How do I get decent antenatal care this time (sorry, very long post)

[baboon]

I have just found out I am pregnant and am really excited. The only thing is I am afraid that the care I get from midwives and doctors will be like it was last time.

I wanted the pregnancy and birth to be natural as possible and wanted a home birth. I was told I couldn't have a home birth, the midwife was funny with me because I wanted one, when I was concerned about anything she didn't reassure me.

When I had really bad morning sickness and pain in early pregnancy, the hospital insisted on giving me pethidine and an anti-sickness drug even though I said I didn't want either. The doctors said neither would harm the baby but if I was really worried they would just give me pethidine and not the sickness injection but later on, as the pethidine made the sickness worse they insisted I had a sickness drug too otherwise my baby would suffer from undernourishment. Later on in the pregnancy I was told by my GP that anti-sickness drugs should not be used in pregnancy at any time, certainly not in the first three months.

Also, even though my periods were regular no one could decide when my baby was due and sent me for frequent scans. In the last few weeks the midwife said my abdomen felt tight and wanted me to go hospital for monitoring in case I was going to labour. The CTG showed very strong contractions and they said I would have a premature delivery so kept me in hospital for days. Then they said I was dilating so would deliver in the next couple of days but said I could go home as long as I went in if I felt the contractions any stronger. Then when I was finally in labour and described the pain to the hospital they said I just had an upset tummy as the pain wouldn't be that bad so early on in labour, it couldn't be labour. I was having contractions every two minutes at the time! When they finally said I could go in, they insisted keeping me on a CTG throughout labour, wouldn't let me change postion and told me to bottle feed as it was the easiest.

They also asked if they could put my baby in the nursery overnight so I could rest and I said I wanted her with me,but when she started crying and wouldn't feed, instead of helping me settle her, she took her to the nursery as she was disturbing the other mums.

I really can't afford an independent midwife. I have been thinking about doing my own care, I have a blood pressure monitor and urine testing sticks and I have health related qualifications and know what danger signs to look for, I know what symptoms should be investigated, I can feel the fundus so I can check the fundal height and I was going to buy a foetal heart monitor. I would still consult a doctor if anything concerned me and I was going to pay for private scans and either give birth at home, calling someone at the last minute or go into a private hospital for the birth.

When the person who delivers me asks who my midwife is and finds out I haven't had the usual sort of antenatal care, could they get concerned and phone social services, thinking I don't care about the baby?

And what would I do about post natal checks? Would they just send a community midwife from the hospital; I am not registered with a GP at the moment. Ideally I would rather not have post-natal care anyway but I know a midwife has a legal obligation to attend for the first ten days so would I be breaking the law for not having post natal care?

Mears, what do I do if I am not going through the GP' can I just contact the hospital and then they will send a community midwife to my home or what?

Have you spoken to Diane? She may know people in your area.... maybe a better midwife or GP.

No, I haven't yet pupuce, I will have to give a ring. I've just thought, I have heard that you don't usually have so many visits with your second baby as long as its low risk , about 6 rather than the 13-15 I had before.

Although I think here you normally have the same amount in every pregnancy. I could probably just about cope with the same midwife as before as long as I don't see her more than 6 times

You actually can book directly with the midwife - although most hospitals tend to 'share care' with the GP. You don't actually have to do that. When you book at the hospital, you are booked under a consultant. Some areas have changed that way of working, so that you book with the midwife and she will refer you to the consultant if there are any problems. Therefore it should be your choice which professional you see. Often consultants like to see women at booking and then nearer term. That system is changing as well, with the consultant only seeing women who want to see them, or if they go past their due date. A lot has been changing even over the past year.

Mears, because of the trouble I had before and because of the way the professionals thought about me as being awkward etc, I am worried about what will be in my medical notes in case that affects the care I have next time. I did see one letter to the consultant saying that I was a very difficult patient,who didn't like cooperating with the staff and wanted everything my own way. If I book at a different hopsital, will they need my notes?

No - when we have women booking with us having delivered at a different hospital before, we do not ask for their previous notes. If you had had a complicated delivery though, the consultant would write to the previous consultant to find out more, if it would make a difference to the present pregnancy.
You could of course get access to your notes to see what was in them. You now have a legal right to get access to them by writing to the hospital. You do not need to have a special reason.

You are in Scotland aren't you? Do you know if that is the same here. I didn't have any complications last time.

Everyone in the UK is entitled to access to their notes.

Sorry - just realised you meant your notes at previous hospital. I would expect it is the same because there is nothing to be gained by getting them. And let me tell you, medical records secretaries do not like notes going to other hospitals incase they get lost. They will just take your previous obstetric history from you - you do not need to tell them anything that you don't want to.

Sorry mears, I meant wherever the new hospital is, will they not need my notes

ni

sorry - meant no. I am actually on my mums computer and am going home now. Will log in later if you need any other info baboon.

Thank you so much mears, I will see what other hospitals I could use in the area. You are wonderful, thank you. I am feeling much more positive now. Maybe I will be able to start enjoying this pregnancy properly now.

Is it right that you often only have about 6 checks in low risk subsequent pregnancies? Oh, and will I stay have a midwife if I do things this way or would I just see the consultant every time?

Leese is a midwife in England - maybe she can help. If she does't pick up on this thread you could start another one asking for her help. I'll chip in too.

You could see the consultant each time, but it would be ideal to meet a midwife you could relate to. There are loads out there honest. You have been so unfortunate in the past, having a good midwife experience would let you get over the past ones. Consultants can be great, but you would get more of a 'relationship' with a midwife. I'm definately gone now till later. So glad that you are feeling more positive

Would I still be able to have a home birth doing things this way as I would be booked in at the hospital wouldn't I?

You won't know the MW at all for your home birth...

But would I be able to have a home birth if I book into a different hospital the way Mears suggested?

Hi Baboon,

The way it works at our unit is that women are booked under a consultant, but do not nesessarily ever see them. Antenatal care is provided mainly by the midwife, but the woman can choose to see her GP is she prefers. Even though she is booked at the hospital, she can opt to have a homebirth. The care is provided by the midwife, who provides antenatal and post natal care. This is an integrated hospital/community service.
I think what you would ned to do is contact the Head of Midwifery at the hospital you chose to see how they are prepared to provide care. If you book at a hospital which provides care similar to ours, the only problem I can foresee is travelling distance for the midwives. If however, distance is not a problem then you should be able to book a home confinement. For instance, women can travel to another hospital from ours to deliver, but their postnatal care os provided by our midwives because of the distance involved. It means that the women do not get to know the midwife antenatally, because they travel to get their antenatal care at the hospital they have chosen to deliver in.
We are the only maternity unit for our area. Where you live you may well have a choice that will not affect whether or not you can book a home confinement.

Baboon are u near Nottingham by any chance?

No carriemac, I'm not, why

When I book into the hospital, any idea what the schedule of visits will be? I had at least 13 last time, but have heard if low risk may be just 6 - 8, but am wondering as I am booking with the hospital. does that mean I will have more visits?

And will I see the midwife at the hospital or at home? Last time it was at the GP's surgery.

These are the questions you need to ask the hospital before you book. Visits can be tailored to mothers needs. If all is well then you will not need the number of visits you had first time round. Visits can be planned where they are most suitable for you.

Baboon, just because i had a lovely midwife and obsteretrician (female) who with my twin pegnancy were so supportive and helpful, did some antenatal checks at home , took my lead for postnatal checks (just popped head around door to see if i was ok, basically)
My obs was wonderful, concentrated on my feelings as much as the babies health and progress, offered as much/little intervention as I wanted etc. So it is possible to have a good experience too

Feeling much more optimistic about getting antenatal care now but still interested to hear from leese