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Pregnancy

Posted By ColorfulOrca11

"Pregnancy"

About: Fiona Stanley Hospital / Antenatal Clinic, Birth Suite, Maternal Fetal Assessment Unit, Obstetrics and Gynaecology Unit, Wards 3B, 3C, 3D, 3DO, Visiting Midwife Service

(as the patient),

I am currently under care of Fiona Stanley Hospital and am sharing my story regarding the lack of a clear birth plan for my current pregnancy. I am currently 31weeks pregnant, having weekly bloods/urine tests, weekly ctgs, weekly bloods pressure profiles and at home blood pressure/sugar monitoring. 

I have multiple documented high-risk factors, including:
-Gestational diabetes with a large baby (87th percentile)
-History of severe pre-eclampsia in previous pregnancies
-Current elevated and labile blood pressure, including hypertension earlier in this pregnancy (170/100 requiring labetalol)
-GBS positive status requiring intrapartum antibiotics
-History of precipitous labour (1 hour)
-Previous postpartum haemorrhage
-Current use of anticoagulation (clexane and aspirin), requiring planned cessation prior to delivery (as per haematologist) 
-Living rural 1 hour 40 minutes to 2 hours from the birthing hospital
-Responsibility for three special needs children requiring coordination of care

Despite this, I have been advised that no induction date will be provided, even at 38 weeks, and that inductions are generally avoided unless there is an emergency. 

Whereas all 3x of my previous pregnancies at Fiona Stanly have had induction dates (provided - not requested) at 3x 37weeks, 2x ended with 35week inductions. 

I have also been advised of contingency plans that I feel are not practical or safe in my situation, including:
-Calling an ambulance in labour (without provision for my children)
-Relocating closer to the hospital (not feasible due to my children’s needs/education) 
-Seeking NDIS respite (which is not an immediate or realistic solution)
My concern is not preference-based, but safety-based. 

Without a planned induction:
-I am at risk of rapid, unassisted labour given my history (living rural with the main road down the hill being a no reception road)
-There is a risk of missing timely antibiotics for GBS
-There is no safe plan for managing anticoagulation cessation
-There are significant risks associated with my previous obstetric history (pre eclampsia) 
-There is no practical plan for the care of my children during labour

All I was requesting:
-A documented and agreed birth plan, including a planned induction window
-Clear guidance regarding timing of cessation of clexane and aspirin
-Consideration of my individual risk factors, including distance, history of precipitous labour, and prior complications

I am not seeking unnecessary intervention, but a safe and coordinated plan that reduces risk to both myself and my baby.

Now I am stuck seeking urgent review of my case with external sources to try advocate for myself and baby. I am so upset, I chose to move to Fiona Stanley because I had 3 good experiences there, and felt safe. Now I feel like my individual case isn't being assessed properly. 
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Responses

Response from Nyrene Jackson, Acting Executive Director, Fiona Stanley Fremantle Hospitals Group 4 weeks ago
Nyrene Jackson
Acting Executive Director,
Fiona Stanley Fremantle Hospitals Group

Submitted on 20/04/2026 at 5:08 PM
Published on Care Opinion Australia on 21/04/2026 at 9:45 AM

picture of Nyrene Jackson

Dear ColourfulOrca11,

Thank you for taking the time to share your experience regarding your maternity care at Fiona Stanley Hospital (FSH). I am very sorry to hear how distressed and unsupported you have been feeling. The clinical and personal factors you have outlined are significant, and it is entirely understandable that you would be seeking a clear and well-defined plan for your pregnancy and birth.

You should feel confident that your individual risks, previous history, and personal circumstances are being carefully considered, and that your care is coordinated. I apologise that this has not been your experience to date, particularly given the positive care you received during your previous births.

At FSH we are committed to ensuring all patients feel safe, supported, and cared for with compassion and professionalism. We would welcome the opportunity to work with you to establish a clear and consistent plan, so you can feel reassured and supported moving forward.

I encourage you to contact the Coordinator of Nursing for Women’s and Newborn Services on (08) 6152 0124. Alternatively, you may wish to contact our Patient and Family Liaison Service (PFLS) on (08) 6152 4013 during business hours, or via email at FSHFeedback@health.wa.gov.au, and we can arrange for the appropriate team to contact you directly.

We are committed to working collaboratively with you and your treating team to ensure a clear, safe, and supportive plan is in place for the remainder of your pregnancy and birth.

Thank you again for your feedback. I hope we have the opportunity to assist you further.

Kind regards,

Nyrene Jackson
A/Executive Director
Fiona Stanley Fremantle Hospitals Group

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by ColorfulOrca11 (the patient)

Dear Ms Jackson,

Thank you for your response and for acknowledging my concerns.

Since submitting my original post, I have been contacted by the antenatal/diabetes clinic and have now been verbally provided with a planned induction date (38 weeks + 4 days). While I appreciate that this is a step towards a clearer plan, I am still seeking formal written confirmation and a fully documented care plan.

I have also been advised during this review that:

My routine weekly monitoring (including CTGs, blood pressure profile and blood/urine tests) is to be ceased - which I am 100% not comfortable with and made this known

The OB suggested I relocate closer to the hospital, making this a suggestion of 2 OBs now

I am to present to hospital only if I have concerns or symptoms and all MAFOUT appts are to be cancelled.

I am being commenced on insulin for gestational diabetes management.

Given my clinical history and current risk factors, including gestational diabetes now requiring medication, labile blood pressure, previous severe pre-eclampsia, history of precipitous labour, anticoagulation use, GBS positive status, and significant distance from the hospital, I am concerned that a reduction in monitoring without a clearly documented and coordinated plan may increase risk.

While I understand the preference to avoid early induction where possible, I would feel more comfortable with consideration of an induction closer to 37 weeks. This is consistent with the planning in my previous pregnancies and would reduce the risk associated with rapid, unplanned labour and risks given my history and location.

I was also advised that it is unlikely I would go into spontaneous labour requiring induction, which I am finding difficult to reconcile with the decision to plan delivery close to 39 weeks, particularly in the context of my previous obstetric history.

I also have concerns over my last OB appointment where I was advised to "do what I want" when I asked when I should next have a monitoring or blood test, and that "this is your 4th child im sure you know what youre doing by now".

My last 3 experiences with fiona stanley antenatal have never been this dismissive or rude.

My concerns remain focused on:

Lack of a clearly documented and communicated birth plan

The fact multiple OBs put me on significant monitoring and now one has ceased all monitoring

Guidance around timing of cessation of clexane and aspirin in relation to the planned induction

A practical and safe contingency plan should labour commence prior to the induction date

Ensuring that any reduction in monitoring is appropriate for my individual risk profile

I would welcome the opportunity to work collaboratively with the team to ensure that a clear, consistent, and documented plan is in place moving forward, and to revisit the timing of delivery in light of my individual risk factors.

However I have spoken to multiple OBs and their opinions are all significantly different from one another. I have been referred to the social worker.

Kind regards,

ColorfulOrca11

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