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!

GPs are nothing to do with midwife care.

When I had a positive pregnancy test I phoned the GP, they gave me a phone number to call for the midwife team. Never saw a GP for anything pregnancy related.

All my midwife appointments were at the Children's Centre in our town, not at the GP surgery.

It sounds like the GP has given you the number for the wrong midwife team, or the midwife you spoke to should have given you a different number for a different team. There's not going to be swathes of the city not covered by a midwifery service, there will be a team that serves your area.

I'd call the GP back and say the midwife told you she was the wrong team, do they have a number for the team that covers the area that includes x road? If they say its a central number, call the midwives again, hopefully speak to someone else (who isn't barking mad) and ask who you call to register with the midwives that cover your address.

If they insist that there's a midwifery black hole where you live then I'd call the EPU at the local hospital where you expect you'll be having scans etc, and ask them which team covers your area.

As others have said I have no idea what the midwives are on about, GP’s don’t provide any antenatal care at all. They refer you to the midwives at whichever hospital you choose and from there they organise your care.

My daughter is 9 months old now, none of my appointments were at the GP, and the midwife comes to your home for the checks post-baby.

Dear God. I would complain about this midwife as she has spun you a load of rubbish.

You do not need to change GPs.

Midwife services and GP services may not have identical patches, but all patients are covered by antenatal services.

If you are not in the catchment area for Midwife Team A, you will be covered by Midwife Team B. Midwife from Team A who you have spoken to just needs to slide your referral letter across her desk to her colleague in Midwife Team B - if they are all based in the same hospital, that is very easy for her to do. If she was based in a different hospital, she might have to ask your GP to re-send the referral to the correct hospital, but you’ve said that isn’t the case in your area.

I have no idea why she is making such a production out of this. Referrals come in for the wrong team every day, you just pass them over to the right team. Given that she is being bizarrely difficult about it, I’d suggest you ring your GP and ask them to re-refer you directly to Team B.

You’ve got the wrong end of the stick. Your gp should not be providing you with any routine antenatal care, it is literally not in their job description. You will receive care from a midwife. Don’t complain about your gp as they’ve done nothing wrong.

Thank you.

I really don't mind the 20 minute drive but it was more that the midwife didn't want to take me on at all, and said that would be impractical.

The crazy thing is I'm genuinely not out of the catchment area for the GP and live closer than some of the people in the 'catchment' the midwife says she has. The address of the GP practice itself isn't even in the midwife's catchment area!! It's madness.

If that's the case then I've got the wrong end of the stick from the midwife! She's the one saying it all needs to be done through a GP.

Contact the hospital you want to be under the care for the birth and they should be able to help you. The midwife you talked to should have been able to tell you who you would be cared for if it isn't her team- bad showing from her.

Thank you, that's really helpful.

The whole thing is bizarre.

You will be in the catchment area for a different midwife team. You just need your referral redirecting from this team to the right midwife team.

If your midwife was remotely reasonable she would just have forwarded it to the right team, instead of creating like this.

This is nonsense. GP and midwives aren't usually linked. I suspect that your GP belongs to an ICB that isn't linked to the health trust your address would come under for midwife services.

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..

Also nonsense - in my first pregnancy I moved house and started over with a new midwife team. It was not an issue at all.

I was also 'booked in' with two health trusts as my two nearest hospitals belong to different trusts and I was undecided which I was going to use due to the move.

I called the GP and they said I had to self refer to my local midwife team for my catchment area. My GP had nothing to do with my antenatal care.

My booking appointment, 12 week and 20 week scan were all at the hospital. Interestingly the hospital I chose was the closest to me (20min drive) but not the same trust as my midwife team. So the services were very disconnected and they did not have access to the same system, all my notes had to come with me hard copy. My other midwife appointments were with the midwife team and took place at a health centre. I had a c section and they visited me at home after birth.

It's very common for gp to have nothing to do with the antenatal service and for the midwife care to involve a bit of travel

Echoing what other posters have said, I don't think it's actually all that common for GPs to be directly involved in antenatal care these days.

I'm pregnant, FTM, and had no idea how it works. I contacted the GP at 7 weeks when I was discharged from an IVF clinic to let them know I was pregnant, because that's what I assumed I was meant to do! They explained that they don't do any antenatal care, and they directed me to a link to a website where I registered my pregnancy online. I had my booking appointment with my midwife at 10 weeks at a different GP surgery in another district. My 16 week appointment was with the same midwife but in a different location (she's community based so works in different places each day). I just have to travel to where she was. My 24 week appointment is scheduled to be at a third different location and will be with a different midwife.

I'm not sure if it varies by area, but when I registered my pregnancy I had to pick a hospital which I would like to have my care based at. The hospital then wrote to me separately to inform me when my 12 week scan would be. The midwife had nothing to do with organising it. The hospital also booked in my 20 week scan appointment before I left on the day of the 12 week one.

It sounds like possibly you've been misinformed by the person you spoke to on the phone, or they've been unclear and confused you in your panic. I would suggest Googling maternity care in your local authority and see if any clear advice comes up online. It's also very early days to be worrying about post-birth care; focus on the short term priorities for the time being.

The GP doesn't have much of anything to do with any of it. In lots of areas they aren't in GP surgeries at all and are at hubs instead.

It's also very common if you've had a normal delivery to have to travel yourself for check up appointments in the first few days you are home, there is nothing set that you will get a home visit for that and many areas don't offer it.

I don't think there's anything much to complain of - its just the set up where you are and that's what's on offer. I would just go with the option of these midwife's and not change GP.

Some of these catchment border things can be insane.

My manager has just solved a 10 year border dispute about which team serves a GP surgery on the edge of our catchment area.

In a previous job there were different rules for different parts of the border, these all being maintained by what appeared to be myth - in that bit we have to go 1 mile across the border (can be a long way in central London), in that bit the whole surgery belongs to someone else etc etc.

It kind of makes sense when you work in community services but the patients all found it hard to comprehend.

I don’t think you ever see the same midwife throughout! So I’d go with driving to midwife and trying to switch GP. I think better to have the appointments. What a rubbish situation. In grand scheme of things I don’t think this will matter so try not to worry 💐

I’d ask around any local mums groups you can find. There’s usually ones on Facebook.

if you give a street or a partial postcode they’ll tell you which midwives cover your area. Then you can call them up and talk to them. The set up varies a bit it seems between areas, but while they’re often based out of a GP practise they’re usually a separate service and not part of the GP practise staff.

To get a definite answer, ask your local primary care trust. They’re who place the contracts for the services.

Argh OP that sounds like such a faff! I don’t have any advice really as all this is new to me to, but wanted to share my recent experience as I feel it’s all a bit chaotic!

Im 10 weeks pregnant (first pregnancy) and last week I met with the midwife in the community midwife section at my local GP. We had to choose what hospital we want the baby in. I live in a major city too so picked the one nearest to me. For context actually, there is a closer hospital but it’s small and they don’t have an antenatal centre. So the one I’ve gone for is second closest in distance, but closest one I can actually use.

They told me that following my apt I need to go to the closest hospital (the one that doesn’t have an antenatal section) to collect a bundle of vitamins and things. Then I got my blood and urine results back and was told I need to go to the OTHER hospital to pick up my antibiotics. I called and asked if there’s any way I can get them sent to my local gp but they said no. And then I got a message on the app today saying I need to drop another urine sample into my gp. I don’t want to sound like I’m complaining as they all do an amazing job but that’s THREE places I now have to to this week, all whilst trying to hold down a full time teaching job. I don’t know if it’s just pregnancy hormones but I’ve found it all really stressful!

It appears to be a postcode lottery. My antenatal care was arranged through the GP. They referred me to the midwifery team who covered our area. My booking appointment was at home and the later general midwife appointments were at a different GP surgery to mine, they were the same day every week so my assumption was they set up at a different surgery in the area every day. If I needed to see them outside of this I had to go to the health centre/hospital.
They also did home visits after birth to check over/weigh baby, check in on my stitches/general wellbeing etc. They kept me on until 3 weeks pp as I had history of PND but the usual is 10 days.
I would have no idea how to register with them if not via the GP.

If it helps, it is not that many times you see a midwife.
i saw one in a clinic at 8 weeks who booked the 12 week scan, one at clinic at 16 weeks. Then 20 week scan.

that was it up until 20 weeks.

well, there were complications but those appointments were hospital based and no extra appointments with midwife.

Oh and post birth had one home visit and was discarded to HV team.

Self refer to whatever hospital you want and they will help sign post you/arrange your community midwife care.

people often assume that the midwives are part of the gp but often it’s entirely separate and they just operate OUT of the gp practise.

i gave birth in x hospital who’s community midwives did not cover where I lived in y area, they just referred me to the y area midwives who were fine with looking after me. Y midwives didn’t work out of my gp practise it was out of a community centre in z place.
the only additional complexity was that the y midwives were paper free and all stuff was recorded on an app, but x midwives in the hospital (who did the scans and where I birthed) were still on paper notes. So the community y midwives had to write everything up in the app and also in my paper notes.

ahhhh classic nhs

Yep, agree with pp, you have to get your head around the fact that antenatal care is NOTHING to do with your GP. It's run separately and will have its own catchment areas.

Have you read the website for your local hospital? Midwives are often based out of the hospital and have sub teams which each cover different geographies. Perhaps by being referred via your GP you've ended up speaking to the wrong person.

Hopefully it will be more straightforward if you can track down the midwife team which does cover you, and I can't think why you would need to change GP.

It doesn't sound like you are rural so hopefully not a complete black spot for coverage.

There was a thread a little while ago about how GPs are pushing back on antenatal care due to the way it is funded and the work to rule industrial action going on, so I wonder if OP has somehow got caught in the middle of some local politics?

Anyway, like pp, I'm in London and just self referred on the hospital website that I wanted to give birth in (not my catchment hospital). Noone cared it wasnt my local one. Had all my MW appointments at the hospital itself. Never saw a GP in two entire pregnancies. Still had a day 1 home visit from a MW at my catchment hospital (not even the one I gave birth in) then the rest of my postnatal appointments at the children's centre. So I agree with pushing back and trying to get referred to the correct MW team.

Good luck getting it sorted!

As others have said midwife care has nothing to do with your GP - either you're in their catchment area or not, so if you are then great and if not, why on earth she is suggesting you change GP is beyond me. Honestly I'd want to self refer to a different team of midwives in case I got this flapping pain in the arse as my midwife - she literally hasn't given you a workable solution and all she's done is stressed you out. For no reason. I'd do what @GrannyAchingsShepherdsHut suggested and get a referral to the team who do cover you.

I'm 14 days postpartum. Day one check a community midwife I'd never met before came to the house. I had to drive to my day 5 and day 12 checks - or rather my husband did, as I'd had a section. I was appalled.

I was consultant led so had most of my appts at the hospital, but even so I never saw the same midwife twice.