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?

Sorry baboon - just caught up with this thread. Cannot quite believe the treatment you have been given - think we would have been struck off at our hospital (and rightfully so) if we displayed such behaviour.
This thread has been so long, I've sort've lost the gist of the exact questions you'd like answered, so feel free to ask anything directly, if I don't cover it.
I work in the South West, and we offer midwifery led care (woman just sees the midwife), GP care (tho' this is uncommon), or consultant led care. As mears pointed out (always so eloquently!), you may well be booked with the consultant as your 'lead professional', but may only see them once in your pregnancy, the rest of the time being taken up with your midwife. Changing Childbirth in the 90's encouraged us, as midwives, to offer ante natal care tailored to the needs of the woman - it suggested that our current rate of ante natal care was too high - women could be seen less without any risk to mum or baby. So, it was suggested that we ASK womwn when they would like to be seen again, and tailor their care this way. Some women like to be seen often, some less often. As long as a woman feels healthy and well, I do not see the need for very frequent checks. As a rough example, this is how often we may offer ante natal input:

9 - 12 wks - booking appointment
15 wks - offer AFP
20wks - seen at hospital for routine scan
24wks - midwife
28 wks - midwife
32 wks - midwife
34 wks - midwife
36 wks - midwife, then weekly until delivery.

Of course, these can be tailored to suit YOU. Have you checked if the same midwife/midwives still work in your area. Ther is such a high turnover of staff, this may be worth checking. You may also wish to combine midwife appointments with GP care, as also suggested, so see him/her for a couple of appointments.
It is your absolute right to have the delivery you want - home or otherwise. As midwives, we are duty bound to attend and most importantly, support you though labour.
I would second mears, and urge you not to do your own ante natal checks. As she pointed out, urinalysis and BP checks are a small part of the check as a whole. What about palpation? the baby will more than likely be in a favourable posisiton - but what if not? Gosh, I just think it is tragic that you really feel you would be better doing your own care - your midwives really failed you.
Many hospitals now work towards acheiving 'Baby Friendly' status (some already have it), which all round encourages breast feeding. These hospitals have to follow '10 steps' - one of which is to abolish 'nurseries' per se, and to encourage 'rooming in' - ie. baby with you at all times. So, the baby should categorically stay with you at all times. This is also encouraged now from a security pov.
If you opt for a home delivery, you will likely book in with the midwife, who would offer you all ante natal care herself, but you could requset consultant input if this is what you would like. Even if you book a home delivery, you will be 'attached' to a hospital that you would transfer into in labour should the need arise.
Playing devils advocate, say you did not see a midwife ante natally, then delivered at hospital, a community midwife would be notified of your discharge from hospital, and would be duty bound to visit you. You would also be bound to give her access to check your baby post natally - if you did not, she may have cause to contact social services. This would be the case because she has a duty to care for the newborn. The same is not true ante natally - you would have the right to refuse ante natal care without any involvement from social services (although I am in no way endorsing this!), as the childs rights come into play once he/she has been born
Not sure if I have answered what you want here baboon - feel free to ask any more. Which general area are you from?

Thanks for replying leese. I am not registered with a doctor so if I just book directly into the hospital, will I have to go to the hospital to see the midwife? I always thought you always had to go to the surgery to see a midwife.

Thanks for picking up this thread leese - you will be able to give more relevant information than I can, being here in Scotland.

It seems things run more or less in the same way.

baboon, you can see the midwife wherever it suits you. Midwives have the use of GP's premises and that is why you might see them there. Your own midwife would advise you where you could access her - does not mean you would need to see the GP. I must say though, I think you should register with a GP, even if it is not for antenatal/postnatal care. You never know when you will need their services and it is so much better for you if they have a medical history.

baboon - we work from a clinic which houses us, GP's and other healthcare workers. At our clinic, we see women affiliated with that GP surgery. We then do satellite clinics at other GP surgeries, seeing women 'belonging' to those surgeries there.
However, some women cannot make the appointments we have at their gP surgery, so we tend to fit them in at the clinic we work from.
If you book with us, as midwives, we do ask that you register with a GP. This does not mean you ever see the GP - it is just a case of getting registered, then seeing the midwife (or not if you prefer!) from then on. Lots of our women never see the GP in pregnancy, but we sometimes refer women to a GP if we have any concerns which may not necessitate a trip to the hospital. Do you have a particular problem with registering with a GP baboon?
Hi mears - good to hear you sound a little cheerier in yourself. Thinking of you

I've just had a look on a website that gives details of different units all over the country, gives pain relief available, home birth rate, csection rates etc and breast feeding info. Bit disappointed there are none in the area that have UNICEF accreditation although some have breastfeeding counsellors and breastfeeding helplines. However there are a couple that provide aromatherapy in labour which I am pleased about.

Also, if I want to just have midwifery care, do I have to go for a domino scheme; there are two which offer this?

Wouldn't have thought so baboon. Domino scheme just means that care is delivered by the midwife, when labour starts the midwife accompanies you to hospital, delivers baby and takes you home again usially within 6 hours.
You should still be able to get midwifery care even if this scheme is not offerred. Good thing though, is that if this scheme is offerred it means that there are enough midwives to supprot it.

Oh right, its just that it gives two types of antenatal care for each unit, shared midwifery care with local GP and domino scheme

baboon - just coz the centres close to you don't have UNICEF accreditation, does not mean they are not working towards it, and therefore the care they deliver will be in line with UNICEF recommendations. Our unit has not managed to secure it yet (is difficult to get - 'specially for larger units), but is working rigorously towards it - check it out!
A domino scheme, in our area, means a woman who is cared for solely by midwife in pregnancy. One of a team of midwives will then deliver you, and see you at home again for post natal care.

Thought these information leaflets might be helpful to you baboon. There are ones for women and ones for the professionals.

leaflets

Just thought I'd update. I have actually had to move house cos dp got a wonderful job offer. We moved to a completely different area and I contacted the community midwives office and I now have a lovely wonderful midwife. I can now enjoy the rest of the pregnancy without worrying about a repeat of what happened last time

That is really good news baboon. Keep posting of your proress when you can, it would be nice to hear how you get on.