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!

Is your GP in your catchment area or have you moved but kept the same GP?

I moved and kept with my old GP but was actually now out of their catchment. That only become a problem when I was pregnant as my old GP wasn’t in the catchment for where I was now living. I changed GP and I think it took 2 weeks to change records. All my midwife appointments were at my new GP surgery which was walking distance (so granted much easier for me).

I would start with whatever midwife you want and start the process of changing GP if you are no longer in the catchment for your old one. If there is another closer it will be much easier for the baby to attend their appointments. I wouldn’t delay starting the process. If you are in the catchment of the old one then I would just drive the 20 minutes. Likewise, If you want to stay with your current GP then I would, but it does seem as though they aren’t very helpful with problem solving.

I only had one midwife visit after birth and it wasn’t the midwife I had been seeing for measuring.

Can women still exercise their Right to Choose re: which hospital they give birth in?
You could contact the Consultant Midwife / Supervisor of Midwifes for you chosen hospital and ask for clarification.

Yes they can, I had my baby last year and was asked which hospital I wanted to give birth in when filling in the referral form so it’s definitely the way at least where I am (North East), assume it is everywhere

My GP is a 5 min walk away but my midwife care was mainly at the hospital 20 mins away. I thought that was just common so I don't really see why the midwife has an issue with it.
Just stick with your GP and do the drive for the antenatal appointments. I think it is a better option that potentially haven't 4-6 weeks of no GP or midwife cover.

Home visits are less common since covid. I didn't have any with my last baby. I had to go to them every time, although they did have a clinic setup for post birth more locally.

So I have a bit of an update but sadly still not resolved, which is a big shame as I had been really hopeful after all the posts that midwife care shouldn't be dependent in any way on the GP.

Sadly it seems in my area it is connected to the GP. This is Newcastle btw in case anyone else in the area ever has this problem.

So I looked up the different midwives teams and called the one closest to me and decided to bypass my GP from now on. First thing this midwife said to me: Which GP practice are you with?

And then she explained its all connected to which GP practice you're with so I need to go with the midwives who I spoke to yesterday. I explained what happened and she said they would call that midwife team to discuss.

She felt it wasn't reasonable to tell me I needed to change GP and agreed that would delay things and I would be unlikely to get support in my first trimester if I did that.

It's really upsetting and unnecessarily stressful.

Ultimately I think I'll have to push to let the original midwives see me and drive to them every time, although as I said, they weren't keen on that prospect tbh and don't seem to want me on their books as I'm outside the catchment.

Also just to reiterate how ridiculous this situation is.

I looked again at the catchment area for my GP. I am very much in the catchment - slap bang in the middle.

It's a huge catchment, unusually large for a doctors, covering almost all the city.

Ironically there is very little crossover between the midwives' catchment and the GP catchment.

About 10% of the GP practice area is in the midwives' catchment area, so maybe 90% of patients wouldn't be eligible for support if they fell pregnant.

And then only about 30% of the midwives' catchment area falls in my GP practice's catchment, the rest of their area is outside.

WTAF!

Please put in a formal complaint, that is ridiculous that the system is so unhelpful to you in this time. Things need to be looked at & changed moving forward so this doesn't keep happening!
Congratulations and I hope you can get things sorted moving forwards, the process should be smooth & stress free for you!

I'm sorry you've had a similarly frustrating experience. Literally nothing is joined up at all!

Flapping pain in the arse
This made me laugh!

But sadly, that does seem to be how it works in this particular area, all connected to your GP 😔

This is ridiculous.

I'm North East too although not city centre - DD1 was RVI, DD2 will be Cramlington (I got to choose the hospital both times).
Midwife care is connected to the GP surgery as in who you are allocated to but then the GP doesn't actually carry out any appointments.
So I've just changed GP practice at 30 weeks and I'm having to change midwife as it's a different midwife who covers the area I've moved to (same North tyneside 'team' but different midwife covering the two GP surgery areas).

I don't understand why you are being passed from pillar to post, it's been very easy for me to refer both times.
You should simply be referred to the midwife covering your area and that's that.

Oh wow, that seems incredibly disjointed and poorly run. Though I wonder if it's because issues with staffing has caused community services to be "condensed" as it has in my area.

And those saying GPs having nothing to do with antenatal care is true in most areas, but in my area they do "shared care". For a couple of appointments (ones only FTM and high risk STM+ would attend) we see the GP instead of a midwife. Could have changed in the past 3 years since I was pregnant though.

With my first, there were midwives based at my GP. With my second they were based at a single community hospital "base", and I had to travel to them both antenatally and postnatally for appointments; save for the first appointment after birth which was at home. It was an absolute ball ache to get to via public transport and very little space for cars to park too. I had had a C-section to boot, so the whole ordeal was a PITA.

Don't they do home visit anyway?

read your update, that’s nuts OP

What a pain for you, OP! Once you get it sorted, id consider making a formal complaint about the whole situation. Its ridiculous you are being passed around like this.

I think the problem here is community services including antenatal care are literally ran differently in every area so it's unlikely anyone who doesn't live where you live is going to be able to advise you.

Only thing I'm confused about is, if you wanted to change GPs that should be. Fairly quick process? All they have to do is register you on the desk, I work in community services with people coming and going from respite care and that bit should take a lot less time than 4-6 weeks. Not that you should have to do this!

True. TBH even the people in my area who I've spoken to in real life haven't been able to advise me!

I'm really not sure how it takes 4-6 weeks but that was what the original midwife said to me that it takes on average. That's when I asked if there could be any delay from changing GPs and then trying to get referred to a different midwife from there. And then the second midwife I spoke to yesterday agreed with the 4-6 week timeframe, that was why she said she wouldn't advise doing that.

I don't understand either. Also despite the huge differences in the GP and midwives catchment areas it's as if I'm the first woman at my GP practice who has ever had this issue!

I've been told in relation to other health services that North Tyneside is much better run than Newcastle.. I wonder if maternity care is the same.

It sounds like you can see catchment areas in a map? Can you look at the catchment for all the other midwife teams and see if there is one that covers you? It can't be that a chunk of the city has no midwifery team allocated, that bonkers. The team boundaries must butt together, surely?!

All areas in the city are covered by midwife teams as far as I’m aware

BUT the problem is arising because every midwife team needs you to meet two criteria:

1. For you to live in the midwives catchment area
2. For your GP to be affiliated with that midwife team

I only meet one of those criteria for 2 different midwife teams. So neither are keen to take me on and things have got a bit stuck.

Seems to be a classic NHS administrative issue!

That's utter insanity... Surely this must happen on a daily basis?!

If that's the case why on earth aren't the midwife team catchments identical to the GPs?!

I’m even more confused now OP as I’m actually in the same area and never had this issue! I chose to have my daughter at the QE and was able to just choose that with no issues

Are you in gateshead? It might be different to Newcastle. Or this might be a new thing they've brought in, I don't know.

I guess a lot of people in Newcastle would have no idea unless they're unfortunate enough to have the same issue.

It's probably not wise to name my GP practice on Mumsnet 😂but its basically the biggest GP in Newcastle so covers a very large catchment area. Really they need to be able to refer patients to every midwife team in the city. Whether they can't do that because the GP won't fund it or its a higher level NHS issue, I don't know.

No I’m not in Gateshead I’m in Newcastle (Newcastle postcode), I chose QE for various reasons although it wasn’t my local and never had any issues or push back! My daughter is only 9 months old so it was very recent so I can’t imagine it’s changed much since then, really strange!

I did have to drive to all midwife appointments and none were at my GP but that’s normal, and the post-birth ones they came to me, different midwife each time after birth but again I think that’s normal.

Goodness me. How ridiculous. Is there a local mums Facebook group or something similar you could join to see if anyone else had to resolve this issue too?

Book in and get your scan sorted. Then change GP. As I mentioned above in the early weeks there are long gaps between appointments and you will have time to change.

FWIW my GP practice extends out of the town several miles and the MW team based there probably wouldn't cover the same area further out. Driving to appointments antenatally wouldn't concern me as there are plenty of teams who have a base for their appointments but I'd want to know I'd be visited at home post birth.