Consultant appointment

[GemmeFatale]

I’ve been categorised as a medium risk pregnancy so have a referral to see a consultant next month (I’ll be around 14 weeks).

While I’ve been told at my booking in appointment that I’ll probably just have one appointment and then be sent back to midwife led care I haven’t been told anything about the consultant appointment.

Can anyone tell me what generally happens at a first/only consultant appointment for a medium risk pregnancy? (If it makes a difference I hit the risk triggers because I’m older, this is an ivf baby and I’ve had previous uterine surgeries).

I am mixed care (consultant and midwife) and in my experience every consultant appointment is the same as a midwife appointment, check urine, blood pressure, baby heartbeat, they then go through my notes to check everything is normal and then I'm sent on my way.

I should point out that I am mixed care due to a high BMI so they obviously have checks specific to that (Gestational diabetes test/growth scans for baby), but so far all my results are normal so the consultant hasn't needed to do anything extra. I assume this would change it any results came back which were worrying. I am hoping this doesn't happen (obviously) and I get signed back to midwife lead care at 36 weeks (they won't do it before in my case).

Thank you. Very helpful.

Depends on maternity unit policies over older mothers combined with ivf.

In my case due to age and blood disorders each appointment was generally:

1. Hospital midwife check of blood pressure, urine and baby heartbeat. Though didn't do the latter until above 24 weeks.
2. Talk with consultant (or whatever doctor that was standing in) about risks and health concerns. Sent for more blood tests which were all normal. Decide when next appointment was plus who with, and decide on any other tests needed e.g. more blood tests, extra growth scans that needed to be booked in before each appointment so they could be reviewed.

I ended up having to see house officers/registrars in the consultant's clinic, hospital midwives, my GP and the community midwife for appointments every 10 days from about 25 weeks.

I found the doctors - hospital and GP - on the ball in going over blood test results but the midwives generally lacking in understanding over my medical history and reporting results in a timely manner. For example I have to take higher dose vitamin supplements due to previous deficiencies and was told by the booking midwife to take pregnacare instead. I was then questioned by another midwife about them until the consultant wrote in my notes I must continue to take them as per my GPs instructions. The midwives didn't tell me I was anaemic until 4 weeks before I was going to be induced - they had the results for 4 weeks prior - and it takes 2-3 weeks to get a GPs appointment for maternity care, so it could have lead to birth complications if I hadn't had indate iron tablets from a previous incident prior to conception and they agreed with me.

I never got signed back to midwife led care as I was induced at 39 weeks, but had a much easier birth than loads of other women I know.

As I booked my hospital appointments months in advance I found them easier to schedule that community midwife appointments.

I'm automatically "high risk" as I have epilepsy and have known since we begun TTC that my care would be consultant led.
Other than my initial booking appointment, all of mine have been with the maternal medicine consultant and then the midwife I've been paired with (who did my booking) specialises in high risk pregnancies, and is also partnered with my epilepsy nurse. I've gone to the hospital for everything thus far. As others have said, I assume they do everything the same as a midwife would do it's just they look at your medical history in more detail and can arrange extra appointments for you to meet up with the anethesist team etc to discuss birthing options. Although it sounds like you are not expecting to be consultant led throughout like me.

At my 16 week one we saw the consultant and the midwife together, they do a tag team for people like me and then at my 24 week one on Monday the epilepsy nurse will also come. I've had them every 2 weeks plus extra scans. I've got the scans and appointments all booked in until my due date already which has been great from a work perspective.

I guess they haven't told you anything about it because it will just be more of a discussion to assess your needs and if you need to remain under their care or if you can go back to the midwife. We tend to go with a to do list and have all of our medical letters with us from the various hospitals as they will probably ask to see your IVF letters etc if they're not already on file. You just need to be organised, as they've got enough to do whereas you're just concerned about your care.

Ive no idea if im high/medium risk, but im mixed due to high bmi.
I see my midwife regulary and and ive seen consultant 3 times so far. Once as a 'welcome app' a week after first scan. The next a few days after 20 week scan and directly after my first growth scan.

However my urine, bloodwork, etc are all normal.
And the baby is measuring perfectly. (I.e 28 weeks she should be 2.5lbs and she was)

So i honestly think its all a formality at this point as I get more from my midwife appointments (like hearing her heartbeat) than I do at consultant appointments (as in last time i was there he spent more time complimenting my mother on how she looked than me!!)

Anyhoo, I wouldnt worry :)