Is this too long between midwife appointments?

[moominsmummy]

Am 28 weeks with no2 just saw my midwife today and all ok as usual.

My next appointment is in 6 weeks time - is this usual? I'm sure my antenatal appointments were more frequent last time - alot could happen between 28 and 34 weeks?

Mine is the same, I am 26 weeks now, last time I saw midwife was 16 weeks, next time is 28 and then 34 weeks. It does seem a long time doesn't it?

no thats normal

i ididnt see mine from 12 weeks until 24, with 20 week scan in between.

It's not supposed to be normal (should be every 4 weeks), but it think because of stretched maternity services it is becoming more common.

its right for the NICE guidelines for a second child or more.

in my area they seem to see you a lot, im having number 3, got no problems and having mw led care. so far ive been seen at 8 wks, scan at 14 wks, 16 wks, scan at 20 wks, 28 wks, 31 wks, and there seeing me at 34 wks, 37 wks,39 & 40 wks. seems like quite a lot

I had my 16 week appointment with my midwife and she told me that the NICE guidelines mean that with a second child she doesn't have to see me again until 28 weeks but she thinks that is too long to go inbetween so has booked an appointment in with me for 24 weeks as well. I then should have had a scan at 20 weeks in between which would have meant that I am seeing someone every four weeks which I was happy with but my hospital doesn't do their anomoly scans until 23 weeks so I would have gone 7 weeks without seeing anyone and then two in a week. Anyway didn't like the idea of that so have cancelled my 23 week scan and paid for a private one at 20 weeks so that I am seeing someone every four weeks. I really think that this is long enough to go. Mind you I have had a previous mmc so am quite anxious.

I'm 38 weeks and saw the doc at 36 weeks.I was supposed to see the midwife this week but didn't make the appt in time and she can't fit me in. I'm due in next tues for my elective. I've phoned the hosp and left 2 messages to say can't see local midwife and should I go there and they haven't called me back. My mum is a nurse so I can get her to do my blood pressure tonight and I'm monitoring movement closely.

Do you think that's enough? Or should I try harder to see a midwife or doc? (its my 2nd baby)

I'm 38 weeks and saw the doc at 36 weeks.I was supposed to see the midwife this week but didn't make the appt in time and she can't fit me in. I'm due in next tues for my elective. I've phoned the hosp and left 2 messages to say can't see local midwife and should I go there and they haven't called me back. My mum is a nurse so I can get her to do my blood pressure tonight and I'm monitoring movement closely.

Do you think that's enough? Or should I try harder to see a midwife or doc? (its my 2nd baby)

Normal for a second child and no issues. I get a 32 week as well, but then I have complicating factors.

Sorry to jump on thread and post that twice, am using my blackberry, as having a quick lie down!!

Not as efficient as pc!!
X

My appointments with this one (2nd baby) have been on average every 5/6 weeks I think.

I was seen at 8 weeks at the EPU, then for my booking in appt at 13 weeks, had a scan the following day as was not referred for the nuchal scan. Then was seen again at the Dr's at 18 weeks and am due to be seen again at the Dr's this week (24 weeks). I had my 20 week scan at 22 weeks but didn't really get to speak to anyone.

I was a bit shocked initially because I remember the appointments being more regular first time round. I know I am probably being unreasonable, and I understand that maternity services are stretched but this time round, I don't feel like anybody is that bothered. Even during appts when you are discussing progress, everything I say seems to be dismissed with a wave of a hand and the old 'you've done it all before' chestnut. Yes, I have done it before, but this time isn't any less worrying!

With my first I saw the midwife every 4 weeks but she was rubbish and never once checked my urine, which I didn't know she was meant to at the time.

This time I've seen the midwife every 2 weeks and she is fabbo.

i have had up to ten weeks between appointments and it would have been longer had i not complained.

i am now 37wks, i saw the midwife at 34wks and i will be seeing her again at 38wks, then at term.

i had a booking appointment, a dating scan, then nothing till the 20wk scan, then saw the midwife at 28wks, then 34wks.

if you are worried you can always call and insist on an appointment, or your hospital may have a drop in clinic? ours has one called PAWS, the pregnancy and well being suit or something? and you can self refer to it

I don't know why the appointments are different from your first child to your second/third etc. Surely there is just as much chance of something going wrong with any of your pregnancies.

Not exactly -- if you have a straightforward first pregnancy then there's a higher chance of your second pregnancy being straightforward than if you don't. Issues like gestational diabetes, pre-eclampsia, SPD, premature labour, incompetent cervix, high blood pressure, etc., are all relatively likely to recur in subsequent pregnancies. With a first pregnancy you haven't had any prior pregnancies to assess to see if any of these are likely to be factors. And also with a first pregnancy you have less idea of what's normal or not.

I wish my appointments were further apart, I ahev the normal m/w appointments with ym local midwife plus have to spend about 3/4 hours at the hospital every two weeks.

There is no reason for them to see you more often than the recc'd checks unless bay is either your first (I think you have two appointments more than with subsequent babies) or you have had problems, most of the time as soona s there is a problem you'll eb refferred to consultant care anyway so appointments would increase.

Conky, are you booked in for your elective on tuesday or is it the day before? You must go to the hospital at least 24 hours before your el cs to get any medication they want you to take and to know the procedure for nil by mouth etc. Call them again, unti you can speak to someone and book an appntmnt for the day before. If you can't get through then call the maternity ward and explain the situation, they'll sort it for you.

True P and L and on the physical side I can see what you mean but on the emotional side I think that the checks should still be in place. Although you may have less idea of what's normal or not with your first pregnancy the other side of that is that you are much more aware of all of the things that can go wrong with your second pregnancy and so ahould have the same level of care as with the first. I am much more anxious this time because I know more. With the first one I sailed through it. It really was a case of ignorance is bliss !! Mind you as I say I have had a mmc so I think that I am a lot more paranoid and anxious this time because of that. I agree with Lazylou that you do tend to get a bit of a 'you've done it all before so get on with it' attitude when actually the fact that you have done it all before may mean that you need more support not less.

It isnt the midwifes place to give you emotional support, that should come from friends and family, and most midwives are there at the end of the phone if you need them, so I don't agree lolski.

I think that if you are worried at any point most midwives will offer you an appointment, and once you pass so many weeks the labour ward will happily see you if something doesn't feel right.

I think in many cases midwives are expected to do the jobs of so many other peopel, be it family, doctors, nurses, breastfeeding counsellors, health visitors etc, they cannot feasibly do this and as long as everything is going fine with your pregnancy should not be needed.

'Emotional support' probably wasn't the best wording VS. I agree and I am lucky enough to have loads of emotional support from my friends and family. I mean more support as in peace of mind and knowing that everything is progressing as it should be. For example hearing a heartbeat. Unfortunately this is something that my friends and family can't help with. I don't think that it is unreasonable to expect an appointment every four weeks whether you are pregnant for the first or tenth time.

You can't hear a heartbeat for quite a while anyway, and then you have movements to tell you everything is progressing ok. If a heartbeat is that important you can buy dopplers to use at home.

The trouble is that in some people movements are not always frequent and that obvious and sometimes don't start until quite late. 'If a heartbeat is that important'. I would have thought that to most people especially those that have had previous problems a heartbeat is very important. Home dopplers are great for the extra reassurance but I don't think that people should be in a position that they need to buy them because they are not seeing a professional for 8 weeks.

The amount of people midwives have to see at the surgery, plus everything else they do in the community, every 4 weeks isn't feasible.

Every 8 weeks is, and if something is likely to go wrong, more often than not you will have more regular appointments, if something does go wrong it is rare that there will be no symptoms or that more regular checks would have prevented it, so there really is no point for midwives to see people more often just to put their mind at ease. To do this we would need to employ more midwives to work in the community base and we don't even have enough midwives in the hospitals so it's not likely to happen.

I'd imagine if the choice was between a m/w visit every 4 weeks and less staff when you are actually in labour or having problmes and in hospital or a visit every 8 weeks and a better number of staff (which often equates to a better standard of care) most people would choose the latter.

I can understand for those who have had mmc that it is incredibly hard not to worry, and for people in this situation, maybe the first sets of antenatal checks should be more regular, until movements can be used as a reassurance, but pregnancy is a normal thing to go through, women do it all the time, we can not be expected to be babysat through it by busy overstretched midwives.

FWIW, I'd happily give up some of my appointments to a woman who had previously miscarried and wanted reassurance and rarely bother my m/w if I have a problem but go straight to the specialist unit I am being dealt with as they have more time and budget to deal with it.

VS I really don't think that expecting to see a midwife once a month for the last 5 or 6 months of your pregnancy is being 'babysat'. And whilst it may not be feasible for the midwives to see you more often because they are too busy it doesn't make it right (and I am in no way being critical of the midwives themselves because I think that they do a fantastic job under the circumstances).You say that if something does go wrong then it is rare for there to be no symptoms but sadly you have only got to look at the amount of people on MN that have suffered mmc to know that this is not necessarily the case. You cannot under estimate the importance and reassurance of regular checks.

I don't know much about mmc, so forgive me if I sound ignorant or offend, but I'm not aware of anything a midwife/doctor/HCP can do to prevent this happening, and I don't see what difference it would make being seen every four weeks after the initial period of risk (which is something I did agree could be put in force for peope with history).

With a mmc sadly the fetus can have died weeks before and you may not have had any symptoms. You are right a midwife or doctor couldn't prevent a mmc but they can provide reassurance that you haven't had one. You say that you don't see what difference it would make being seen every 4 weeks but believe me waiting four weeks to be told that everything is ok seems like an eternity when you need this reassurance let alone 8 weeks.