Barts and The London Maternity Service | For women and families | Care plans and types of care
Care plans and types of care
Types of care
What does ‘low risk’ and ‘high risk’ mean?
All women booked at Barts and the London will have an individual care plan made with them following their initial scan. Broadly your pregnancy will be categorised as ‘high risk’ or low risk’ depending on whether you have risk factors. Having risk factors means that you may need additional / extra care to prevent problems for you and your baby. As risk factors may arise at any point in pregnancy, this care plan is constantly under review and may be changed at any time if needed. You will always be informed and involved if this care plan is amended.
What if I have or develop complications?
Historically all women with complication in pregnancy would have been referred to an obstetrician. However for some specific conditions we are increasingly able to care for these women with midwife led care or shared (midwife/GP) care. We are able to do this safely as we have clear guidelines with fixed criteria (which women this may be suitable for and what additional care is recommended).
If you have a) risk factors not covered by our stringent guidelines, b) a number of risk factors, or c) at your request, you will be offered consultant led care.
Midwife led care
Most pregnancies are straightforward and classed as low risk. If you have a low risk pregnancy you will receive care from our midwifery team in our community clinics - this is called midwife led care. Clinics are located across the borough of Tower Hamlets, in children’s centres, health centres, GP practices, the Barkantine birth centre, and at the Royal London Hospital.
Shared care (between midwife and GP)
Women may have some of their care provided by a GP trained in antenatal care - this is called shared care. Some appointments will be with a community midwife, and others will be with the GP.
Consultant led shared care (between midwife, GP and consultant)
Women who have risk factors which require referral to an obstetrician or other health professional will usually have their care shared between a midwife, a GP and obstetrician. Usually for these women care is split between midwives in community clinics (or Antenatal clinic if they live outside Tower Hamlets) and obstetricians who are based at the Royal London Hospital. This is usually called consultant led care (even if most of the care is delivered by midwives) as the obstetrician is planning the care which the midwife is delivering. This may also include appointments with other healthcare professionals. Very occasionally women who have severe and/or very complicated medical histories will receive obstetrician led care and will only see an obstetrician. Women who fall into this group can request to have some of their care (or additional care) delivered by a member of our midwifery team.
