Antenatal care, feel slightly abandoned

[feelingabandoned]

So I am 35 weeks PG with my first. Obviously I've never done this before and with the covid situation I've had some face to face contact replaced with phone appts and some cancelled. Despite that I have had quite a lot of scans and appts because I am high risk due to a pre existing condition. I am consultant led in hospital

Every time I go in I see a different person. I've had 4 midwives and 3 different consultants, as well as my consultant for my other condition. They have told me different things so that for example, after being prescribed something by a consultant, one of the midwives asked me about medications. I said "I'm taking X for Y reason" and she scoffed and said "no that's not why you're taking it".

I've had appointments booked for me (letters to my home address) which I've turned up to and then been told to go home as I shouldn't have an appt that week. The attitude is that I should know this.

I've been asked questions in really leading ways ("I assume you are doing X") and I'm really unsure, so I've said I don't know, can you explain what that means/what my other options are. Then I feel like they have been put out/annoyed that they're having to explain things to me.

I was previously told by a community midwife (who I'm not seeing any more because the hospital wants to lead the care) that she would go through labour and birth with me, and my preferences, at 34 weeks. That appt didn't happen but I had one today (35 wks) at hospital and asked the midwife if we could go through birth. She was noticeably surprised and looked at my notes, pointed to the triage number and said "well the signs of labour are on the website and if you think you're in labour you ring this number".

I explained that I wanted to discuss the process, pain relief, induction, monitoring etc. She focused on the induction part and started explaining at length why it's normally better to wait for spontaneous labour. I tried to say I know this and I wasn't necessarily saying I want to be induced, I'm just saying I want to discuss it, and she said "ok I don't have time for this now but I'll call you some time next week".

Just want to add that I have done tons of research, reading, watched videos etc and I'm not completely clueless but I thought that talking it through with a professional would be valuable and pretty much expected? I only had a few brief questions and I'm a bit frustrated that I wasn't allowed to ask them today while I was there face to face.

I'm just wondering is this all normal, or is it just because of covid, or is it a problem? Does anyone have similar experience/advice? I'm sorry this was so long, it turned into a bit of a rant!

Hi OP, sorry you're feeling so anxious and abandoned.

I'm a FTM and high risk too. I'm 32 weeks so a few weeks behind you but I can definitely feel my anxiety getting worse the further on I get. I even bought some blood sugar and urine dip sticks from amazon to do at home as I was worried about something being missed and I've paid for 2 extra private scans at 17 and 31 weeks.

To be honest though, I do feel almost fortunate to be 'high risk' as it has meant a few extra appointments which I wouldn't otherwise have had so I can't say I'm feeling particularly abandoned. A lot of what you mention in your post sounds like bad attitude and staff being unprofessional which, fortunately, hasn't been an issue in my area. Everyone has been fantastic. I was even on an antenatal ward for 3 days the other week and have no complaints about the care I received while in hospital.

I'm having an ELCS for medical reasons and not actually talked this through properly with anyone yet so been doing lots of research and watching online videos etc myself the same as you. I've also booked a private NCT course which starts next week so hoping that will cover a lot too.

There are, naturally, some changes due to covid but I don't think the bad attitude you've experienced can really be blamed on that. It sounds like you've just been really unfortunate with the people you've encountered.

Not sure if this helps or not, but these are the appts I've had so far:

9 weeks ish - booking appt
13+6 - dating scan
14+6 - first consultant appt
16 - midwife appt
20 - anomaly scan
23 - extra scan
28 - 2nd consultant appt
29 - midwife appt
32 - midwife appt
34 - next consultant appt

I've seen the same midwife but never seen the same consultant or registrar twice.

I think sometimes mothers expectations of maternity care are too high. Why do you want to discuss induction unless you're having one? Again with pain relief, you can't really decide until you're in labour and see how it goes for you. I didn't discuss these things, I'd read about them and had a vague plan in my head. Turns out I needed an EMCS anyway.

The appointments thing is very frustrating for you. There should be better communication so you don't have a wasted journey.

Some of what you describe is a bad attitude but some is probably you over thinking it.

Perhaps the community midwifes are feeling a level of stress at the moment - for some homework I recommend the positive birth book by milli hill which is great and covers loads.

I was terrified about birth hearing so many bad experiences from a relative that this book helped.

I also binge watched one born every minute to get a feeling of what happened at hospital. Even when things got scary there is a good outcome.

Lastly - labour ward midwifes are totally different to the ones you meet in the community. My antenatal midwife I had to start with was to laid back it drove me crazy but my labour midwife was amazing.

That sounds like poor care, it is hard when you don't see the same person.

If you want to look at some things around birth and birth plans, I hugely recommend the Positive Birth Company digital pack which is about hypnobirthing. I found it helpful and empowering. X

@Hercwasonaroll it's great that you didn't need to discuss those things and that you felt informed enough to read about and make a plan for yourself. Not every woman feels that way or is capable of doing so, and so her questions and concerns need to be taken seriously. Pregnant women are not a homogenous entity and the care given to them should not treat them as though they are.

@Hercwasonaroll

I think sometimes mothers expectations of maternity care are too high. Why do you want to discuss induction unless you're having one? Again with pain relief, you can't really decide until you're in labour and see how it goes for you. I didn't discuss these things, I'd read about them and had a vague plan in my head. Turns out I needed an EMCS anyway.

The appointments thing is very frustrating for you. There should be better communication so you don't have a wasted journey.

Some of what you describe is a bad attitude but some is probably you over thinking it.

Well the NICE antenatal guidelines say that induction and pain relief in labour should be discussed with women in the antenatal period. So I don’t think it’s unreasonable to want to discuss them with a midwife.

@Hercwasonaroll my appointments outline what should be discused at each appointment and even the NHS website says the following

"Your midwife or doctor should give you information about preparing for labour and birth, including how to recognise active labour, ways of coping with pain in labour, and your birth plan"

I don't think women expect too much when what should be expected is there in black and white 🤨

Thank you all for your replies.

@sel2223 I agree I am very thankful for the extra scans and monitoring I've had, it's been reassuring to see baby and be checked regularly so I know I am lucky in that sense.

@Hercwasonaroll You are right I'm probably overthinking everything, just having nothing to compare to I don't know what my expectations should be! I think it's maybe because the community midwife told me she would go through birth with me that I just assumed the hospital midwife would be ok with doing that too. I want to discuss induction because there is a reasonable to good chance of early delivery by either ELCS or induction, because of my other condition. If that happens, the details surrounding induction and any risks etc might influence my decision whether to have a section or not.

@Emelene I have watched some hypnobirthing videos and I considered getting the virtual pack, how long does it take to complete (roughly)?

@RestorationInsanity @JacobReesMogadishu @FirstTimeBumps Thank you for your replies, I do wonder whether I'm expecting too much but it's there in my notes with boxes to tick when we've discussed it, so I thought it was normal to do that!

@feelingabandoned it is about 10 hours I think, but the videos are all named so you could always pick the ones most relevant (like birth preferences / role of a birth partner) and do the others if you have time.

It did honestly make a huge difference to me so I always recommend people look into hypnobirthing! All the best xxx

I'm 37 weeks and last week they did my birth plan . It was done at my 36 week appointment.

Have they got a 36 week appointment scheduled ?

Apart from the midwife calling me next week, I have one more appointment booked in at 38 weeks.

Yes, birth plan is normally discussed at 36 weeks so hopefully the midwife will go through it with you in the phonecall next week.

I didn’t get to discuss birth plan until I was in the labour room last time, this time I’ve been assured we will discuss at 36 weeks. Unfortunately my trust you see whomever is working on the day of your appointment even if you have seen x before and they are working if y is free and it’s your slot you see y. It’s such a silly system and as a ftm I really feel for you with the worries of pregnancy and the current situation heightening things life is tougher than is should be!

Since you already did some research into pain relief and birth preference options available..

Go ahead and fill out the page in your mat notes for birth plan / preferences.

IME they do read it when you are labouring at the hospital. You do not need to wait for community midwife, she would not fill it out in any case, you would.

When I was FTM my CM could not give less of a shit. She was horrible. I followed NCT advice and filled it out. It was listened to. Second time around I just filled it out. It was ignored because by the time I got there DC2 was pretty much crowning.

Anyway fill it out and make sure your birth partner knows and understands your preferences.

And is prepared to advocate for you during labour