Are your children’s vaccines up to date?

Set a reminder

Please or to access all these features

Pregnancy

Talk about every stage of pregnancy, from early symptoms to preparing for birth.

Ante natal care .... does this sound right?

38 replies

PandaBear · 11/06/2004 13:28

Hi All,

I am 18 weeks pregnant with our 2nd child. I also have high blood pressure (not pregnancy related). With DD this meant that I had to have quite a few extra hospital appointments, and had 2 additional scans later on in the pregnancy.

This time, I've been told I don't need to see the midwife until I'm 23 weeks, and apart from the normal 20 week scan, they don't want to see me at the hospital until I'm 37 weeks.

Nothing has changed since my last pregnancy, so does anyone know of a reason why the ante-natal care is so different?

Thanks

OP posts:
Are your children’s vaccines up to date?
Toothache · 11/06/2004 13:35

Pandabear - I noticed mine had dramatically decreased this time too.

I'm assuming you have regular antenatal appointments in between your 23 wk MW appointment and the 37wk hospital one???

I s'pose they just work on the theory that there isn't much they can do in the early stages. I had a blood test at 16wks then as scan at 20wks. But my first proper antenatal visit was at 22 wks.

I booked into the hospital at 9wks and I've not to return until 40wks!

Pants isn't it.

pupuce · 11/06/2004 13:39

Antenatal care for women who have had babies already is LESS intensive.... and generally more and more trust will drop the number of visits though the idea is that each visit would be more in-depth. It is recognised that women do like to go to the MW but most of these appointments are not necessary.... of course if a problem/concern is picked up, the mum is "managed" differently.
Why do you need to go to hospital if all is fine ?

Pandabear, at 23 weeks your BP will be taken and if they feel it needs to be monitored more closely it will.... high blood pressure in itself is not a problem in pregnancy. When combined with proetin in the urine it can lead to pre-eclampsia.... which is mostly a first pregnany problem.

Nimme · 11/06/2004 15:21

Pandabear - I am 14 weeks (no 2) and much the same. Saw midwife for the first time last week - for medical history. DD wasn't born in this country so I don't really know anything about the UK system. Am not to return to hospital until 20 week scan. Feel a bit disappointed, guess I want lots of attention (cos I do!) and would like to build rapport with a midwife.

We did think about hiring a private midwife for that reason but have now decided to spend that money on a nanny later (so I can sleep loads...)

Sorry if that wassa bit waffled and no help at all

Samcj · 11/06/2004 15:50

Hi,
I'm currently 16+3 and don't have my booking in app untill monday, I had to ring and ask if I was going to have one!! I have had one anti natal app with my GP when I was about 6 weeks pregnant. This is my first, I haven't had any bloods done, nothing! I think I have confused everyone though by choosing to have my baby at a hospital out of the area though...

sponge · 11/06/2004 16:20

All sounds quite normal. They start monitoring you much more often from about 24 weeks - every 4 weeks and then every 2 in the last few weeks.
Obviously if they detect a problem then they'll keep a closer eye on you but you get pretty much left to fend for yourself for the first half of the pregnancy.
I haven't been to the hospital except for my booking appointment and scans and I'm 32 weeks so there's nothing unusual that. I'm happy going to the midwife clinic as it's nearer than the hospital.

ggglimpopo · 11/06/2004 16:33

Message withdrawn

Canadianmom · 11/06/2004 19:18

I am so glad you asked! In Canada, the care is far more frequent and weekly after 35 weeks. I was amazed to hear that there is 'not much that can be done in the first trimester' so I was sent packing and am still waiting for my booking in appt and scan date. Feeling mighty frustrated as I am now 14 weeks 5 days. No bloods drawn yet or anything! WEIRD!
Thank heavens I would not consider a termination no matter what but what if I felt that I needed to have an amnio? The best time is between 14 and 15 weeks and that will be behind me before I even hear from the midwives.
Odd really as the NHS is ultimately responsible for the care of the baby so why are they not interested in offering better ante-natal care so that their patients are born healthier? Sorry. Ranting again. Too home sick to think properly. I am used to living in a place where you can walk in to the gp's at any time and have a scan the same day if things seem less than 100% (and we have a public health care system in Canada as well).

Canadianmom · 11/06/2004 20:04

Oops! I posted the un-previewed message by accident! I tried to make it clearer that my fist 2 were born in Canada and that we now live in the UK.

sponge · 12/06/2004 12:20

To be fair to our NHS I had a bleed at 8 weeks and was scanned there and then. I did have a nuchal scan at 13 weeks. I had bloods at my booking appointment at 16 weeks, another set at about 28 weeks I think and will be having another set at my 34 week check.
I also had a small bleed at 24 weeks and they asked me to come straight into hospital, monitored me pretty closely for a couple of hours and did a number of checks, including a strep B swab since I was there. So I don't feel that badly cared for .

Jimjams · 12/06/2004 13:10

gglimp it's like antyhing- postcode lottery. I had ds2 in Bromley. Because I'd had a previous (very early!!) miscarriage I was given a "reassurance" scan at 7 weeks then anopther at 9 weeks and I turned down the offer of one at 11 weeks (as I was having a nuchal at 12). My m/c had been uncomplicated and I had not been freaked by it at all. Because of low platelets I saw the consultant a lot- especially when pregnant with ds1.

Now we are in Devon. There is no scan until 20 weeks. I did go and get my bloods sorted yesterday and the midwife is coming round later today to do a booking in visit. One area where devon has a very good reputation is homebirths (I think its over 30% here). Unfortunately I am not really a candidate for that (2 previous sections). I also like the way the m/w is coming to my house to do the booking in. With a 2 year old and an autistic 5 year old that makes a huge difference.

NHS services down here are pretty patchy (had far too much experience of them in the last couple of years). But I still think that generally antenatal care is something the NHS does reasonably well. The service is at least passable and something exists - rather than non-existent which has been my experience with the other services we have needed. just been told today that it is going to be a 7 month wait for ds2 - who almost certainly has verbal dyspraxia- to see a SALT- verbal dyspraxia is a PITA to fix- and requires lots of intervention- the NHS will be totally unable to provide what is needed. Luckily I knew this already so have been on workshops and am able to do it myself- with guidance from ds1's private SALT (note private- paid for for a reason!) otherwise he would be stuffed.{} The NHS is falling apart at the seams and anyone who thinks otherwise has either not had to use it recently or has only used it for an emergency.

mears · 13/06/2004 12:30

This information here may be helpful for questions about antenatal care antenatalcareguidelines

There is a move away from unnecessary hospital visits for normal, low risk women. For them there is no need to see a consultant unless a problem arises. The issue of scanning is one that is debated all the time - there are a lot of worries created by scans, certainly more than are solved so there has to be a need for one. For a number of years scans were done very frequently with no positive benefit.

In my area, scans are done at 10-12 weeks and then the anomaly scan 18-20 weeks.

I think that we forget that pregnancy is a normal process that has become extremely medicalised over the years. There are now moves to try and regain the normality focus, but those who have beeen through the older systems feel neglected. There are women who feel deprived because they haven't seen the doctor, not realising that the midwife is the professional trained for normal pregnancy and childbirth. She will refer to an obstetrician where there is the need.

It will be useful to look at the NICE guidelines to see if there are an appropriate number of planned visits and scans. All areas should be aiming to provide care within the national guidelines.

highlander · 14/06/2004 05:50

Canadianmom,
I'm in Vancouver and my care is exactly the same as I would get in the UK ie a minimum of scans. I had bloods at 12 weeks and a repeat at 25 wks. The only scan I was offered was the 20wk anomoly scan. The Children's and Women's hospital state the best time for amnio is 16-18wks. Once I get to 30wks I see my OB every 2 weeks.

I agree totally with Mears - there's no need for anyone with a healthy, normal pregnancy to continually run off to the doctor.

I don't like the way you are slagging off the NHS - they're doing a good job of looking after you. Good care does not equate to frequency of visits. You'll get the appropriate tests as and when you need them.

Given that everyone over here has to pay into the government healthcare scheme, I'm very impressed with the NHS.

I would actually prefer to be home, being looked after by a midwife, rather than some over-paid OB attending.

zebra · 14/06/2004 07:14

Not sure about something else Canadianmum said... About amnio best being done between 14&15 weeks pregnant. I thought that amnio before 15 weeks carried elevated risk of limb abnormalities in the fetus??

Canadianmom · 14/06/2004 08:19

Highlander: Very sorry to have offended. The NHS CAN be an amazing system but that is not always the case. To clarify a few personal points: my pregnancy has been deemed 'high risk' (heart murmer and two prior missed-miscariages at 13 and 18 weeks) but I just can't seem to even get an appointement with the midwives/(under-paid)OBGyn. AT 14 weeks I went back to the GP to ask about my booking in appt and was told that it should have come through between 11 and 13 weeks but that the hospital is swamped. When the GP could not find the heart rate she did make an attempt to contact the hosptial and that is when an appointement for the 24th of June was made.

I am sorry that you find the health care system in BC as upsetting as I seem to find the NHS (I will not attempt to defend their health care despite your slagging. I am not familiar with their ante-natal care as I am from Alberta and health care is done provincially. My SIL did however have all four of her children at home with the care of a midwife and BC Med picked up the bill.)
Have you had a baby here (in London)? Have you stayed in a hospital with no toilet seats and no disenfectant? For a charming glimpse of reality, don't take my word for, take the word of Auntie Beeb: news.bbc.co.uk/1/hi/england/3754389.stm

You state that I am being well taken care of and yet I have NOT been taken care of FULL STOP. I freely admit that my concern is compounded by home-sickness but that does not make it any less valid.

Sorry about the confusion re amnio. It is entirely possible that I am incorrect. Thank you for the correction. Point taken.

sponge · 14/06/2004 10:06

I'm with you for the most part CM.
I'm being quite well looked after with this pregnancy so far but with other general medical problems for either us or dd I have always resorted to going private as GPs don't tend to have the knowledge and the specialists they refer you to have such long lists you don't get seen.
For instance my dd got something stuck in her ear earlier this year. Tne doctor couldn't get it out so we took her to paediatric a&e. They couldn't get it out either so referred us to an ENT for the following week. So far so good. But turned up for the specialist appointment and was told that this ENT didn't do kids and I would have to go back to the hospital that had referred us! Then tried unsuccessfully for 4 weeks to get an appointment there (all this time my dd is in pain) before phoning my gp to ask for a private referral, which he happily gave saying that the NHS was falling apart and couldn't be relied on. Was seen privately the next day and dd operated on 2 days later. Luckily I have private medical cover for the family through work but for thise that don't have this option the NHS can be a pretty hit and miss affair.

ggglimpopo · 14/06/2004 10:17

Message withdrawn

highlander · 14/06/2004 20:05

Dear Canadainmom,

I had no idea you are high-risk. I apologise profusely

I'm actually happy with the BC care - that obviously didn't come across in my post!

highlander · 14/06/2004 20:12

Actually Canadianmom, maybe you can help me out here - does everyone fly a Canadian flag from apartment balconies on Canada Day? I'm dead keen to get into the spirit of things and buy loads of wee flags for the car etc but DH doesn't want us looking like prats if no-one else does it!

Jimjams · 14/06/2004 21:43

Yes- whilst in the whole antenatal care is done well in the UK, I think CM has demonstrated something that is unforuntately very true about the NHS. When you really really need the care it often is not available - full stop. The more intervention you need, and the more complex your case the less likely it is to be able to meet your needs. This is something I have found to be very much the case with ds1 (who is always being described as having "complex needs".

Another "female" example. My friend was bleeding heavily. Had a major panic attack as her sister died from cervical cancer. Her GP gave her drugs to stop the bleeding and told her her she must not take them for more than 2 weeks and that she must get a scan in that time. Went to book the urgent scan and was told it was a "3 to 4 month wait". My friend explained she could only take the drugs for 2 weeks and was met with a shrug of the shoulers. She paid for her scan privately.

I agree that scans in pregnancy can cause their own problems, and that a low risk pregnancy need not be medicalised at all, but there is something wrong when people who need access to medical help cannot get it at all.

And as for the state of the toilets- I think you must have been in the hospital I gave birth to ds1 and ds2 in!

Highlander- I hope you have lots of canadian flags to hand out. I came back from travelling with loads of candadian flag badges

Jimjams · 14/06/2004 21:43

shouldn't be a wink! His complex needs are a PITA!

Celou · 15/06/2004 15:10

People keep using the term "unnecessary hospital vistits". As far as I'm concerned, there are always necessary even if you're healthy in pregnancy. Otherwise how do you spot a problem?
You shouldn't have to wait until you have a severe pain or bleeding to be given proper care.
I believe in prevention and spotting things in the early stages before it's too late.
This is my first pregnancy and I have had a lot of bad experiences which minimized my faith in the NHS.
I don't think there are enough antenatal visits/scans, and when there is a problem, I don't think it is dealt with properly.
Glucose was found in my urine last week, and I was told I should be given a blood test to check for gestational diabetes, as well as a full blood count. When the midwife took my blood, she didn't seem to know what she was doing and hurt me (which I ignored), and when the painful experience was over, I realized that she forgot to do the glucose test (the most important).
I had to point it out to her, and all she said was: "Sorry, I'm going to have to take blood from your other arm now. The tick on the box wasn't big enough and I missed it!!". Basically trying to blame someone else for her (big) mistake.
The other thing is, they do not communicate with you and with each other. Which means I spent the best part of my pregnancy chasing them and litterally demanding tests and scans.
For example when you have a blood test done, the results shouldn't take more than an hour. And they always say to you: "You'll get the results within the next 10 days, and if there are no problems, you won't hear from us."
Why ten days? And why don't they let you know if the results are good to stop you worrying? I always had to insist in getting the results (good OR not good) on the same day, (because I know it's possible)and they finally pulled their fingers out.
The NHS in this country has this attitude: If you don't ask, you don't get. And I think it's wrong. You shouldn't have to ask, chase or insist.
The one good thing I found was the parentcraft classes. They were very comprehensive and covered a lot of things. But I'm wondering if it's because the person running it was absolutely amazing.

Samcj · 15/06/2004 15:46

Wow this really has become an NHS slating thread hasn't it? The NHS has many many failings, most of which is down to a lack of money. Not all, but most. To be able to provide you with the blood results Celou, it is meaning that more work is having to be done. Not that I am trying to say it shouldn't. I am a nurse. I work in Intensive care. The only way I am able to get blood results back within an hour (if I am lucky) is to send the samples as VERY urgent. Otherwise they can take up to about 3 hours to come through, and our results, due to the nature of the job, our prioritised. Basically though, if everyone sends their results as very urgent (even we don't routinely) the system just wouldn't work. If everyone is urgent they would just become routine, do you see? Shouldn't be the case but lack of equipment and lab staff means that this is the way the system has to work. Urgent samples should be sent only for people who are in life threatening conditions. If this is not the case, results will not come back as quickly which could cause big problems.

I am also shocked at how upset you are about the nurse who took your blood, I am sorry it hurts and she missed a sample but surely everyone makes mistakes! I know I certainly do. It is human nature, they only way to work around it would be to employ robots which I hope no-one would want?! In my experience most people are grateful for the human caring they recieve from health professionals.

I had my appt yesterday and was very impressed with how they operated. There WAS a mistake made and my midwife was on maternity leave, but they found a midwife who could see me, even taking me into her office rather than a 'proper room' to take my information. This wasn't unfair treatment because I work there, they weren't aware. But I arrived for my appointment correctly, they made a mistake and they tried their very best to resolve it to the best of their ability, for which I am very grateful.

I would also like to add that I have had awful experiences of the NHS, most notably when I presented to A and E after a full morning shift, in uniform with pelvic inflammatory disease. I was refused any pain killers and was left crying my eyes out in the waiting room for 10 hours before being told I had a urine infection (results later showed I did not), although as I had suffered from it before i knew what the problem was.

On private healthcare, it is very good if you are covered or can afford to pay for the often limited service they provide. But many do not have intensive care units, meaning transfers of critically ill patients may be required, they refuse to accept any patients with any kind of infection, no matter how much money you have paid them, and also they lack experience in many fields. In one speciality I used to work in the consultants would admit them to the private hospital, bring them to ours for surgery, and then would not allow them back untill they were well. All the time they are paying for this service to be in a NHS hospital.

I realise that this post may be viewed as offensive and please believe me when I tell you it is not intended to be. I feel I work very hard, very long days under very unpleasant and stressful conditions, as do the vast majority of NHS workers to provide the public with the best service possible. It is very disheartening when people seem determined that we can't do anything right as hard as we try.

piglit · 15/06/2004 15:55

Samcj - I just wanted to say that my ante natal care has been absolutely wonderful (I am 24 weeks). The midwives I have seen have been brilliant and everyone at the hospital has been great and made me feel very relaxed and looked after. I had thought about a home birth but on the basis of the wonderful care I have had so far I have no hesitation in having a hospital birth. I appreciate that not everyone is as lucky and I think there is certainly a postcode lottery (don't get me started on that subject!) but I just wanted to say that I have been really happy with the care I have received so far.

PandaBear · 15/06/2004 15:56

I didn't mean to start a big debate here!! I was just wondering whether I should be having more appointments because of high blood pressure.

I have not got any issues with the NHS per se, I think the people who work for the NHS do an amazing job under highly stressed, not to mention stretched, conditions!

Thank you Pupuce for putting my mind at rest - I now understand why less appointments are required for me this time!

OP posts:
Samcj · 15/06/2004 16:00

Piglit, definately is such a thing as the postcode lottery, and probably only going to get worse under the new government inititives.

Glad you got your question answered anyway panda bear!!