Routine NHS care/scans etc

[buddabun]

Hiya

I'm just trying to determine what the average normal pregnant woman will have during her pregnancy. I know there is the 'dating' scan at 8-14w which checks for measurements, placental position, some physical abnormalities and checks the baby's development

and then the 'abnormality' scan at 18-21 weeks which checks for abnormalities like spina bifida, Down's syndrome etc and determines gender (in some places).

Is this it? Is the nuchal translucency test offered to everyone or just 'high risk' mothers? Is this a separate scan or done with the abnormalities scan?

What about midwife appointments - how often and what happens?

So far I have had one (around 7w) where they took blood to check for HepB, blood type, rubella immunity and diabetes. They also took a urine sample (presumably for signs of infection and proteins/sugars) and weighed me, took our family histories and gave me advice.

How often do you have midwife/antenatal appointments and what do they usually do/ask?

Sorry for the huge amount of questions, I am just trying to compare the NHS service with the service we get out here and determine what I will have to go private for.

Thank

 

[KikoDinoGirl]

The nuchal scan in my area is routine - but I don't believe in most. So I am low risk but still offered it. I then have a scan in March which is the abnormality scan, but not sure past that!

Your first midwife visit sounded very much like mine.

 

[buddabun]

I read on the NHS website that 'testing for Down's syndrome' is offered to all pregnant women regardless of age etc. But it didn't specify whether this was the NT scan or blood tests or combined. I get the impression the blood test is available to all but it varies with NT?

Thanks Kiko

 

[KirstyD]

Hi hun, i thought this might help you:

It's a print out i was given by my midwife to show all the standard appointments you should get (this is in my area, things do seem to vary across different authorities!)

My area offer the nuchal scan for downs, you have this at the same time as your dating scan. Not all places offer this as standard yet, you'll be offered blood tests i think around 16 weeks if your area doesn't do the nuchal scan!

 

[splashmonkey]

The two scans you've mentioned are usually it on the scan front, unless there's any reason they have to do later growth scans (e.g. for smokers etc.) or, as in your case, early scans. The abnormality scan doesn't usually check for down's I don't think, I'm not sure how they could tell - it's just generally for any problems in development.

The nuchal translucency, if you get it, is usually done as part of your 12 week scan - it's just a matter of measuring behind the neck and means that you get a longer scan and they have to make the baby move! In the UK it's currently offered only in certain areas, they're in the process of slowly rolling it out across the country. Whether or not you're offered it has nothing to do with risk, just where you are. In fact the scan result is what tells you if you are at high or low risk - it's not as simple as age or whatever any more, which is why they do these early tests now. Again, depending on where you are, the NT scan may be combined with blood tests (in whcih case they take the blood on the same day adn don't tell you a result until the bloods are back), done on its own (in which case they tell you the resutl on the day normally I think) or, if not done, you'll have a blood test instead, which can be done anytime between 12-16 weeks as far as I can tell, as opinion seems to vary. If they determine that you're at high risk, they'll offer you further tests, e.g. amnio/CVS, which you don't have to have and which have some risk of miscarriage as they're more invasive.

Blood test wise there's one main round of tests in the early days, again variously done between 8-16 weeks, where they test for all the diseases/immunities you mention. I think they test again at 24-28 weeks or something like that but I can't remember what for. They also might give you a glucose tolerance test depending on risk of diabetes (but it sounds like you already had that). At every appt (round here anyway) they check your urine for protein and sugar, but that's just weeing on a stick while you're there.

Midwife appts in my area are the same as on Kirsty's list - they're all just check ups really, listening to the heart, checking where your uterus is to see how the baby's growing, talkign to you about plans and any problems, checkign your blood pressure. There's nothing really specific that has to get done assumign all goes as normal.

TBH things aren't that great over here either in terms of frequency of care! It depends on your risk factors. I have to see a consultant as well, but if he keeps me at high risk I think that will replace some of my mw appts, so it's just a case of at what level your care is being managed.

HTH hon!

 

[buddabun]

Kirsty that's ace thanks so much for that!!!

ETA: Thanks for that splash (just seen your reply)

12w scans here are not routine (she looked at me very oddly when I went to book mine today ) but I think that's the only difference.

The diabetes thing was odd - they didn't do a glucose tolerance test as such, just a fasting bloods (i.e. one blood sample, no glucose to drink or anything). She said it was a one off (thank GOD!)

Thanks ladies you have been so helpful

 

[Nicky_Jones]

It's a print out i was given by my midwife to show all the standard appointments you should get (this is in my area, things do seem to vary across different authorities!)

I saw this and thought wow that looks just like the print out I was given when I was PG with Ellie. I then noticed you are in Reading. It is the same printout I had as I lived in Wokingham and came under RBH.

I still haven't had an appointment with anybody though I have spoken to the MW over the phone so I could at least ask her some questions where I had concerns. I don't get my first appointment until I am 10weeks. I just hope that Salisbury hospital is less busy than RBH otherwise I doubt I will get a dating scan before I am 13 weeks.

 

[splashmonkey]

Don't worry about your scan, Nicky, it's not necessarily the case that the mws don't request them till they see you. I was really panicking as I didn't see my mw till 11+4 and still hadn't had a scan date, but she gave it to me when I got there for like three days later! She said it was becuase they have to talk to you about the nuchal scan and get your consent, so they don't send out the date in advance. Crap I know! But anyway, even if not for that reason, you still might find that your date has already been booked or something. Or they'll just send it in the post.

 

[Bec78]

Kirsty's printout is roughly the same as ours now.
It used to be that you were booked in at 12/13 weeks and only had a 16 week scan unless there was a medical need for further scans.
But now our NHS trust has made the 12 week nuchal scan and 20 week scan routine and scrapped the 16 week scan.
So we're booked in sooner (mine is this Thursday when I'll be 7+6), and we get scanned at 12 weeks and 20 weeks for the anomoly scan.

Once you get to 34 weeks you see the mw every 2 weeks. Some areas like you to alternate between the MW and GP, some areas you have to see the consultant at least once.
I'll have to do this because of health problems (I've got spina bifida), they usually make me go at least once, but usually sign me off to the MW unless anything else crops up.

If you're considered a high risk pregnancy, you see the consultant more often.

 

[KirstyD]

It's a print out i was given by my midwife to show all the standard appointments you should get (this is in my area, things do seem to vary across different authorities!)

I saw this and thought wow that looks just like the print out I was given when I was PG with Ellie. I then noticed you are in Reading. It is the same printout I had as I lived in Wokingham and came under RBH.

I still haven't had an appointment with anybody though I have spoken to the MW over the phone so I could at least ask her some questions where I had concerns. I don't get my first appointment until I am 10weeks. I just hope that Salisbury hospital is less busy than RBH otherwise I doubt I will get a dating scan before I am 13 weeks.

Ahh small world, i live in Winnersh! I know what you mean about the RBH being busy!! I had a nightmare trying to arrange my dating scan and nuchal within the required times as they didn't have any appointments within 3 weeks!! Had to phone the antenatal sister in the end who sorted in the end!! Hopefully Salisbury will be better for you!!

 

[Nicky_Jones]

Thanks Splashmonkey, hopefully they have, or maybe they just know that the resources aren't so busy as Reading.

Hi Kirsty, speaking to the MW on the phone it sounds like they aren't as busy in the area. Due to how stretched they are with staff I only just got my homebirth last time by the skin of my teeth, I was asking how many they have on call for homebirths and she said there was 5 of them covering our new area. IT was only 2 covering our old area and they kept getting called onto the ward when they got too busy. A few minutes after the MW was called to come to me, he was called to go into the ward. Thankfully he told them he couldn't because we was going to attend a homebirth.

 

[buddabun]

thanks guys. It looks like most things are normal except for the lack of a 12w scan.

I will look into getting that privately.

Is it just me who, if money weren't an option, would go for u/s every week... I am already curious to see how much buddabean has grown. Imagine the days before u/s when you had to wait a whole 9 months to see your baby

 

[Jaded Diamond]

I would so go and have one everyweek! lol.
xx

 

[splashmonkey]

So totally, budda - every day I reckon lol!