Ante-natal appointments

[AimeesMum]

Hi. I was just wondering how important people think ante-natal appointments are? I went to all of mine, and had three scans in total, and I think they're important. Does anyone feel different?

Agree totally - in fact, in my case , had I not been to them - I would have lost both dd and ds.

They're very important, even if only for reassurance. Our health authority have cut funding since I had ds, so with dd I had far fewer antenatal appointments. This wasn't too bad, given that she was my second baby, but they've cut them down for first-time mums too.

Having said this, antenatal appointments were the source of major stress for me when I was pg with dd. I went to one when various people had told me I looked small for my dates and I was worried whether the baby was OK, only to be told by a locum doctor that he couldn't hear the baby's heartbeat but that he "was sure that everything was OK". Just what a concerned pregnant woman wants to hear. Then towards the end of the pregnancy the midwife kept telling me that the baby was breech - I got very stressed about how I was going to cope with a CS, until my sympathetic GP sent me up to the hospital to discuss turning the baby. They did a scan and we found out that she was head-down (and obviously had been all along, because I would have felt if she'd turned). The midwife had obviously been feeling a bottom and thinking it was a head.

Very important. I didn't have too many at the hospital as Glasgow (or the Queen Mum's) does a "shared care" system so most of my appointments were with the GP with only a few at the hospital.

In Scotland we usually ony get one scan, at c.12 weeks, and a second scan only if there is thought to be a problem. Unusually, I got an early scan as well (8 weeks) - I can't actually remember now how I arranged it, but I suspect it was a combination of asking for it/being an older mum/going off on holiday skiing at 11 weeks/being a doctor's daughter (who had practised at that hospital).

I agree. Its best to go to all app. Anything can change during one app to another. I had to keep an eye on my blood pressure which was up and down the whole 3rd pregnancy. Also my weight was up and down so much. These are just the smaller of the problems that can happen unexpectently.

I seem to remember a trial was carried out three or four years ago, (maybe at Queen Charlottes??)screening women for AN care into low/high risk categories and giving them less/more appts according to status. The usual number of appts is about 13/14 but it was reduced to eight or nine if you were low risk.

The end result was that wellbeing of mother and child was not compromised and that the number of appts could safely be reduced in most cases but they decided not to go ahead with the scheme because women liked the reassurance of appts.

Maybe Mears or Leese could recall the details more clearly??

I had an ovarian cyst and had regular scans which I loved, as did dh. I also went regularly to have dd's heart monitored as she didn't move very much during the day (but made up for it all night) and I'd rather have made a total fool of myself worrying that risked anything happening.

You're right SueDonim - it has long been suggested that we see women too much during the ante-natal period, and that we could safely reduce the number of appointments without compromising maternal or fetal well being (as this study showed). Our directive now is really to try and be 'woman - led', so if you want to be seen you are, but if you're happy not to be seen (and all is well), then you can go a little longer between appointments.
Trouble is, all the women we don't worry too much about (ie regular attenders, no problems) like the assurance of midwife appointments, so see a lot of us. Those we DO worry about (those who don't attend any clinics/appointments/are out when we visit) would choose never to be seen, so we end up leading them (or chasing them may be a more appropriate term!)
Suffice to say, ante natal care is extremely important for all the reasons outlined here - both for maternal and fetal well being. However, there could be a good balance between being seen too much, and not at all. As a general guide, we like to see women:

1. At 'booking' appointment - 1st midwife appt
2. 15wks
3. Scan at 20 wks
4. 24wks
5. 28 wks
6. 32wks
7. 34 wks
8. 36wks
9. Every week from then until delivery

This is only a rough guide. Some women will need/want to be seen more. Dates of scan etc also vary from place to place.

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