Consultant meeting on Thursday

[LuckySalem]

Hi all,

Have got a meeting with a consultant on Thursday as I've been classed as high risk after DD's birth.

I'm not sure what to expect or what I should have prepared.
I had a letter through to say to leave upto 3 hours for the appointment so what's going to be discussed in these 3 hours?

Also I want as natural birth as possible with the least medical "touching" as possible, is this where I'd argue my case as according to my MW I have to go in as soon as first contraction comes and be constantly monitored on the bed. Not to mention as least 6 hours in hospital after baby is born and I seriously do not want this.

Thanks all.

bump

Hello Lucky, I can't comment on your situation as, obviously, it depends upon your circumstances and why you've been classed as high risk. I'm high risk because I have various things wrong with me (wonky spine and a few other bits and pieces) and have been under the care of the same consultant with both of my children and will see her with this one too.

I have always got on really, really well with my consultant. I felt she was very straight-talking, told me what the latest research was in relation to things that concerned me, listened very carefully and took my preferences into account. She seemed willing to accept higher levels of risk than midwives but also, when it turned out that intervention was needed, she gave me all the evidence I needed. I remember one particular time when I'd been diagnosed with pre-eclampsia whilst at a routine appointment with her at 36 weeks. I desperately wanted to go home and get myself prepared before I was admitted on to the ward (for what I knew would be a long stay). I asked her whether I really did need to go in that day or whether I could go home. She simply said that if I went home it would be against her advice. That really pulled me up as she didn't try to pull rank or patronise me but left me with no doubt that I'd be foolish not to go straight onto the ward.

In terms of the 3 hours allocated, I think that's just because sometimes you have a scan/see the midwife and then have a bit of a wait until you see the consultant as, obviously, the appointments get a bit out of kilter. My appointments with the consultant were generally for about 20 minutes.

I really hope that you get someone you can trust and who listens to you. My experiences have all been good and I wish you the same.

Thanks for that.

I became high risk due to having to have an emerg CS after DD presented with the wrong part of her head (cant remember what its called)
Although on my notes its been classes as failure to progress which is damn right depressing

It sounds like this consultant should be really good then.
Apparently she will be taking care of my 20 week appointment and I wont see a MW at all. Have just had my scan today so shouldnt need that either.

Will I see her again then? I assumed that I'd only see her at this apt and then at the birth (if there was complications)

anyone else?

It sounds as if it is simply a routine appointment for all women booked under shared care with consultant/midwives to me. 3 hours probably refers to 2.5 hrs waiting and 30 mins with the medic! They will want to discuss options for this birth, and talk to you about what you do and don't want. Have all this prepared in advance and do a bit of research on VBAC if that is your preference. Failure to Progress is a standard (if often unhelpful) classification for why a section was necessary but it sounds in your case as if the position of baby's head made a vaginal delivery impossible. Check your notes (perhaps ask that the consultant has a copy for your appt) for more details. Good luck.

I can understand why you have been put under the Consultants care, but I think to call you high risk is somewhat alarmist.

You have said you would like a vbac, so my advice is read up and be informed as much as you can on vbac.

Know and understand:

The risk of scar/uterine rupture and the statistics involved.

The warning signs of uterine rupture.

The dangers of induced labour.

The usefulness of constant monitoring. Is it useful? Will it help or hinder your labour and birth?

If you understand the processes involved you can then use the 3 hours you have to have an informed talk with your Consultant and go through any questions you may have.

If you are informed you can also stand your corner and have some counter arguements. Of course you may not need that, but you never know!

I also think your MW is talking out of her arse. It wouldn't surprise me if they wanted to monitor you for the whole time, but the rest of what she mention seems a bit odd.

Good luck! One year later on I am still on a vbac high!

I think the 6 hours in hosp following birth probably refers to a '6 hour discharge' where the staff undertake to discharge you as quick as possible. Usually a lot longer than this due to organisational rather than medical factors (e.g at least 1hr skin to skin, observation of 1st & 2nd feed if bfing, staff caring for lots of women on postnatal ward etc). Also the paed check on baby is recommended to take place at least 6 hrs following birth due to structural changes to the heart. This can be done after discharge if you prefer by suitably trained mw or GP. 'High risk' is again a standard, if somewhat alarmist, way or refering to a woman with a previous emergency section.

This is loads of help.

Will start reading now that I know what to look for.

Failure to progress is so depressing cos we progressed, I was fully dialated and pusing for 45 mins before it was realised that she was positioned wrong. I PROGRESSED DAMN YOU!!

Now I know what to look for I can find the arguments in case I need it again.

As for the 6 hour discharge thing the way she described it we would be monitored for 6 hours before the peads apt would be arranged etc hence her saying at least 6 hours. I personally would like to be out within 2/3 hours. Assuming all goes well as my hospital stay was HORRIFIC for me. (prob not any where near as bad as some people have had)
Basically I was left after the CS with all that goop on my belly (orange stuff) a cathetar and drip attached and DD put well out of reach. I wasn't allowed out of bed for 24 hours so was left in the gown and yucky stuff. Everytime DD cried I had to call a nurse who never arrived for at least 10 mins after the call. I was so happy to get out! lol
Plus I really don't want to be seperated from DD or DP for that long and I know that he'll get kicked out again which I DO NOT want.

I need to write all this down then. Thank you again.

Heres a good www.caesarean.org.uk/website to help you get loads of information, and gives you other useful links as well.

dont know what happened there, try this www.caesarean.org.uk/

THANKYOU

Ok have written some bullet points for both a HB (in case she ACTUALLY agrees) and a hospital birth in case she doesn't.
Can you tell me if these sound reasonable?

HOMEBIRTH

Homebirth because there was no other risks during birth with DD other than presentation being wrong. Can there be a scan before birth to check positioning? or a exam to check this?
No pain relief was needed and I feel hospital birth would make me need pain relief and end up in a more medical delivery.

Why do I need a hospital birth
whats the risks of a HB
why am I high risk
what extra things does being high risk mean

HOSPITAL BIRTH

As hands off as possible
Pain relief to be restricted to G&A and TENS machine unless specifically requested. Don't suggest it to me
Every step that needs to be taken needs to be explained to me as I need to feel in control
no continuous monitoring
must be mobile
skin to skin straight away
BF straight away
I would like to find out the sex.

Why would any of this need to be different?

Hope your appointment goes well. If this pregnancy continues to progress for me (looking unlikely), I too am high risk as my baby passed away shortly after birth due to overwhelming infection. Her growth slowed in the last 2 weeks and my placental fluid volume dropped also. The reason for this has not been established.

Anyway, had my consultant apt at 7 weeks to talk through ante natal care. I will just have regular swabs towards the end and more serial grwoth scans. Delivery at 38 weeks (I haven't decided on induction or c-section yet). Took all of 25 minutes. I had done all my reading beforehand and so he didn't say anything I didn't expect.

thanks for the info sh.

I hope everything goes well for you too.

Oh arse, I'm probably too late.

I would suggest that instead of continuous monitoring you come to a mutually agreed alternative.

For example, your blood pressure, heart rate, temperature and the baby's fh is checked by dopler every hour.

They don't like this as it means a mw actually has to make regular checks on you instead of relying on a machine.

I would say the only reason you are high risk is because of your previous csection, not because of the position of your previous baby - as tat wouldn't impact this pregnancy.

You then have to decide whether you are determined to have a hb or not. There is no reason why you shouldn't if all is well.

I hope it all went ok for you today. But remember whatever you discuss today isn't set in stone

Am keeping my fingers crossed for you sh77

Today was nothing to get excited about at all.
It was just like a normal 20 week appt with a registrar rather than a consultant (?)

I managed to get from her that basically it's all up to me what I wanna do and can even change my mind during the birth.
Also that with DD they tried forceps but she hadn't decended enough for them to reach safely.

Well that certainly sounds promising. Are you happy with how it went?

Luckysalem I have been classed as High Risk this time due to my DS's PG. I had Placenta Previa, restricted blood flow to the womb, signs of pre eclampsia and group B strep present in waters. I also had an emerg C section due to bleeding heavily as I went into labour.

Im ready to fight it tooth and nail but I can see why they are cautious.

In your case however - huh!? Failure to Progress is a completley barbaric term to use. They have 'time scales' to adhere to and they call 'FTP' Failure to tick all the time boxes on their list. If they started to intervine and suggest sections etc you will have became very very tense - right? Im sure your birth would have been more uncomfortable than normal but I don't see why this resulted in a section.

I totally suggest hypnobirthing for you. It has really made me positive this time - and determined. Im very grateful for the medical intervention I recieved in a clearly dangerous birth but this time I feel annoyed that im classed as high risk. They will not test me for group B strep as they 'presume' I will be as I was last time?? The plan is according to them......Im high risk, Im not allowed a Home Birth, I get hooked up to IV antibiotics throughout labour which means no moving around so watch this - failure to progress looming on the horizon!!
Im half way through hypnotherapy classes and it has made me so much stronger. It doesn't only teach you how to relax and all the best methods of pregressing with your birth. It also gives you all the info you need on your rights and how to deal with pushy hospital staff without upsetting yourself.
Im pretty depressed this week though as Ive discovered I have a UTI and now have a 7 day course of antibiotics. This will make the chance of me eradecating GBS and talking them round to testing me even harder. Hoping my class on Sunday will help.

Good luck. x
Good luck.x

Oh I sound a bit stupid.

I have not got placenta previa this time, or restricted blood flow, or signs of pre eclampsia (im 31 weeks). I have been scanned 5 times already and the baby is fine so im not being silly.

Oh I sound a bit stupid.

I have not got placenta previa this time, or restricted blood flow, or signs of pre eclampsia (im 31 weeks). I have been scanned 5 times already and the baby is fine so im not being silly.

Oh god, Now Im really looking stupid

Thank you very much for your input.

I understand why I had to have a CS. I had feotal (sp) distress as well so I understand that need for it but not the need for high risk this time,

I however, found out I get another scan at 36 weeks which i'm dead excited about

I'm not really happy at this week cos (without sounding mean to anyone) I expected to see someone knowledgable that I could understand and I ended up with a polish lady who I could barely understand and didn't really make sense when she talked about anything and actually made me feel guilty asking some questions.

I'm just hoping I get my nice MW when I go back for my 28 week apt and can talk things through with her properly to the point that I understand it.

anyways. Thanks again :D