Should I stop consultant led care?

[Harley8888]

First time poster here... I'm 30 weeks pregnant with my first baby.

Bit of background first - I was referred to have consultant led care at my 12 week booking appointment as my BMI was 32 which apparently classes me as OBESE eventhough I'm a solid size 14 haha.

I haven't had any major pregnancy problems apart from hyperemesis which is managed with medication and being anaemic which is also managed with iron tablets.

I find the consultant appointments SO useless. They are literally like 5 mins long and he asks me a few generic questions about how I'm feeling jots down some notes and sends me on my way. I also see the midwife who does the same thing - I think because she's leaving it to the consultant.

I feel like my care has been quite laidback and I'm not being checked properly.. I've never been weighed since my booking appt, my belly has never been measured. The consultant didn't even spot that my haemoglobin was super low in my last blood test. I had to book an appointment with my GP because I was so exhausted and it was him that said I was anaemic. My next appt is at 35 weeks and I feel that's ages to wait without an appointment. No appointment from 28 weeks to 35??

Is this normal? Am I expecting too much? I feel like asking to not to be consultant led anymore as I feel the midwife and the consultant are both just leaving it to each other to check me when neither are checking me!

Any advice??

No you are not asking too much in terms of getting a good servicebout of your review appointments but I think the consultant led aspect is about safety during Labour and having a consultant available. Are you confident to raise your concerns with your midwife and/or consultant? Or you could ask for your Midwife's supervisor.

Thanks for your reply. Yes I raised it with my midwife at my last appointment about feeling like I don't need consultant care and she just suggested to speak to the receptionist at his office if that was the case? She didn't give me any reasons from a care perspective as to why I should stay with the consultant.. I just feel really in the dark about my own care and I don't really understand why I'm having to see both the midwife and consultant if neither of them has much to say!

I absolutely wouldn't be making any rash decisions, but I do understand where you're coming from.

I'm having almost the opposite issue, but with a similar outcome. I'm having twins so I'm consultant-led. As a result my midwife said to me at 16 wks that she didn't need to see me again until 30wks. Only when I saw the consultant at 24 weeks I mentioned that I wasn't seeing the midwife and they were not impressed and said i should be doing both. I'm not really clear on why, since they'd be doing exactly the same checks at basically the same time an I'd have to take twice as much time out of work. it has left me wondering if I'm missing out on aspects of the advice/care I should be getting from the midwife. So difficult knowing if you're being unreasonable in challenging the professionals though - esp. as it's my first pregnancy so it's all very new.

Maybe try raising it with your consultant next time? It may not be the case that they suggest they stop seeing you, but they might be able to address your concerns that you're not getting what you need from them.

As PP said I think the consultant led aspect of it has a lot to do with labour plans etc but not having an appointment until 35 weeks doesn't seem right. I had appointments every 4 weeks up until 32 weeks and now every 2 weekly. Also not sure why they're not measuring FH. Have they mentioned having any growth scans planned for you? It doesn't seem right that they're not in any way monitoring the growth of baby.

I’m also under a consultant for a raised BMI of 35. Is this your first baby?
My bump wasn’t measured until I was 30 weeks exactly but I was having precautionary growth scans so that’s why.
It’s generally the midwife who takes those measurements and I think it varies in different areas but you should be seeing a midwife around once a month and then from 36 weeks every two weeks. So that’s something to raise with the midwife.
As for being under consultant care you could ask to be discharged to midwife led care but the risks remain the same. Has anyone explained to you the risks of having a BMI over 30 in pregnancy?

• big baby
• shoulder dystocia
• gestational diabetes
• pre eclampsia
• blood clots
• post part in haemorrhage
• increased risk of stillbirth

I’m sorry If it sounds like I’m trying to scare you I’m really really not but just checking you’ve been made aware of all the risks that’s all. Although it may seem like the appointments are unnecessary (lots of mine felt pointless too) at the point of delivery should there be any issues you are already under the consultant so it makes things easier. I’m going in for induction tomorrow at 41 weeks, there’s no medical reasons as such other than the increased pain in my back but my consultant has decided to induce where as my midwife wouldn’t have suggested that until I was 12 days overdue she told me! I couldn’t have gone 12 days over 7 days has been a killer 12 would have destroyed me!

Those appointments were purely midwife led care as well which is strange as I thought consultant led care meant more frequent appointments! Maybe I'm wrong there though

Thanks for all your replies. Sorry I don't know how to @ people in individual replies

It's interesting to hear of people's different experiences... It just doesn't give me much confidence especially since the consultant missed out vital information on my last blood test results with me being anaemic .. It makes me wonder what the point is of seeing so many professionals when I was left for weeks feeling exhausted and it could have been sorted if it was spotted by the consultant.

I definitely see the point of it may be handy when it comes closer to delivery time. My last scan was the 20 week scan. I have another at 34. I was supposed to have one at 28 weeks but I found out they didnt book one for me.

Could this be a case of changing consultants as opposed to stopping consultant care entirely?

Yes changing consultant may well be the thing to do however you need to advocate for yourself no matter what. What happened at 28 weeks? Did you turn up for the scan and one wasn’t booked?

I saw my midwife yesterday and she was expecting there to be notes on a 28 week growth scan that I didn't even know I was supposed to have. She just told me it was supposed to be booked in but they never requested an appointment for me

Interesting as my bmi was 32.2 and ive remained midwife led.

Ah they're being a bit useless aren't they? Not that it helps but my midwife has been the same! Not sent me for scans I was supposed to have and "forgot" to tell me for 6 weeks that I needed iron tablets!

At least the 34 week scan has been made for you so your baby's weight and your fluid levels will be monitored.

@needanappp it sounds like we've had similar experiences.

I probably have to think about it a bit more as I don't want to disadvantage myself closer to delivery.

I had consultant led for same reason. At 20 week scan I was advised I needed one at 28 so I went to the desk to book it - are you sure you weren't meant to do the same but thought they were going to do it?

Midwife still did everything else. Don't think I got weighed but she measured my bump etc so I think you need to have a word with her too

Congratulations

I’m in a similar boat. They keep sending me for scans every 2 weeks for absolutely no reason. Everything is showing as perfect on the scans, I have no health conditions or overweight. Hospital takes over 3 hours to get to due to traffic and distance and I have to get 2 buses

Recently changed to a new hospital and they questioned me on the scans as they couldn’t work out why I had so many. I asked for advice whether to go them or not on a fb group and got a load of absue from it so just carried on going

My bmi is 33 and I’m midwife led. Weird, maybe it’s different in different parts of the country. Only difference to my last (thinner!) pregnancy is I’m to get the glucose test at 28 weeks.