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Is prenatal care really essential?
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IzzieKay posted:
I'm 11 weeks today. I've seen two different OB/GYN offices that offer midwives as well as physicians. I've not liked either office at all. I'm wondering what is the importance of seeing a health care provider during pregnancy? I've already had initial testing done, I don't want any early detection testing done (amnio, CVS, etc.), and I'm a low risk pregnancy. Is there any real harm in forgoing monthly OB appointments? I know that most women (myself included) would prefer to deliver with a doctor that they have 'gotten to know' throughout their pregnancy, but that doesn't happen anymore. Every office I've seen/talked to cycles their patients through each provider because they never know who will be on call the day of delivery. Couldn't I just consult a physician if and when I have concerns? Thanks for the input.
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hoping101 responded:
Lurking from 2nd trimester...

Care during pregnancy is extremely important. They monitor you and the baby to ensure that your health remains stable throughout pregnancy.

Here are a few that I can think of off the top of my head...
- Monitor blood pressure to ensure you aren't showing signs of pre-eclampsia which can be deadly if not properly handled.
- Check for gestational diabetes which is tested further on down the line during pregnancy which is also a serious condition for mom and baby.
- Check to ensure your not displaying pre-term labor signs by cervical checks.
- Ultrasounds to ensure number of fetus' and well being of the fetus.
- Pelvic exams to check for infections
- Group Strep B culture to ensure your on antibiotics during labor and delivery if you test positive. This can be serious if passed on to baby during birth.

Please don't opt out of care simply because you haven't found the doctor that you like at 11 weeks. There are things during pregnancy that can go unknown to a woman without a doctor. You really could endanger yourself and the baby unnecessarily.
 
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IzzieKay replied to hoping101's response:
The reasons that I can't find a practitioner that I care for are because I want to be the one in control of my healthcare. I know the difference between reasonable and irrational risks. I don't want tests ordered because they are protocol. I can't afford that and frankly I've made it a personal habit not to let every Tom, Dick, and Harry shove their appendages into my body cavities on the first meeting. Why is it that I can opt out of genetic testing such as an amniocentesis or CVS, but I can't opt out of having myself screened for STD's when I know I've not given myself opportunity to contract them. This is my child and if I choose to put them at risk, that's nobody's business but mine. The fact of the matter is, I know that I've not put this child at risk for anything. In fact, there is a potential for harm by allowing some of these procedures. I understand that a doctor has to safeguard their practice and reputation, but not at the expense of mine and my unborn child's safety or comfort.
My husband is an EMT and we own a blood pressure cuff as well as a fetal heart doppler. I've already been checked and cleared for gestational diabetes, I'm monogamous and therefore not at risk for STDs, I can test for UTI from home with a simple OTC test kit. The only real convenience I can see is the availability of ultrasounds to determine the sex. I've already decided that I would never terminate this pregnancy due to a genetic or anatomic abnormality. So, really, is it important at all?
 
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KimberlyHall2015 replied to IzzieKay's response:
First, even if you have been checked in the past or even recently for gestational diabetes it canand typically does manifest AFTER the 20 week mark. Also, ultrasounds are not used to determine sex of the baby...that is just a happy surprise we get when we have one done. Ultrasounds at the 20 week mark are used to find problems with the placenta, uterus, and fetus that would not show otherwise. Two examples...my cousin's son was born with his intestines on the outside of his body. Because they knew about it before hand they had a medical team on hand and delivered him via c-section. He would have died otherwise. Also, a friend of mine opted to NOT have ultrasounds done. She lost her baby during delivery because she didn't know she had placenta previa. If the doctors had known she would have had a c-section and her baby would be here now. Monthly ob visits are NOT invasive or an invasion of your privacy. They are to insure your unborn baby's health. He/she should be top priority...not your privacy.
 
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RobynMia replied to IzzieKay's response:
In all actually ultrasounds are not proved to provide any benefit, as a general rule, to the health or mom and baby. In fact, my insurance and many other insurance companies do not cover this because of that. (Seriously, do the research!) Same as it is proven that health insurance doesn't actually improve health...the data is out there. So prior to getting a sex read make sure it's covered.

If you have had all the initial pre-natal test (blood work and such) and you are a low risk pregnancy, it probably won't hurt to skip a few appointment if it doesn't provide you piece of mind.

However, there are always risk which can go undetected which is why prenatal exist. You can opt out of genetic testing because it doesn't harm you if the baby is at risk for these diseases. Besides you can always tell doctor you do not want a certain test or treatment. You may have to find one you can work with or you may have to sign a release. It is your money and health.

And, it is your choice. As far as blood pressure goes, a BP check once a month, one time a day is a poor indicator of your true BP. You have the right idea with the cuff (I do the same) and it is perfectly safe and more efficient to do this at home.

I would be concerned with occasional blood test to ensure you body and baby are getting what they need. Bodies change during pregnancy. What you may not be at risk for initially can pop up such as gestational diabetes, thyroid issues, correct amounts of iron, BV's that can not always been known and symptoms can go undetected.

And, it is also important as you near the due date to monitor where the baby lays. A breach or low placenta can be deadly and easily detected with a pelvic exam or ultrasound.

Again, it is absolutely your choice. Don't let anyone tell you otherwise. Look at it this way, you may go your entire pregnancy perfectly healthy without prenatal (women do it all over the world). But, could you live with yourself if you denied the care, when you do have access, and something did occur that put you or baby at risk? It is your body, your responsibility, your burden!

Good luck. And, when you do find a regular provider I hope you can find someone you like!
 
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hoping101 replied to IzzieKay's response:
You can be in control of your healthcare, you just have to keep searching for that doctor. You simply can't just give up. Do some research online and ask around. Your first appointment won't consist of "appendages shoved in your body cavities"... they usually only consist of your medical history/ family medical history. The idea that you can't opt out of certain screenings is insane... you as a patient can opt out of whatever you want. You might have to sign waivers but you don't have to do anything that you don't want to.

It's good to hear that you personally haven't done anything to put your child at risk... but like a previous poster indicated... your body goes through major changes. I was Strep B positive and borderline diabetic. For the safety of my child I had to take two doses of antibiotics while I labored to ensure my child didn't catch it. Risks of not taking antibiotics... serious illness or death in the newborn. For the diabetes I had to watch what I was eating or else I could have been in some trouble. Normal routine procedures do not cause harm to you or the unborn so I am not sure where you came up with that information. It's great that you are able to watch certain things at home however there is more to it.

You are going to do what you want and I am not going to judge you however, to me it sounds like your more worried about costs. You asked for people's opinions and it appears everyone has listed the most important information... I truly hope you take these things into consideration and do what is really best. This is one of those things like vaccinating... people will always different.
 
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Haylen_WebMD_Staff responded:
Here is a new post from our expert in the Trying To Conceive Community:

Things to Consider When Choosing a Healthcare Provider


With both of my pregnancies, I found a small practice with only 2 docs. I knew one of them was going to be there.

Best health wishes for you and your baby -

Haylen
 
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speechtxjessica responded:
My personal phylosophy is better safe than sorry. But that is just me. My neighbor almost lost her baby last year because her placenta was dying and not providing the baby with the nutrients she needed. The doctor was able to catch this and deliver the baby early. Saved her life!
 
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IzzieKay replied to hoping101's response:
I think that I may have misrepresented myself. My absolute, overwhelming, top priority is the health and safety of my child. That being said, I don't believe that the top priority of every health care office is the health and safety of their patients. I believe it's become about cutting costs (including reducing the risk of malpractice suits.)
Here's a brief overview of my story thus far:
I stopped having periods in November of last year. I took 4 pregnancy tests between December and January all came out negative. I figured that it was because I'd just stopped taking birth control the previous September. In January, I began experiencing more and more symptoms or pregnancy so I called an OB office and requested a blood test. They suggested I take a home test. I explained that I had and they were all negative to which they responded, "Then you're not pregnant. We could schedule you for a GYN checkup." I declined, went to the store, and bought another box of tests. As it turns out, these tests came back positive. So I called back to schedule an OB appointment. They asked for the date of my last menstrual cycle and over the phone diagnosed me at 10 weeks. I, again, asked for a blood test to confirm and they said and I quote, "If the home test is positive then you're definitely pregnant." I scheduled the appointment and when I went in a month later the nurse couldn't find a heartbeat for what they diagnosed as a 14 week pregnancy. When the nurse midwife came in, she palpated and immediately told me that I was nowhere near 14 weeks. After ordering the initial blood panel (including an HCG test), she insisted that she perform a pelvic exam because "We need to find out what's going on with you." As it turned out all that was going on with me was that this office was incompetent. They have a policy against ordering tests before a patient has seen a clinician, but they're completely comfortable misdiagnosing over the phone. So my husband and I spent 6 hours that night trying to find a way to explain to our family and friends that I wasn't pregnant after all. I understand that diabetes and pre-eclempsia are dangerous. So is a high level of stress.
I've since left the first office and moved to a new one. My first appointment was last week where they did the initial intake/health history and since I'd already had the blood panel done, they just wanted a urinalysis. I'd already had that done as well, but the records from the last office weren't sufficient. So, I got a call this week that I tested positive for e coli and would need to take macrobid for a week. I explained that I'd already taken macrobid prescribed a month ago by the last office and perhaps that just wasn't working for me. Their response was, "this time it will work." How exactly is this kind of healthcare any better than no healthcare?
The new office is also insistent that they perform their own pelvic exam, why, nobody will tell me. I can't imagine that there is anything that the last office didn't already check for. My issue with all of this is how political it is. There has been no interest in my well being, it's all about what's going to be in their best interest. That's not working for me.
 
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FarmWife1979 replied to IzzieKay's response:
I'm sorry you've already been through so much. It does sound like the first office's staff was confused and focused what "should" routinely happen rather than what was really going on with you.

As for the second office, I can understand why they would want to do their own test (especially given the inconsistencies of the previous office), as well as the physician wanted to do their own pelvic exam. While it is uncomfortable and intrusive, it is necessary for the physician to have an accurate understanding of your body and symptoms. To give you an anology - you wouldn't trust a mechanic's opinion about what "might" be wrong with your car if he hasn't looked at it himself, would you? As to the medicine, they may be giving you a higher dosage of the antibiotic than the previous office.

Again, I sympathize with your frustration and your concerns, but as the other's have said, I would suggest following up with the prenatal care as directed, insist on speaking with the physician personally if you aren't getting anywhere with the nurse/office staff. My first pregnancy was a challenge because of a neurological disease I have. I struggled to get the nurses and the OB to understand what the big deal was since it is fairly rare disease. My neurologist and my OB pointed the finger at each other on who should decide if should continue my medicines or not due to no known studies of the drugs effects on a developing baby, etc. It finally took me printing off almost of ream of paper's worth of information about my disease (everything I could find online) and highlighting the points relevant to pregnancy and giving it to my OB and asking him to read through it and then let me know if he thought he could handle my pregnancy or not, and if not to refer me to someone that could. That got his attention and he got a whole lot more interested in my case. Your situation may or may not be as dramatic, but my point is, you have to make yourself heard and be your own advocate.

I wish you the best of luck!
 
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hoping101 replied to IzzieKay's response:
Now that you have explained all of this I understand your frustrations. Still I really recommend you hang in there and try to find a doctor you like. It will get better eventually!

*Note* Every doctor will perform their own exams as they want to ensure all of their basis are covered. The previous doctor may have missed something important and your new doctor may catch it.
 
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Cowgal7083 replied to IzzieKay's response:
I can understand all of your concerns. Nurses and esp midwives (who are not medical professionals) can not order or prescribe aything for you. A doctor must do that no matter what. It would be like the babies father doing surgery when he can't even give meds to a patient (I'm also an EMT, so I do know what I'm talking about here).
All doctors want what is best for the patient and OBs have 2 of them, you and your baby. They are always going to do mutiple tests to cover all the bases, just incase. When I go in each month, I have to pee in a cup to check for UTIs, because the walls of the urinary track are getting weaker because of the baby. Its normal, but we want to make sure that nothing is going on in there. If you are still testing positive, then you need a stonger dose of the meds, and then maybe different meds
To your concern with the pelvic, get over it. You are going to have mutiple people down there a LOT as you get closer to delivery. Everyone you see is concerned for you and your baby. Some maybe not in the way you want, but they are trying to make things eaiser for everyone.
Did you have a primary GYN prior to this? If so, go back to them or see who they recommend. Also, check with friends if you still can't find someone you like.
Good luck
 
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IzzieKay replied to Cowgal7083's response:
As it turns out, I have since found a provider who uses logic in her decision making skills. She has assured my husband and I that we don't have to have anything that we're not comfortable with performed. Pelvic exams included. So your expert EMT opinion suggesting I "get over it" is appreciated, but not necessary. Thanks anyway. Not everyone that I've seen was concerned about mine and my baby's health and well being as was clearly demonstrated with the first office that I visited. They were concerned with dollar signs and ego boosts.
 
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vava123 replied to IzzieKay's response:
Hi. I recently read your post that you wrote a year ago. I too desire to not have unnecessary testing done. Can you please give me the information of who your provider was and where can I find them. Even if it's not local to me maybe they can refer someone.


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