Extremely anxious at 34 weeks

[Ftm2026]

I am currently 34+2 weeks pregnant with my first baby. I have gestational diabetes and low Papp A, I also had a low lying placenta but that seems to have moved as my pregnancy has progressed.

I had a growth scan yesterday and everything looked fine and they checked placenta and it had moved and I was hoping to speak to someone regarding my birth plan as I was told earlier on in pregnancy it would all be decided by consultants and midwives rather than me getting to choose due to everything.

After the growth scan I had to speak to the consultant who I felt rushed me, dismissed me about my concerns and to be honest she didn’t even know my history or notes which my husband advocated for me and pulled her on it, it also didn’t help she mumbled and did not speak clearly and she just said she would see me in 3 weeks. In 3 weeks I’ll be 37 weeks and I still have no birth plan or know what options I can have, I’ve not seen an actual midwife for weeks as they told me I need to see doctors due to the GD and low Papp A.

In the white book if I didn’t have problems they’d see me in two weeks but being told 3 weeks has made me extremely anxious because I know I’m at the point realistically I could go into labour at anytime and I don’t even know what options I have available.

Poor you that all sounds very overwhelming. Firstly, they absolutely cannot tell you what you can and can't do, they can advise based on guidelines but ultimately birth choices/plans are your decision and yours only.

I would ring your antenatal department and ask for a birth choices appointment as soon as possible with the consultant midwife. Be firm and make sure you get it. This is a longer appointment where you are able to talk through your own circumstances and the different things they would recommend or not recommend and help you decide how to proceed.

I'd also recommend reading the positive birth book by Milli Hill which goes through all sorts of different scenarios and may help relieve some of the fear of the unknown.

Best of luck OP x

Sorry you're having a really stressful time.
I didn't have the complications you had, but I had a really poor midwifery experience during my pregnancy so know what it feels like to feel unclear on things.

I would say, even with complications you are still in charge of your birth experience and have the final say on all decisions. The midwives and consultants only advise, they cannot dictate. They may frame it as "you should do x,y,z" but you are still the one who ultimately can say yes or no to their suggestions.

I would do research into GD and low-PAPP A and what that really means for your risks, and how it could impact your birth. So when you are in a room with your midwife / consultant you feel informed and able to ask questions, clarifications and really know what the risk means and what trade-offs you're making (often reducing one risk, increases another risk and sometimes that gets overlooked).

I found the midwives cauldron podcast really helpful during my pregnancy. They chat about different issues each episode and really back up their thoughts with science, which I found very helpful. When I was anxious I wanted all the knowledge to be able to make informed decision.
It looks like they did a couple of episodes on GD from both pregnancy and baby's perspective.

You can also request a new midwife if you feel like yours isn't supporting you. I wish I had requested a new one, but I didn't know I could at the time.

I’m having my third baby, with my second they scared the living daylights out of me with complications and hypotheticals. I was told to prepare for labour from 26 weeks and be ready to spend time in the NICU. I was told he would definitely be premature and have a low birth weight. He was born a week late and was 8lbs 13oz. They don’t always get things 100%, but I would advise asking questions and challenging what they say respectfully.

I am a worrier and have awful anxiety, but the best thing (which I am trying to do) is to just relax and enjoy your pregnancy. Whatever is going to happen is going to happen regardless, keep advocating for yourself and make sure that you are making informed decisions.

sending you lots of positive wishes!

This sounds very stressful
I also had GD and borderline low Papp a, and I managed to go into spontaneous labour at 38+6 and had the water birth I requested. I hope that gives you some reassurance xx

First things first…. No one can tell you what to do with your body in labour or otherwise, there are recommendations that are evidence based.

have you accessed any antenatal/parent craft classes in pregnancy at all? Been reading evidence based info?

low PAPPA can increase your chance of a smaller than avg baby, but you say scans are normal, does the report show you an EFW centile? It can also increase the chance of pre-eclampsia, this is checked by doing your BP and dipping your wee and a few key questions at every contact. GDM is slightly more complex, are you medication or diet managed? This can lead to different recommendations for both mum and fetal monitoring.

no two trusts will have exactly the same guidance but they should be following the NICE guidelines to some extent. This is the place to start in terms of considering options and preparing for the recommendations for your individual circumstances.

contact your community midwife and request a 36/40 appt to inc birth preferences discussion, she/he should be able to prepare you for the appt with the consultant the following week to ensure you are making informed choices that you understand.

not every trust has a consultant midwife unfortunately, but all all Matrons for specific areas such as Community, Outpatients and inpatients.

try to look through your contact numbers, if still paper based they will likely be on a book, if digital they will be in your app, make contact with the most appropriate setting to make the appt

hope you get some of the answers and information you need to move forward

Hi all,

I sent an email to the diabetes team I was under with all my worries as believe it or not I didn’t even have a phone number to call them on but one of the midwives rang me back today and answered all my queries and she has booked me in with an appointment to see her directly as I explained about the white pregnancy notes, I’ve noticed my last two pages weren’t even filled in so she has reported this as an incident and popped it on their “board” - I don’t work within the nhs so not sure what it means! I also explained about the doctor/consultant being quite dismissive of my concerned and she’s flagging that too.

She also explained to me that I should have been seeing the midwife as well as the consultant but the consultant was just sending me home after every appointment and she was very apologetic.

My gestational diabetes is completely diet and exercise controlled and since being diagnosed at 26 weeks I’ve only had one “spike” which was only 0.1 over and the midwife saw this and said she can’t see any problems with me having any preference of birth but she did explain that obviously this can change at anytime as hormones change but as it stands everything looks good for me to have a normal natural birth.

Just want to say thanks everyone, I was really worried as I didn’t know if things were normally like this as it’s my first time and I understand the NHS is stretched.