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Under consultant care?

Discussion in 'Pregnancy' started by biodust, Mar 20, 2012.

  1. Hi all,

    I had my booking in appointment today and the MW decided that I should be under consultant care due to the fact that I got a borderline 3rd/4th degree tear with my son. What does this actually mean and how is it different? Does it mean that I have some checkups at the hospital instead of at MW? She didn't do a good job of explaining it and was running 30 mins late which ment I had to rush back off to school!
     
  2. Hi all,

    I had my booking in appointment today and the MW decided that I should be under consultant care due to the fact that I got a borderline 3rd/4th degree tear with my son. What does this actually mean and how is it different? Does it mean that I have some checkups at the hospital instead of at MW? She didn't do a good job of explaining it and was running 30 mins late which ment I had to rush back off to school!
     
  3. chocolateheaven

    chocolateheaven New commenter

    Hi,
    I was under consultant care from the start of my pregnancy, as I'm a diabetic. Sure this will differ from yours in many ways, but the key things seem to be that checkups are at the hospital. I missed out on a lot of the information-giving side of antenatal care that midwives provide, but with a second preg that might not matter to you? I was at the hospital once a fortnight for my entire pregnancy, but as your issues are with delivery rather than the actual pregnancy, I doubt that this will be for you? When under consultant care, you generally count as a high risk delivery and therefore have more intensive supervision during labour. Not sure how it will differ in general though, as it's not an antenatal issue as such. Sorry - realised that I'm rambling and haven't said anything that's of much use!x
     
  4. Hi Bio - I am under consultant led care as I've had type 1 diabetes for 24yrs! For me it means, I see a midwife, diabetic nurse, diabetic consultant, have a scan and see an obstetrician every 2 weeks! The appts are long........ often 1-5pm and when get to 28wks I will see them every week. The plus side is I get regular scans but these are needed to check for growth as babies of diabetic mothers are often very large. It also means they won't let me go past 38wks.
    As yours is not a problem in the pregnancy itself, I can't see you needing appts this often but it may mean you get a few extra scans to make sure you're baby isn't growing so big as to risk the tears again. How big was LO last time?
     
  5. 9lb 5oz! Apparently I'm also 'not very stretchy'! (Registrar said this to me when he was doing stitches)
     
  6. I have been on shared consultant care since my booking in appointment. It is because my BMI is just over the threshold, this has meant I had my GTT test early and I have had one appointment with a consultant, at about 18 weeks. This consisted of a scary lecture on all the things I was at higher risk of due to my BMI - couldn't decide whether I should be more worried about pre-eclampsia causing a small prem baby or diabetes causing a huge baby requiring forceps delivery [​IMG] and of course then they also tell you that you can't change your weight now and you shouldn't try to diet just eat healthily and they will monitor me more regularly to try and minimise the risks (and actually then the parting shot was 'try not to worry you are only just over the threshold and you should see some of the other mothers we see!' - I think that was supposed to be reassuring)
    For all other appointments I have seen the midwife at my GP surgery. Apparently I don't need to see the consultant again unless my midwife has any concerns as the pregnancy progresses re blood pressure/pre-eclampsia or diabetes (I passed the GTT!) so for me it was potentially just a one off extra appointment in addition to my normal routine midwife care.
    I think I am therefore very 'light touch' in terms of consultant care, but I am still down to deliver in the consultant unit at my local hospital due to fears that big(ish) mama might mean big baby - even though all measurements to date (now 27 weeks) have been bang on average. I don't mind this though as it is the only delivery suite local to me where an epidural is a possiblity (I am hoping I won't want or need one - but I'd like to have the option when the time comes!!! especially if he/she is a whopper [​IMG])
     
  7. I'm WELL over the threshold for BMI and so got sent off to consultant care, without any word on the implications of this for my birth plan or anything... got hit with a GTT twice - once at 18 weeks, once at 28 weeks and very much the assumption they'd find out I had it... sorry to disappoint ya guys!
    Basically I get all the midwife stuff anyone does - but an extra set of checkups down at the hospital at very very long intervals (think I've gone at 12 > 20 > 28 > 34 weeks), which are, to put it bluntly, ****** useless - the last one consisted of the consultant saying, "OK so remind me - why exactly am I seeing you again?"... and I have to see the anaesthetist next month to see if I can have an epidural (assumption being I'm going to want one - again - no input requested from me about what I actually want!).
    No one's talked to me about the implications of being consultant led in terms of the birth either (doesn't help my usual midwife is of course off sick) - so I've got utterly no idea what my options are - and considering I'm faced with giving birth with what is now blooming severe SPD (consultant didn't care about that - just smiled and blamed my weight... thank God the midwife and physio were a bit more tolerant) I kind of need to know what choices they're going to leave open to me really - I'd love a water birth just to have some support from the water - but until last week's ante-natal class, I'd assumed that was utterly off the list of possibilities to be honest, but the women running the class say it's not.
    As for the lectures - have avoided most of those thankfully... just the cringeworthy embarassment of waiting in the ante-natal area and one of the staff obviously being told to hand out leaflets trying to target larger women - and making a huge thing about "oh I hate doing this so I'm going to give them to everyone in here so no one feels singled out"... followed by about 20 pairs of eyes all turning to me as they read the bit of paper thrust into their hands and realise who it was aimed at!
     
  8. I'm under consultant led care as I had IVF treatment. I've got my first consultant's appointment tomorrow. From what 've read online, I'll be signed off back to midwife care if the consultant thinks baby & I are both healthy and doing well.... My local maternity unit is consultant led, so it didn;t impact on my decision about where I'd like to have baby either!
     
  9. Being consultant led should not alter your risk level. It is what the issue is that made you consultant led that may lead to monitoring/ CS etc. I ended up under consultant because I had contractions/ steroids at 31 weeks. In the end I had baby at home.
     
  10. Well, back from my consultant's appointment - it was a *lot* longer than I'd expected! I saw the midwife first - bp, urine tests, etc all fine. She talked me through several NHS classes on offer in my area, although the dates are a bit too soon for me yet. The saw the consultant who was fab - had a good poke around my stomach and listened to baby's heart. She's booked me in for an extra scan at 32 weeks, just for "reassurance", which will be great! She also explained that being consultant led shouldn't stop me me making any birthing choices I want to, and the midwife I saw said the birthing pool suite is great at my hospital!
     
  11. i was under consultant led care from 30 wks as result of polyhydramnios (severely high level of amn. fluid) and baby needing operation after birth.
    Glad to say found it positive experience, lots of extra checks, scans ,times to ask questions. You are free to see midwife too if you want. it doesn't mean an end to all that 'normal' stuff.
    In terms of labour it was also positive for me, consultant with me throughout my labour, and he also performed my emergency c section which i gues you are prob at high risk of needing? Thinkthat is a benefit if the consultant is round for that.
    Try to look on the positive .you will be well monitored from now on and they are being proactive about your care. All the best.
     
  12. Hi Biodust, I too am under consultant care for the same reason as you - unfortunately!! I have had only one extra appointment, which happened to be at my 20 week scan with a consultant at the hospital. It was a rather routine apt to be honest and then we had a brief chat about delivery options this time around. They were pretty much non commital either way when I asked for their opinion about what they thought I should do, so I was offered a CS if I wanted or NVD if I wanted (but supposedly with a v experienced midwife - not sure how they can guarantee this though!). I thibnk it depends on you, how you feel about it and if you've had any long term implications from the tear.
    They then booked me in for another apt on my due date to check progress and book in for induction. Hope this helps - I'd be interested to know if you have a significantly different experience (assuming you live somewhere different!!!) - what with the old 'hospital/post code lottery'.
     
  13. Hi biodust
    I was classified as a high risk pregnancy at booking due to asthma and being born with club feet. Was quite miffed to be honest as I'd never thought of myself as a special case and asthma's never been a bother before. Anyway, midwife arranged for me to see the consultant after the 12 week scan and he decided what, if anything, needed to be done to minimise any risks. So far its been a bonus, as we have an extra 28 week scan to check the baby is growing properly (possible effect of the medications). We're also seeing the consultant again then and I guess at that point, or sooner if necessary, they will decide what further action needs to be taken. Other than that, midwife appointments have been as normal. I guess it just depends on the individual case, but I agree with what Andi suggests. Panic not!
     
  14. Hi biodust,
    I'm under consultant care due to a bad tear like you last time. The only thing it's affected for me is that they won't recommend a home birth, which i had wanted. But i was worried i wouldn't be able to use the pool, as i loved it last time, but my consultant said i can labour in there but they'd prefer me to get out for delivery. So i'm quite happy really with how things have turned out for me. Hope you have a positive experience xx
     
  15. hhhh

    hhhh Lead commenter

    How dare it blame an illness just on your weight. My frind's got that and is a size 6 (or was). And no doubt if you don't give birth naturally you're too big, too old, too lazy, oh it annoys me!
    And for the record, in my area no one gets much advice on birth, when I asked a midwife to look at my birth plan at 39 weeks, you'd have thought I'd asked her to read a hundred page thesis...
     

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