Consultant care?

[freneticfox]

Hi all!

I had my booking appointment with a midwife today (6+1) and my midwife said that because I've had a cervical erosion and also have hypermobility I'll be under consultant care. My head was spinning with so much information I didn't really get a chance to ask what this meant.

Can anyone shed any light?

I have hypermobility-rated resistance to anaesthetic so I too am under consultant care, as opposed to midwife-led for now.

What this means for me is that although my preference for birth location is a midwife led unit (MLU) not attached to a hospital, until my appointment with the consultant anaesthetist, I am booked into the local university hospital. If they deem that it will be in the best interests of mine/the baby's health, I will continue to be monitored by the consultant (in other words 'under consultant care') and give birth in a more medicalised hospital environment than a MLU. They'd have to drag me there kicking and screaming though.

My hypermobility has been blamed for my intolerance to anaesthetic at the dentist, so I'd guess they have the same concerns for this?

Not liking the ideal of a medicalised birth though, especially after seeing how nice the maternity unit is at my local hospital!!!

It's nothing to worry about, just a few extra appointments!

You'll see a consultant at the hospital at about 16 weeks (in my experience) to discuss the issues that have got to referred to him/her. They may then decide you are 'low risk' after all and you'll return to just midwife care, or they may decide to see you again.

You are generally referred to consultant-led care if your pregnancy is anything other than completely simple. That could be issues in a previous pregnancy, complications in the pregnancy of your mum/sister, a high BMI, all sorts of things. Your notes should tell you why you've been referred.

Good luck!

Yeah and hypermobility can pose problems in pregnancy over an above the anaesthetic issue... hypermobity in pregnancy advice

Mine was diagnosed at the dentist too OP! As Happy said, there's every chance you'll be considered low risk and released to midwife-led (as I'm hoping I will be). The MW at my booking in said pretty much what Happy does, any kind of indication of a medical condition which could be considered atypical might automatically put you under consultant care just as a precaution until they've investigated and assessed the risk.

With resistance to anaesthetic, it's ironic the risk is that we may be unsuited to procedures common to constant-led medicalised births!

A consultant-led birth doesn't have to be medicalised. Yes, the surroundings might be more clinical and less cushions, but there doesn't need to be any increased intervention just because you happen to be somewhere where those interventions are available :)

Your midwives and consultants want you to give birth somewhere where the equipment/people that they think they might need are available. They also want you to feel in control of your birth and fully engaged in the decisions that need to be made. But it would be negligent of them to let you continue on to a midwife unit birth if they genuinely think there's an elevated risk that you'll need anesthetics/doctors/other interventions that are not available in a midwife led unit.

The statistics will tell you that there are more interventions in a hospital environment than a midwife led environment. Of course there is! The people who are more likely to need an intervention are selected for hospital units, so naturally there will be more interventions there. That doesn't mean that any particular mother is any more likely to need an intervention because she's in the hospital - your birth will pan out the same way wherever you are. The interventions you might need will be available to you if you're in the right place :)

Good luck again!

Sorry, yes I didn't chose my words well but I did mean clinical medicalised environment as opposed to inevitable medicalised interventions.

Agree with Happy. I wanted a midwife for pregnancy/birth but landed an ob/gyn. I fretted about a hospital birth, unwanted interventions etc but eventually accepted it was where I needed to be. Birthing went exceptionally well ( and for which I am eternally grateful and appreciate how fortunate I was) and there were no interventions whatsoever. Inform yourself about the process, go in knowing how you would like the birth to proceed, what your choices would be should the need arise and keep an open mind to how the day may unfold. (I was quite surprised and in a good way - happy story).

Thank you all for the responses; definitely keeping an open mind, especially at this early stage!