Declining antenatal care

[Casuallydresseddeepinconversation]

I've declined midwife appts,I had a call last week to try and change my mind and another today,I feel coerced and bullied,patronised and ignored,I'm 20 weeks today and just want to be left alone, considering not going to my 20 week scan now too, the 13 week one wasn't a pleasant experience either and I feel very anti NHS,tho I don't have funds for complete private care, just feeling very emotional atm

Having a growth restricted baby increases your risk of stillbirth 4x. Having an undetected growth restricted baby increases your risk of stillbirth x8.

I'll copy and paste a good bit from the study which looked at over 92,000 women.

18.2% or 71 stillbirths in our cohort could have been avoided through improved antenatal detection. Extrapolated to the UK population, this would represent 600 fewer stillbirths per year.

And that is just discussing moving from non customised growth charts to customised growth charts. I'd imagine the number of babies which would be saved if you compared no fundal height measurement to customised growth chart would be even more.

I would argue that a study looking at 92,000 women is scientific. They went back and looked at the unexplained still births over the previous decade (?) and plotted the measurements on customised growth charts (which hadn't been used when these women were pregnant) and the vast majority if the new charts had been used would have been picked up as growth restricted. Sadly on the old non customised growth charts they weren't.

So you can think what you like, but the evidence is the polar opposite of your opinion. Of course you are perfectly entitled to do what you like and I wish you well.

I have asked this several times now, @Casuallydresseddeepinconversation - if you aren't going to go to the midwife visits, will you at least consider monitoring your BP (if it's high, it might indicate pre-eclampsia), blood sugar (gestational diabetes) and urine (high protein might indicate pre-eclampsia, and sugar in your urine might indicate gestational diabetes).

You can buy (from Amazon) a sphygmomanometer, a blood sugar test unit, and urinalysis strips.

Well nationally stillbirths in units where Saving Babies Lives has been implemented have fallen by a fifth so I don't know what that particular hospital is still doing wrong.

ObjectiveTo assess implementation of the Saving Babies Lives (SBL) Care Bundle, a collection of practice recommendations in four key areas, to reduce stillbirth in England.DesignA retrospective cohort study of 463,630 births in 19 NHS Trusts in England using routinely collected electronic data supplemented with case note audit (n = 1,658), and surveys of service users (n = 2,085) and health care professionals (n = 1,064). The primary outcome was stillbirth rate. Outcome rates two years before and after the nominal SBL implementation date were derived as a measure of change over the implementation period. Data were collected on secondary outcomes and process outcomes which reflected implementation of the SBL care bundle.

ResultsThe total stillbirth rate, declined from 4.2 to 3.4 per 1,000 births between the two time points (adjusted Relative Risk (aRR) 0.80, 95% Confidence Interval (95% CI) 0.70 to 0.91, P<0.001). There was a contemporaneous increase in induction of labour (aRR 1.20 (95%CI 1.18–1.21), p<0.001) and emergency Caesarean section (aRR 1.10 (95%CI 1.07–1.12), p<0.001). The number of ultrasound scans performed (aRR 1.25 (95%CI 1.21–1.28), p<0.001) and the proportion of small for gestational age infants detected (aRR 1.59 (95%CI 1.32–1.92), p<0.001) also increased. Organisations reporting higher levels of implementation had improvements in process measures in all elements of the care bundle. An economic analysis estimated the cost of implementing the care bundle at ~£140 per birth. However, neither the costs nor changes in outcomes could be definitively attributed to implementation of the SBL care bundle.

As you can see there has been an increase in scans, lscs and induction but a reduction in stillbirth. Guess it depends on priorities?

I think you are getting a hard time. I fought the system a little with mine as wanted natural births, low intervention. Of course a lot is up to you and I think it is healthy to question the norm and find out why those test and meetings have been planned in the way they are. Knowledge is power.

But I would urge you to decide and organize to have either the private anomaly scan you spoke of or the NHS one, as close to 20 weeks as possible. Especially if you are hoping for home birth. Some of the babies I saw in in the cardiac pediatric intensive care ward would not have survived a home birth. Mothers had changed plans from home birth to hospital birth in order to save their children's lives based on the results of the anomaly scan.

Good luck to you whatever you decide.

Yes sorry for not replying I will be going with this suggestion

Ok but my last thought on this, regardless of the statistics, is that according to the data under the pathway my first baby would have been labelled SGA. At 3.5 kilos!!
As you say it's about priorities. I'm not arguing against prevention of stillbirth although the mumsnet police will probably say I am.
Inductions have risks too and I'd argue they are understated. But that's not a topic for this thread!!

Sorry, I think my quote linked to the entire thread, not just the bit that said "but in France they leave you to 43 weeks rather than only 42", so I was pointing out that their 43 weeks is the same as our 42 weeks.

And yes, placenta needs to be checked as it's a big risk. I had very good reasons for refusing induction, and at the time, the consultant wouldn't agree to c-section at 42 weeks without trying induction due to some confusion in my notes (I moved hospital and they lost my notes). So after very long discussions they agreed to let me go to 43 weeks, but with literally daily checks. Luckily, I went into labour naturally and had him at 41+5!

I will be having an anomaly scan, either private or NHS,haven't decided yet but at no point have I said I won't, but even having the 20 week scan that only shows baby is OK at that point, but the NHS don't offer regular routine scans until the end of pregnancy they are happy to use the findings of that scan to cover the rest of pregnancy so I would book a further,private scan myself to check well being at a later point too

@JusteanBiscuits You should not have had to feel like you "got them to agree" to anything. Your body, your autonomy.
I went 14 days over with my first and was very naive so agreed to induction. Made no such mistake second time around!

I developed pre eclampsia at 41+6 with my first and was taken straight in for induction. This was during a massive "minimise csections" time, and me and baby ended up very poorly, partly due to the induction itself (he was born at 42+4 so that shows you what a shit show the induction was!). So there wasn't a hope in hell that I was allowing induction second time. I had a very slow second stage with second baby - I was only 5cm when the doctor came in and said I needed syntocin drip. I managed to convince her to give me an hour longer - baby was born 9 minute later!!!!!!! Obviously my body was like HELL NO.

My pregnancies naturally run past the NHS arbitrary dates for intervention and as such I was bullied into unwanted interventions in both my pregnancies because it was their policy, even tho i was only post their dates,not mine, I had straight forward and low risk pregnancies so induction and intervention was not necessary but I was still bullied into it, and had I been in France I wouldn't have been forced to have unpleasant, unwanted sweeps,I wouldn't have been pushed to have invasive unpleasant induction procedures, my baby wouldn't have been born with cuts on her head due to an over zealous midwife trying to remove what she assumed was membrane on her head when ifnact she was just clawing away at her scalp, I was even pushed towards a section because my labour wasn't moving quick enough didnt need that pressure during labour,my 1st stage was less than 4 hours my 2nd stage was less than 10 minutes, I didn't even tear, I didn't need the c section they were trying to push on me,I was able to leave hospital without having had a completey unnecessary major operation, birth doesn't need tk be such a medicalised event

I was referring to the whooping cough vaccine. The one designed to give your baby protection when it is born but you have conveniently avoided that vaccine and gone for the COVID one.

This thread is annoying. If you want to refuse antenatal care that’s your choice. Stop updating every 5 seconds.

I'm not updating every 5 seconds but if people keep tagging me then I'll respond,if you find the thread annoying, by all means stop coming on and reading it? You have that choice

She is answering people on her own thread, @LadyGabriella - I'm not sure what is wrong with that! 🙄

It keeps notifying me.

…… so turn off notifications then.

That’s easy to say in hindsight. It would be a very different story if you had lost the baby because you refused a c-section or you had the c-section and it had actually saved your baby’s life.

Medical professionals are going to be more cautious because they will see the devastating consequences. Interventions save lives.

Also antenatal care is free on NHS ovbviously. Why wouldn’t you take the free scans, bloods, blood pressure check, carbon monoxide checks. Now they’re doing another scan at 36 weeks which is a great idea. It’s a no brained, take it

@LadyGabriella It's not free. Workers pay for it in tax.

How were you forced to have sweeps? Language matters, and yours suggests that you did not only not consent, but that an element of force was involved. Is this really what happened, or were you nagged and decided to give in? The latter is not great, the former is sexual assault. Neither of them are anything to do with declining antenatal care though.

Oh, the cut off for pregnancy length is only arbitrary in the sense that it isn't personalised to each woman. There are very real risks to continuing a pregnancy beyond a certain duration.

OP, pregnancy and childbirth are very much a case of past results cannot guarantee future performance. My best friend was low risk and had a lovely home birth with her first, baby happy, mummy happy, everybody happy. With her second she had a placental abruption and was raced (they literally ran pushing her bed) into theatre for a CS under general anaesthetic. She and her daughter are extremely lucky to have emerged physically unscathed (her husband could well have been widowed, bringing up their eldest on his own, had she not already been in hospital). Mentally, the experience will never leave her, although she has had counselling and is no longer acutely traumatised by it.

Why are people on here so snarky. Obviously I know that NHS treatment is funded by tax. I pay a high rate of tax. But I discount that as money I won’t see again, so it feels like treatment is free.

@LadyGabriella You're well-off so you may well see it as "free", but I doubt people earning minimum wage do. Every single test or procedure on the NHS costs and it's important to consider this.

They are intervening because of the overall risk. That doesn't mean that not intervening will end up with an adverse outcome every time, it means that intervening will save lives overall. It's worked out on a population level, not an individual level. If you have a small risk over a larger group (i.e. 1000 women), there will be adverse outcomes. I understand why you don't want induction, but they've worked out that there's a higher risk of stillbirth if you go over 42 weeks. They did a clinical trial on this in Sweden and they had to stop it as babies in the 43 week group died.

https://www.theguardian.com/lifeandstyle/2019/oct/28/post-term-pregnancy-research-cancelled-babies-die-sweden