bills for tests MW's office did without my permission - Page 2

[HaikuMommy]

That would worry me about Kaiser, the "coincidence" of your friend having manual removal of the placenta too. Hospitals/medical systems have different standards about waiting for the placenta to deliver. Some hospitals seem to think that if the placenta doesn't come out in a few minutes, that they NEED to go in manually and get it. (Unless you are bleeding out of control, that's not true, it can wait!)

In my case, I asked them to wait 20-45 minutes for the placenta to come out on it's own before trying anything... but they only waited 2 minutes before trying "gentle traction!" They had 3 other women in labor and since 95% of the time a little tugging on the cord makes it come out without a problem, they just thought they'd fudge on my birth plan a little and they could move on to someone else. The person who delivers my next baby is going to know I mean it... I will sue if they tug on the cord without medical necessity.

I don't meam to sound like an activist or like I hate Kaiser, but I'm still traumatized 18 months later. Guard your cord, girl!

P.S. Odd coincidence: you referred to me as "Dena", who was the post before mine. The funny thing is, my name really is Dena too! Just thought it was funny...

[HaikuMommy]

Duh, pregnancy brain... it does say "Dena" in my posts.. hee hee!

[jsh7809]

Ha ha, that's okay, we're all in this "distracted" pregnancy brain place together
Yes, it could be coincidence (what are the odds?!) but it could be another systemic trying to speed things up situation that I will for sure mention to my doula as something she can watch for while DH and I are in baby blissville. Sounds just awful!
I don't know if they pulled on my friend's cord but they did give it 40 minutes for the placenta to come out on its own. Not an ideal situation for anyone, and it hurt like hell (she birthed naturally but ended up needing morphine for that part) but after 3+ days of slow labor, she was just glad she didn't need surgery for it to come out!
I guess I'm not sure how it would be different if they didn't pull on your cord, though - did they tug too hard and that somehow affected how the placenta would come out on its own, or was it more that after the cord snapped they went to the manual removal option right away? My understanding, from my friend, is that her placenta was just not going to detach, tug or no tug, in the "safe" amount of time - not sure how tugging the cord would change that?
I just want to have all of the info going into it, not to be completely off topic!

[luv-my-boys]

I would definately send everything certified mail and demand a lab report of what was done. In fact I would contact the lab myself and ask for a printoff of the lab and what was done. It is quite possible that someone elses lab specimens got labeled with your information. so although a hiv test was performed it may not have been yours. scary but it happens, literally its a sticker mistake.

on the whole HIV and urine. There are several urine tests available. However its certainly not "widespread" and in fact I dont know many labs who would do them because most HIV testing is done in conjunction with other lab work so it makes sense ($$ wise) to run it with blood. Plus blood hiv testing is more sensitive.

[jsh7809]

Oops - I was wrong! :(

wow - UPDATE! Big time. I FINALLY got a clear answer from the 2nd midwife's office: apparently I did NOT get these tests done at the first practice after all! I thought they did them because they took like 6 vials of blood and my understanding was that they tested for every STD they could - but I just finally got someone on the phone from each office, and the first practice confirmed that they did not do the chlamydia/ gonorrhea test in that bloodwork, because it is their standard of care to do it at a later date. So... although I had no idea my urine was going to be tested, or how much the test would cost me, it wasn't after all a duplicate test. I also don't know why they ran my urine instead of asking for a blood sample, where I would've known what was going on, but apparently that is the case.
I feel kind of stupid because it was my understanding all along that this test was a duplicate - and now I have confirmation that it wasn't, it was the one test that they hadn't done upon my first pregnancy confirmation. And now I have to pay the stupid bill (nevermind that I could've told them I don't have gonorrhea or chlamydia, I probably would've had them test for that if they explained it to me as a normal standard of care anyway just to make sure everything was safe and sound for the baby).
Sorry for wasting everyone's time... I would stress to you to make copies of all of your medical records, and to ask about what tests might be run each and every time (and how much they will cost!) you go to your practitioner, though. I am embarrassed but also think it is very indicative that it has taken me since last August (when the tests were done) until now to get a straight answer. Grr.
So... end of problem

[HaikuMommy]

Sorry to hear you have to pay a bill for a test you didn't mean to have!

As for the manual placenta removal issue -- your friend's retained placenta sounds like it was a different situation than mine. They may have done the right thing for her. Her placenta may have been retained because of "placenta accreta" -- where the placenta embeds itself too far into the wall of the uterus and just won't come out on its own.

Mine was retained because when they tugged on the cord minutes after the baby came out, the cord broke, leaving the placenta in place and bleeding. Then they had to get the placenta out ASAP so I wouldn't bleed to death, hence the digging it out instead of waiting 40 minutes or more for it to come out on its own. Cord breakling = immediate manual removal required.

Sorry if I led you off on a tangent!

[jsh7809]

Originally Posted by HaikuMommy

Sorry to hear you have to pay a bill for a test you didn't mean to have!

As for the manual placenta removal issue -- your friend's retained placenta sounds like it was a different situation than mine. They may have done the right thing for her. Her placenta may have been retained because of "placenta accreta" -- where the placenta embeds itself too far into the wall of the uterus and just won't come out on its own.

Mine was retained because when they tugged on the cord minutes after the baby came out, the cord broke, leaving the placenta in place and bleeding. Then they had to get the placenta out ASAP so I wouldn't bleed to death, hence the digging it out instead of waiting 40 minutes or more for it to come out on its own. Cord breakling = immediate manual removal required.

Sorry if I led you off on a tangent!

No worries, and thanks for the clarification. I appreciate the information, I want to go in with as much knowledge as I can (though hopefully I won't need it).

[twead]

ok. I don't get it. Just because your 1st mw didn't do the labs you thought, still doesn't mean you consented to the 2nd mw doing labs you didn't want. I'd still contest it, but I'm very much a squeaky wheel. I totally agree w/ sending stuff by certified mail, disputing w/ the collectors, etc. But I do tend to accomplish alot on the phone when I call. Particularly when they tell you something that doesn't sound right or they don't know which end is up. IME the person that answers the phone has no authority to do anything except answer questions. "I'm sorry, we just aren't getting anywhere, do you have a supervisor?' Usually works wonders. By the time I use that line they are glad to pass me to someone else. Sometimes, they say, they are the supervisor, then I start asking for their boss. Once I got a real obstinate person who supposedly had no supervisor, so I started asking for who ever she reports to, does her performance review, signs her paycheck, owns the company, you get the idea. She found someone for me to talk to. Just be factual, calm and polite and go about it like 'I'm trying to understand how you can do labs w/o bloodwork, consent, etc. even after explaining to my healthcare provider that such testing was not ok.'

good luck, it sucks to pay for stuff you don't want, didn't expect, or have the money for.

[jsh7809]

Yeah, I'm definitely frustrated that I didn't know about or expect this test, BUT my whole reason of contesting it is that I thought at first that it hadn't been done (since they were telling me it was from bloodwork, when I didn't have any bloodwork done there), and then I thought it was done as an unnecessary duplicate. After finally, finally getting the billing dept. to talk to my actual midwife, and confirming with my first practitioner (who did all of the other usual tests) it became clear that this was the only test that the first practice didn't do, so the MW/ 2nd practitioner did them as part of their usual protocols/ panel of tests to ensure that my health is 100% and nothing is overlooked.
Still a drag, because they were not explained to me beforehand - but in my and friends' experiences, no doctor or midwife has ever said "okay, this is exactly what we are taking blood for and what we are testing for." I know that this is sadly not an exceptional situation, because the office I"m with now has me go to the lab sometimes and when I ask what exactly all of the blood they're taking is for, they have to go look it up.
I don't really care WHAT they test for (i.e. I have no moral quandary with it other than being expected to pay for something that seems pointless and unnecessary to me), and I think if it had been presented and explained to me and DH as "we know you don't have any of these STDs, but it is our standard of care to test for all of them just to make 100% sure that everything is clear for the health of your baby", we would've consented. But that's not the way things work in this country, unfortunately, at least with most practices

What I'm taking away from this experience is to ask even more questions than I already do (which is a LOT), and that I am not alone in being frustrated that tests and procedures are very, very often done without any explanation, explicit consent, approval, or understanding of cost. Everything about our health care system is in such a sorry state, it makes my stomach hurt.

I'm going to pay the bill, and move forward in my care asking as many questions as I feel I need to get clear answers, and make really really sure our doula understands all of our desires and concerns so that she can help slow decisions down during birth if I am unable to focus on what's going on! I've heard way too many stories about episiotomies, etc., being done without permission or awareness, and want to avoid anything like that at all costs.