36 week scans bring cancelled

[UnilakTea]

Morning! Just thought I'd let you know that atleast in my area of Kent they are cancelling 36 week scans unless your high risk!

@hopefulhalf great! So glad you're here to give us all the wake up call we need. Are available for phone counselling sessions? Because I was looking for a mental health professional with antenatal expertise to help manage my concerns. I'm free whenever you are.

We're all super happy you're here to share your expertise and listen to us xx

I don’t think the current issue is a shortage of midwives (although I’m sure they have their share of those self isolating and ill) but that many maternity related checks rely on contact between the midwife and pregnant women which has to be restricted at the moment.

No 36 week scan up where I am.....at least there wasn't last year, unless something has changed??

@parker231 We get that, but it doesn't mean that we can't be worried or concerned about the monitoring that we would have otherwise received, which was previously deemed to be essential...

Until a few weeks ago I had to attend a weekly clinic for gestational diabetes. I saw a range of different staff each time, and it couldn't be missed. I now have a weekly telephone call. It is better than nothing, but it is concerning that what was previously considered essential has just been dropped. I have the b/p machine, Doppler and dipsticks, and have had a previous baby so know some of the things to look out for, but I am not medically trained. I particularly feel for FTMs who haven't been through it before, and for the reduction in postnatal checks.

Most women and most babies will, I am sure, but fine, but there is a risk and we are allowed to be concerned.

I agree but what is the solution?

Well said @IvinghoeBeacon

@Parker231 why do people keep going on about a solution? There isn’t one.
It’s shit and that’s why boards of pregnant people across the world are voicing their worries as a problem shared is meant to be a problem halved

It’s comforting to know we are not alone.

I’m 3rd trimester - I’m scared.
I’ve also been on the waiting list for surgery that would have been happening within weeks of baby being born and that’s been cancelled.

The fact that il be in pain for a longer period of time after birth is the smallest of worries for me rather than coming out the other side of giving birth with a healthy baby and getting home from hospital without either of us catching anything

The shortage of midwives in our trust was last week 40%
M

@Parker231 the solution is getting a bit more mental health support, communication and clarity, and some women honestly just need to feel heard.

The communication from the midwifery team here has been pretty poor (almost non existent), and yet when I went to see them for a check up (fully acknowledge I'm lucky to have that, given some of the women posting haven't) there were loads of midwives and no patients. It might have been a quiet day but no one seemed busy. They also
Nixed the birth centre and made it a covid ward, and failed to explain restrictions on my partner coming in for parts of the labour.

Would be nice just to feel heard, or discuss concerns.

I wish I could get the mental health help I was referred for 5 weeks ago

I’ve assumed they’ve all been reallocated so not even worth putting extra pressure on them to chase it up any more

@hopefulhalf the problem is how does anyone know their pregnancy is healthy without the checks? I'm lucky to be far enough a long that my fundal measurement was taken a few times before all this kicked off. It was consistently measuring behind so I was sent for a growth scan. This identified a problem that has made me high risk and has required twice weekly scans in the knowledge that baby may have to be whipped out if any of those scans are unfavourable and the minute I hit 39 weeks baby is coming out. I've had no other symptoms so without the fundal measurements noone would ever have known. I've been very lucky so far that baby is managing ok, but that could change at any minute and things could have turned out differently.

Under the new system this potentially life threatening problem for my baby would have been missed. So don't preach to a bunch of scared pregnant women that they shouldn't complain because they're having healthy pregnancies. They're bloody terrified because they don't know if they are in fact having healthy pregnancies.

I feel for everyone in this situation. It’s hard and it’s extremely anxiety provoking. Changes in plans are hard. As others have said the 36w scan is not universal so it’s not surprising it’s being cut in some areas.
It’s a balance of risk to mums and babies partly - and also a balance of wider risks and resources and trying to stop infection spreading.
But I don’t think it’s that people don’t care about pregnant mums and babies. Or have forgotten about them. This is affecting everyone in more or less difficult ways. Some very hard decisions are being made. It affects us all differently but it does affect us all.
Rather than contacting MPs I’d suggest contacting midwives and talking about anxieties and what the best alternative might be - be that home monitoring or something else.
I have never given birth during a pandemic. Not pregnant now. I do however have a kid who has just finished chemo and won’t get her follow up cancer scan on time (she didn’t choose to have cancer at all never mind in a pandemic). So I get the anxiety and the fearfulness that comes with changes to the plan.

@hopefulhalf First of all, women in third trimester are NOT at increased risk (where did you get that rubbish from?)- they are the only group that we have any data from at all since any women who gave birth having it were in third trimester obviously. We don't know of any risks for any trimester pregnancy really.
Secondly, the point about Shamina Begum is a bit weird since she had a pretty god choice of NOT choing to become and ISIS bride and could have stayed with her fmaily in the UK safe and sound.
Thirdly, while a lot of women here can make peace with the fact that they may give birth without their partner or not have an 'ideal' birthing experience, not seeing your midwife/consultant for pretty important (a lot of issues do come out of routine testing) appointments is ever so slightly different. There is a difference between the fact that kids don't get to sit their GCSEs (which will not impact them physically) and that someone's gestational diabetes may not be picked up on time and create complications.

My hospital btw changed nothing (Londond) and all appointments carry on as usual. had a scan at 36 weeks yesterday, there were only 3 other people in a huge usually crowded waiting room. My midwife appointment is carrying on as usual too.

The comment about increased risk in third trimester isn’t rubbish. It’s unclear because this is a new virus so data evolving but other respiratory viruses more severe in third trimester so RCOG recommend different approach to women in third trimester - eg pregnant health care workers not being patient facing in third trimester. Still overall low risk for pregnant women.

www.rcog.org.uk/globalassets/documents/guidelines/2020-03-30-occupational-health-advice-for-employers-and-pregnant-women-during-the-covid-19-pandemic-20200406.pdf

It won’t be just for high risk pregnancies though, others shouldn’t worry. Mine is measuring on the large side so I still had my 37 week scan and will be returning at 40 weeks. There are many other reasons for scans

I was also given sheets of info that clearly state ‘increased risk after 28 weeks’ and sets out guidelines for those still in work. Hope that helps (not sarcasm)

@chinateapot It is rubbish as it suggests there is data on it, while there is not. As I said, there is no confirmation about anything at this point, just a guessing game based on China numbers really, which is underlined in the document. So we dont know if the risks are increased (compared to 2nd or 1st trimester for example, since no one who were in those trimester gave birth yet). In China, they reported some women who had other health conditions like diabetes found it harder to manage for the same reasons as we now face here- lack of support, not being able to see a doctor, not having their regular appointments. So yes, in a way the risk is increased, but for everyone in the same way, but not necessarily because of the point in pregnancy.

I agree but what is the solution?

The RCOG has published guidelines recommending changes to the usual schedule of checks for low risk women, easily accessible as a PDF on their website. I would expect that to be followed wherever possible and yet I've seen multiple women in FB groups who aren't getting anywhere near that level of care.

@starrysimon Is there any chance you could share the sheet- my trust has had nothing similar, so I would be really interested to read that. We have had long discussions with my employer about wfh as there was nothing to indicate that being in 3rd trimester I was at any more risk than anyone else pregnant.

I'd be interested to know why, when many Independent Midwives have offered their services to NHS on bank contracts, mpat Trusts have declined this offer?

Not all Trusts have cancelled home births, some have been creative with solutions to help keep them going. For example, one Trust has partnered with a private ambulance company in order to address the apparent issue of ambulance shortage. So again, why isn't this true of more Trusts?

As someone said, in other countries they are saying the risk of catching Covid by going to hospital outweighs the the benefit of antenatal appts etc. Doesn't it make sense that for low-risk women such as myself, we are kept out of hospitals so that higher-risk women can be better supported and put at less risk themselves?

Once again I accept there is a pandemic, but I am still well within my rights to challenge decisions that are being made, a lot of which I strongly believe are not in the best interests of pregnant women and their unborn babies. I don't believe alternative solutions are being fully considered and I won't be told just to "suck it up".

• most, not mpat!!

I think it will come down to individual trusts having different demographics, resources, pressures etc. You are absolutely right about challenging decisions but what works for one trust obviously won’t work for all (and I appreciate that you realise this). As it is I am likely to give birth within the next two weeks and my time and energy for challenging things are rather limited, so I have to go with acceptance. In fact my concerns for my own personal circumstances are more to do with the lack of support network (either in the community or from my own family) after the birth, though obviously the process and outcome of the birth has an impact on this in itself. Which is not to say I’m not concerned for other women’s priorities too!

Do you actually want to come to hospital for routine blood tests, or scans at this time? Given that women in the third trimester are at increased risk?

@hopefulhalf What a stupid question. I’m terrified of going into hospital at the moment (who isn’t?) but as a high risk pregnancy I have no choice - it’s for my baby’s sake and for mine that these scans and checks are done.

Are you actually pregnant yourself or have you just come onto the pregnancy board to goad and upset pregnant women?

Not pregnant, attempting risk managment in an acute NHS trust , although thankfully day off today.