There was no reason for me to see a doctor, other than this is standard practice in the Coombe. Whereas in the Rotunda, you see an obstetrician at your booking appointment (around 12 weeks) and care options are discussed and assigned at that point, in the Coombe this assessment doesn’t happen until your second appointment. Once the obstetrician has met with you, you will be assigned to the DOMINO team (continuity of care with a team of midwives), a satellite midwifery clinic, midwifery care in the hospital or obstetric care, depending on your health and your preference. In Ireland, most women are under obstetric care, despite being healthy with healthy pregnancies, in which case the midwifery model should be standard. However, my experience so far with the Coombe is that midwifery led care is encouraged, if you are suitable for it.
One of the wonderful things about being booked with UK Birth Centres (UKBC) for my home birth is that I don’t need permission to birth at home. Were I having a HSE home birth, I’d need the obstetrician to ‘sign off’ on it, as I am over 40. So today’s appointment would have been about getting her approval to birth at home. I’d also have been very concerned that the sonographer who did my 12 weeks scan had said she was going to change my EDD by bringing it forward two days, as this could potentially impact on getting a HSE home birth. But I didn’t need her approval, so I approached the appointment with curiosity rather than trepidation.
After my last experience with the sonographer, where I felt the power dynamic of healthcare provider / patient very much indeed, I decided to dress for confidence, so wore smart casual work-type clothes. It’s well documented by behavourial psychologists that what we wear affects both how we think and behave and how we are perceived by others. This is the concept of enclothed cognition. So it’s important to always dress for how you want to feel! And I wanted to feel like the obstetrician’s equal.
It turned out to be a very positive appointment. She was really supportive of home birth, saying I’d had two normal deliveries so it was all likely to go well. She offered me the Glucose Tolerance Test (GTT) for gestational diabetes because it’s routine in the hospital for my age but had no problem at all with me declining it. She was very interested in the UKBC home birth service and finished up by saying she hoped she wouldn’t be seeing me again! There was no mention whatsoever of changing my guess date. And, oh yes, baby was doing fine too!
So just my scan in the hospital now and hopefully I won’t need to go back there. Can’t wait for my first midwife appointment on my couch at 20 weeks.
For more information on the Glucose Tolerance Test, this article is very informative: http://42weeks.ie/2013/10/16/the-glucose-tolerance-test-gtt/
For information on home birth options with UKBC and their partners Neighbourhood Midwives, check out http://neighbourhoodmidwives.com/