The tape measure method? Small bump, concerned.

[Iworrytoomuchh]

I hate to slam anyone doing their job but my Midwife is useless, there’s no nicer way to put it. E.g She doesnt give me a pot to wee in at appointments and just puts ‘NAD’ as if she’s tested it. I have an anterior placenta and when she try’s to get the heartbeat it’s difficult for her, she usually gives up and says ‘he’s moving so it’s fine’ and puts a random number in my notes for his HB. So basically, she doesn’t fill me with any confidence.

Anyway I’m 39 weeks and noticed in my notes she hasn’t logged/ measured my bump since 33 weeks (it was measuring 33cm at that point)I’ve been worried about being small which I’ve mentioned to her, being much smaller this time than I was with my first. My bumps also very ‘firm’ I.e it’s all baby, I can feel him everywhere as opposed to my first where you could feel a ‘cushion’ (of water?)

I had the tape measure in my notes so measured my own bump this morning as I’m curious (first born was a whopper and always measured waay bigger) and no matter which way I’m doing it, and dp has done it, it’s showing 34cm which I know would be small for this gestation.

But I also know the tape measure method isn’t very accurate. I’m having a c section in a few days but now I feel worried... is this something to worry about or not? I last saw Midwife last Wednesday and have a pre op at the hospital tomorrow for my c section, is it not worth getting worked up over? If I call hospital about it there’s not much they can do is there? My Midwife isn’t working again till the day of my section.

Please ring the hospital now and ask to urgently speak to the community midwifery manager. Falsifying records like this is serious and potentially dangerous. I would expect someone to be reported to the nmc for this.

And yes 34cm at 39 weeks is something to worry about regardless of the planned section in a few days... You need seeing.

It’s a load of shite. I was sent for a growth scan and the consultant told me they have no idea of babies size until they scan. I just don’t know why midwives still use such ancient unscientific practices. I was also told be every midwife I saw baby was breach by the ‘feel’. Total rubbish. Again the consultant said they would never tell someone without a scan. I think if your having a section in a few days and baby is moving I wouldn’t worry but you could register it with a midwife just in case they want to give an extra scan.

It depends on the woman and position of the baby. It doesn’t necessarily mean they’re small.

She should have definitely tested urine though! The woman sounds incompetent.

Sorry to hear you've had such a crap mw. I'd have had to have called her on it at the time. But then what's to have said, if a urine test showed an anomaly, that she'd have done anything about it, if she's that rubbish? Her filling in false info is downright wrong. I'd definitely bring it up with someone.

It’s not a load of shite at all - of course it isn’t accurate but it gives an idea of growth which is what’s important - it’s useless in deterring the actual size eg trying to say 35cm = 8lb Baby/90th centile or whatever but it is not useless in picking up a potential lack of growth. There is no other real easy way to tell growth so it’s the only thing they can use.

I measured slightly behind all the way through but then jumped so I got a scan to check, baby was indeed a big baby and was confirmed as a big baby when I had him on Saturday (9lb 6). Two weeks after the growth scan I then hadn’t grown so I went in again to check the placenta - all was fine but I am go glad they measured religiously.

This is really poor and you need to make a complaint, it’s shocking. The urine test is so so important, I am shocked.

Whilst I agree that your midwife isn't being thorough enough , I do think that the tape measure test is useless.

I was sent for 2 growth scans and an hour of monitoring because of the tape measure. My baby was fine , just on the small side because I'm small. For example I measured between 2-4cm below number of weeks all along and had a baby of just under 7lb. All three of mine were around this weight at birth.

It actually doesnt depend on the position of the baby. That's old way of thinking. Sorry I teach this for a living. Fundal height measurement actually measures the contents of the uterus not the baby. Liquor volumne as well so fetal position is irrelevant.

Where we are, if your numb measures anything less than 3cm your automatically sent for weekly scans.

I had pre-eclampsia and one of the first signs was a small bump. My placenta wasn’t working and I didn’t have any amniotic fluid. As a result, my baby was much smaller than he should have been.

You need to get this checked out immediately.

Also, I would seriously consider report your midwife. She’s putting lives at risk.

It's a screening tool not diagnostic but it does save lives.

In your notes there should be your local preganacy units number. Ring them and talk to them. They would rather see you and there's nothing wrong than not see you and there is. Xx

As a medical professional myself, you need to report this woman. She needs some serious re-training and potentially a referral the NMC. She is practicing dangerously. Urine dips and fetal heart checks are incredibly important parts of the appointments. The tape measure isn’t very accurate and my midwife isn’t doing them as I’m having regular growth scans but if I wasn’t she would to pick up any sudden changes in growth. Please, please, please report this woman! For the sake of her other ladies who she may miss something on.

Thanks so much everyone, I called DAU and they said if movements are good and I haven’t noticed leaking of waters I should be fine and to stick around after the pre op appointment tomorrow.
She said someone is calling me back though (maybe she was a student?)
I will report her, the lady at DAU said to mention all of this to the community Midwife’s when I see them post baby as it’s a different hospital/team of Midwife’s.

I would definitely put in a complaint about her falsifying records, that's incredibly wrong! And if you're worried about the fundal height then call the hospital but 34 cm at 39 weeks is normal according to the chart in my maternity card (I'm not in the UK so possibly a different chart but 34cm at 40 weeks is 0 on the standard deviation so 50th percentile), I've been measuring 34cm the last few weeks (39 weeks now) and had a scan last week and baby is measuring bang on the 50th percentile so makes sense. Don't blame you for being worried though, I was really worried about it a month ago so definitely call the hospital if it's worrying you a lot.

Cross post, glad you are reporting her.

I had a small bump twice, each time I’d lost waters without realising. Sounds silly but it was very slow.

I struggled to be taken seriously until it became very uncomfortable without waters and scans confirmed it

I'm not an expert but I just wanted to reassure you that I had a tiny bump with dd1 - in fact I didn't tell some work colleagues until I was 7 months and they hadn't noticed.

Dd1 was a good size 7lb 10 oz. Sadly I was the size of an elephant with dd2!

Anyway you're right to report her.

It's nearly impossible to accurately measure your own bump. If you're able to reach, you'll be straining an your uterus won't be the size it would be if you were lying down properly. Also, it's totally normal to measure 'behind' at term because baby starts to drop as does your pelvic floor, so it's unlikely, even measured correctly, that you'd measure 39 at 39 weeks unless you were huge. I would try not to worry assuming all else is fine, which is seems to be. But I would definitely raise your concerns and ask if someone else can check you and update your notes. They should be able to do that in the DAU.

The thing about your measurements going down at term due to the baby dropping is no longer considered correct. If the baby drops then liquor just gets pushed up so overall volume and measurements should be the same regardless of whether baby has dropped.