What happened at your 16 week check?

[randommangoandpear]

Just curious. I remember with my first, they always checked urine and I think they checked the heartbeat!

I had my 16 week midwife appointment today. All she did was give me my combined screening and gestational diabetes results (negative) and check my BP. No urine or Doppler, or bump measurement.

NICE guidelines have been updated.

We should no longer be listening to a heartbeat at 16 weeks.

Had mine last month.

Urine. Blood pressure. Doppler and a quick chat about a couple of things but not in depth.

I didn't hear heartbeat with my midwife until my 22 week appointment. It's all changed now!

This is the updated NICE antenatal care pathway. If you scroll through it shows you what should be happening at each appointment.

https://www.nice.org.uk/guidance/ng201/resources/schedule-of-antenatal-appointments-pdf-9204300829

Thanks. So they should have asked for a urine sample then.

Every trust is different. I had urine, bp and Doppler. They didn’t start measuring my bump until 28week appointment.

Every trust shouldn’t be different. The whole point of NICE guidelines is to standardise care.

Currently yes they should have. But there is talks of this being stopped so they may have thought it was already in place that we were no longer routinely assessing urine.

https://view-health-screening-recommendations.service.gov.uk/asymptomatic-bacteriuria/

They should for every appointment. They forgot at my 28 week appointment.

@Madwife123 I’m only saying what I’ve seen and heard. I had the Doppler at the 16 week appointment. On the due date thread people in other parts of the country varied on if they had the Doppler or not (hence my comment about the trusts being different).

Some trusts are following NICE guidelines as they should. Some midwives are old fashioned and are not following guidelines. This isn’t a good thing.

There is absolutely no evidence that listening to the heartbeat at 16 weeks improves outcomes and in fact it’s proven to increase maternal anxiety and waste NHS resources (unnecessary ultrasound) when it comes to the large proportion of women where a heartbeat can’t be found this early.

At my trust they say they don’t routinely use the Doppler anymore but they still do, they just have to write that the mother requested it to cover themselves. They should still do urine sample , blood pressure and then just go over blood test results. Very short and pointless appointment without hearing the heartbeat

Had mine yesterday and did BP, urine and heartbeat. Had to ask to hear heartbeat though and she caveated it with the fact she might not be able to find it and if she couldn't I mustn't panic and she wouldn't refer me anywhere.

So what should I do then? Call them and ask them to do a urine sample?

It’s not pointless. It’s to screen the mother for many conditions.

Writing the mother requested it to “cover themselves” basically means that if they can’t find a heartbeat and you are distressed because of it they can pretend it’s your fault as you asked for this to be done despite evidence saying don’t do it. This really isn’t ok!

@Madwife123 the 16 week appointment is pretty pointless. During covid the 16 week appointment was only done over the phone. They’ve always told the mother that there’s a chance they can’t find the heartbeat when using the Doppler at my trust. Although I havent come across anyone that they haven’t found it for. I’m unsure why you’re getting very agitated telling people what is and isn’t ok.

I’m not. I’m telling you what the national guidelines say and they say this for a reason. It’s fairly common to not find a heartbeat at 16 weeks and if that’s the case the new guidelines are you will not get a scan. So women are left 4 weeks in sheer panic as a result. It’s cruel. Pretending that women have asked for this isn’t ok at all. It’s blaming women for their own distress when the midwife is the one not following the National guidelines.

@Madwife123 noone is pretending women have asked for it. They tell you they can’t do it unless you request it so then they put a note on your file to say it’s been requested. They also tell you that there’s a chance they may not find the heartbeat but that it doesn’t indicate there’s any issues. If you don’t want it you don’t have to have it. This is my third baby so I’m fully aware of it all but they still go through it all anyway. Like I said without doing the heartbeat the 16 week appointment is a bit pointless, as proven by them only doing them on the phone during covid.

@randommangoandpear I don’t think you need to call and request a urine sample unless you have concerns. As I said on my previous post during covid we only had a phone appointment at 16 weeks. Just make sure they do one at your next appointment, if you do have worries you can call them at any time

And do they tell you that the guidelines state midwives should not listen to the heartbeat at 16 weeks? That if they don’t find it you will not get a scan, they will not try again in a few days etc. You will wait 4 weeks not having a clue if everything is ok until your anomaly scan?

Because I don’t believe anyone says yes to that.

FYI the trust I work for never did 16 week appointments by phone during covid so not all did. And lots of things happened during covid that were detrimental to the health of women. That doesn’t mean it’s ok, or why are they not still doing this appointment over the phone?

What 16 week check?
I had my 12 week scan then I've got my 20 week booked in. No 16 week check.
I did have a private scan though for gender (sex yes I know) but that's neither here or there.
They always do bloods and urine though.

I can't remember if I had one or not with my first either

@Madwife123 they do actually tell you that they don’t routinely do the Doppler at 16 weeks as I’ve mentioned in my previous post. They’ve never mentioned that if they don’t find one you will get a scan, they’ve always just said that if they may not find one yet. This has been the same throughout all my pregnancies and my eldest is almost 12. If you have a look through a lot of the covid posts you’ll see that many trust did the 16 week appointment over the phone. I’m guessing there’s something going on and this forum is being used so you can vent a little as I can’t imagine any other reason for the hostility. I sincerely hope you work through it.

Not at all.

As a midwife I’m passionate about all pregnant women receiving evidence based gold standard care, that’s why most of us choose to do this, and it bothers me to know there are whole groups of midwives out there deliberately ignoring those evidence based guidelines and risking causing women distress.