Midwife Appointments?

[dee_bee]

My daughter is 12 weeks pregnant, and has been classed as high risk because of an autoimmune disorder. This is her first pregnancy, and she has been told she will have to have the baby in a hospital, and see a consultant . Her pregnancy notes say "shared care", but the midwife is saying she won't have any appointments with them, only the consultant. My daughter feels very unsupported, the whole thing is becoming a medical procedure with no regard for what she might want or hope for. I can't imagine the consultant (who didn't even turn up for the first appointment...) wanting to discuss a birth plan! What exactly is "shared care" meant to be please?

[Lydialego123]

I am classed as high risk on my second pregnancy with consultant led care, but still see my midwife on the normal schedule, but with a few extra consultant appointments on some of the weeks.

I’d get her to call the central midwife team for your hospital and ask them to confirm what should be happening in her circumstances. I’ve got a list of phone numbers on the front of my notes, I’d just call the duty line if she has an equivalent.

As it could be that the reason for her being high risk means that there should be no midwife care, but from what I know from myself and other mums that sounds unusual.

[JLR94MM88]

I have an autoimmune condition too - I see both a midwife for regular appointments and then have some extra consultant appointments and growth scans on top of the usual midwife ones / usual tests or scans!

To be honest there wasn’t as much contact or support early on (I presume they are waiting to check you don’t miscarry in the first tri before making much effort) but for me it was pretty much “normal” level of midwife appointments in 2nd trimester + 1 telephone consult with the consultant who basically checked my latest rheumatology blood tests for any scaries (there weren’t any) and then booked in additional appointments and scans which are all starting in the third trimester.

If your daughter is “so high risk” that a midwife shouldn’t even see her to do basic health/wellbeing checks - then she’s so high risk that a consultant not showing up to an appointment is actually dangerous and not just unacceptable.

I would complain to the department as the consultant not showing up is bad (even if your daughter were still having usual midwife appointments as well) or even go to PALS and explain the situation and your daughter feels unsupported and not getting the level of care that she should be.

[Twiglet2]

👋🏼 I was high risk I saw the central midwife team at the hospital plus consultants. I was meant to be ‘shared care’ but after the local midwife team being so useless I asked to go completely over to consultancy led only which is what the local midwife planned anyway as soon as I was on the ‘red path’ I did ‘normal’ local midwife booking appointment at 10 weeks over the phone, 12 week scan at hospital, 16 weeks with local midwife (who didn’t show twice) and then from 20 week scan I had scans every 4 weeks in the hospital and then straight afterwards a ‘consultant appointment’ what this meant in reality was that one of the central hospital midwife team took my bloods, blood pressure, urine sample and asked me a few questions looked at my scan from that day then a consultant would swing by at the end for an overview. It really worked better for me than the local midwife (who when finally showed at 16 weeks did my bloods wrong and the hospital midwife team had to repeat them anyways). The consultant did spend more time with me when my iron was low, protein in urine and nearer the end when looking at the birth (they wanted to induce 1 week early). But if wasn’t needed that week it was really just the hospital midwife team I spoke with. The consultant also did a sweep for me prior to induction (that the midwife wouldn’t do as wasn’t at due date but it worked!) and I was able to get anti sickness meds, heartburn tablets, additional iron etc right there and then rather than midwife at GPS recommend it, having to get the GP to write prescription then having to go get it etc they just handed me the meds there and then with a consultant signing off so it seemed better when there was something needed medically to be in that process.

For me personally it might not have always been the same person I saw every 4 weeks (then every 2 near the end) but it was far better than if I hadn’t been on the high risk path where I would have been lucky to see the local midwife 4 or 5 times from what other have told me. It also gave me peace of mind to know the consultant was on hand if they were needed.

In terms of a ‘birth plan’ I’m not really sure what you mean by that? Consultant discussed options with us about 36 weeks (induction, natural, c-section) and gave their reccomendation and why and answered any questions we had. We opted for their recommendation of induction (although the sweep worked for me the day meant to be induced anyways) and then when we went to the Labour ward we just discussed pain relief plan with the midwife there (which ended up completely different to what I thought we would do in our ‘plan’ before hand) anti natal classes is where we got the most info on the pre and post birth stuff like pain relief breast feeding etc and the consultant or the midwife Will give more information on resources for those nearer the time. Hope that helps cover what your daughter might expect care wise but yes I dont think the consultant would sit and talk ‘gas and air vs epidural’ type questions but the midwifes might and the anti natal resources will help with that 🤗

If your daughter feels she needs more care or has any medical concerns she feels aren’t being addressed she should absolutely raise them with the consultancy team though and we were also given a helpline number to call if we needed them x

[dee_bee]

Thank you so much for sharing your experiences and views - it has been incredibly helpful. My daughter has Lupus, so we do know that she will need monitoring, and equally we understand that the community midwives might feel it is a risk they cannot manage, but it still feels like something has gone awry somewhere. I've read your responses to her and she now feels much better informed, so we can come up with a plan going forward. Thank you again. xx