# Antenatal care in the UK



## Minou (Jul 21, 2016)

Hello all,

I have finally got BFP with DE. The treatment was done in Moscow and I am now 5 weeks pregnant. I am still taking progesterone and have been told to keep it till 8 weeks and then gradually reduce it..

The clinic in Moscow says that I need to find somewhere locally who can provide further care. 

How did you go about it, ladies? Those who had BFP from treatment abroad? Did/do you fly back for scans, consultation etc? Do you just go with the standard NHS care? Do you find an alternative fertility clinic I  the UK?
I live in Cornwall and any sort of private services are virtually non existent.

Many thanks


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## StrawberrySundae (Jan 30, 2017)

Hi congrats! I contacted my local hospital as I’ve seen the same consultant there for a few years and also contacted my GP who’s also supported me throughout my IVF. I’ve had regular NHS hospital appointments but also chose to have extra private scans due to past miscarriages. There’s probably no  need to go through a UK fertility clinic now unless you want to have scans & blood tests with them, but your GP & local hospital/antenatal clinic should be able to support you and get you on the system. I had an early private scan at about 6 weeks. All the best


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## Minou (Jul 21, 2016)

Hi Strawberry! And congratulations as well.

Thanks for your reply, and I appreciate that one way or the other NHS will get me on their system,  but I am worried that being 45 and still on a massive doze of progesterone,  I would prefer to have a bit more personal approach than standard checks by midwives.
I think  you are quite lucky that you had a good relationship with your consultant, so that he continuess to monitor your pregnancy,  but I wonder if there are other options than standard route.


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## StrawberrySundae (Jan 30, 2017)

Thanks   I’m not sure what’s the best thing to suggest, hopefully you’ll get some other responses & ideas here too! I’m still on progesterone now and will have it for most of my pregnancy. I did have a biopsy a few years ago and Professor Quenby wrote a list of recommendations for me then that my hospital consultant & GP have followed (like prescribing the progesterone & clexane etc). 

Can your clinic write a letter for you to give to your GP about your treatment & medication maybe? I wonder if it’s worth contacting another clinic here otherwise? I had some immune consultations & treatment with Mr S at the recurrent miscarriage clinic just before my latest ivf transfer and he wasn’t very happy I’d gone ahead with that at another clinic rather than wait til he told me (it turned out he was wrong and the transfer worked) but all consultants are different! I don’t think I could afford a private hospital, but that’s another idea?


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## deblovescats (Jun 23, 2012)

I had my first DD baby at 47 and my second at 49, and thankfully, both pregnancies went smoothly. I had my first scans at 7 weeks at the clinic in the UK where I had treatment, but after that I was referred back to GP and NHS. Being an older mum, you are classed as an 'at risk' pregnancy, anyway, so you have consultant led care. As a result, I had scans more frequently to make sure the baby was growing well, which was fine as I got to see the baby more often. I had progesterone until 3 months. So I don't think you have to access private care at all. Hope this reassures you.


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## Minou (Jul 21, 2016)

Hello Delovescats, and thank you for your reply. It does reassure me, indeed.
I think, I will ask for a letter from the clinic abroad, as suggested by Strawberry, and go with NHS.


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## Tincancat (Mar 19, 2012)

Your GP makes all referrals for antenatal care.  Just visit your GP.  Some areas you can self refer to the midwives but it's just as easy to get the GP to make a referral for your care.  The GP might not be willing to prescribe your progesterone so ask for an urgent referral so the hospital doctors can prescribe what you need.
It doesn't matter where you had treatment if you are usually entitled to NHS care then you will get NHS care for your pregnancy. 
TCCx


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## Minou (Jul 21, 2016)

It's driving me mad, but I can't seem to find a way to get any appointment at all 😨. I called the hospital where I'd prefer to be looked after. They say I can't self refer and it should be done through a midwife... how and where do I get an appointment with a midwife? Do I get any options of which services to choose? I would prefer to be "attached " to a hospital,  rather than a birth centre. Can I decide? Or simply would have to accept whatever I get?
I have informed my GP, and they say that a midwife would get in touch with me.
I find this hugely worrying🤯
I have booked my first private scan  but I would really like to be able to have access to doctors. Is it even possible to have all routine care in a hospital? Or is it always done in some sort of birth centres?

Any suggestions?


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## StrawberrySundae (Jan 30, 2017)

Can you make a face to face appointment with a GP? They should be able to make any referral you need or offer some help? Is there a midwife base at your GP surgery? Do you need to make a few more phone calls and pester them a bit? After all the effort you’ve already made, you deserve to be supported with this. I also went to my local early pregnancy unit at my hospital when I was worried about thrush & infections etc - a lot of sitting about and waiting but I wanted to be on the safe side.

There should be a choice of which hospital you can go to & a range of birth options. If I hadn’t gone through so much I’d have opted for a natural home birth, but not now. Hope you find some more helpful info soon x


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## Minou (Jul 21, 2016)

Thank you,  Strawberry, for your support. 
I will see my GP tomorrow and ask for a referral to the hospital antenatal unit, and hopefully he'll agree to it. Although they can be reluctant here. I think it's to do with local NHS budgets and guidance. 
I had to insist on having a second opinion from a London clinic, before the local hospital agreed to give me MRI scan when I had my cancer treatment..
How did you manage to get to the early pregnancy init I  your hospital,  Strawberry? Did get a referral as well?


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## Ms G (Aug 4, 2014)

Minou,

Please don’t worry. You will be allowed to choose which hospital you attend. You will not be forced to use a birth centre. In fact, they may not allow you to use one due to it being an IVF pregnancy. That is the case where I live. At my surgery, the choice of hospital is asked when you register with the midwife but you can change this later if you want. 

The midwife begins the process with a booking appointment at 9 weeks. He/she will collect lots of info and do some physical checks e.g blood pressure etc. No checks on the baby at this stage. Once you have been booked into the system, they will most likely refer you for consultant care. In my experience I saw a consultant every four weeks. I had no complications, this was simply because it was an IVF pregnancy, I would be 40 at the due date and my clinic had me on a low dose of Levothyroxine for thyroid. I suggest you get the process started with the midwife. Everyone sees the midwife. You will see the consultant in addition to the midwife not instead of. Hopefully, your midwife will be supportive and you will find the relationship reassuring. Mine was great. I called her if I was worried about something and together with the consultant they took wonderful care of me. 

I really would encourage you to meet the midwife. They will be able to explain the process and all the choices. You don’t have to wait for the 9 week booking appointment. Get the telephone number from your GP and give the midwife a call. 

Good luck. Ms G. x


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## Minou (Jul 21, 2016)

Thank you,  Ms G.
I am feeling much more reassured, and will push for a midwife appointment when I see the GP today.
I got some light  bleeding today, and it would be nice to get a check up and a professional advice.


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## StrawberrySundae (Jan 30, 2017)

Hi Minou, I agree with Mrs G, your midwife appointment will help get you in the system and it’s nice to go through all the routine things. I hope you manage to get it sorted soon. I’ve got a community midwife and a hospital consultant. I feel like I know more about ivf etc than my midwife but she was nice and reassuring last time I phoned her. I’ve only seen her twice and next appt is a home visit when I’m 27 weeks. I think different parts of the country organise things differently, but it can be nice to have a few scans and consultations as you’re  going along. Sorry to hear about the bleeding, it seems to be so common in ivf pregnancies, usually nothing to worry about  

About the early pregnancy unit, I kind of just walked in! It was a Sunday so I was prepared to have to wait or come back, but luckily I did get seen. After that I made proper appointments and told my Dr & consultant about the pregnancy, which was really the proper way to do it


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## Minou (Jul 21, 2016)

Thank you for your reply, Strawberry.
I got a referral fro. My GP to an early pregnancy unit., and arranged an appointment with a midwife next week.

Hope all goes well. 

Thanks everyone for your support.xx


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## Minou (Jul 21, 2016)

I had an appointment with a midwife today  but then she called me and cancelled it 2 hours before it was due... she said that the standard procedure is to have  1st appointment at 10 weeks and a consultant at 12 weeks.

She would not budge despite all my arguments and concerns. 

I don't think I can sit and wait for another 6 weeks to see a consultant. They basically leave me unobserved all first trimester.  It is scary and frustrating.

I called the GP and he said that he asked another community midwife to get in touch with me, but they all start appointments at 8 weeks the earliest, which could be fine, if then I would see a consultant shortly after, but somehow i don't think that will happen.

So I will be looking for a private scan/consultation elsewhere.  If anyone has any suggestions, please fire away, but I'll probably start a new thread in a general forum.


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## Tincancat (Mar 19, 2012)

To be honest that's pretty normal unless you have medical issues already and they will see you sooner.  This is basically because nothing much can be done in early pregnancy to change the outcome.  You should however have a dating scan at around 12 weeks. Hopefully you have enough medications and if not you may have to ask your clinic for another prescription if your GP can't help.  If you are concerned why not book yourself in for a reassurance scan with perhaps a cervical length scan and NIPT blood test such as Nifty or Harmony? which are more accurate than the NHS screening tests. A consultant will cost you a few hundred pounds yet won't do much else than I've suggested. 

I only saw consultant earlier because of needing a cervical stitch at 12 weeks otherwise I wouldn't have seen consultant until 12 weeks.  Then they don't bother with you until 20 scan and NHS doesn't become seriously bothered until baby is viable from 24 weeks of pregnancy.  It's hard to understand until you realise there is very little which can be done before viability. 
TCCx


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## Minou (Jul 21, 2016)

Thank you Tincancat,

I don't agree with nothing can be done at the early stages. You've seen your consultant earlier.. someone has referred you earlier, someone advised that you needed a cervical stitch. 

I've had an early scan on Monday, they suspected fibroids, which can grow very quickly during pregnancy due to increased oestrogen. I am taking additional oestrogen. Maybe that should be stopped to minimise complications, maybe someone can check my hormones and adjust the medication.. 

Maybe they can check if the bleeding was due to an infection? Maybe I should be taking antibiotics...

Oh, I don't know, and that's why I'd rather see a consultant to go through all the questions .

A few hundred pounds will really not make much difference in the total amount spent.  It will be much harder though to lose the pregnancy.


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## Pv7882 (Jan 25, 2017)

Hi Minou,

Pls dont worry, i can understand ur frustration. I was in a similar situation for my earlier pregnancy. 
If u re willing to go private, can u check if u hav BMI hospitals near u? One of the gynaecologists ther agreed to see me but i miscarried before seeing her.
Jus not BMI, u can check with any private hospitals like Nuffield healthcare and get an appointment with the ob-gyn ther.
Good luck and take care..


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## Tincancat (Mar 19, 2012)

I lost previous pregnancies which is why I was referred earlier as in my case cervical weakness was suspected and it needed a preventative stitch: it was done at 12 weeks and was advised after my previous losses. 

All I can advise is you what the reality is.  Later in pregnancy your body will produce far more natural oestrogen than you are taking now.  They won't reduce your dose because that could cause miscarriage.

They can swab you if you have other symptoms such as smelly discharge but they won't swab for simple bleeding as this procedure itself can introduce infection. 

I've been through it all.  It's totally up to you what you want to do.  I can only advise on the reality of early pregnancy is: one whole anxiety and nothing can be done practically. 
TCCx


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## Flossy34 (Aug 11, 2013)

I just spotted this post on the front page and thought I’d reply in case you’re still wondering about things.

I think you’re very wise to be thinking like this and looking into options for more care.
The NHS is wonderful in many ways but of course deals with ‘stamdard’ Pregnancies day in day out. I really struggled with their approach although was fortunate enough to have care with my clinic in London until the pregnancy was well established at 20+ weeks.

Are there private clinics in Cornwall?
Would London be viable by train maybe? Even if it was once a month? I had some scans at the foetal medicine centre and they were excellent there.
I presume your clinic will continue to prescribe cycolgest/gestone? You can then get that locally just so you’re not high and dry if it stops. I was on it until about 24 weeks I think but of course every case is different.
It would be worth speaking to your gp as you may find they will give it to you. Mine did although with cut backs they might be different now.
I’d defintley consider early scans to put your mind at rest and start looking into what is @available via your gp too.
They should be able to detect a heart beat via scan at about six weeks.

Hope that helps a bit but once again I do think you’re doing the right thing to look at additional care now.
I didn’t Beyond about 24 weeks and really struggled with the Nhs approach to be honest. I wish I’d spoken with a doula or a private midwife in hindsight now. I’m sure it would have alleviated some of the stresses x


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## Minou (Jul 21, 2016)

Thank you,  ladies for your input.. 

I might be worrying unnecessarily, but  I haven't had a great experience with the local care. And I think the least the midwife could do is to keep the appointment perhaps just to give me some general info, or simple answers. I doubt she received another patient instead, so she chose to cancel my appointment and have free window  rather then listen to my concerns.

I am looking at options in London,  Flossy... I tried to get in touch with one obstetrician today, but she is away till next week 🤯 .I might try to find someone else, but really don't know where to look.

I have also self referred to an NHS hospital in London. Having to travel back and forth and even relocating temporarily worries me less than a possibility of being offered no other option but to give birth in the closet hospital to me, which i dread.

Many thanks again for your support.xx


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