How often do we need to see doctors/midwives before 20 weeks? - Mothering Forums

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#1 of 19 Old 09-02-2013, 05:54 PM - Thread Starter
 
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I'm currently 15 weeks and a few days pregnant and so far everything has been very easy, aside from basic exhaustion and mild nausea during first trimester (and a very frustrating sudden aversion to Thai curry!). I've been careful with my diet and general health- lots of walking, lots of veggies, etc.

 

The thing is... my husband and I are in a massive transition period (literally), having left our jobs in Shanghai when I was about 7 weeks pregnant. We didn't want the baby to be born into such a polluted city, nor did we want the pregnancy to continue there when air quality readings were dangerously unhealthy. I didn't go to a doctor while we were there because, frankly, being at the high end of normal weight and nearly 39 years old, I didn't fancy getting yelled at by doctors who thought women over 28 years old or bigger than a size 8 were in serious dangerous of killing themselves and their baby (it happened to friends).  I did talk to a close friend who is a paediatrician and she said as long as I hit the 12 and 20 week scans, I'd be fine unless something notable developed. The 20 week scan would let me know what I needed to do next, regarding pre-natal care.

 

Since we left China in early July, we've been bouncing back and forth between Canada and the UK (he's British, I'm Canadian), trying to sort out a residence permit for me to move back to the UK with him to be near family. Until then, I'm technically a resident of no country, as I'm not in Canada long enough to qualify for medical care (you need to be back here 3 month to reinstate residency). It makes getting an obstetrician/midwife very very hard. We tried getting me an appointment when we were in the UK on a tourist visa but the fact that I wasn't going to be there uninterrupted until the birth made the obstetrician annoyed with me, even though I explained to her that I wasn't trying to be difficult, I just needed time to get my visa sorted out. All I wanted was to make sure everything was okay. We ended up going to a fancy private clinic in London's Harley Street and paying cash for the 12 week scan/nucchal test and everything was just fine.

 

Now we are back in Canada, waiting for my UK visa and I don't know what to do. I can't enter the Canadian system as we will only be here a month, max. I haven't lived here in years so I don't even have a GP to talk to. We are looking into getting the 20 week scan done privately and acting accordingly based on those results. 

 

Am I being irresponsible? I'm feeling fine, belly growing bit by bit, and intend to get a midwife as soon as we are settled in the UK (around 20-25 weeks). Any suggestions for what I can/should do, being so in limbo?

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#2 of 19 Old 09-02-2013, 06:40 PM
 
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I saw my midwife at week 12 (basic check-up plus nuchal), week 16 (basic check-up), and week 20 (check-up plus anatomy scan). I don't think you are missing much by skipping the week 16 appt. When I say it was basic I mean really basic. How are you feeling? Any questions? Are you taking your prenatals and drinking plenty of water? That kind of thing. We got to hear the heartbeat with the doppler but really, lots of women skip that and you just heard it at 12 weeks. I think the biggest thing is, who can you call if you do have questions or feel unwell? Hopefully you won't need it but I think that is more mportant (or would be to me) than the 16 week appt. Hopefully someone with experience in Canada can assist you there. I definitely don't think it's irresponsible to wait until 20-25 weeks to have your care provider in place. The unfortunate truth is that if anything went wrong before 25 weeks there's not much they could do for you anyway, so your prenatal care at this point is really just some testing but mostly taking good care of yourself and waiting it out. Good luck!

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#3 of 19 Old 09-02-2013, 07:06 PM
 
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Sorry for the stressful situation, sounds crazy!!!! I use a midwife for my prenatal care, and there wasn't a lot that was done prior to 20 weeks, other than checking my weight gain, heartbeat, and some blood work (iron levels, etc.). The trick with paying for the 20 week scan is that they need an ob or midwife to send the results to. Maybe there are places that can do it differently, but around here, they won't just give you the results, you "get them" from your care provider. Maybe at a hospital?

If it were me, I would just wait until I was settled in the uk to be seen. I have low risk pregnancies and boring appointments, ha! My blood pressure is always low, blood work normal, baby's heartbeat fine, etc. You could check your blood pressure at those free DIY kiosks at pharmacies. Track your weight gain so you can share it with your provider when you get one, helps establish that you are educated and taking care of yourself too. If you feel baby move before your appointment, write that down, take your prenatal vitamins, etc. That is what they would have you doing anyway!

Hugs for a quicker than expected transition!!!!

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#4 of 19 Old 09-02-2013, 08:51 PM
 
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You could always visit a walk in clinic in Canada, except I'm not sure that is necessary unless you're having any issues. I've just gotten confirmed with a midwife practice and even our "first meeting" appointment (which is basically chatting and taking your health history) isn't till 10 weeks. I believe the appointments are once a month till you're 28 or 32 weeks or so, not very frequent because not much tends to happen early in pregnancy! We are not planning to do the early scan so we technically don't need to see them till about 20 weeks or so anyway. I think last time it was at the second or third appointment (so 3-4 months along) that they did a bunch of blood test to check my iron and get a baseline for some things). Sort of around that time we listened for the heartbeat too, but none of those are that crucial I don't think. It is good that you will be settled for the last trimester because that's when things can start happening.

 

One thing you might consider is to look up some urgent care or walk-in clinics near where you are staying (not sure what the equivalent would be in the UK) so that in case you have bleeding or any issues come up with the pregnancy you will have the info at hand and won't have to scramble to try and figure out where to go.

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#5 of 19 Old 09-02-2013, 09:03 PM
 
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is there a red cross center near where you live or some sort of set up to deal with the health care of illegal immigrants or people out of work and living rough on the street ? they might now where you could be seen for your pregnancy needs ...  i don't know how it works in Canada, but when i switched countries quite a while back and was like you "in between" health coverages, i still managed to see a gynecologist & didn't have to pay (it was financed by the region) ... on the other hand, it's true that there's not much that needs doing for the first half of the pregnancy ...

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#6 of 19 Old 09-02-2013, 10:59 PM - Thread Starter
 
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Thanks everyone. So far everything feels just fine but I just couldn't help thinking that maybe, just maybe I should be doing more. I have found a walk in clinic not far from here that does maternity, just in case. I haven't gone in yet because, well, I don't know why I would need to. Everything is pretty ordinary for now. Otherwise I'll just keep on doing what I'm doing- I'm tracking my weight, taking my vitamins, etc. Crossing fingers for now!

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#7 of 19 Old 09-03-2013, 01:52 AM
 
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Hi Nobaru. In the UK, unless there is a problem, I think we normally see midwives at 12 weeks for the scan and 20 weeks for another scan. You might also have a blood test in there somewhere. In three pregnancies I've never seen a doctor, only midwives. You'd then, from around...30 weeks, I think? ...start seeing a midwife once every few weeks, increasing to once a week nearer the birth. I did opt for the most midwifery led care option-you certainly could push for more if you wanted-but that was fine for me. Just to give you an idea of what you'd get if you were actually UK resident. I'd say that if you feel well in yourself, most UK women have very minimal care to around 32 weeks. It was a tiny bit disconcerting actually!

 

What I also wanted to ask, in case it helps, is whether you've considered using an independent midwife in the UK. I think the cost is around £3-5k, but that would include the birth. Obviously you don't have to be UK resident to do it. What I don't know is whether, if you had to have hospital care during the birth, eg an emergency transfer, you would then be charged for it-I'm not sure whether the UK charges people for emergency care. It would be after the fact though-all UK emergency care is free at the point of service. I am pretty sure emergency care itself is free-so that would be the birth-but if you had to receive inpatient treatment, I think you have to pay.

 

Total curve ball thought and odds are you have considered it but thought I'd throw that in there.


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#8 of 19 Old 09-04-2013, 06:42 PM - Thread Starter
 
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Hi! And thanks for the UK specific info. Appreciated. We're still trying to figure out exactly where we will end up (depends on where his job search takes us, as a prearranged job is a prerequisite now for spouse residency visas) so it's hard to research facilities and midwives. It's pretty weird being in limbo whilst pregnant! We did go the private route for the 12 week scan and wouldn't be averse to doing it again if needed. To be honest, I'd be happy with just a basic midwife and birthing centre set up, if possible. I like how low key it's been so far due to not being geographically stable enough to get regular checkups, but I don't want to be stupid and jeopardize the baby's life (or mine). Hopefully, my visa will be quickly processed so I can qualify for the NHS before it's too late. Crossing fingers!

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#9 of 19 Old 09-04-2013, 11:52 PM
 
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HI Norburu. Sure you have access to this info anyway but my understanding is that you have to be planning to settle permanently in the UK to use the NHS. Even a British citizen returning from overseas can't use the NHS if they are back temporarily, assuming they have been away for a few years. That's my understanding and there may be loopholes. Assuming you have some proper situation specific advice anyway.

 

We don't tend to have private birthing centres here afaik, independent midwives tend to operate out of clients homes. But some of them are very good (and some less good. You have to shop around)


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#10 of 19 Old 09-05-2013, 02:20 PM - Thread Starter
 
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Interesting. I lived in the UK about ten years ago (on a 2 year working holiday visa as a 20-something) and had full and immediate access to NHS. Maybe things have changed. The spouse visa we are applying for is of the sort that leads to permanent settlement but starts at just 2.3 years residency (including right to work), renewable. We were told that it should get me a national insurance number etc and qualify for healthcare. If not, we can afford to go private for the first three months before it kicks in. I'm due late Feb and we're aiming to be there by October or early November, max. Crossing fingers. We can't stay here in Canada as I can't sponsor him (long story, stuff about residency, my own recent income history here etc) so we need to find somewhere he can work while I'm very pregnant and beyond. It's so complicated!

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#11 of 19 Old 09-05-2013, 02:40 PM
 
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Things have changed somewhat in the UK, specifically re immigration. Its a political hot potato. I'm sure you would do this anyway but do get it checked is all :-)


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#12 of 19 Old 09-05-2013, 04:47 PM - Thread Starter
 
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I just double-checked and this is what I've found, in case anyone else needed the info. I highlighted the bit I think (hope!) applies to me once my spouse visa is sorted:

 

Quote:

You can get free NHS hospital treatment if you are lawfully entitled to be in the UK and usually live here. This is called being ordinarily resident.

 

Some people from abroad who are not ordinarily resident in the UK can receive all NHS hospital treatment free of charge. If you are entitled to free NHS hospital treatment, family members including your spouse, civil partner and dependent children will also be able to get free treatment, but only if they are lawfully allowed to live in the UK. In many cases, they must also be living with you throughout your stay to qualify.

 

You can receive free NHS hospital treatment if you:-

  • have been living legally in the UK for at least 12 months when you start treatment, and did not come to the UK for private medical treatment. Temporary absences from the UK of up to three months (in England, up to 182 days) are ignored
  • have come to the UK to take up permanent residence, for example, if you are a former UK resident who has returned from abroad, or if you have been granted leave to enter or remain as a spouse
  • have come to the UK to work, either as an employee or self-employed person. In England and Wales, if you are employed, your employer's main place of business must be in the UK or be registered in the UK. This could be, for example, a branch of an overseas company. If you are self-employed your main place of business must be in the UK
  • normally work in the UK, but are temporarily working abroad for less than five years. You also need to have lived in the UK continuously for at least ten years before going overseas.
  • In Scotland, you normally work in the UK but are temporarily working abroad. You must have lived in the UK continuously for at least ten years and taken home leave in the UK at least once every two years. However, if you are studying abroad you may not be entitled to free NHS treatment
  • are receiving a UK war pension
  • have been granted, or made an application for temporary protection, asylum or humanitarian protection
  • in Wales, have applied for asylum
  • in England, are an failed asylum seeker in certain circumstances, or in Scotland and Wales, are a failed asylum seeker
  • in England, are a child the local authority has taken into care
  • have been identified as having been trafficked from abroad or are believed to have been trafficked from abroad
  • are imprisoned in the UK or detained by UK immigration authorities
  • get a UK state retirement pension and live in the UK for at least 182 days a year (in Scotland and Wales, six months a year) and live in another European Economic Area (EEA) member state or Switzerland for the other part of the year. If you have registered as a resident of another EEA state or Switzerland, you may be entitled to free NHS hospital treatment if you fall ill during a trip back to the UK
  • are from a European Economic Area (EEA) country or Switzerland and have a European Health Insurance Card (EHIC). The EHIC does not cover coming to the UK just to get medical treatment but it allows you to get free care if you're referred to the UK for pre-planned treatment with an E112 or S2 certificate
  • are a student following a course of study which lasts at least six months, or a course that is substantially funded by the UK, Welsh, Scottish or Northern Ireland Governments.
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#13 of 19 Old 09-05-2013, 04:55 PM
 
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Hi Noboru. Its the issue of permanent residence that is tricky. I seem to remember you saying you were only planning to stay for a while. 

 

 Its a very, very long time since I did this stuff too

 

Listen, that looks like a wiki page? all I'm saying is personally, I'd double check this with a lawyer. I'm sure you are anyway, especially if you're applying for a visa.

 

Just trying to help :-) . Best of luck to you.


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#14 of 19 Old 09-05-2013, 05:04 PM - Thread Starter
 
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Thanks- and yeah, I know how weird and complicated and restrictive it's become in the past few years to secure residency through partners/spouses. A few of our friends and colleagues in other countries have tried and some were successful and, well, others weren't (but they were a bit more complicated- Chinese-UK same sex partnership, with UK partner being student not currently earning minimum requirement...). We're hoping ours will be okay as we're a fairly straightforward textbook case with all financial documents/requirements in order. If not, we have other options. We would just prefer this one so we can be near friends and family. Crossing fingers!

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#15 of 19 Old 09-12-2013, 07:01 PM
 
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Hi I'm a midwife and the only piece you are missing of your early pregnancy care (but it's a very important one) is to get your bloodwork done. See if there is a private clinic or urgent care that will order a "prenatal panel" of labwork for you. This should include:

 

CBC - Iron levels

Blood type & antibody screen

HIV, Syphilis, and Hep B

Urine chlamydia & gonorrhea

Rubella antibody

Urinalysis and Urine culture

TSH (Thyroid)

1hr 50-gram glucose test

 

If those come back normal, along with your 20 wk scan, then you should be ok to wait until 25 wks to be seen again. But they are quite important; please do make the effort to get those done - for your baby's sake :)

 

Congratulations and best of luck with your pregnancy!

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#16 of 19 Old 09-12-2013, 08:00 PM
 
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The 50 g glucose challenge test is generally not done until 28-ish weeks.

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#17 of 19 Old 09-13-2013, 03:39 PM
 
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I'd get a pregnancy CBC and start monitoring your blood sugar if you're close to 28 weeks. Also monitor your blood pressure. In the states you can go to a pharmacy to get your blood pressure checked. It's not perfect, but it could alert you to any early signs of pre eclampsia.

ETA: sorry, somehow I didn't register that you are only 15 weeks. Yeah don't worry about prenatal stuff until 24 weeks or so. Still get your anatomy scan at 20-22 weeks, and a CBC. My midwife/OB practice won't see you till 12 weeks, and then it's just for blood work
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#18 of 19 Old 09-13-2013, 06:09 PM - Thread Starter
 
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Thanks! Much appreciated information. I've been monitoring my blood pressure at the pharmacy (it's comfortably at the low end of normal- 116 over something, I forget offhand) and keeping track of my weight. Doing lots of reading to make sure I'm up to date on what needs to be done (I think). We're going to go to a local walk in clinic soon to see if I need any of these tests done anytime soon. I just hit the 17 week mark so it's time to start thinking about the 20 week scan and all.

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#19 of 19 Old 09-21-2013, 08:14 PM
 
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Regarding the glucose test - Noboru, because you're both an older mom and also at a higher weight, it is recommended to get an "early" baseline glucose test to check for pre-existing diabetes - as well as the usual one at 26-28 wks. Good luck with the pregnancy!

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