Obstetrician recommendation Post Reply

[Mrs.AAA]

This is my first post, so please bear with me.

I'm from the US, so the NHS healthcare system takes some getting used to for one who is used to something completely different. Anyway, I'm really early in my pregnancy, 6 weeks, and I would like to see an Ob/GYN at this stage to get a 6week ultrasound scan, as I would do were I back in the States, just to make sure everything is on track. I'm almost 36 and as this is my first child, I'm a "bit" anxious.

Can anyone recommend a great Ob/GYN, anywhere in London, presumably he/she will be central? I'm not bothered if I have to travel.

Thanks so much ...

[dudette]

The medical system here is different from the way it works in the States (I lived there for two years). Firstly and most importantly is that GPs who are the equivalent of internists in the US have a gatekeeper role so if you want to see any sort of specialist you usually need to get a referral from your GP. Secondly we don't (unfortunately) have obs/gyn doctors working in the same way they do in the US. They're much more specialist here and are attached to hospitals.

Your best bet for an early scan is to go to somewhere like the Fetal Medicine Centre which is great (you don't need a referral either). There are plenty of obstetricians who you could get referred to to look after you during your pregnancy (privately) but NHS care is generally midwife led (sometimes in conjunction with your GP). Personally I'd much rather have a midwife delivering my baby than an obstetrician as they deliver so many more.

I suggest you go and see your GP as soon as possible to talk through the options. 36 really isn't that old for a first baby round here!

[ChicagotoClapham]

Hi and welcome! The NHS is organized differently, but I've found if you do a little digging you can get equivalent support.

My advice is to go to the Early Pregnancy Units at either St. George's or St. Thomas' hospital. They are walk in clinics where you can get an ultrasound, betaHCG and progesterone tested. No GP referral needed. If you provide them with your GP's info, they will mail a copy of all results back to your GP for consistent medical record keeping.

Once you register your pregnancy with your GP, you will get all of your registration information within 2 weeks. They mail you letters informing you of your first booking appointment.That first appointment is essentially a detailed interview of your medical history.

If you do not go to an EPU, you will not hear the heartbeat or see your baby on ultrasound until 12 weeks so I highly recommend it. Something else to consider is doing private($) genetic testing like the Harmony, Panorama or Nifty test. They are non-invasive tests to look for Down's, Edwards, and PAtau's as well as some micro-deletions and aneuploidies of sex chromosomes. These tests can be done as early as 9 weeks and involve an ultrasound as part of the process so you can see your baby while waiting for the NHS process to engage.

Good luck!

[Ali_Harp]

Hi there,
It can be be so daunting when you're in a new country and dealing with a new experience. I arrived from Australia 10 weeks pregnancy and completely ignorant (if not a little frightened). Im 36 weeks now and can guarantee everything falls into place once you find the right GP or obstetrician. They will provide you every bit of info you need and support you through the process.

There is a new program run by MyHealthcare Clinic (www.myhealthcareclinic.com) who are in Battersea Reach (Wandsworth). A GP clinic that can manage your pregnancy, help you make the right choice for delivery (through either NHS v Private). They have a leading obstetrician (Dr Penelope Law who was on 'One Borne Every Minute),who sees you at the clinic if. Worth giving them a call 02070995555

Best of luck x

[pie81]

Hi

Just a word about the EPU centres at St Georges/ St Thomas's: they are primarily intended for women who have a reason to be worried that they may have miscarried ie have bleeding, pain or history of recurrent miscarriage.

So yes you can walk in but if you have none of these risk factors then you will go to the back of the queue behind those who do (which is of course as it should be when resources are limited) and you may not get seen as they only run the clinic for a few hours each morning.

If you have the money, I second the suggestion of a private scan at the Fetal Medicine centre. They are well known for their expertise in this field and they can also do tests like the Harmony test described above which is not currently available on the NHS (I would strongly recommend the test given your age). And they can also do more reassurance scans later on too.

Under the NHS you should see your GP first, you will then be referred to a hospital (you have some choice of hospital, though tbh they are much of a muchness). The next step would be your booking in appointment at about 10 weeks. At that appointment there will be blood tests but no scan or heartbeat check. This appointment will be with a midwife not an obstetrician.

If you have risk factors then you would be allocated to consultant led care but even then you may never actually meet the consultant (only more junior doctors) unless you have a particularly risky/complex case. If you have no risk factors then you will be allocated to midwife led or shared GP/midwife care.

The next NHS step would be your first scan at about 12-13 weeks. Then there are various GP and midwife checks (and doctor checks if you have been allocated to consultant care), but not that many compared with the US I think, plus a further scan at 20 weeks. You will only get further scans on the NHS if there are any concerns about growth or development.

So if you want more checks/scans than this: go private! There are various private options. The FMC mentioned above is great for scans. You can go the whole hog and find a private obstetrician for antenatal and delivery, but this is ££££ unless your insurance covers it (rare). Or you can find a private midwife, obviously they cannot do scans but can do other pre natal checks and accompany you at the birth (which you could have at home or in an NHS hospital). This is still ££ but less so than a private obstetrician.

Which GP are you registered with? The Thurleigh Road practice is very good if you are with them, I would go and chat through the options as they are likely to be familiar with private as well as NHS options.

[Nameloc]

Just to add that St Georges are currently offering the Harmony test if your combined screening comes back high risk, as part of a trial. I think the Harmony is pretty expensive to have done privately.

[Mrs.AAA]

Thank you all so much for the very detailed and insightful feedback. I feel much better. I booked in at the Fetal Medicine Center for next and I'm really excited!! I'll post again after I have my consultation and scan with feedback.

Thank you very very much...

[dudette]

Good luck with everything! I had all my scans at the Fetal Medicine Centre. They're really good and worth paying for if you can afford it, in my opinion. If you're used to the American medical system you'll find it a lot more familiar than an NHS hospital. Maybe chat to them to see if they have any suggestions for obstetric care. The first pregnancy is so exciting. I'm envious!!

[Henriettab]

i think it also really depends on where you live. if you are battersea Chelsea side i would go straight to the Chelsea and Westminster. The kensington Wing which is the private clinic is amazing.https://www.chelwest.nhs.uk/private-car ... rnity-unit


there is a great centre across the road too where you can get scans and they are affiliated with the hospital too http://www.womenswellnesscentre.com

congratulations

[Mrs.AAA]

Follow-up post to my visit at the Fetal Medicine Centre:

I had my first visit a week ago tomorrow and a sudden one today, both visits made me feel monitored, informed and well taken care of.

My first visit was to do an initial 6 week viability scan. Once I arrived and registered, I saw a doctor soon after and she was very gentle and kind.

I would concur with those who recommended this place. It's a great place and I felt really well looked after, especially as I'm so early on in my pregnancy and full of questions. I'll be getting all of my scans and tests done there as a result.
Money well spent!

Thank you Ladies again for the recommendation!!!