Community midwife experiences

[Clockworkbananas]

This is my second pregnancy and I am consultant led (this is know as shared care in my area) with a community midwife who I see for antenatal checkups. I see my consultant at each scan, I am having these every 4 weeks due to my previous baby having FGR.

In my last pregnancy my community midwife was very good, even though I was having growth scans she still measured my bump, felt baby position etc at each appointment but this time around she seems very abrupt and rushed. It is the same midwife but she has not felt the baby’s position or measured me, we did a birth plan but it was very quick (I wanted to discuss a VBAC but she just put in preferences for a section as I do have this booked for my due date) and just generally she seems dismissive.

Is this normal for a consultant led pregnancy? I’m wondering if she’s leaving it up to the hospital to do most of the care. My last baby was also transverse up until 36 weeks and I’m concerned this one is too!

I think it is likely that as you are already having 4 weekly growth scans- fundal height measurements are superceded by these. The scans will also check baby's positioning. In my second pregnancy I had growth scans and they didn't do the measurements or feel for baby's position until towards the end when labour was potentially imminent to check she was still head down between scans.

She shouldn't be dismissive of a discussing a VBAC though but it may be that she thinks your consultant should discuss that with you as it usual for them to discuss your individual circumstances, risks, benefits, how your previous delivery could implicate this one etc.

How many weeks are you now? At your next appointment you could ask about discussing a VBAC if it is something you would like more info on. I would also ask for her to check positioning between scans as you get towards full term in case of spontaneous labour or baby being in a transverse lie.

I've had two different situations with being consultant led too. My midwife input has varied depending on the amount of input from the consultant

I was consultant led with my first due to mental health but this ended up mostly midwife led and with one appointment with the consultant to arrange appropriate care support.... 2020 so they were keeping as much in the community as possible

I had my second in September, consultant led for mental health and medication. I'd now moved and had one consultant at the big hospital where I was due to give birth and same situation as my first one appointment where she ensured I had an appropriate care support package. I was under another consultant for medication through a cottage hospital where I was having my antenatal care. It started as seeing the midwife as per the extra care pathway and consultant every 6 weeks from 16 weeks then I developed obstetric cholestasis and my care got switched to the big hospital and the midwife didn't see me. I was being monitored every 3-7 days in triage/day unit where they monitored my blood results, blood pressure urines and did a ctg. After a few weeks I switched back to the cottage hospital for blood tests and I had a couple of hospital admissions in the meantime and had one appointment with my midwife when she was doing my bloods and she did the other usual checks too as I hadn't had them done at the hospital that week. The consultant was seeing me when I was in hospital and in the cottage hospital after growth scans and phone calls after blood tests so there wasn't really much for the midwife to do.

I had growth scans from 28 weeks so only had my bump measured at 25 weeks. My bump at 25 weeks was borderline for needing a referral for growth scans for being too small where as the growth scan showed an average baby so I didn't feel it necessary to have both. Baby was nearly 1lb bigger than predicted based on growth scan anyway and very similar weight to my first so I don't think the fundal measurement would have added anything useful. When I had my daughter my bump measured 10th percentile and she was 60th