Growth scans - when would you be transferred to consultant care?

[seeingdots]

I'm currently 31 weeks with my second DC and green pathway. I'm hoping for a birth at home or MLU after having had my first in hospital (induced) and feeling pretty let down by the care I received. Essentially, I really don't want to give birth at the hospital again if I can avoid it.

I'm booked in for growth scans at 32 and 36 weeks as a precaution because my DD was born slightly small for her dates (6 lb 6 @ 40+13). I'm not particularly anxious about these but I'm just wondering under what circumstances my care would be transferred to consultant-led as a result of a routine growth scan?

In my mind it's as likely he'll be judged as 'too big' than 'too small' and personally i'd take either of these results with a pinch of salt. Also, so as not to dripfeed, my BMI is 33 (or was at booking) but my midwife hasn't been at all concerned about this and my bloods and measurements are all fine so far.

TIA!

I've just been referred to consultant because of reduced growth. My understanding is that you're referred to a consultant when your growth doesn't stay on the same trend line, is above 90th centile or below 10th.

I fear my maternity led unit plan might be put the window... but I find out more when I see him Monday (scan with reduced growth was today).

Oh no, sorry to hear that @physicskate. Good luck for Monday. I didn't realise there were definite thresholds they applied like that. Worries me slightly as DD was 9th centile when she was born but was completely healthy and thrived immediately so I'd hate to get referred for just being a little on the small side according to a possibly very inaccurate scan. Of course if there's real concern about restricted growth you don't want to fuck around though!

I believe I'm being consultant led but I'm still seeing a midwife, so not sure what "consultant led" actually means!!!

Just had my 2nd growth scan and baby is a little underweight, 3rd is in 3w where they we will decide if he should be born a little early.

My first was 5lb13oz at 39+5 (2nd percentile?!) and I'm highly anxious about having intervention given the traumatic 1st time.

The doc I saw did however say, some people just give birth to small babies, so as long as the line is consistently low (rather than a spike) there is no reason it couldn't be a standard text book 2nd baby.

After each of your growth scans you should see a consultant to discuss the results. The main one will be the 36 week one as they are looking at the rate of growth between one scan and the next. If there are any worries about the rate of growth they will likely discuss inducing you early, which obviously would be at hospital. They should also be looking at the placenta function/cord blood flow and take this into account in deciding whether the growth is due to this.

Just wanted to check - have you discussed your plans for the mlu etc with your midwife already? I’m pretty sure my nearest one has a BMI cut off of 30 but wouldn’t swear to it...

@MonkeyToucher yeah I've talked through my birthplace preferences with my midwife. They don't seem to have any particular rules like that here. Initially I thought my BMI would be an issue for a home birth in particular but was told our home birth team wouldn't have any concerns about a BMI not too far over the 30 mark on its own. I'm also expecting a quick labour so the idea of having to travel an hour to the hospital in the case of a spontaneous labour would really freak me out.