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

I’m sorry but I’m struggling to believe anyone can be so stupid. Go and have a look at the miscarriage boards. Plenty of people have things go wrong at the end.

Honestly, don’t have any more children if you can’t be bothered even looking after them before they get here. That’s the whole point of antenatal appointments. To make sure your child is ok.

I appreciate this isn’t the kindest of messages. I’ve had 4 miscarriages though and as I have a condition that increases my risk of miscarriage as pregnancy progresses, with the last trimester being the highest risk, and not being allowed to go past 37 weeks due to this, I wouldn’t dream of missing an appointment.

If you don’t like your medical team, get a different one. It’s not a good reason to miss these vital appointments. Refusing should flag alarms and you will probably (rightly so) be referred to social services.

Hi OP.

I'm sorry you're feeling like this. Has your midwife upset you? Or the person who did your last scan?

It's not right if they don't treat you well, and you can and should complain about sub-standard care.

The trouble with you declining anymore care is that you'll be missing out on opportunities for pre-eclampsia to be picked up. Also asymptomatic UTIs and gestational diabetes.

None of these conditions make you feel unwell, until they're very serious and life -threatening.

You're also missing out on things like a breech presentation or a transverse lie being detected.

It's important for you and your baby to be seen.

If you've fallen out with your midwife, do ask for another one, and complain about the other one.

I'm a midwife myself, and I've complained about more than one midwife when I was pregnant!

But please will you reconsider your plan to have no antenatal care.

It's obviously your choice, but there are lots of things which can only be detected if you go to your appointments.

I hope you'll change your mind.

On the question of how likely abnormalities are to be picked up at the 20 week scan, the answer is much more likely - bigger baby, better views, that's why they do abnormality checks then. My child had a serious heart defect which would have been fatal shortly after birth if they hadn't picked it up at the 20 week scan and meant that there had to be a lot of planning to ensure availability of beds at a different hospital for surgery. No issues whatsoever identified at 12 weeks because it was too early for the organs to be seen properly.

"I've literally had nothing in either pregnancy, oh actually apart from anemia but I know what that feels like so if I felt aneamic I would get a blood test then,I just don't over medicalisation of pregnancy and birth,unnecessary interventions etc"
You won't have over medicalisation or unnecessary interventions by going to routine midwife appointments. They are there to monitor you & the baby, not make things awkward & uncomfortable for you or create unnecessary work or expense for themselves.

Would you consider making an appointment to talk about your antenatal care with a senior midwife and have the rationale for each one discussed with you?

Are there accommodations that could be made that would make opting into some care acceptable for you?

Your midwives will be concerned about you opting out of antenatal care as it is important for identifying issues with the pregnancy, for both yourself and your baby, where earlier intervention might affect outcome. They may well be happy to engage with you to see what could be offered to make you more comfortable.

Hi OP, sorry you had such a bashing on here.
I do understand wanting to be left alone. You absolutely can do that if you want to, obviously that brings with it some risks that can not be anticipated. Having healthy pregnancies already is no guarantee that something wouldn't come up this time.
In your position, I'd be inclined to think about which appointments you would be comfortable attending, and let your midwife know.
I'd have thought as a minimum, the anomaly scan and urine tests have a clear purpose and are there for the wellbeing of you and your baby.
Its not unheard of to completely decline antenatal care, it's called 'wild pregnancy: and you will probably find Facebook support groups ect if you want to find experiences from others that have done this.

@Casuallydresseddeepinconversation
you may believe a lot of us on the forum can mind our own business but you joined it for a reason and you must expect some kind of negativity. A lot of women on here, myself included pray for a healthy pregnancy with a healthy baby at the end.
talking from my own personal experience right now. I paid for a private scan.. the woman who completed it failed to deliver compassion, care or empathy. Especially considering this is my first pregnancy. She did discover a concern within my progression which wouldn’t have been picked up without a scan.
but there I was being ushered out the door and put back into the hands of the nhs.
my nurses at the NHS have been amazing, supportive, caring on the other end of the phone even if it’s at a stupid hour.. wouldn’t wish for a better system to fall into.
I am now living on a knife’s edge for the next 8 days wondering what the hell is going to be the outcome for myself, but more importantly my baby!
I would happily take every illness thrown at me right now to know my baby is growing well and developing so they should be.
we here in this country are fortunate enough to have the NHS system, to have people who care passionately for the women and babies in their hands.
your poor midwife maybe feel as though she is failing by your refusal. Yes you are well within your right to refuse treatment, but remember your baby relies on you to make decisions on their behalf. They can’t tell you if there is an issue.

my only advise to you is:-
have scans.. even if these are private
talk to your midwife. You don’t have to have hospital appointments.. but she can inform you of issues if they arise, how to treat and deal with them in a way in which is safe for you and your baby.

Ultimately, it's your choice. You have the right not to consent to medical procedures (presuming you are deemed to have capacity). The foetus has no rights. The comments on this thread are overwhelmingly pro-antenatal care but, even if they weren't, I wouldn't rely on MN to help you make an informed decision. Listen to medical professionals; it also sounds like you might benefit from engaging with the perinatal mental health team. They were brilliant for me.

No family history of structural heart issues. No genetic propensity. No risk factors. No external symptoms in pregnancy prior to the scan to tip me off that something was wrong.

Please don’t put your unborn baby at risk. Go to your midwife appointments. You don’t have to do anything you don’t want to do but just make sure baby is doing ok.

Thank you for such a nice response rather than name calling,I know my blood group and rhesus status I spoke to a midwife last week and a matron today so I feel well Informed

Have some compassion fgs.

I hope social services pick up on what an absolute fool you are being. You sound very negligent. Are your other two children safe? Or is it just this unborn child that you're neglecting?

There are so many pregnant women in the world that would bite their arm off for regular prenatal care, ultrasounds etc. We’re incredibly lucky to receive the healthcare we do to ensure the best start possible for our babies.

Don’t take it for granted. The evidence is clear that prenatal appointments matter and improve the health of mother and baby.

@Casuallydresseddeepinconversation

"There's lots of women on this forum so thought it would represent a balanced proportion of pregnant women"

It does and they all think you're being weird and self absorbed.

There is a (good) chance you will be referred to social services as declining antenatal care will (rightly so) ring alarm bells.

Its your body, your baby - do what you want.

But you are not doing best by your baby, so if you can live with that then so be it.

PS - You don't need family history to determine whether you may get diabetes, or pre-eclampsia. They happen with or without family history.
Same way as you won't get symptoms if your baby wraps the cord around its neck, or stops developing as they should.

But its your life.

Oohh second home birth care, mine were amazing and it didn't even feel like antenatal care honestly. Barely stepped foot in a hospital.

@Casuallydresseddeepinconversation

With all due respect. I was perfectly healthy until I developed pre eclampsia with no symptoms so didn't ring the midwife, until I had a stroke, and I was 20 years younger than you are now.

Those tests are for the sake of you and baby,

There doesn't need to be any history in your family for issues to arise

Things can be picked up on your 20 week scan that wasn't on the first scan.

I've taken care of babies were abnormalities where only picked up later on

@Casuallydresseddeepinconversation - if you aren’t going to go to antenatal appointments, can I strongly encourage you to get a blood glucose monitor (to check for high blood sugar which would point to gestational diabetes) and a blood pressure machine, so you can check for high BP - an indication of pre-eclampsia.

As a nurse, I can tell you it is possible to feel entirely healthy and symptom free, but have high blood sugar or BP. These tests could give you early warning of problems so you could seek medical help.

@Casuallydresseddeepinconversation when you get to baby #3 I found the midwives were generally way more relaxed about seeing you. When I had my youngest over 20 years ago, it seemed like they didn't want to see me until the third trimester and tbh I didn't need it. With my first I wanted the reassurance and appreciated the midwife appt every 4 weeks then every 2 weeks after 28 weeks then weekly at 36 weeks. four years later, I think I saw the midwife at 12 weeks then not again until 20, then again at 28 weeks - went to two weekly at 32 weeks. Saw the consultant once at 32 weeks then didn't see him again someone else did the CS.
I do understand the way you are thinking, but its not just your health that you need to keep an eye on. I know you know this after two babies already but how many appointments are actually being planned? I'm sure they would be more than happy to only see you once or twice given the pressures the NHS is under

Sounds like you're scared OP. That's ok. But doing the ostrich thing, hoping everyone will just go away will probably get you more outside involvement. Not less.

It seems to me that no one else has declined care. In fact, many have shared experiences which show how important these check-ups are.
Even so, with one or two exceptions, reading all of these will not ‘inform’ you, or not adequately to make a choice on which your baby’s life and your own could depend.
I urge you to talk it through with a healthcare professional that you trust who can help you make a genuinely informed decision.

I refused a gd test. I didn’t agree it was warranted, as their method of testing (tape measure across tummy from different positions, by different midwives at weeks apart) seemed prone to inaccuracies.

the midwife got very shitty with me for declining and brought up all manner of risks. She went to get the doctor to speak to me. He agreed I could decline if I wanted to. I never had gd or any symptoms.

during birth too I declined a probe in babies head. Midwife kept pushing me and asked me why I declined. I gave her an informed answer and she agreed with my choice.

you do have a right to decline. Weigh it up yourself, make informed choices. I personally wish I’d declined some extra scans they asked me to take due to concern on babies size.

I am glad I went to every midwife appointment though personally. And I was glad I gave birth in hospital. But knowing all of the options/interventions and risks helped me say yes to somethings and no to others.

And yet this whole thread sounds like you’ve already made your mind up.

I think you would be foolish to opt out of medical care for yourself.

I think you would be neglectful to opt out of medical care for your baby.