Consultant \ Midwife led care

BOB2017

Hi all

Apologies if this has already been asked and answered but I'm just wondering about what the difference is between consultant led and midwife led care in terms of what happens at appointments etc. Will be going to the Coombe but not in their catchment area for Domino.

Thanks!

Gatica

The content of the appointments tends to be the same AFAIK. However in midwife led the centres aren't as busy so you get seen a lot quicker. One only qualifies though if you're low risk.
In consultant led it's usually at the hospital so takes longer to park, get seen, etc.. and most of the time it's still only someone from the consultant's team that sees you and not the consultant himself.

BettyBump

Hi Bob, I'm currently under the Domino Scheme in the Coombe. As the other poster has said, the difference is in the appointments. AFAIK the community mid-wife appointments are the same, just different clinic times to the Domino. So you don't have to attend the hospital, you attend the midwife in your local health centre. You'll be given a time for appointment and will usually be seen at that time. I have had to wait at most 10 mins after my appointment time. If you attend the public consultant led clinic in the Coombe you will more than likely have a wait time. I know it has improved but I can't say from personal experience. The only big difference with the actual appointment is with the midwife led, you won't get a mini scan at your appointments, which I think you get with consultant led. You get your 12 week and anomoly scans same as consultant led. I needed a follow up after my anomoly scan and I saw a consultant for that, so the level of care will be the same and if you need a consultant, you will see a consultant - this goes for the birth as well. There's a number on the website to ring for further info on the midwife led care, give them a ring if you have any specific questions.

BOB2017

Thanks for the replies - I have been put with the midwife clinic in the Coombe following my booking appointment. To be honest I think I would rather be consultant led because of the mini-scans, especially as I'm with the midwife clinic in the Coombe so will have to go to the hospital anyway.

I've found everyone in the Coombe very helpful up until now but rang today to ask a couple of questions about it and felt a bit like I was being ridiculed for saying I would like to have the mini-scans, the person I spoke to in the outpatients department seemed quite annoyed that I had even suggested it. So I now feel a bit like I'm being pushed into it and its making me quite uncomfortable.

I know many people have a preference towards midwife-led clinics, Domino etc and its not that I have anything against them I just feel a little anxious as its my first pregnancy, I'll be 35 having the baby and feel that if there are mini-scans at consultant appointments this will give me some extra reassurance as the pregnancy goes along instead of just having one more big scan at 22 weeks.

If anyone has any thoughts I'd appreciate the input although I'm currently leaning towards my OH's view of do what makes me comfortable!

lazygal

I choose consultant care for many reasons. I wanted a high number of scans, I wanted one person in charge of my care for the entire pregnancy and afterwards and I wanted a consultant looking after me. I also wanted a good shot at a private room.
I had complications on my first that meant I would have been sent straight to the public consultant system, it might have been too late to go private at that stage. Further complications meant I had a c section and my consultant did this herself as well as all follow up care. I got my private room which for me was essential for my own sanity, especially as I was in for five nights and getting to grips with breastfeeding.
I had a similar experience second time, I returned to the same consultant and had all the same level of care including her doing my section and follow up care.
I had some experience of the public system and that was enough to put me off it. It was only adequate, I felt there was a communications gap that meant I had to explain myself repeatedly and some of the nurse were not people I want to see again. There was one or two who were good but overall my experience has been than if we go again I will beg, borrow and steal to go private. I wasn't in the Coombe, but there are good and bad stories about every hospital and care option. I knew myself I didn't want midwives in charge of my care.

Orangetaster85

Yeah I felt the same re: ringing the outpatients department in the coombe. Made me feel like a piece of **** for wanting to find out why I was high risk due to high blood pressure (wasn't given my auctul results of the blood pressure at appointment) I was extremely hormonal that week so I was so upset after the phone call! Still don't know what my result was.

mrsmags16

BOB2017 wrote: »

I'll be 35 having the baby and feel that if there are mini-scans at consultant appointments this will give me some extra reassurance as the pregnancy goes along instead of just having one more big scan at 22 weeks.

If anyone has any thoughts I'd appreciate the input although I'm currently leaning towards my OH's view of do what makes me comfortable!

Hey, not sure if you have thought about it but you can get the Harmony or Panorama test done from 9-10 weeks if you are concerned about certain abnormalities (can also tell you sex, if that's another query) - it's just a blood test from yourself and costs about 300 quid, results back in a week or so.
I am private and get scans every 3-4 weeks which were brill at first but to be honest not sure how much they add - the 12 and 20 week ones plus the Panorama test were most useful for me.

BOB2017

@lazygal I'm public so I know many of the benefits that you have outlined won't necessarily apply to me, but thanks a million for the reply. I just feel a bit pushed towards it which I don't like. I think my best bet is to just go with my gut really as at the end of the day its me that's pregnant!

@orangetaster OK glad to hear its not just me. The person I got through to on the main phone line was lovely & everyone else I've come across was so nice, just this one in outpatients who might as well have called me thick she had such an attitude with me! She told me theres no point going to a consultant if you're not high risk and the mini scan just checks the heartbeat. I just wanted to know if consultants give mini scans at every appointment and had to stop her and ask could she just answer my question, to which she barked at me "that's what I'm telling you its just the same to check the heartbeat with the scan as the doppler". Really didnt like the attitude for a simple question!

@mrsmags16 I've heard of that alright - its not so much checking for abnormalities that's my concern, I just love seeing the baby in there even if its for a split second, it just makes me feel calmer about the whole process.

LirW

BOB,

I am in midwife-led care in the Rotunda and I can't fault anyone there, the girls are absolutely lovely.
The appointments are with the midwife and the GP and it's usually a rotation between the two of them. My GP does a scan everytime to check everything and the midwives are very experienced too.
Had my booking appointment in the Hospital as well as the 20 weeks scan. After that everything was carried out between GP and midwives and to be honest I'm so glad I didn't have to wait ages every time (In fairness, depending on the Midwife clinic it can be a little bit chaotic but I avoided that usually by being early).

I originally planned to go home right after birth and a midwife would come home every day for a week. And this is like the only downside I have to mention: My baby is breech and didn't turn, I'm now due to a section in a few days. You will be treated as a public patient then and can't switch into a semi-private or private scheme. Which means I have to stay now on the public ward. Not particularly looking forward to it but also not the end of the world.

All in all, if I'd ever have a kid again, I'd totally go with the midwife care again if I'm not high risk. I personally didn't feel comfortable in the whole "waiting a million hours in the hospital-thing" and I've only been there like 3 times during my pregnancy. I also don't feel like I missed something.

Oh and it's my second, but I didn't have my first one in Ireland, so the care level I received during my first was not comparable

BOB2017

Thanks a million for the input LirW, much appreciated. I was going to have to go to the hospital anyway as i'm not in the catchment area for the outside midwife clinics but I've spoken to the hospital today and switched. I felt so relieved when they said I could, so that's enough for me to know that I've done the right thing for myself