Advice needed - importance of consultant/hospital care etc

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Tragen Posts: 370
Ladies I need advice based on your experiences. DH and I are planning to start our TTC journey in a few months time, and as we living abroad and have not yet interacted with the health care system here other than taking out insurance, I thought I best do some research. It appears that other than seeing a GP to confirm BFP, I will not see a doctor through out the pregnancy, no consultant appointments, no blood tests etc. An echo at 20weeks. They encourage home birth and if you really don't want this (which I definitely don't) you have to organize a hospital yourself. I think I would like a natural birth, just as well as they don't like to give pain relief (only 10% of women are given it). So my question is... based on your experience, would this set up sit well with you? I currently feel very uncomfortable with this, it is very basic care, but I would like opinions from you ladies who have or are currently going through pregnancy yourselves. Thanks in advance!
Bigsurprise Posts: 961
I'm sure others could answer this better than me but here's my thoughts. In Ireland mid wife led program's are very popular where all care apart from initial hospital appointment where a patient sees a consultant are cared for by midwives only. So to me I suppose it's not necessarily important to get consultant led care. However obviously this isn't clear cut. It wouldn't sit well with me to not receive the necessary hospital expertise. To me the GP visits are a back up to this expertise.
babyblaBBer Posts: 2448
for me i like seeing the consultant every time, he knows me, knows my history, feelings, fears etc and will defo be at the birth. he will stitch me up if needed which is quite important to me and i get a scan at every visit which i find very reassuring. i know loads of people who rarely if ever saw a doctor throughout their pregnancy and all went well so it's very personal to you. i think though i would pay for a private scan at around 11 weeks as i couldn't wait until 20 weeks to see the baby and find out that all was well, and another scan towards the end, as my cousin had a very bad experience where they didn't realise her baby was breech until she was in labour. rare but a simple scan would have picked that up.
strangeangel Posts: 1269
Not sure about the no blood tests (they don't check iron levels, STD status, rubella immunity etc?), but seeing midwives only (which is I guess what the situation is) is perfectly fine for me. I did midwife led care on first and on this pregnancy and have nothing but praise for them. I'm sure that should complications arise, you will have access to the necessary medical experts, but for standard care and delivery on a healthy pregnancy, I have no problems seeing only midwives. I can understand your not being comfortable with homebirth, but I think the good thing about a natural approach to delivery with no pain relief for the majority is that it means the midwives are equipped to help you deal with that way of delivering, and there's lots you can do to alleviate the pain. I think the most important thing is that you feel comfortable with your level of care, and hopefully you'll be able to talk through all your questions and concerns to get the information you need to feel happy with how things go.
Anne Cordelia Shirley Posts: 4731
I think blood tests are a must. Before TTC it is recommended to have your immunity to rubella, chicken pox etc checked and I also had bloods done with the hospital at my first appointment. This second set of tests showed up a low blood count so I've been put on iron-has made a difference to my energy and will help if there is blood loss, but it was my consultant who explained this to me. I am going private and see my consultant at each visit, during which I can ask questions, she checks my weight, does a mini scan, checks urine (important to check for signs of protein etc in urine) and generally makes sure I'm doing ok. I could have combined her visits with my local GP but I want to maintain the continuity of care with her. I've had an anomaly scan at 20 weeks and will be back for another at 34 (as I have an anterior low lying placenta). I have no option to go with a midwife led scheme due to where I live. I have mixed feelings on home births, especially if its the first child. I would also wonder how any issues like my low lying placenta would be dealt with or how your urine/bloods are monitored. I've had one or two issues spotted through these tests and luckily they have been able to be sorted with minimum effort at an early stage. If hadn't had them done I'd be in the dark. I personally like having the backup of a consultant led system and purposely chose to go private because I wanted a certain level of care. It is a very personal decision but I would rather have my pregnancy monitored the way it is being done than just 'let nature take its course' and not seeing a doctor. I mean, for a lot of other conditions (not saying pregnancy is an illness but it can have serious consequences) you wouldn't just see a nurse, you'd want to see a doctor and be under that kind of care. To be honest, I personally would not be happy with the level of care you've outlined for me and my baby. But that's me, not everyone is the same.
wollysocks Posts: 1773
That sounds extremely basic- are you sure this is all you get? As others here have mentioned- in public health system-you would go to gp and confirm pregnancy. The gp or yourself then sends letter to your chosen hospital re your pregnancy. You have booking visit with hospital/ community midwife where they check your bloods for iron levels,immunity to ruebella, AIDS (I think) and syphilis. Also to establish if you are Rhesus negative. In most hospitals you get a dating scan at 12 weeks and the anomoly scan around 20 weeks. Combined care is common- shared between gp and hospital- after 20 week and increasing as your pregnancy progresses- after 30 weeks I think you have alternate appointments every 2 weeks. I personally think the public health scheme is very good in Ireland- there is a very very low level of deaths here and if you or your baby is in any danger, you of course see a consultant and get the very same emergency treatment as a private patient under a consultant. I wouldn't have a problem with mid-wife led care- even under consultant led care- the midwives do all the work at the birth....mid-wives are perfectly capable and trained to manage normal pregnancies- which is the vast vast majority. If midwives see a possible issue, I imagine then a doctor would be brought in...they are concerned for your safety. Home births are more common in some countries like Holland that are more advanced than Ireland in terms of supporting this. Giving birth is a natural event and many women would prefer this option. Only 10% getting pain relief seems low but there are pros and cons for some pain relief- my midwife at birth was German and said that way more Irish women get pain relief than in Germany...and I dont consider Germany would be backward in this area. Similarly, a doctor friend told me that foreign women she had seen given birth were much more tolerant of pain than Irish women! So where you are may have a different system to Ireland but it may be well resourced and just have a different focus- one could argue that birth in Ireland is too medicalised with a lot of interventions if you know what I mean....good luck with it- try and talk to women who have given birth there would be your best bet and see what they think....
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