Minimum amount of care to expect in pregnancy- Mears , any one?

[cori]

I am 8 weeks pregnant with second child. I have just recieved a letter for my booking appointment which happen when I am 15 weeks pregnant. I have no appointments with any midwives before this time. I will be calling my GP tomorow to complain. It seems a bit late to be starting my anti antal care. I am concerned. I seem to remember having appointments every month with my last pregnancy, but I was in a different area then. Surely there must be some national standards on the minmum amount of care pregnant women should recieve.
If any one can give me some advice on this, it would be appreciated.

hi Cori, I do remember reading something about this before on here, and it had me concerned as trying for another soon! it was the same case, with a very late appointment for a 2nd pregnancy, I seem to remember the outcome was local authority funding based....although it shouldn't be......I shall be watching this with interest.

HI Cori,
I am 10 wks pregnant, and won't be seeing any midwives til week 14... however, I AM seeing my GP every month ("shared care"), so at least someone is on the case, so to speak. Are you seeing your GP as well, or is the 15 week midwife thing 'it'?

Well this eems to be 'it'- When you se your GP what tests are they doing. Just BP and urine samples, if this is the route I have to go, I think I will have to make sure she knows what she is supposed to do.

cori,
im 25 wks pg with our first baby and i havent even seen a midwife yet.
my first midwife appointment is next week and thats to discuss the birth plan
i've had about 3 appointments at my gp's and one at the hospital so far,aswell as them testing me for gestational diabetes.i think it probably just varies on which part of the country you live in as this does seem quite "normal" where i live so i dont think i'd worry about it too much

I have only seen my GP once so far, but she did bloods, urine and BP basically. I wouldn't worry too much, there's another thread going on about people only having one scan during pg, so this seems fairly normal!

Hi Cori,
Apart from my booking in appt with the gp at about 6-8 weeks (and he was supremely disinterested in the whole thing, just told me to take my folic acid and not drink any alchohol...), I didn't see a midwife until 16 weeks when I had a booking in appt then, which was pretty comprehensive (blood pressure test, pee test, full history taken, loads of blood tests etc). At the time, I felt slightly neurotic and short changed, but actually, now I'm at 33 weeks, I feel it was fine. I had no complications or real problems though, and would have gone back to my GP if I did. Oh, and I did have a 12wk nuchal scan (available for mums over 35 at my local hospital), but there was no examination there apart from the actual scan.
I would say that you are probably fine starting your mw appts at 15 weeks, but you might want a 12 week scan if it is available in your nhs area. Otherwise, use your gp as much as possible, as you think is necessary. Good luck!

Hi Cori - I am a student midwife and where I am training the midwife care starts between 10-12 weeks with the booking and then there is no appointment with the midwife until after the 20 week scan - normally at 22 weeks then it is GP at 25, MW at 28 and then every 2 weeks until 36 weeks and weekly until birth. some midwives are adding a 16 week appointment to this at the moment due to the NICE guidlines which is good because that 10 week stretch is quite long without seeing anyone. However - there is not very much the midwife can do for you at booking and in the early months. she is really just getting information from you, getting to know you, and giving advice (- make sure you know what you should be eating as the first 12 weeks are the most important.) at least at 15 weeks she should be able to hear the baby's heart beat which is nice for you. It can be quite a struggle at 12 weeks to do this. But as someone else said - if you want a nuchal scan this needs to be done before 14 weeks and preferably a bit earlier so find out about it and organise it early if you want one.

If you want some back up for you complaint then look at this link

www.nice.org.uk/pdf/CG6_ANC_NICEguideline.pdf

Page 36 has the recommendation for antenatal care timing from the government organisation NICE. But trusts don't have to do what NICE says and it it depends on money - like everything else - so it might not help.

good luck

sorry - try this:

www.nice.org.uk/page.aspx?o=89892

NICE says 10 appointments for 1st time mums and 7 for subsequent ones... starting at 12 weeks or earlier.
You can question your GP!

with last pregnancy (ds is almost 5 months old) i think i saw midwife 5 or 6 times - mind you he was 3 weeks early so may have seen her a couple more times if he'd been on time!

I am mostly concerned about not having any care at all until 15 weeks. The GP did not suggest that I come see her. A lot problems can occur in pregnancy with out you knowing about it, such high blood pressure, diabetes etc.

High blood pressure doesn't usually start until the third trimester - so the blood pressure your midwife will take at 15 weeks will be for a baseline to compare. Gestational diabetes is normally checked at booking but 12 or 15 weeks shouldn't make too much difference. I think if you want to complain the person to speak to is the head of midwifery at the hospital as she is in charge of the pattern of care from the midwives. Also could you ring your midwife and tell her your concerns? maybe she would be able to put your mind at rest. Good luck

Also Cori, you could always book yourself a/some GP's appt(s) for regular blood pressure checks, and maybe even blood test for glucose levels/gestational diabetes? THat way at least your concerns are being addressed, even if you are up against a "system" that won't admit you before 15 weeks.....

Hi Cori - have just come across your post. Here is a link to nationalguidance

However each area provides care in different ways. Do you need to see your GP? Can you directly book with the midwife? Ideally you should have a dating scan by 12 weeks but that depends on the area. If you are sure of your dates then it isn't vitally necessary.

Try not to worry too much about it all. There should be less visits this time because it isn't your first pregnancy. Was all well last time round? If so, you have a high chance of having an uncomplicated pregnancy again. Better off not being interfered with in some respects

Thanks for that Mears. My last pregnancy was quite uneventful but the birth was not. I need to talk to the professionals so I dont spend the next 7 months worrying what will happen.
Basically last time I went two weeks overdue, I was induced, it didnt work. I think I dilated 3 cm after 12 hours. Emergency ceaserean, quite a bit of pain during the procedure and afterwards. Also 3 days after ceaserean, I was in A&E with a severe allergic reaction to codeine ( or volatarol). SO am concerned about how pain relief will be managed if I have another ceaserean , which I think is likely.

when you have your booking with the midwife ask if she can arrange for you to speak to the anaesthetist about pain relief for another caesarean. If you and he/she can plan together what would be done in this situation in advance then it might put your mind at rest.

i am 29 weeks and had an appointment with the midwife last week, all was well, but i was a little surprised when she said 'come back and see me in 6 weeks'. in all the literature i have it says from 28 weeks you should see your midwife every 2 weeks. is this normal?

Would I have any difficulty in getting a midwife to arrange this.?
Will they take my concerns seriously? I always feel fobbed off by health professionals.
When I spoke to the hospital about my booking appointment, they suggested that my concerns would be addressed at my appointment with the consultant at 36 weeks!!!!

I don't know how difficult it would be. You sound worried about it now so they ought to arrange it for you now. I expect they would routinely discuss it at 36 weeks but I think they could make an exception for you if you wanted. You can only ask.

Maybe I am just hormonal, but am getting quite upset thinking about it too be honest. MW appt is not for another 6 weeks, what can I do.

Hi Cori

Just wanted to say that I feel exactly the same as you. I am 12 weeks pregnant with my first child and have my first scan on Monday. I booked to see my doctor who wasnt that informative considering i was completely over anxious being a first time mum and was surprised that he didnt even confirm my pregnancy himself. He just filled in a form, took my blood pressure and said a midwife would contact me. This still has not happened so i called the doctors and again the most unhelpful receptionist said they wouldnt do anything in the first 12 weeks but could say my form had been picked up by the midwife. I think this is really unexceptable considering I am a first time mum and dont really know anything, am frightened scared and confused and i know it is routine to everyone else in the profession it isnt to me and i thought the first trimester was the most risky and I wouldnt even know who to call as my doctor has put me under the midwifes supervision (whoever this may be) so I completely sympathise with you Cori and think that you shouldnt be left alone to worry at this time. So sorry I dont have any advice to offer but just wanted you to know that there is someone else who feels like you!! Take care!!

Thanks for the support.
As a first time mum you need to know who to turn to. I am suprised that you havent had more support.
Pregnancy can be a highly stressful and emotional time for many women. Regular appointments give reassurance that someone is looking after you, not just there to pick up medical problems

My problem has arisen because I am not using my local hospital, and going to the one in next borough.
So dont have a community midwife that I can see. I have refused to go to local hospital as it apparently one of the worst maternity units in the country.LAst year a woman died after ceaserean, as a result of blood loss. Too Scary.

Thanks Cori. I know will be raising alot of questions at the scan on Monday believe me. Am shocked at lack of support.

Sounds like a bit of a nightmare for you and I agree I would not go to the local hospital either. can you doctor not offer you more care considering you are having to go to another hospital in another borough.

I was very surprised by the lack of contact in my 2nd pg, at one point I even rang the midwife to ask if it was right and whether I had missed some appointments!
Think it's due to antenatal care still feeling a little fetus orientated, so even though the first months of pg are probably the hardest for the mum, with the tiredness and m,sickness the care seems to only come later on, and revolves round the baby and not so much around the mum IYSWIM