“This has simply never come up before…”

Those were the words of my obstetric consultant’s specialist registrar, yesterday, when I pointed out beyond all reasonable doubt that his dates for my pregnancy are wrong.

First he spent ten minutes explaining (complete with little diagrams on the back of a slip of paper) why the scan couldn’t possibly be wrong. Then he spent a couple of minutes explaining that whilst a woman can be expected to know when her last period was, it does not necessarily follow that she subsequently ovulated on the expected date. Then I pointed out that, whilst my ovulation date is not known for certain one cannot become pregnant before one has had sex. It’s elementary biology, coupled with elementary arithmetic. This baby cannot be due as early as their scan is insisting.

He opened and closed his mouth like a goldfish for a moment, then said, “No. You’re right. You can’t. Are you absolutely sure?” Absolutely. There were other factors. I know when was the first time that month. I can work it out.

From there, I told him that the midwife who took the first scan didn’t believe they would change my dates, since hers were less than five days out, and the scan is, in her words “only accurate to within five days” for dating a pregnancy. I have enough experience of the Liverpool Women’s Hospital to be able to say that most of the staff know about the thing they do in great detail, and guess at every other element of everyone else’s job with wild inaccuracy – I’m used to that, and I wasn’t that surprised to discover that the woman concerned was wrong. Nevertheless, my worst case scenario, here, is that at term +6 I could go into spontaneous labour, and be refused access to the midwife-led unit, and/or a home birth, because my notes insist that I am at term +11, and therefore perceived to be high risk.

To be fair, I think my wee man was convinced, from that point. He has never, apparently, in all his career, changed a woman’s due date, though, and had no idea how to go about it. He said woolly things about how the hospital believes in flexibility and negotiation with patients regarding care (and I think they really believe it’s true, oddly enough), and suggested that my best route forward was to leave the dates the same, but write the manager of the midwife-led unit requesting confirmation that I could be admitted there even if I was beyond their post-dates cut-off. I shook my head as definitely as a could. I have been through this process already. The patients, unlike most of the staff, get exposed to the entire procedure from start to finish, and know what the rules are. I was pretty sure that at term +10 I became a Delivery Suite case, with no discussion. He didn’t believe me.

Fine, I said, I’ll write. What’s her name?

He didn’t know, so he went to find a midwife to find out for him. She, when she joined us, was very helpful. She rang the MLU to confirm the name of the boss up there (it’s recently changed, apparently) and was writing it down on a piece of paper for me when she asked, casually, “What’s it about?” I told her, and she looked up with a very definite look on her face, and said, “No. They won’t do it. They’re not allowed.”

“I tried to tell him that, but he wouldn’t believe me,” I pointed out.

“Really?!” demanded the little registrar man, with wide eyes. “No flexibility, no discussion?!”

He actually made the midwife find the policy documents on the intranet system before he was quite prepared to take her word for it (though that makes him sound like he was nasty about it, and he wasn’t at all. I rather liked him. He just didn’t know what he was talking about, and couldn’t believe how wrong his assumptions had been).

So, we got two documents on screen, one saying that you can’t go to the MLU after term +10 (ie, 41 weeks and 3 days pregnant), and the other saying you can’t get support for a home birth, either.

I really, really don’t want to deliver on the Delivery Suite unless someone can suggest that there’s an actual problem with my actual body and the baby inside it, rather than just waving their stats and policies about, so then we had to rethink.

Our agreed approach, now, is that I shall write to my consultant himself, laying out the maths in words of one syllable, and requesting that he arrange for my notes to be amended. The registrar chap asked me not to mention his name, but I think he was joking… Anyway, he seemed to think that it would a) get the attention of the only person with the authority to change my notes so substantially, and b) put my case in writing in my notes, for future reference, rather than relying on his documenting of our conversation. I can see the merit in that, so that’s what I’ll do.

Has this really never come up? Really? There is simply no procedure for saying “The scan was wrong”.

The two of them seemed to believe that my consultant, more than most of them, will see the common sense angle, and happily make the change. That, of course, remains to be seen. Still, it’s an avenue. All is not yet lost.

The other point is, this baby may not be late at all. Daisy was born at 42+2, which is well into the period of them being nervous about it, but nothing was ever said to suggest that it was a problem. They checked my “liquor volume”, it was fine, she showed no signs of distress, and she was perfectly healthy when she was born. Second children are, statistically, likely to be much earlier, but even if this one is a week earlier, by my dates, I would have crossed the threshold by theirs. I really want this sorted out before it happens.

Of course, knowing my luck, I’ll fight and fight and finally get my dates changed, then go into labour at 37+6, by the new dates, and be denied all the same things for being too early. C’est la vie…

4 thoughts on ““This has simply never come up before…”

  1. It doesn’t surprise me that changing the EDD has never come up before; after all, how could a human (and one without a medical degree at that) possibly know more than one of the machines that go ping?

    They can choose who they admit to the MLU, but they cannot, ever, deny you a homebirth. It doesn’t matter what their policy says; nobody can stop you from birthing at home if you choose to. You don’t need a consultant’s permission for a homebirth, even a post-term one, and the midwives don’t need a consultant’s permission to attend you at home, and in fact you don’t even need to see a consultant if you don’t want to – ever.

    Oh, and should anyone ever argue “that term + 10” makes you high-risk, you can point out that the WHO definition of “term” is 37-42 weeks, and thus “term + 10” means 43+3, and ask why they think you should trust their advice when they can’t even get the definition of one of the most basic terms in obstetrics correct.

    And while I’m being pedantic, “ramblings” is mis-spelled in your site tagline 😉

  2. I thought I’d save the big-gun stroppiness for when this line of approach didn’t work. Quibbling with their definition of “full term” struck me as a way to get them all cross, and uncooperative. I have another appointment at 32 weeks at which to check that they’ve sorted it all out, and I can trot out all that stuff then.

    As far as being “denied” a home-birth goes – let’s hope it doesn’t come to a fight. If my dates are correct, it’s less likely to, anyway.

    (and if there’s only one mis-spelling in the tag-line, we’re doing pretty well…)

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