high risk pregnancy in the UK

Hi, I'm wondering if any of you have had experiences with high risk pregnancy in the UK.  I'm contemplating having another child someday, and as I'm Rh sensitized and had complicated pregnancies before, I know that from fairly early on, I will need lots of monitoring and eventually, fairly tricky procedures.  Assuming the birth is successful (it would be premature almost certainly), the baby would require aggressive treatment.   Sheesh, perhaps I'm insane for even considering it at this point..:/..anyway..Must be my American stereotyping at work, but I'm just terrified that I'd get lost in the NHS shuffle, or that there would be a lack of skilled perinatologists, or any number of nightmares that I come up with when feeling paranoid.  Any experiences or suggestions you'd be willing to share? 

Hi there

I have just had my first baby and I'm RH- The midwives and doctors were very careful with me on that score and made sure I got the Anti-D shots that I needed during the pregnancy and delivery.   I would be confident of being looked after during a subsequent pregnancy.   Your experience will depend a lot on your individual doctor, midwife and hospital though.

I think you'll find that there are plenty of Rhesus negative women in the UK who go on to have fairly uneventful pregnancies.  This includes those who were sensitized to the antibodies (perhaps from a miscarriage before they realized there was a problem) and need closer monitoring.  I've checked the NICE guidelines, and they only relate to routine prophylaxis (anti-D), and not to the care of already sensitized women.  I would suggest that you discuss your case with your GP who would then be able to refer you on to an obstetrician specializing in the treatment of rhesus-sensitized women.

I am sure that, living in Fife, that the furthest you'd have to travel for top quality treatment would be the Royal Infirmary of Edinburgh or Ninewells in Dundee.

Did your doctors in the US leave you with any recommendations for the future? 

Well, my family doctor would ask every time I had an annual if I wanted my tubes tied .  The GP here has said to let him know if we are considering a child so he could recommend a risk-assessment specialist or something.   I know at least that I'd need several intrauterine blood transfusions for the baby, and that it would at least be 6 weeks premature, at least that's what I assume going by my other two pregnancies.  Since the procedures are so, well, scary and so delicate I guess if they made me nervous in the US, the prospect of having them in a foreign country with a different health care system is fairly frightening.

I suppose I'm also curious about peripheral care issues.  I assume that when I get pregnant again, my kids will be much older and we'll be closer to family, but say the unexpected were to happen when i'm up here in Fife with financial circumstances less than stellar.  Does the NHS help at all with transportation or figuring out what to do with the kids when I'm in the hospital?  In the states I wouldn't have expected anything of that nature.  As you say, fortunately Edinburgh isn't that far down the train line (though the tickets would start getting expensive .

I'll have to google 'NICE guidelines', i'm not sure what they are.

Nope, the NHS does not help with things like transport or child care.

The NHS does help with travel costs, but your financial situation has to be fairly dire before this help kicks in.

To answer your original question about NHS care in high risk pregnancies - I think this is second to none, and very research-based.  This is borne out by WHO infant and maternal mortality and morbidity statistics (which generally outdo those of the US).  If you need specific information on your particular condition, it is best to discuss your personal situation with the specialists who are likely to be involved in your case.  You are not going to get high quality information from a public bulletin board.

I suppose I'm also curious about peripheral care issues.  I assume that when I get pregnant again, my kids will be much older and we'll be closer to family, but say the unexpected were to happen when i'm up here in Fife with financial circumstances less than stellar.  Does the NHS help at all with transportation or figuring out what to do with the kids when I'm in the hospital?  In the states I wouldn't have expected anything of that nature.  As you say, fortunately Edinburgh isn't that far down the train line (though the tickets would start getting expensive .

Scotland's NHS may not help with travel costs(it depends on region, I know there is n/thing provided for those in Edinburgh) if you need to go to another hospital, so please consider this carefully and discuss this with your care providers before you begin trying for a child so as to determine how best to responsibly deal.  If you have poor financial circumstances your care providers can refer you to a social worker who can help with securing respite care for your kids or foster care if need be.  The NHS is there to deal with your healthcare; matters such as finances and childcare fall under the domain of your council's social work department.

Not to sound callous but why are you considering having another baby knowing what your circumstances are?  If you can't afford to care for the 2 you have and wouldn't even fathom asking for this type of assistance in the US, why are you expecting something different in the UK?  If your GP suggested having your tubes tied, there's probably a good reason for it.

Maybe a bit harsh - I didn't get the impression that elly-ah was expecting anything - she was just asking if there's any help with childcare if she goes into hospital - this would be an issue for most people with children, especially liiving a long way from close family.

Maybe a bit harsh - I didn't get the impression that elly-ah was expecting anything - she was just asking if there's any help with childcare if she goes into hospital - this would be an issue for most people with children, especially liiving a long way from close family.

Yes, but I can see Kristi's point.  As a mom myself, I wouldn't dream of having another baby so long as my financial situation were so precarious that I'd have to ponder state assistance to look after my daughter.  In fact, that's why we've put it off as long as we have.  As far as deliberately bringing a child into the world knowing its health will be seriously compromised by extreme prematurity, well, that's a whole different ball of wax . . .

Maybe I've misunderstood - I thought we were talking about help with childcare for a day or two while she is in hospital, not ongoing day to day childcare assistance.

Anyway if we are to believe what we hear, the governemnt will be introducing child care allowances and suchlike in the next few years ...

Anyway if we are to believe what we hear, the governemnt will be introducing child care allowances and suchlike in the next few years ...

Yes, they want us all back at work as soon as possible so we can pay taxes.     But I'll believe it when I see it. 

No, in all seriousness, if a mum-to-be falls ill w/pregnancy complications that require hospitalisation, and has no respite care for her other children, her case will be referred to a social worker. 

Maybe a bit harsh - I didn't get the impression that elly-ah was expecting anything - she was just asking if there's any help with childcare if she goes into hospital - this would be an issue for most people with children, especially liiving a long way from close family.

I understand if issues come up unexpectedly but going into a pregnancy knowing full well that there will be complications?  I wouldn't do it.  I don't understand why someone would do it.  I understand wanting to have more children and I don't begrudge her that but to ask if NHS will pay for her respite care and transport?  Especially when she admits to not expecting it in the US.  Getting pregnant or planning a pregnancy in those circumstances is irresponsible, IMO. 

Just to point out.. she said she was "curious" about peripheral care and also wanted to know if the "unexpected" happened would the NHS help.  I wonder how the converstation got from someones curious question to one of judging behavior?

She did not say she was going to have a child while she was poverty stricken.  Besides which.... even if she was desitute does being poor mean that you can't have children? 

I wasn't aware that I'm not supposed to give my opinion in a thread that's not in Pettifog.   Think what you want about me.  I'm not a mean person nor unfeeling.

Whether elly-ah is curious or not, she's considering having another baby.  If I was in that circumstance, I wouldn't have another baby.  And I certainly wouldn't expect NHS to provide respite care for my other children whilst being well aware that I put myself in this situation.  I don't have anything against NHS providing services for people, especially in unforeseen circumstances.  However, this isn't unforeseen.  She's well aware of what may happen, based on her previous history.  My opinions have nothing to do with money.  It has to do with personal responsibility as a parent.  If the "unexpected" should happen, she and her husband should have some sort of plan to arrange for care of their children and not necessarily depend on NHS or social services.  Respite care should be a last resort.  Again, not a judgement, simply an opinion.