! You said "if anything was to happen to you or babber due to their neglegance". While an appointment has been missed, there is no evidence of negligence. Missing an appointment is very unlikely to lead to something happening. And I am also rather unsure about what a "babber" is.

Anyway, nelly, as squizita says, the consultant appointments really depend on why you need to see them.

Because of a previous stillborn baby, I get fetal medicine scans at 8, 12, 16 and 20 with fetal echos at 18 and 23 weeks. Assuming all is well, I don't need to see the consultant for a proper appointment until a bit later on when the next onslaught of scans and appointments will be decided.

Getting PALS on the case might be the best way to sort things. Not being able to contact anyone to ask questions and sort this out is clearly not ideal. They have ways and means and need to know where systems are failing so that it can be improved.

Most of the MWs I know are massively overworked, working in understaffed wards and departments, and last time I was in hospital, I was positively encouraged to complain about delays as they get told by management that "well, the patients don't complain, it's just you" so nothing changes.

I've been asking similar questions myself! It seems to vary a lot from area to area but from what I've observed in my area people on the 'standard' MW-led pathway seem to not have to do very much and just get funnelled into a standard set of appointments. Whereas once you start seeing consultants instead of midwives you start having to be proactive as you're not on the regular treadmill.

I haven't seen a midwife for an appointment since my booking-in at about 8 weeks - although I've had regular consultant appointments which for the most part seem to cover the same basics (ie I always get dipstick, BP, bump measurement and heartbeat checked), and I always have the opportunity to mention any particular concerns/ask questions. But the main focus of the appointments has always been skewed to the specific medical reasons I'm seeing the consultant in the first place.

I have double-checked that it is (in my area at least) correct that I only see the consultant, but I'm allowed to book to see the midwife in addition if I want (which I have done and I'm seeing her tomorrow at 32 weeks) - but that's entirely down to me. I've realised there's certain things that seem to have been missed (I've never had my MATB1 form, no-one's talked to me about the Whooping Cough jab yet) which I assume would be more likely to be part of the standard midwife checklist.

Just to add I saw the midwife today which was helpful - flagged up the fact I'd not had a 28 week appointment so I've got to go back this afternoon to have my bloods done which should have been done a month ago.

So based on my experience I'd definitely recommend anyone on consultant-led care being on the ball about making sure that all the routine things get covered.