"Pregnancy/obstetrics"

I am currently in my second trimester and have been wondering if I should share my story or not. I have come to the conclusion that the communication surrounding my pregnancy is terrible and I believe patients, should be advised of all issues, given information surrounding their pregnancy and their options. Currently I feel I am only given information from the obstetrics team if I ask the right questions.

I attended a booking in appointment at around 15 weeks. I advised the team then that my preference is to birth naturally in Swan Hill. This is my second birth. My first was birthed naturally at Swan Hill. I have rheumatoid arthritis, so was placed in the 'high risk' category during my first birth and I had to jump through hoops and get lots of boxes ticked, before Swan Hill would allow me to birth there. At 36 weeks I was given the all clear to birth. I suppose it was naïve of me to think this would be the same process second time around.

I recently received a call from another health service telling me that Swan Hill have advised them that I was unsuitable to birth in Swan Hill. Imagine my surprise to this news, without any warning, call or communication from Swan Hill.

Later that day, Swan Hill rang me to advise me that the other health service had made the decision that I was unsuitable to birth in Swan Hill. Which first of all I find very hard to believe a different hospital would make that call. And it's the start of mixed messages, and trust being broken. When I asked why, I was told it was due to my RA. I reminded them, that this is no different to my first pregnancy, which I birthed safely in Swan Hill. I asked what risks they were worried about and I recall I was told, higher risk of diabetes & higher risk of preeclampsia. I asked why the decision was being made now, when there is still a chance I will not even get these problems? They weren’t sure, so went away to ask.

Later upon the OBs call back I was told I could not birth because I had 2 risk factors (so now I feel I am being drip fed some additional information) 1. RA, 2. I'm advanced maternal age. Again I asked what the risk factors were? I was told the same as above, but then also told there were concerns about growth and placenta function (so I was drip fed a little more information). Again, I had additional scans for all of this during my last pregnancy and I am booked in for additional scans for this pregnancy to monitor all of these factors, so I asked again why the decision was being made now, when none of this has happened or is even a problem yet. Lets be clear, I would never endanger myself or my child. But I am of the opinion that if everything progresses well and normally, then I am still unsure of why I cannot birth in Swan Hill.

I was later told that it is hospital policy that if I have 2 risk factors, then I am not able to birth in Swan Hill. When I heard this I asked, why then have Swan Hill not had a conversation with me about this, since I had informed the hospital during my booking in appointment, that my preference was to birth in Swan Hill...... By this point I was feeling furious. I was told that they wanted to see my 20 week scan results. I asked what the results told them and they said my scan was perfectly normal. So again, if that was not going to change the decision, why was the conversation now at 23 weeks, rather than after my booking in appointment?

Not only that, I have been given 'shared care' with two other health services..... This in itself is confusing, I am currently booked in at 3 hospitals to have this baby and attending 3 different OBs.

Also after my 20 week scan, I had an appointment with the Swan Hill OB (9 days after my other regional health service appointment and 8 days after my metropolitan appointment). I gave the OB the little folder for appointments, but they informed me they didn't have any communications from the other two health services... I think this is extremely disappointing 'shared care'. I don't know what the process for sharing information should be, but to have no communication I feel is terrible.

I have requested an appointment with the senior OB at Swan Hill to discuss 'what are my risks? what is the information I need to know? and what are my options? A discussion that I feel should have happened after my booking in appointment, if Swan Hill were never going to allow me to birth in Swan Hill or take on my care.

It is hard enough being pregnant, but to be seemingly kept in the dark about your care and the perceived 'risks' that you and your baby may encounter I feel is unacceptable. I believe my care information should have been shared with me, as should have the options I had. I am extremely disappointed that the hospital have not had open communication with me about my pregnancy and I think this needs to be addressed to ensure it does not happen again.