Consultant appointment - what to expect?

[Teeste]

I'm 19 weeks today, I've got a consultant appointment tomorrow and my anomaly scan on Friday.

I vaguely remember this consultant appointment being because I'm high risk due to BMI, so they have to make sure they can site an epidural and that I can extend my neck in case they need to intubate. Is this right? Should I be expecting anything else?

Also, would this be a good time to mention the sporadic spotting/bleeding I have? Neither my GP nor my MW has taken it seriously and keep assuming it's piles (it's not), but it's still happening and I have no idea why. Or should I ask the sonographer on Friday?

You need an anaesthetic review for epidural/intubation questions.

My consultant review was probably the same as a midwife appointment in that took blood pressure, dipped my urine, checked previous bloods, listened to baby heartbeat. And generally just chatted about my other health issues.
I went with a list of questions for her.
(She then arranged an anaesthetic r/v as a lot were about epidurals.)

I also asked if I needed to stay on consultant pathway. The midwife has a set criteria so will have sent you there for confirmation as to whether can go back on midwife led service (or that's my understanding as I asked consultant if needed to keep seeing her or go back to midwifes. I'm back under midwifes with just another consultant appointment around 30 weeks to make sure everything okay with other health issues etc)

Definitely mention the spotting to your consultant. And to your sonographer if you still concerned.

HTH

Thanks Fudge :)

I have been seeing my MW throughout though, maybe they do the anaesthetic review + consultant in one here? My MW said to wait to see what the consultant said before e.g. taking baby aspirin. I'm also booked for a glucose tolerance test at some point. Does this mean I might not see my MW again? I'm confused :( I guess I'll find out tomorrow though! Good call on the list of questions.

I hate all this high-risk stuff, just feels like I may as well book myself in for an ELCS and have done! I'm clearly doomed to have a terrible birth and ALL the problems.

Re the bleeding (sorry if TMI) - I've had two scans that were absolutely fine, no problems noted, so I have to assume it's not life-threatening. I have PCOS, so could be a cyst or something. It's normally only after a bowel movement, but is definitely not from the back area! It still worries me though, especially after my MC last year. Gah! I may be a bit hormonal and anxious today.

They may do. Although my anaesthetic review isn't until week 28. I'm 20 weeks. So loads of time to wrap my head round things.

I would write out all your questions. But in the first instance it sounds like the MW wants the consultant to decide on whether you should start taking aspirin. But once that decision is made I'm sure you can go back to appointments with MW.

I've heard of people seeing both mw and consultant - so loads of appointments that were unnecessary. Just make sure you clarify that point.

I've still not even met my midwife (last appoint was a consultant one and my mw is in a different base from where I went for booking appoint! Confusing much!)

I had my 2nd consultant appointment yesterday due to high bmi you may find they wont even speak to you about anything like epidural yet, they will just do what they do at a midwife appointment.

Check hear beat, BP, Urine don't forget to take sample with you. Ask about family history. And probs asks about referral for health weight clinic (I still not had a letter about this 29 weeks now kind of pointless)

She/He will then most likely book you in for a growth scan for 28 weeks if everything had been going well.

If MW and Doc not concerned about your bleeding you probs won't get much of a response from a consultant either.
I have to visit doctors every 2 weeks now as well due to family history of blood pressure problems but that's it so far for me with my consultant Next to see her at 34 weeks when I think more things like birth and so on will be discussed.

Donno if any of this info is a bit of help to you. :) My midwife is also a higher band then my consultant and seems to always go against what my consultant had put down kind of a pain!

OK, so I'll expect another round of body fluid tests and guilt and shame weight warnings :) I've written some bullet points down to ask about anyway and have roped DH into coming with me as he's way better at remembering stuff than I am!

With the bleeding, MW said most common cause of painless bleeding in 2nd trimester was placenta previa. I googled it and I really shouldn't have - slight panic! But then it doesn't sound like what I have, I just really wish I could get an answer. Is it just me or do the NHS generally not give much of a crap about you worrying unless it turns into depression?

Tbh i find they all seem to be so rushed they don't really give a shit about you I feel like I am wining it most of the time!! I just go with the flow an try not to worry to much.

winging it that ment to say :P

Hi op.

I am also classed as high risk due to my bmi im a bit nervous about my consultant appointment could you please let me know what happens?

I really want a water birth and my midwife says if I go back to midwife led care then there will be no reason why not. I also hate the "OH your overweight you wont be able to give birth naturally" kinda vibe im getting be interesting to see how you get on xx

Sure, I'll update tomorrow.

I'd love a water birth, my MW said it might be possible, the MW I saw at my 12 week scan at the hospital said no way They've booked me in with some kind of advisor much closer to my due date to 'discuss options'. I'm pretty sure my 'options' are going to be severely limited :(

See Ive had no such conversation. I have seen my midwife once at 5 weeks pregnant. I am now 16. I have my next scan when I am 21 weeks and then see my consultant straight after. I hope that its not rushed and get to ask some questions. The high risk part of all this is making me dread the birth. Im terrified xx

Did you not have a 16 week MW appointment? I had to book it myself, it's not automatic, but it was really helpful. She listened to the heartbeat and answered a bunch of questions, checked me for piles (so glamorous) and did the urine and BP tests.

Re water birth and general high BMI births - this blog is a breath of fresh air! I reckon we have to stand up for ourselves when it comes to the NHS and their rigid policies, but I'll give it a go. Rest assured most large women have perfectly fine pregnancies and births. It's just that NHS policies are pretty disapproving of us and they have to protect themselves against increased risks.

Oh yeah I do have one next week. Hopefully ill feel a bit better after that.

Ill have a look at that blog now thank you :)

Thank you Yeah I completely agree no one can make us do anything we dont want to do. As long as baby is okay, is this your first? X

Yes, my first. Can't wait to see it on Friday again, maybe find out which kind we're having You too?

I mean, with water births, it would be fab. I'm such a water baby myself, never happier than when splashing about. And I'd love to give one a go in early labour to help with the contraction pains and for general support.

But I reckon when pushing comes to shoving, I'll be screaming for an epidural! All the mums I've spoken to say your birth plan goes right out the window anyway. If I have to have a CS, I'll have a CS and then hopefully a healthy baby :)

I feel very much the same as you I love the idea of it but I dont know if im gonna cope with just gas and air.

Yeah its my first but we aren't finding out the sex :/ im dying to know but at the same time I do want a suprise. Very excited for you to find out.

At the moment I dont feel pregnant anymore cause the movements im feeling are making me doubt whether it is baby and sickness has gone away etc. When are you due? X

OK, so update:

HB (140), BP, urine tests. Lecture on healthy eating (yay). Referral to a dietician. Baby aspirin prescription. Good old rummage around to investigate the bleeding but no conclusive outcome. Booked in for 3 extra scans from 28 weeks. Referred for anaesthetic review. Told to stop Metformin. Took about 40 minutes, not rushed, answered all my questions. Nice doctor. Not bad :)

Thanks for the Update. I hope you dont mind me asking but what is your bmi? And whats HB? x

My booking BMI was 40. I have PCOS so losing weight just does not happen for me. She did actually suggest I could try eating 700 calories a day, as recommended by the more 'strict' experts. I laughed.

HB = heartbeat :)

700?! I thought that something that extreme is not recommended at all. Thats crazy. Ah Yeah of course it means heartbeat, sorry. My booking in bmi was 35 and I dreading to see how much weight I have put on x

Yes, 700!! I'm betting said 'experts' are sadists. Dr did look sheepish in the end and said up to 2000 was probably fine. Frankly, I'll eat what I normally eat, I'm not going to torture myself when pregnancy is stressful enough.

I haven't been weighed since booking though, there's little point what with you carrying a baby, retaining water etc. I'm kinda glad I'm getting extra scans, the reassurance will be nice and who doesn't want to see their baby?

Exactly sounds like you had a nice experience. I have no idea why she suggested 700 calories thats insane.
My 'normal' weight friends say that get weighed at every appointment so I was expecting that but we shall see.

I haven't been weighted at my appointments :S i actually had to ask midwife if I could weigh my self as I wasn't sure about my weight I'd only put on 3 pounds you might find you will lose abit of weight before you put any on us bigger lady's don't seem to pile it on as much.

Surely 700 calories isn't healthy for anyone?!

OP if you concerned about your weight/what your eating try following slimming world guidelines as I know that's the only diet MW's suggest. More to follow the eat more fruit and veg and less cars aspect of it.

I've yet to weighed again officially but keeping an eye on it myself as lost about 8/9lbs in 1st trimester.

I'm glad your consultant was so nice and listened to your concerns/questions. Worth the appointment just for that!!!

I know, I couldn't believe the 700 calories thing either. I mean, two slices of toast with jam and a glass of orange juice and you're practically done for the day! Balls to that, quite frankly.

I've been referred to a dietitian, so I'll see what they say. It's apparently something like 3x as hard to lose weight with PCOS than without it, so I get very disheartened and miserable when trying to lose weight and eating rabbit food as I don't see results in a reasonable amount of time.

The consultant was actually the first HCP to actually understand how worried I must be after a miscarriage! Nobody else seems to give much of a toss, they must see it so often. So yes, deffo worth it just for that :)

Also just had my anomaly scan - it's a boy! All perfect so far, just have to go back for a better view of the heart in 3 weeks

Oh lovely! I had mine today. Didn't find out sex though. But lovely to see them close up again and see their heart beating.

As for eating rabbit food..... It gets so boring after a while. I'm a poor eater when it comes to veg. But I'm just trying to add more each day, keeping portion sizes sensible and trying to drink more water.

Also we use hairy dieters cook books a lot which are great!

The little heart is so amazing, isn't it? I've gone all gooey again... I can't help it, I cry every time I see him! I hope all went well with yours?

I read somewhere that the sex of your baby is life's only surprise - but we just couldn't wait! We've already picked out a name for him. I may even allow myself to buy a few things now. Kudos to you for restraining yourselves :)

I have a Hairy Dieters cook book somewhere, but judging by recent TV appearances, it doesn't seem to have done Dave & Si that much long-term good I think we all know what healthy eating would look like, it's just a) doing it despite emotional ishoos and b) (for me) not seeing results quickly thanks to my stupid chronic condition. I do tend to eat somewhere around 5 a day anyway, it's everything else that's the problem!