Pregnancy booking appointment

[chattycaterpillar]

I have my pregnancy booking appointment next week and I'm very worried about the following:

A) I am overweight, ( BMI approx. 29/30). I understand they take your height/ weight at booking and am worried they will judge me, assume I will feed the child rubbish, make me go to dietician.
B) Last year I took a low dose antidepressant, ( 10 mg fluoxetine), for the first time in my life, ( very stressful situation that has now resolved). I stopped taking the fluoxetine, (with GP approval), when I found out I was pregnant due to potential risks. I also accessed NHS counselling via IAPT last year, ( that finished several months ago). Do I have to disclose this , as I feel it' my private business ? I don't want a well meaning referral to a mental health midwife/ social services on the grounds that would stress me out more.

I can't comment on the weight element, but please do tell them about the antidepressant and counselling. All they will do is check how you're feeling now and let you know there's a mental health midwife to talk to if you ever need to. Hopefully you won't need mental health support during your pregnancy but if you do, it's better that they know your background. They really won't judge, just let you know there's support available if you need it, and if you don't then great, they won't push anything on you.

I'm just freaking out and googling the booking appointment and everything they ask.
To add context, this was mild depression, ( I was and remain in full time employment). Wasn't signed off work, no suicide attempts, self-harm, inpatient stays, CMHT , psychosis, antipsychotics anything like that.
It was triggered by a stranger assault, and I rather wouldn't have to go into detail about that either.

I'm also confused whether the midwives can access your GP records and find stuff out ?

Weight wise, the will be concerned if you haven’t taken higher dose folic acid. You are high risk for some things but in my experience they won’t really do anything about it. I had blood thinning injections after birth. I think that was it.

Antidepressants, pls just tell them. They won’t be judging but they will put a bit more of an effort asking you about your mental health. Mental health is a big concern for all pregnant mothers, it’s a time of physical, psychological and chemical changes so every mother to be may potentially need some metal health support. Depression caused by pregnancy is higher than postnatal depression.

e.g find out about the previous antidepressant prescription and the NHS counselling.

A referral would only be made to social services if they thought your child was at risk. 1/3 people have a mental health issues during their lives, more women than men. Midwives aren’t referring people to ss because they once took antidepressants or had some kind of mental health issue. If they did they would be referring half if the women they see.

@Duracellbunnywannabe

Weight wise, the will be concerned if you haven’t taken higher dose folic acid. You are high risk for some things but in my experience they won’t really do anything about it. I had blood thinning injections after birth. I think that was it.

Antidepressants, pls just tell them. They won’t be judging but they will put a bit more of an effort asking you about your mental health. Mental health is a big concern for all pregnant mothers, it’s a time of physical, psychological and chemical changes so every mother to be may potentially need some metal health support. Depression caused by pregnancy is higher than postnatal depression.

That's the thing, I don't feel depressed now, I feel the issue has resolved, ( I've moved away from where the assault took place, and obviously the assault happened before this pregnancy). I've always wanted to be a mum, so the pregnancy isn;t making me depressed, more worried about being judged/ referred for extra "support," ( which I feel is extra monitoring by another name). The weight also increased significantly after the assault.

@Duracellbunnywannabe

A referral would only be made to social services if they thought your child was at risk. 1/3 people have a mental health issues during their lives, more women than men. Midwives aren’t referring people to ss because they once took antidepressants or had some kind of mental health issue. If they did they would be referring half if the women they see.

Yes, my friend is a midwife, ( but not in the same nhs trust), and said it would be very rare to refer for historic antidepressant use. It's just part of me feels it's my medical confidentiality, and should be respected, and I shouldn't have to disclose private and irrelevant medical details if I don't want to ?

Op my BMI was exactly the same as yours
( I'm 5.2 not sure if this is the same as you) and was anti depressants years ago
Neither of these was an issue in my pregnancy, so enjoy it :)

My weight was high at my booking appointment. If your BMI is over a certain point it might trigger certain things such as a glucose tolerance test, being referred to a consultant, not being allowed a water birth. All trusts will have different policies relating to this. My trust certainly didn’t try to refer me to a dietician or assumed I will feed baby crap.

With regards the anti-depressants, they ask for history on everything. They noted down the arm I broke when I was 10. They just like to gather a full picture. You should disclose the antidepressants because you might need help again during pregnancy. You might not. They would rather get you the help needed sooner when it can be more effective. You should also disclose it because the midwife will write a letter to your GP asking about safeguarding concerns, this could be domestic abuse at home or potential mental health concerns. The GP will mention that you have previously had antidepressants, no longer need them but it is more concerning if you don’t disclose that upfront. As the antidepressants were the result of an assault, you have to consider how much you may want to be touched during labour when you’re vulnerable and if that is going to bring back memories for you. If it will, this is something to discuss with your midwife now so that she can put you at ease and also discuss plans for you.

It’s natural to be anxious during pregnancy, especially the first trimester. However, you’ve some serious concerns about being judged, being referred to a dietician and social services. This is something to discuss with the midwife as it could be anxiety. A referral to the mental health team in no way means you are being judged or they are going to take your baby but it’s just going to offer you more support. The same if you get PGP during your pregnancy, you’ll be offered physio. If you can preeclampsia or gestational diabetes you’ll have extra monitoring. If your baby measures too small or too big, you’ll get additional scans and check ups. All of it is just to minimise any potential risk.

My BMI was 29.5 at booking in - nothing happened.
My SIL was slightly higher, and she's having some extra checks (blood glucose etc). It has nothing to do with judging you or what you'll feed your child in future - it's about there being an increased risk of certain conditions (like gestational diabetes) so arranging extra monitoring just in case.
I was offered a mental health referral based on my history - it was up to me if I wanted it or not though.

I was on Citalopram for about 6 months about 2 years ago, I told my midwife during the booking in appointment when she asked, she asked how I was doing now and I said fine; she said fine and we moved on. I know you're worried but it's so so common almost to be a non event to them.

If your BMI is over 35 that counts as a high risk factor so they may not even mention yours as it's well under that.

My BMI is similar to yours and I was just given a prescription for higher dose of Folic Acid and I think they mentioned some thing about a glucose test at some point, but that was it. As mentioned, it's only when it's over 35 that things might be an issue.

Thanks all, I guess I just keep worrying about being judged.

I don't get what you think your going to be judged about!? Sorry to be so blunt, but you need to get a grip. A midwife is not going to two hoots about the fact that your slightly over weight and once took an antidepressant!

Your midwife won't care about your bmi or previous history of mental health problems from a judging you point of view. The will care if your bmi tips you into needing medical interventions like extra scans and checks for diabetes. They will care about checking on your mental health through your pregnancy and more importantly afterwards when you are more at risk of post natal depression. It's in your interests to be honest. They will genuinely not be referring you to social services. I would just be honest and I'm sure your midwife will be supportive.

My friend , ( midwife), said I have no drug/ alcohol misuse history, no secondary mental health services involvement, no issues with DV, stable housing/ employment and they won't let antidepressant use, ( specifically a very low dose), be a red flag/ concern.

Hi, my BMI is 34, 1 point under the high risk category, the only comments I've had about my weight is that I need to take extra folic acid. They've not commented anything else, other than when discussing my birth plan (in 2 weeks, overweight people have an increased risk of forced delivery) they've been very uninterested in my weight.
In terms of anxiety and depression, I was heavily medicated a few years ago, i mentioned this in my booking appointment and my midwife offered counselling (I rejected) and asks me how I'm feeling each time I see her. She mentioned I may be high risk for post natal, but explained all thr support available.
I'd reccommend disclosing because their there to help, I've found my midwife isn't the best in terms of discussing pain relief (she's anti epidural and will only suggest I have a natural birth) but has been VERY supportive r.e. my depression/anxiety and not interested in my weight at all.
Hope all goes well

@Monmon28

Hi, my BMI is 34, 1 point under the high risk category, the only comments I've had about my weight is that I need to take extra folic acid. They've not commented anything else, other than when discussing my birth plan (in 2 weeks, overweight people have an increased risk of forced delivery) they've been very uninterested in my weight. In terms of anxiety and depression, I was heavily medicated a few years ago, i mentioned this in my booking appointment and my midwife offered counselling (I rejected) and asks me how I'm feeling each time I see her. She mentioned I may be high risk for post natal, but explained all thr support available. I'd reccommend disclosing because their there to help, I've found my midwife isn't the best in terms of discussing pain relief (she's anti epidural and will only suggest I have a natural birth) but has been VERY supportive r.e. my depression/anxiety and not interested in my weight at all. Hope all goes well

Forcep not forced lol

My BMI was high for my last pregnancy and I had a GTT and blood thinning injections after birth but that's it. Nothing else happened. I was allowed to have a water birth in a birth unit (until ds2 had other ideas!).

I specifically told my midwife unit to make a note to stop talking about my mental health in my records. And this has worked.

But I was on antidepressants 12 years ago (for 1 month) and a care experienced child (now 36). So I'm a big red flag (regardless of everything else I've done successfully since then!) for things completely out of my control. I am actually putting in a PALS complaint because they kept bringing it up - not asking me how I was but reminding me my past made me high risk for PPD. My complaint is they need to be trauma trained because that's unhelpful and just telling me I'm going to get PPD and literally nothing else was massively unhelpful!

I do have moments I wish I'd not said anything but I don't think lying helps anyone. Just mention the situation, explain you are fine now and you'd prefer to be the one that broaches the subject in future.

Am I understand this correctly? You think you will be referred to social care because of past antidepressant use?

Op, we'd be referring bloody everyone!!! Please do not be worrying about that. It's an absurd thought.

Yes at booking we weigh and measure you so we can generate a growth chart for your baby. We also do other things like make sure you're getting the correct dose of vitamin D/Folic acid and the correct referrals have been made for the rest of your pregnancy.

We see thousands of women. If these are your only issues then you're easy compared to some we see.

We wouldn't refer to perinatal mental health if there aren't any issues with your mental health either. The NHS is underfunded, we don't make extra work for ourselves where it isn't necessary or helpful to you.

You do sound anxious though. If you need support with this do seek help from your GP or midwife.

I care deeply about the well-being of the women I see so I don't want this to come across wrong BUT, I don't care enough to judge them!

They're strangers to me at booking. Why would I care if you have a slightly raised BMI? The majority of my colleagues are on anti depressants/anti anxiety meds, including me! There is no room for us to judge.

Sending best wishes for your booking. Take a breath. You'll be fine.

Thanks @DottieDam, I'm very sorry you had such a poor experience x

@cdba88

Am I understand this correctly? You think you will be referred to social care because of past antidepressant use?

Op, we'd be referring bloody everyone!!! Please do not be worrying about that. It's an absurd thought.

Yes at booking we weigh and measure you so we can generate a growth chart for your baby. We also do other things like make sure you're getting the correct dose of vitamin D/Folic acid and the correct referrals have been made for the rest of your pregnancy.

We see thousands of women. If these are your only issues then you're easy compared to some we see.

We wouldn't refer to perinatal mental health if there aren't any issues with your mental health either. The NHS is underfunded, we don't make extra work for ourselves where it isn't necessary or helpful to you.

You do sound anxious though. If you need support with this do seek help from your GP or midwife.

I care deeply about the well-being of the women I see so I don't want this to come across wrong BUT, I don't care enough to judge them!

They're strangers to me at booking. Why would I care if you have a slightly raised BMI? The majority of my colleagues are on anti depressants/anti anxiety meds, including me! There is no room for us to judge.

Sending best wishes for your booking. Take a breath. You'll be fine.

Thank you.

I think I'm almost "stigmatising," myself, because I never thought I'd end up taking antidepressants. Tbh, I don't think they made a particular difference to my mood either way, and the GP agreed I should stop taking them when I found out I was pregnant due to the potential risks and I don't feel any different. I guess I was worried they'd just be very interested cos although not currently taking them, the antidepressant use was very recent.

Can I ask what type of questions they ask at booking ?

I'm also allergic to the antibiotic Doxycycline, ( fine with all other antibiotics). Should I make sure I mention that, or would it be unlikely they'd give you doxycycline in labour anyway ?