My GP won’t provide antenatal care

[Fluffydino21]

Hi everyone,

Found out I’m pregnant at the weekend (4-5 weeks) and have already encountered a bit of a big bump in the road. It’s my first time being pregnant so I don’t know what to expect, have a lot of questions and could do with advice and reassurance. I’m vaguely aware that I’m supposed to have an appointment with a midwife at 8 weeks, and scans at 12 and 20 weeks. I’ve no doubt there’s other appointments and milestones too.

I called the GP straight away Monday morning and they said they would refer me to the midwife team. Great!

But then the midwife called and said although I’m in the catchment area for my GP practice I’m not in the catchment area for the midwife team. Essentially my GPs will only provide antenatal care for approx. 25% of the catchment area their patients fall in…

After I asked a lot of questions she gave me two options:

1. Move to a new GP immediately - she was strongly pushing this and originally stated it as the only option I had. However she also said it usually takes 4-6 weeks with their processes to sort everything out / transfer my records etc. so even if I find a new GP who’s taking on new patients tomorrow, all my appointments may have to be after my first trimester.
2. Drive to these midwives for every single appointment - she said she would strongly recommend I don’t do this as it wouldn’t be practical for the appointments a few days after birth with a 3 day old baby etc. especially if I’d had a caesarean / baby was unwell / sleep deprived. I’m not 100% sure where this would need to be. I think they’re probably about a 20 minute drive away. I thought part of the point of some of these appointments was for them to see you with your baby in your home though?

I asked about starting with these midwives (and driving to them) so I didn’t have to delay my appointments while I sort a new GP but she pushed against this. Apparently it’s vital it’s the same midwife throughout..

DP is pretty angry and wants to complain to the GP and insist they provide me with care. He doesn’t think panicking and going with any random GP that’s willing to sign me up at 24 hours notice and then having no care indefinitely until they transfer things between them is the answer.. maybe he’s right. He says he’ll make a commitment to drive me to every appointment with the baby if I needed him to. I don’t know how many appointments were talking about and how practical that is.

I feel like I’m just choosing between 3 shit options here tbh.

I would really appreciate hearing from some people who have been through all these appointments before and know what would be most practical.

thank you!

Thats awful! You should definitely complain!

But in the mean time I'd go with the option of you driving to the midwife for your appointments antenatally. That means you don't miss your booking appointment, dating scan etc. But in the mean time look to move to a new GP where you can get home visits. Thats just my opinion though! In an ideal world it's nice to have the same midwife throughout, but the main thing is you get all your care. Driving to your appointments pre birth will be fine, but you're right that you'll need home visits in the days afterwards. I hope you get it all sorted, what a ridiculous situation!

Are you planning on having the baby at hospital? If so do you know which one (or do you have more than one choice)? I am 37 weeks pregnant and live in a black spot for maternity care. I started with a midwife team based on the hospital I thought I'd like to give both at, I had one appointment at home and the rest I had to drive to. Unfortunately I had some issues with the consultants at the hospital and suffered some mental health issues but wasn't allowed to be referred to the mental health team at the hospital as I didn't live in the right postcode! I ended up changing hospitals and in doing so had a new midwife team who are amazing and only come to my house and have a continuity of care ethos so one will be with me at birth. I know it's slightly different circumstances but might be worth enquiring if there are other options other than the ones you already have!

I would start out with that midwife then transfer to a new gp and midwife during the pregnancy. Not much happens between booking and the 16 weeks appointment, and the 12 week scan is kind of separate to the midwife appointment, so I would try and move across then.

Yes the midwife should definitely come and see you after baby is first born! I had a csection and the midwives came out to see me for that reason. If I hadn’t had a section I would have been expected to go to a hub.

I'd be complaining about the ruddy midwife me, what a pile of tripe. Reads like they just couldn't be bothered adding you to their books.

Call her bluff and yes you get home visits after the birth. Definitely sounds like they just can't be arsed.

i don’t think she’s being entirely honest!! The midwives will be visiting you straight after your birth (we are in the North but I don’t know anyone who drives post birth for appointments!!). Also they only keep you to day 10, as long as everything is okay and pass you onto your health visitor.

I would go for the MW team, if in any doubt ring the GP tomorrow and explain to the receptionist, I’m sure they will also say the MW is trying to pass the buck!!

My GP was nothing to do with antenatal care. I went to all my appointments with the midwives at their centre at the hospital (20 minute drive/40minutes by public transport).

It was fine. And totally normal. Still had a home visit my first day home and day 5.

As others have stated GPs play no part in UK antenatal care. Midwife has totally misinformed you.

My GP is 5 min walk away but none of my appointments have been with my GP as my midwife only does antenatal appointments at my local hospital, which is a 15 minute drive away. The labour unit is in a different hospital 35 mins away. No one has mentioned home visits etc. post birth but it may well be a different midwife team.

I don't think it's unusual to have to travel further than your GP to attend appointments, particularly if you live in the countryside, but TBF I never really questioned it!

Hopefully you get it sorted and congrats!

Thank you, that's helpful to know.

I think we will complain. I had absolutely no idea they would only provide this care to a tiny proportion of patients and they never warned me even when I was getting birth control removed to conceive!

I think I'm just wary of when would be a good time to make the shift to a new GP and risk being between GPs and midwives for a month or two... this is the worst possible timing!

Wouldn’t that mean that some other midwife service should be covering you, not that you need to switch GP?

a 20 minute drive is trivial. I had near daily appointments towards the end of pregnancy and daily and sometimes twice daily appointments once baby and I were discharged. The offices we had to attend were never closer than 30 minutes away. That was just the way things were. DH had did all the driving.

I'm not sure this is your GP's fault, they have their catchment and are you as a patient. The midwife team have a different criteria and catchment which probably the GP has no control over even if they have that MW user rooms in their surgery etc.

Home visits are desirable after birth but aren't always offered. I work with babies in busy London borough and sometimes post natal appointments are in clinic presumably because of capacity. Often mums don't go home after birth but to stay with their own mum or extended family and are seen by MW and HV in that borough instead so I think the continuity of care aspect is managed differently in other areas.

Make the decision that works best for you long term, if you like your GP I would suck up the drive to appointments annoying as it is.

I'd maybe understand if it was the countryside but I'm actually in a major city!

Good to know that you've been making it work with going to the hospital for appointments. I'd be happy to do that. Might just need to bite the bullet and commit to doing it after the birth too

Yes, at the hospital. It would be the same hospital whether I stick with this GP or move to another in my city.

Thank you, that's really helpful. Maybe I should see if there's any midwife option for people without GPs or something in the city

See my midwife was based on my GP surgery we had to go see GP get the pregnancy confirmed and they done the referral to the midwife team. This was 12 years ago. I was at a very small GP due to being in a village. After birth the midwife came to the house never heard of anyone having to drive post birth to an appointment xxxx

Thank you, this is helpful. Do you know how you access midwife care if not through the GP?

Thank you for sharing. That's helpful to know that maybe after the initial appointment would be the best time to swap GPs and midwives.

Do you know who sorts the 12 week scan? i.e. the GP or midwife?

Because that's my other big worry, I'd assumed that was the midwife that I don't have and therefore no one would be booking it until I was AT 12 weeks..

My area you self refer to the midwife team via a website.... so maybe have a google if your area has something similar.
All midwife appointments were held at a local children's centre pre birth. Think post birth I maybe had one or two home visits before the HV took over.

I live in London and all midwife appointments were a 20 min drive away minimum. I also had to go to the clinic for my 3 day post check and didn’t have a day 1 check - zero home visits! This thread has been eye opening (to be clear my care was amazing so no complaints).

I think the midwife is in the wrong not the GP - I didn’t even contact my GP when I was pregnant referred myself directly to the midwife. Midwives and GP services aren’t linked in my experience (and neither are midwives and hospital stuff eg scans/consultants).

I’d just start at the midwives you’ve been offered and don’t move GP - I often got the bus to my appointments and I was a very high risk pregnancy.. I even got the bus to my induction! It will be fine or hopefully husband can drive you if not.

For my pregnancies I self-referred to the midwives at my chosen hospital - I just typed in the hospital name and 'maternity' into Google and there was a form to fill in, it was quite straightforward. Hopefully there's something like that in your area too!

I drove to all my midwife appointments for my first two pregnancies - my current one they're at home as I'm registered with the home birth team. Then I've actually also driven/been driven to my postnatal appointments too - the health visitors came to me at home but my midwife ones were all in the clinic, which luckily is close by. Obviously being at home would have been nicer for those but it wasn't the end of the world. I think it's usually three appointments, then you're discharged to the HVs at about 10 days (give or take - my second hadn't quite regained his birthweight so I stayed with the midwives until 2 weeks for example).

I wouldn't stress too much yet, hopefully it's a miscommunication!

It sometimes happens that GP practices sit on the border between 2 community services.

So for yours, 75% of patients go to one team of midwives, 25% go to another.

I used to work in a similar (not midwifery) service and a good part of every morning was looking at all the new referrals and working out if they were for our team, and if not sending them on to the team we thought was responsible. Sometimes this was remarkably complicated and went down to 'we cover up to house 35A on the left hand side of the street, team B do 35B onwards and team C do the right hand side'

Your midwife has misinformed you, there absolutely will be a service covering the other 25% of patients and the sensible approach would be for the midwife to pass your referral to them, instead of asking you to change GP.

Thank you this is really helpful.

TBH I knew so little about the process and what's the norm I wouldn't have realised I was missing out on anything / being inconvenienced by not getting home visits, if it hadn't been for the midwife saying they won't cover my area.

They weren't just warning they wouldn't do home visits though they seemed to really be pushing me towards a new GP and saying they couldn't help..

They weren't keen on the idea of going ahead with me and me driving to them but that's probably my preference.

Same here - where I live you don't even tell the GP that you're pregnant, you self refer yourself to the midwife unit and you don't get seen for your first appointment until 10 weeks (a high number of pregnancies are sadly lost up until that point which is why they don't see people as soon as they get their bfp).

A 20 minute drive isn’t crazy. My closest midwife team is further than that away!

Call her bluff and yes you get home visits after the birth.

Not necessarily, if you’re out of area, or if your midwife team is manic. For my first, I had to have all of mine at the midwife centre, including the day after birth, and daily for weight checks as he wasn’t gaining quickly.

Your GP doesn’t usually play any part in pregnancy, it’d be your midwives. They refer you to the hospital for your booking apt and scan, and that referral should be possible regardless. Your booking in apt would be between 10 and 13 weeks here; they don’t do it at 8 weeks anymore, and your scan would be 12 - 14 weeks. Sometimes they’re at the same time soon.

I probably would move to a closer GP if you’re now out of area for yours; you’ll likely have to do it after birth anyway or you’ll be at a different GP to your baby and that makes joint appointments like the six week one an absolute pain, but start off where you are first.

I think that midwife just doesn't want an extra patient to look after. You never get the same midwife all the way through anyway so what she said about that is a load of shit. 20 minutes drive is nothing really and if you are not up to traveling straight after the birth with the baby they should come to you. Don't panic and don't feel pushed into doing anything.

Thank you, this is really helpful. I'm going to call the GP again tomorrow and see what they say about this.

And have also now found a number for different midwife options in the city so will call the one that looks nearest to me and see if I can just sign up and bypass the GP