Pregnancy after loss - Consultant , not what I expected... Feeling let down

[JennyRMorris]

Hi Mumsnetters,

Don't really know why I'm writing this to be honest, I think I just feel a little confused and let down (possibly) by my first encounter with a consultant.

Back story -

In May last year my partner and I lost our little boy Edward at 38+2, he was sadly stillborn. We decided against a post mortem as we didn't like the thought of our son being poked and prodded. We were happy for the placenta to be analysed and for both myself and my DP to be tested for whatever they thought necessary.

Anyway, nothing much was found, the only thing to note was that the placenta was far smaller than they would have expected and it was assumed that this was the cause of Edward's death as it could no longer support him any more.

We were advised that any future pregnancies would be monitored by a consultant and midwife, I'd have many more scans and watched very closely, etc.

Fast forward to today, I have just returned from my first consultant appointment - I am currently 14+5 weeks pregnant with our second child.

The lady I saw was not the person I was told I would be seeing, (this didn't transpire until later) she was a registrar working under the consultant. I wouldn't have minded this, however when I asked her whether I would see her for my next appointments she replied:
"No, I'm not Miss DrYouShouldHaveSeen. You will most likely see someone different each time."
Now the thought of this fills me with great dread (although this particular woman was awful), having to repeat my circumstances over and over is pretty distressing when you've lost your child.
I was (rightly or wrongly) under the impression that I would see the same consultant throughout, at least for continuity of care(?!)

We sat down, she started flicking through my pregnancy booklet.
"So, why are you here? Ah, you had a baby last year at 38 weeks, is that why you're here?"
I looked at her a little gobsmacked, especially since it is written all over my notes that our baby was stillborn.
I replied, "Yes, but he was stillborn. That's why I'm here."
She muttered under her breath; "oh, sorry".
Insensitive to say the least.

I asked the consultant if the placenta would be measured this time (I was told on multiple occasions by various medical professionals that this would be the case after we lost Edward).
Her response:
"No. It's impossible to do that."
At this point I started to cry. I asked her how they would know that the same wasn't happening this time - obviously I'm super paranoid that something terrible will happen with this pregnancy.
She gave me a crumpled hard hand towel to wipe my face, (luckily I was prepared with my own tissues).
She said that I would have more scans this time and they would monitor the growth of the baby, etc. Her response made me feel as though I was being an inconvenience, firstly for crying and secondly for asking a question.

We talked about scans, starting at 28 weeks. I asked her if I would have any more between now and 20 weeks (I have had two reassurance scans earlier on in the pregnancy, just for my peace of mind more than anything). Her reply:
"No. This is it." nothing like "it depends how you feel" or "If you're worried we can fit you in".

She asked if she could listen to the baby with the doppler. I said "Yes please, I've been really worried as it's such a long wait to see someone between the 12 and 20 week scans. It's really quite scary not knowing if everything is ok." (In reality I've been afraid for the last week that something terrible has happened to this baby too). She didn't bother replying.

I did have more questions but she made me feel that uncomfortable I didn't bother asking them. I figured I'd just wait until the next appointment and hopefully I'd get someone nicer.

Long story and rant... I guess I just expected something a little different? I thought that perhaps the consultant would be a bit more understanding or have some compassion.

She didn't even say goodbye to me as I left.

All I know is that I now feel worse than before.

Not once did she ask how I was during the appointment. Even if she had I don't think she would have given a shit.

The "mental health and wellbeing discussed" box in my notes was obviously left un-ticked.

Pregnancy after loss is rough. I was a wreck by the end. I made it to 20 weeks thinking I'd be fine after I passed that mile stone and if anything it just got harder. You need support. Maybe make an appointment with your midwife and see what services are available? My local hospital is quite good with bereavement services, it's not the same everywhere though sadly. I had my bereavement midwife as I said and I go to my local baby loss support group once a month. Being around people who get it helps, even though I wish I had never had to meet them.

So sorry for your loss of your son Edward.

I am so so sorry you lost Edward. Beautiful name.

Op I'm sorry for you loss and this doctor you saw needs to be reported. I agree with putting a complaint in with PALS. Also, should you not get a timely response or follow up go to your MP clinic and tell your MP asking them to follow up on your behalf because time is of the essence.

I had all 3 of my babies here in the US and had preeclampsia with my first baby. With subsequent pregnancies I was more closely monitored and the scans they did were able to monitor blood flow of the placenta and it's size. The equipment to monitor the health of the placenta is available but your hospital might not have it. I've been shocked at how dated some of the machines are that my father was subjected to during his cancer treatments. I took pictures and showed the doctors here in America and they said they hadn't been used here for over 20 years. There might be a better hospital for you which is better equipped with up to date scanners to manage your and your baby's health.

BTW - the fact you had to explain why you were at your appointment is what would have made me furious. They should have read your notes. Here they color code the physical files and it flags on their computer if you have had a miscarriage or still birth. My friend had a blue file with a blue and pink ribbon selotaped to it. Not hard or expensive to do and anyone treating her knew right away she had two still births, one girl one boy.

My friend found it really hard to talk about her losses while she was pregnant. She had a lovely consultant who wrote up an overview of her pregnancy history and emailed it to her as well as printing it off. Her told her to bring it to every appointment and give it to the person treating her so she didn't have to talk about it. It did help reduce her stress levels. He also had her seeing a therapist once a month who specialized in pre/post partum depression. The rates of PND are much much higher when you have a complications. It might help you to speak to your GP to get help now to help manage this. My friend who had two still births had PND after but she was already being closely monitored and help was already in place so it didn't get as bad as it could have.

So sorry to hear about the loss of Edward and your treatment in this pregnancy.

Ask your community midwife to flag up the need for continuity/fact that you don't want to have to explain yourself to every new person you meet. I have ptsd from a previous traumatic event which was made so much worse by the arrival of my son and the way I was treated in hospital and this pregnancy, my notes have ptsd in giant letters scrawled all over them along with a brief explanation of what happened originally/what I really struggle to cope with etc on them so I don't have to explain myself that the community midwife put there at my booking appointment. I haven't seen a consultant yet (friday is my first appointment at 24 weeks) but we have more than one community midwife and it stopped the second asking questions so hopefully it will work on the consultant or her minions.

I've just called the secretary of the consultant and left a message for her to call me back.
Let's hope this one is a little more compassionate.

So sorry to hear about the loss of Edward and gentle congratulations on your pregnancy with your second child.

I haven't been in your situation so can't offer any real advice but wondered whether you'd come across the Legacy of Leo blog? It's written by a lady called Jess whose son Leo was sadly stillborn two years ago. She's written extensively about mental health and anxiety in pregnancy after loss and a Rainbow clinic in Manchester that supported her and her wife through her pregnancy with their second son. They aren't local to Manchester but were able to travel there. I think they also had support from a specialist bereavement midwife from Tommy's the baby charity.
Just thought it worth mentioning in case either of these are options for extra support for you.

bookhelp

A consultant should have a scan of the notes and be aware of these issues. It’s very basic stuff. OP has been treated appallingly here.

OP I’m so sorry for your loss. The advice above is good - get a note out in your notes somewhere prominent - you cannot be reliving that trauma every time you visit it’s completely counterproductive.
PALS definitely.

I’ve not had anything anywhere near as traumatic as you, only HG (and please don’t think I’m comparing this is any way to what you went through, I’m not, just using it as an example) and I suffered from severe anxiety over it - the difference between doctors I’ve seen has been immense. Some wonderful, some so dismissive you come out feeling an inch tall.

Good bedside manner IS PART OF CLINICAL PRACTICE. It’s not supposed to be an nice extra, it’s a deeply embedded part of treating the patient. Respect for the patient isn’t optional.

Please also speak to your midwife about this - she is your gateway to accessing support on the mental health side.

Wishing you a healthy and successful pregnancy.

Thank you for all your kind responses

I am equally sorry to hear of all your losses, life is so cruel sometimes, we don't need anyone else to be mean and heartless to us

x

Sorry for your loss and that the registrar was do compassionless. It's very annoying when they don't read the notes. They can measure and monitor your placenta. I had a low placenta and had extra scans to check it. They measured it and checked the flow at the scans and was able to see when it moved up.

Jen, my friend whose son was born sleeping, had the same midwife and consultant throughout her second pregnancy. Continuity of care meant that she had the same midwife and consultant also present during her csection. Are you in London by any chance?

In sorry for your loss what a horrible thing to go through.
I would complain for sure.
I can imagine that appointment left you feeling sad and confused and I would not be happy with the registrars attitude.

Oh and @bookhelp Do Fuck off

I am an NHS midwife and that is very poor care. In my overstretched trust we would outline a plan of care for you at that first appointment.
I would try and get the email address of the Head of Maternity Services (might be on the website) or ring the Antenatal clinic and ask them for it.
In the header line, I would write something to catch their attention eg "Urgent. Previous term stillbirth. Problem in care this time"

This is a priority area of care and she/he knows that.

So sorry OP that the consultation was so upsetting. Do you have a nice community midwife to talk to?

Sometimes I find senior medical practitioners become caught up in their own self importance and lose touch with normal human interactions. I’m seeing a consultant privately for an ELCS and he has zero personality/charm/charisma. Thankfully, the local community midwife (NHS) is lovely and helpful for questions, so I see her as well as the obstetrician.

Sending a big hug xx

Unfortunately Consultant-led does not mean seen by a Consultant at every visit. It means a named Consultant is in charge of your care. When a registrar or a member of the consultant team sees you - they will either discuss with the Consultant or get the Consultant to also come along and see you if there is a concern. I'm a Consultant and I see all my patients at least the first time but it would be impossible to see everyone under me personally. I do supervise my team and I am kept abreast of all the cases. The poor bedside manner is inexcusable though and it seems some empathy and a little prep by the Registrar before you were called in would have resulted in a better consultation. Take care and hoping the rest of your pregnancy goes smoothly

newmummy - Unfortunately I didn't realise this would be the case. I have only ever seen a consultant once after Edward died and she was the consultant I was told I would be seeing. I never assumed that I wouldn't see the lady I was told I would and it wasn't explained to me either. I thought at least I would see said consultant at my first appointment...

Kitty My midwife is really lovely, I will be speaking to her about this too.

Greyland - No, I'm in the East Midlands. I'm hoping I may be able to get a single consultant pinned down who is actually nice and may take a bit more of an interest in my care and case.

Just spoke to the secretary of the consultant I was supposed to see yesterday, she was very understanding and pretty shocked at the way I was treated. When I told her I had a complaint about said registrar she didn't sound particularly surprised though.
She said she would pass on my complaint to the consultant in charge and she will call me back with a new plan either this afternoon or tomorrow morning, hopefully to see a nice person this time.

Jen, well done speaking to the consultant secretary.
Once your care issue is resolved, still consider a complaint because that is evidence that the service manager can use to improve services for other women.

Jen hopefully you get to see a more caring and sympathetic person the next time who will be consistent in your care so you don't have to keep repeating yourself.
I am also under consultant care for different reasons but haven't seen him yet but I see the same specialist midwives ( 2 of them ) whom I had with my son. I don't see anyone else. It takes a lot of stress off my shoulders seeing the same nurses. They are really lovely, sympathetic and kind to me. I hope you at least get to see the same midwife from now onwards as it does make a big difference in how you feel. Your mental well being is as much important as the growing baby. I feel so much for you

Mayhew's advice is good, particularly the subject line. I would send it to PALS at your hospital as well. PALS teams usually have an office that you can simply walk into as well.

You have received really poor care and you would be right to shout about it from the rooftops in order to make sure that you get the correct care going forwards. Complaining through the correct channels does help a lot. Hopefully the secretary will be able to help, but I have had mixed experiences with this approach and I really would go the PALS/Head of Maternity services route as well.

Op, I'm so sorry for your loss with Edward

I'm not sure if this would help or not, but have you heard of the charity Kicks Count? I believe they do stickers to put on the very front of your maternity notes, that explains you've had a previous neonatal loss. I don't know how effective they are in reality, but the idea is that they (hopefully) help to avoid the situation you were placed in yesterday.