Wednesday 17 August 2011

The Doctor Will See You Now

In England how your pregnancy is managed depends on your area. In our area you are normally managed by a community midwife and if you have any complications, you will probably be under consultant care, but may only see the consultant once or twice. In our area you can just call your surgery and book in directly with a midwife. I, however, did not know this and went to see my GP. My GP at the time, wasn't known to me, I'd only just moved to the practice and hadn't had a need to see one. I knew from town gossip that whilst well respected, he wasn't considered a likeable person, a bit gruff and to the point, my husband had been seeing him for years.

I at once found him funny and extremely likeable. I told him I was pregnant, and he said "well, have you identified the cause?" peering over his glasses! I noticed straight away, that although originally from Scotland, he had completed his training in Australia, and as such, was an obstetrician and gynaecologist by training as well as a general practitioner. He took my blood pressure and we had a chat. He asked me if I knew anything about pre eclampsia.

The only thing I knew was that if you had it, you normally had a c-section as it was a life threatening condition for both the mother and baby, I didn't know the symptoms or how it could manifest. He asked me not to worry, and not to google, but to just be aware, and gave me a run down of the symptoms - headache, visual disturbance, excessive swelling. He told me that my body type put me at risk, and to make sure I kept all my appointments religiously. Importantly, he said to come to him with any concerns.

At around 13 weeks I went back. I felt weird, worried, and insecure about my pregnancy. He felt it was probably depression and discussed anti depressants, which I declined. I asked for non medicated therapies, he peered over his glasses again. There was nothing, any referral would take 6-8 months. So I found my own therapist.

I then returned at 16 weeks, things were getting worse, although I didn't feel depressed, just anxious. I was crushingly exhausted, I looked huge, I felt weird. I asked to be signed off work for a week, and my GP agreed. He had a meeting with my midwife to discuss his concerns on the Thursday, having seen me on the Monday. My blood pressure was sky high, and my heart rate was high. I know now that a high heart rate can indicate that all is not well.

Every week I extended my sick note, with full agreement of the GP. I negotiated a return to work with my employer for around 24 weeks, but every week my blood pressure was higher, and I wasn't happy to return. And then, of course, at 27 weeks I had full blown pre eclampsia.

My GP had been on holidays. I gave him a call to let him know what had happened. He was lovely and joked that whilst it normally takes three trimesters to make a baby, two obviously was enough for me. He shared a few experiences of his own (I discovered he was the dad of three premature babies, not triplets), and I thanked him profusely for his care. I honestly think that without his initial explanation and warning, I would have been less prepared for what eventuated. I also think that the counselling I had really helped prepare me mentally.

I do think that there is a role for GPs in managing pregnancy. Midwives are fantastic, but in many cases, such as mine or if there is a pre existing medical condition, GP management can mean the difference between a good outcome and a sad one. There is a move to go back to shared care in this country, and I think, personally, its a good idea.


  1. "have you identified the cause"

    LOVE it!

  2. Great post.

    I too had a great experience with my GP. Unlike you though it was after the event as my care before was community midwife and hospital led. But 6 weeks after Littlebit was born my care was handed from the hospital to the GP. I have a large practice where you don't tend to see the same Dr twice, but I always request this particular Dr now as he was just so fab.

    He chased me out of hours for my BP reads and was in touch every couple of days for "status" checks. Think he was keeping an eye on me for PND.

    I was very impressed anyway and would agree with you on the shared care idea.