“Pregnant & Winging It” is a short series about a first-time pregnant Autistic woman in Nottingham. Claire writes about her views and experiences around pregnancy and how it’s not all as she expected
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The second trimester should be when you’ve adapted a bit better to your new physical condition and feel a little bit more able to deal.
Second Trimester is usually from 14 weeks to 27 weeks. That 28gram humanoid will grow to around 900grams during this time (so around 2lb).
Your weight is going to change far more than that because you need to take into account placenta, fluid around the baby, any fat you gain, etc. I stopped weighing myself so I didn’t get myself down seeing how much I’ve gained.
Remember: No pregnancies are the same, it’s all a very individual experience, so please don’t think that all I am saying here is correct for everyone, this is just my experience 🙂
Dealing with Medical Professionals
There is a lot to deal with when pregnant when it comes to medical appointments and this will vary depending on your age, weight and medical history. As we learned last time, I am (apparently) very old, very fat and very disabled so I am probably going to mention a few more appointments here than the “average” person will require.
Midwife Appointments
After the first midwife appointment, that wasn’t a very nice experience, the following ones were mostly better. I was given a named midwife that I would go see and had 2 face to face appointments, one at 16 weeks and one at 23 weeks. These appointments can involve many different things such as:
Blood Tests
Measuring your “bump”
Listing to the babies heartbeat with a doppler
Urine Tests
The frustrating thing I’ve found is not getting told what’s happening in advance. I would get a letter in the post saying “we’ve booked your appointment for the midwife on this day/time” but nothing else, so I would arrive and they’d be like “where’s your urine sample?” erm… you didn’t tell me to bring one? nor did you send me something to put it in??
Communication with community midwifery is also highly inaccessible for Autistic/Neurodivergent individuals. They send you these letters where they just give you an appointment if you need to change it, you must call up and leave an answerphone message. Someone will then call you back at a random time, from a private number, and not leave a message.
So for someone like me who can struggle to process information over telephones (due to sensory processing disorder) and is at work 9am-5pm on week days, there is no accessible way to get in touch.
I had to go through the formal complaints process with PALS to get this point across, which is highly unfortunate as this is something with a really simple administrative fix; you keep this as the “standard” way of operating and for those who cannot access it, you offer an email address… apparently that’s not something easily done, but hey ho.
Scans
I find these the more fun part of pregnancy, getting to see the baby on the little monitor 🙂
We had one in the First Trimester, at around 12 weeks and then comes the 20 week scan. This is “Anatomy Scan” where they check that the baby has all its limbs, organs, facial features, etc. and they can more accurately check if there are any disabilities or genetic anomalies. This is also where you can find out what the baby’s sex is if you’d like to know. I would recommend allowing more time than you think is necessary at these appointments. Realistically is should be 15-20mins maximum, but you’ve got to take into consideration:
Arrival/Parking
Getting through the hospital to the right department
Delays (there’s always delays in the NHS)
Any additional professionals you may need to speak to after
For this one, another thing we were not told, is that if you consented to being tested for genetic disabilities you will need to go for a blood test directly after the scan. This wasn’t helpful as husband had booked out 2hrs from work to drive, get scanned, and return and it ended up taking way longer. Also, children are not allowed to come into the scan with you. You are only allowed one person to accompany you and they must be over 16 years old. One scan we attended was during half term and a lot of people brought their children with them and had to be told it was not allowed. There are signs up all over the reception stating this, and when I checked back through my appointment letters only half of them were clear on this rule. You can bring children to the hospital with you, and leave them in the waiting area with another adult (I saw some people come with their child and their own mother, get scanned alone and leave the child with grandma in the waiting area) but you can’t just leave your children unattended in the waiting area (as I saw a lot of people trying to do when told their kids weren’t allowed in).
Our scan went really well, everything was in the expected ranges, but this is certainly the scan where is something is going to different/wrong it’s going to flag up here, so be prepared. They do a lot of measurements of different parts of the babies body to check, but these are not an “exact science”, it’s entirely possible for them to measure “normal” and there be an issue and also for them to flag an issue and when they are born the baby is perfectly “normal”. My husband did get concerned as they were repeatedly scanning the babies neck (they measure something in the spine around the neck to check for certain disabilities) but when he asked when they were rescanning it was just due to the baby moving. So if you’re concerned, ask questions, the sonographers are good at explaining what they are doing and why.
We went for a private scan at 16 weeks at “Meet Your Miracle” in Basford to find out the sex earlier. It is a very different vibe to going to the hospital, it’s really calm and cozy, the scan rooms will allow you to bring in children or larger groups of people (you can book a scan room that can seat up to 6 people). They do packages where you can get a digital download of images/videos of your scans and they sell keepsakes/gifts that can be made from your baby images. They are qualified medical professionals who do your scan and include a “wellbeing check” so can recommend you return to your hospital/medical professional if anything concerns them.
And both scans said we’re having a boy 🙂
Antenatal Doctor
I was sent to see an Antenatal Consultant at the hospital, something that is not done for everyone but is not uncommon either. This is one of the least organised departments I have ever had to deal with.
You are sent to Antenatal if you are having a risky pregnancy or suspected you may have a risky pregnancy. When I arrived they asked why I was there and I had say “well, you told me to come?” because I had no idea.
They tried to tell me that a 36years old my age made me a risk and as my BMI was over 30 (it was 30.1) I was also overweight and at risk. I told them I didn’t buy it and they didn’t really know how to respond?
BMI has its uses in medicine, such as calculating medications you need during surgery, but it’s not the be all and end all. Not once since this process started had anyone asked about my lifestyle, they had looked at this one number and decided I was “grossly obese”.
For reference: Before getting pregnant I worked out 30mins a day 5 days a week (3days a week if I was having a bad week). I was able to run a 5km in around 40mins (not amazing but I could do it without stopping), I ate a varied diet and was a size 14 in clothes. My issue wasn’t that I was unhealthy, it was more that I just ate a bit too much on occasion.
So to be told that I putting myself/baby at risk due to my size was a bit insulting, as well as being told I was really old… I wasn’t taking those as reason to be at high risk. We did then discuss that I had POTS, which I could see might be an issue and was happy to discuss. They decided to refer me for an ECG and Echocardiogram, which I was happy to do. If those came back without issue they would discharge me back to midwives as “no risk”.
This appointment was in February, and as I write this now in almost June, I have still not had those tests…
They booked me for a “review of the results” appointment in mid April, I happened to be at the hospital a week before and spoke to the reception about how they had not happened yet and it turned out no one had even sent the referral in. They moved that “review” to mid May, which I attended (because I wasn’t chasing any further) and they had sent the referral but there was a 6 month wait for tests… When the baby is due in July, that doesn’t really bode well! At this appointment they were still adamant that I would not be allowed to have a homebirth (my preference) until they got these test results back. They clearly do not communicate with midwifery as by this point I had already have my initial appointment with the homebirth team,
As of today, they have booked the Echocardiogram for the beginning of June and the review appointment for middle of June. If anything flags up on the test it will mean a hospital birth with additional support from Cardiology, but as someone has had many of these done over the years and they have never shown anything sinister, I would be highly surprised if something popped up now.
Glucose Tolerance Test
This is another one that pops up if you have a BMI 30 or over.
Gestational Diabetes can occur in any pregnancy regardless of your age, weight, health, etc. but it is more likely if you are overweight and inactive. If you do have it, it can cause complications in your pregnancy such as a larger baby, pre-eclampsia, premature birth, etc.
I originally was going to refuse because of, again, finding it rather insulting, however, after taking some time to think I realised it’s better to participate in these tests and to show they are clear than to refuse them because I am a bit miffed people keep calling me fat.
The test involves arriving at the hospital first thing in the morning. You must not have eaten after midnight the night before, but you can drink water. Your appointment involves blood being taken and then you must drink a large cup of a “glucose mixture” that essentially tastes like flat lemonade. I was preparing myself for something truly disgusting but it was actually quite tolerable (not nice to drink but it doable). You then have to go into the waiting room for around two hours before being called back in for a second blood test. The idea is that they will test you ability to digest sugars and see if you have developed Gestational Diabetes or not.
I took my PA with me and we just sat around talking/playing games on our phones for the two hours, whilst she got me water intermittently. I felt sick the entire time we had to wait, probably because I am not good with high sugar foods. I can never have full sugar cola or things like mars bars because I feel blergh so having nothing to eat for a good 12hrs and then being given pure sugar I just felt awful.
I got the results through the Badger Notes app within a day and it was all clear 🙂
Homebirth Team
This is technically a Third Trimester item but I will put a bit in here now with more details next time.
My initial thoughts of childbirth were “be in the hospital, with the medical professionals, and medicines, and so on” but after taking time to think about it, that’s actually the last thing I want.
Going to a hospital, for me personally, it quite stressful. The idea of going into labour, rushing to a hospital, being put in a bed and just left to wait whilst random medical professionals come in and poke/prod at me… it’s all a bit much.
Being at home though, knowing I can control the environment, I can put what I want on the tv or play my XBOX, walk around, whatever I feel I need to… that feels so much better. Husband can go into the kitchen and eat when he’s hungry (at a hospital he’d be stuck in the room with me or risk missing out if he nipped out for food).
So I made a request to be referred to the homebirth team, which is a group of community midwives who prepare you to have your baby in your own home. They come to your home for appointments leading up to the birth and do all the same things that the midwife was doing when I was attending appointments at the children’s centre (taking bloods, doing measurements, etc.).
They come to see you every 2-3weeks throughout the Third Trimester to get prepped, do all the necessary checks. If at anytime they suspect there is a risk they refer you to the hospital or necessary medical professional.
For example: my bump was measuring on the larger side, this could mean a “large baby”. When your baby is oversized it can cause issues in a “natural birth” that wouldn’t be appropriate for having at home so you’d need to be at the hospital or have a cesarean section.
They homebirth team referred me back to the hospital for a “Growth Scan”, this is similar to the “Anatomy Scan” we talked about earlier but they are measuring the baby to see how big they are. I was seen with 24hrs (which was a total shocker!), had the ultrasound and all the measurements came back that the baby was perfectly “average” sized, maybe 1-2 weeks ahead of schedule but that’s quite normal. The report went back to the homebirth team as “no risk, carry on with what you’re doing” and so they’ll be back in a few weeks to continue with the preparations.
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Summary Notes:
Be prepared for communication issues; this system just isn’t set up for Autistic/Neurodiverse people, I can’t even see how Deaf people would be able to access this service with no alternative communication methods.
Have a second person; doesn’t need to be the Father of the baby, but always have a second person present at every appointment, especially if you struggle to self advocate. Before each appointment talk to whoever is going with you about your feelings, expectations, difficulties in expressing these view, etc. so they can be repeating what you are saying when medical professionals are not listening to you and also a witness if you are being ignored/ having their (the medical professionals) decisions pushed on you without taking into account your own.
It’s also handy to have a second person to help with the “life admin” of all these appointments. I have a folder I put all letters in, in timeline order, and I make sure my husband reads and checks them too so that I am not missing something appointment (like bringing urine samples or not eating before a blood test). Just because with baby brain and the anxiety hospitals cause me, I know I’m going to mess up at some point, and having a second person go over it gives me peace of mind for preparing to attend.
Decision Making; You do not need to consent to any of the above tests or attend any of the above appointments, it is entirely up to you.
I have found it all quite overwhelming trying to balance all these appointments and tests; getting to places on time, getting a PA booked (or husband to get time out of work), arriving prepared with all the paperwork, samples, whatever… it’s been a lot, and somethings I have considered just not doing because of it.
At the end of the day, you need to consider your own physical and mental health as well as that of your baby and get that “second person” we just discussed to have a conversation with you about these appointments. As I said above, I was all ready to refuse the Glucose Tolerance Test, but after a discussion with a few trusted people I realised it was only because of stubborn pride.
I also discussed with a few people disengaging with Antenatal because of the amount of times they were booking me an appointment to review tests that they were not requesting. The people I discussed it with did agree on that one; there’s not point using your care budget and your own time to travel up to the hospital just to be told to come back in a months time to do the same thing all over again.
You know your body and your tolerance to these things and you must make those decisions that are right for you.
Next Time: Mentally Preparing – What can be done to get ready mentally for childbirth/child raising?
Autistic Nottingham 