Pregnancy after premature birth

[CoalCraft]

Just to be clear, I am not currently pregnant or TTC, but I know I'd like another at some point and maternity us leaving me with a lot of time to think.

DD was born in November at 33 weeks gestation. She's done really well and is thriving, but obviously I wouldn't have chosen for her to be born early.

The reason for the premature birth is unknown; I had 1st trimester bleeding and an irritable uterus throughout, and ended up spontaneously going into labour at home. My symptoms prior to labour were quite extreme, but I was only ever seen by midwives and I feel as though opportunities to delay labour and also to prepare DD in case of premature labour were missed. For example when on the ctg for reduced movements I had strong, regular contractions, but the midwife seemed completely unconcerned. I have birth less than a week later.

I've been told that future pregnancies would have consultant involvement but I'm not sure how that process works. Who would refer me? Would I be seen regularly by the consultant after that?

The main question I suppose here is, if you had a premature birth and then a subsequent pregnancy, how was your care different?

I had DD1 at 34+0 and honestly my care with DD2 wasn’t particularly different apart from paying more attention to cervix length in scans. Possibly I had an extra scan at 32 weeks, I can’t remember.

I did however make my own changes, in particular I used annual leave to cut down my working hours increasingly through the second and third trimester. I think this helped but who really knows. DD2 was born in exactly the same way (PPROM for no apparent reason) but at 36+6.

I am seen by a consultant for different reasons and your midwife refers you.
You will see your consultant usually at around 28 weeks and then a couple of times more. Usually after growth scans, so once or twice more every 3 or so weeks as if you're under consultant care you will usually have growth scans too.
This will be as well as your normal midwife appointments. However you have less midwife appointments for your second baby

Thanks for the responses both

Bit worrying for me to hear that you don't see the consultant until 28 weeks as for me the problems/symptoms started well before this. Perhaps you can be seen earlier if it seems necessary.

Obviously I'm hoping that a future pregnancy will be problem-free and go to term without incident but I'm aware that I'm at increased risk now. It would be so helpful to know why she came early but I've just no idea and suppose it's too late to find out now.

Were you not under a consultant though? I thought even if you only see midwives you still had a responsible dr overseeing your care. Maybe not, I was consultant led. But in my case this was chosen/discussed at the booking appointment and my GP was actually able to name a particular consultant on my initial referral. I think you should maybe try to find out who your responsible dr was and maybe try to organise a birth debrief, perhaps through a specialist midwife or pals.

I would insist on consultant led care for subsequent pregnancies, as that way you see a dr for all appointments. I only saw a midwife at my booking and my 28 week check up in the community. I had many miscarriages so that's why I was so uptight , nothing against midwife led care! But I do understand anxiety during pregnancy and seeing a dr with a background in my issues meant I felt supported and reassured the whole way through