Need advice...I'm having to beg Dr. for blood work!

[stellamia]

I've read so many posts here from women very early in there pregnancy who have their hCG and progesterone levels tested right away. I called my Dr. this morning and requested to have my progesterone levels tested and they said I don't need it. The Midwife who called me back said that "there's not even proof progesterone does anything" and that my "placenta will do that work." She also warned me if I try to BF my 20 month old much longer, it'll be a huge strain nutritionally because I'm "trying to feed 3 people." Huh?!?!? I'm 12 DPO (which they knew) so my placenta isn't even fully formed yet!! And progesterone (suppositories) absolutely helps if progesterone levels are too low!! I don't understand why they wouldn't even want to test me! I'm fully insured so they aren't paying for it! I talked to my friend who works at a Dr's office and is on pro. supp. herself and she told me to call back and told me exactly what to ask for and what to tell them as well as what not to tell them. I'm waiting for a call back from the Dr. so she can schedule my B/W. Hopefully I don't have to argue with her to get it!!!

Anyone else go through this or have suggestions?

Thanks!!

[MaerynPearl]

Do you have any reason to believe your progesterone levels are low?

[Mosaic]

I do not believe that hCG or progesterone tests are standard for early pregnancy, though they are pretty common for women who have experienced previous losses or other fertility issues. Many doctors do also believe that the jury's still out on the impact of progesterone supplements.

As for still nursing? Yeah, that one just seems misinformed. If I were you, I would just take good care of myself and nurse as long as it still worked for us all.

[MaerynPearl]

Originally Posted by Mosaic

I do not believe that hCG or progesterone tests are standard for early pregnancy, though they are pretty common for women who have experienced previous losses or other fertility issues.

the only reason I even had them tested (at 8 weeks pregnant, mind you!) was due to a 13 week loss with my first pregnancy.

[Maurine]

I have wondered the same thing. My two most recent pregnant friends (there are a lot of them) both were told by their docs not to come in until 9 weeks, or their first listen to the heartbeat. They didn't even want to give them bloodwork.

I think that's so silly. In the above cases one was pregnant with (so far) healthy twins (which would have been nice for her to know sooner, yes?) and the other ended in a miscarriage.

[MaerynPearl]

Originally Posted by Maurine

I think that's so silly. In the above cases one was pregnant with (so far) healthy twins (which would have been nice for her to know sooner, yes?) and the other ended in a miscarriage.

in neither case would going in sooner change anything.

finding out you are having twins could happen at 20 weeks or not until they are born for some women, even those going in at 4 weeks, the day they get their bfp!

And most miscarriages cannot be prevented. MOST miscarriages are not caused by progesterone problems.

Would like to add, my first stopped developing at around 6 weeks and I did not lose it until 13 weeks. Those 7 weeks of thinking I was pregnant before finding out I wasn't did not make it any harder to lose. It did get me out of a really rough time in my life before finding out though. Going in would have done nothing but cause the doctors to give me pills to expel the pregnancy sooner rather than allowing my body to do it on its own.

[Maurine]

Originally Posted by MaerynPearl

in neither case would going in sooner change anything.

finding out you are having twins could happen at 20 weeks or not until they are born for some women, even those going in at 4 weeks, the day they get their bfp!

And most miscarriages cannot be prevented. MOST miscarriages are not caused by progesterone problems.

Would like to add, my first stopped developing at around 6 weeks and I did not lose it until 13 weeks. Those 7 weeks of thinking I was pregnant before finding out I wasn't did not make it any harder to lose. It did get me out of a really rough time in my life before finding out though. Going in would have done nothing but cause the doctors to give me pills to expel the pregnancy sooner rather than allowing my body to do it on its own.

I still think it's a shame that docs won't at least have the women come in for a "well woman" discussion about proper diet, avoiding alcohol, all that jazz. I mean, most women know that at this point but neither of my friends heard a peep from their docs until that first appointment.

[YummyYumYumMama]

i agree with mae. in a healthy person with no prior history of loss, it is not at all standard to test for hcg and progesterone. the only people i know who have been tested for both have a history of loss or were undergoing fertility treatment (or both). i was never tested for either when pregnant with my daughter, and my first appt was at 8-9 weeks. they wanted to make the appointment at 12 weeks, but i needed a pap so i got to squeeze in earlier. you can't always reliably hear the heartbeat through doppler till 12-14 weeks anyway.

when i do hear of practices wanting to confirm a pregnancy, i hear they tend to use pee tests (and not always the most sensitive kind). if i wanted a blood test with hcg and progesterone, i would call my primary care doctor and not my midwife group.

do you have any reason to worry about a loss? if not, just relax and trust your body! plenty of women never ever get a blood test and still go on to have healthy pregnancies and healthy babies.

[Steph152]

I think that if you request a test your practitioner should either give it to you or give you a good explanation of why they don't think it would be helpful/ necessary instead of just blowing you off. The remark about breastfeeding would concern me too. If you are already unhappy with the care you're getting, maybe you should look at other practitioners.

[MommyNicoleTX]

Originally Posted by stellamia

I've read so many posts here from women very early in there pregnancy who have their hCG and progesterone levels tested right away. I called my Dr. this morning and requested to have my progesterone levels tested and they said I don't need it. T

Anyone else go through this or have suggestions?

Thanks!!

My Ob/gyn wouldnt order the bloodwork either ...my MW would be she is only in my area once a month. i had 2 m/c in '09 and wasnt going to chance it (low progesterone-when its easily treatable). so i found a lab that is "no appointment or doctors orders needed". I go in, get drawn, get results in the morning. $85 total for HCG & progesterone. Cash pay only-they dont take insurance. but i LOVE being in control of MY care. So I called back that ob office with my low and dropping progesterone levels and told the nurse "the OB really should have listened when I asked for a blood draw" and she agreed, the ob called in progesterone suppositories. so id say google "no doctors orders lab" and your city and see what comes up.

[lovestolearn]

And if you intuit low progesterone, you can get Progesterone cream over the counter (Emerita is the brand I use.) It won't hurt, if you use it according to the package directions--and it will definitely help your piece of mind. Personally, I prefer to feel empowered and not reliant on someone else's idea of what my body needs.

[karmab]

as frustrating as it is, many hcp don't see women till they are 8 weeks, and progesterone isn't tested unless you know (or suspect) you have a problem with it, in which case, a lot of hcp would skip the test anyway and just put you on prog supps as soon as you know you are pg, if not sooner, like as soon as you o if you are ttc. if you do have a prog problem, make sure they know about it now.

you are bf-ing, so you are taking prenatal vitamins, yes? if not, then since you may have to wait for your appt, you might just want to go to your local pharmacy and pick some up and start taking them now. the only one of my children i weaned instead of letting them wean themselves was #3 when i got pg with #4 because it actually was too much for me. after the 3rd time i fainted, and figured it out, i did have to start weaning #3 down- he was 17 months and still nursed a lot. i couldn't drink enough or eat enough to keep from losing weight and being dizzy and seeing stars everytime i stood up- but that's just me. i know a lot of people do it with no problem.

[stellamia]

Originally Posted by Maurine

I have wondered the same thing. My two most recent pregnant friends (there are a lot of them) both were told by their docs not to come in until 9 weeks, or their first listen to the heartbeat. They didn't even want to give them bloodwork.

I think that's so silly. In the above cases one was pregnant with (so far) healthy twins (which would have been nice for her to know sooner, yes?) and the other ended in a miscarriage.

I'm sorry for your friend who miscarried. I just don't understand why some women are in their Dr's office confirming pregnancy and getting B/W done as soon as they get a BFP and others aren't seen until 8-10 weeks. With Midwives I'm used to going in for my first appt at 10-12 weeks, but my old Dr. wasn't so relaxed about it.....

Originally Posted by Steph152

I think that if you request a test your practitioner should either give it to you or give you a good explanation of why they don't think it would be helpful/ necessary instead of just blowing you off. The remark about breastfeeding would concern me too. If you are already unhappy with the care you're getting, maybe you should look at other practitioners.

Totally agree! I know I didn't go to Med school and I don't know everything, but they didn't hear me out or even really seem to understand my concern. I actually am not going to see this Dr. again....I'll be getting all my pre-natal care through my Midwife (who will also deliver my baby at home) but I wanted to go to my Dr. for the tests and early stuff that's covered by Ins!

Originally Posted by MommyNicoleTX

My Ob/gyn wouldnt order the bloodwork either ...my MW would be she is only in my area once a month. i had 2 m/c in '09 and wasnt going to chance it (low progesterone-when its easily treatable). so i found a lab that is "no appointment or doctors orders needed". I go in, get drawn, get results in the morning. $85 total for HCG & progesterone. Cash pay only-they dont take insurance. but i LOVE being in control of MY care. So I called back that ob office with my low and dropping progesterone levels and told the nurse "the OB really should have listened when I asked for a blood draw" and she agreed, the ob called in progesterone suppositories. so id say google "no doctors orders lab" and your city and see what comes up.

Thank you SO much for this info Nicole! I found a lab and was going to order the test but thankfully my Dr. finally listened to me! I am so glad to know that, should I need it in the future, I can order my own B/W! My Mom will probably use them for my brother too because we're convinced he has hypothyroidism but no one will test him (we ALL have it in my family so he has a huge chance of having it too and needs 12hrs of sleep to function among other symptoms).

Originally Posted by YummyYumYumMama

i agree with mae. in a healthy person with no prior history of loss, it is not at all standard to test for hcg and progesterone. the only people i know who have been tested for both have a history of loss or were undergoing fertility treatment (or both). i was never tested for either when pregnant with my daughter, and my first appt was at 8-9 weeks. they wanted to make the appointment at 12 weeks, but i needed a pap so i got to squeeze in earlier. you can't always reliably hear the heartbeat through doppler till 12-14 weeks anyway.

when i do hear of practices wanting to confirm a pregnancy, i hear they tend to use pee tests (and not always the most sensitive kind). if i wanted a blood test with hcg and progesterone, i would call my primary care doctor and not my midwife group.
do you have any reason to worry about a loss? if not, just relax and trust your body! plenty of women never ever get a blood test and still go on to have healthy pregnancies and healthy babies.

I actually did call my Dr., but she works closely with Midwives so the Nurse had a Midwife call me back for some reason.

I haven't had a loss but I needed NPC to extend my LP long enough to sustain pregnancy so I'm concerned that it may still be low. I'm prolactin sensitive and still BFing my little guy who's 20 mos so I was hoping that testing my progesterone levels will either get my Dr. to see I need suppositories, or, if my numbers are normal, I'll have peace of mind and will be able to BF without worrying that I'm risking my pregnancy.

Thank you for the kind words!

Originally Posted by karmab

as frustrating as it is, many hcp don't see women till they are 8 weeks, and progesterone isn't tested unless you know (or suspect) you have a problem with it, in which case, a lot of hcp would skip the test anyway and just put you on prog supps as soon as you know you are pg, if not sooner, like as soon as you o if you are ttc. if you do have a prog problem, make sure they know about it now.

you are bf-ing, so you are taking prenatal vitamins, yes? if not, then since you may have to wait for your appt, you might just want to go to your local pharmacy and pick some up and start taking them now. the only one of my children i weaned instead of letting them wean themselves was #3 when i got pg with #4 because it actually was too much for me. after the 3rd time i fainted, and figured it out, i did have to start weaning #3 down- he was 17 months and still nursed a lot. i couldn't drink enough or eat enough to keep from losing weight and being dizzy and seeing stars everytime i stood up- but that's just me. i know a lot of people do it with no problem.

Yes!!! Thank you! I take pre natals, extra folic acid under the tongue and concentrated om ega 3.

My best friend was commited to BFing her daughter throughout her pregnancy but had similar problems. She was on the verge of fainting so often that her husband pretty much said "NO MORE" to BFing. As hard as it was, she weaned and felt the difference right away.

I'm really hoping I'll be able to BF and through the whole pregnancy and then tandem nurse! We'll see!


SO! I went in yesterday and talked to the girl at the lab...she had me go talk to the OBGYN receptionist....I felt so helpless and worried and by the time I got up to the desk I was in tears. She went and talked to the Nurse and I went back into the Dr's office, talked to the Nurse and then saw the Dr. who ordered the test right as she was called away to deliver a baby!

So, YAY!!! I should get my results today and I got back tomorrow for my 2nd blood draw to make sure my hCG levels are doubling.

For me, I NEEDED this test for my peace of mind, I had very good reason to question my levels, AND I'm the one paying for it, so in the end it should be my choice. Persistence paid off for me and I'm really grateful.

ETA: Just got my hCG levels! 158!! At 14 DPO!! Yay!!! Pro. levels won't be back till tomorrow!

[finnegansmom]

I'm so happy to hear your results are great and that they finally agreed to the testing.

I think when it boils down it, Dr's don't perform the tests because insurance companies don't always pay for them. When I got pregnant with my second, I was VERY nervous about progesterone levels, prolactin and nursing since I was still nursing my 13 month old. I read a ton on the internet and totally freaked out and repeatedly asked for levels to be checked. My Ob (whom I later switched to a midwife) finally let me come in for 1 beta. I wasn't seen again until 12 weeks, then made the ole switcheroo.

I think sadly, it boils down to money - I can't see any other reason why a healthcare professional would deny testing, obviously I'm not going to walk into my doctor out of the blue and ask for MRIs and EKGs, but a simple blood test that probably cost $40 or something is a no brainer.

[Steph152]

That's great stellamia! Congratulations on getting such good news!

[smartycat]

What did your progesterone levels come back as?

Right now DP and I are fighting because she went in yesterday to see our GP for pregnancy confirmation and she allowed us to get beta hcg but told her she didn't need a progesterone test. DP is breastfeeding our 10.5mo son and I worry her progesterone levels are low. DP says if the GP said it wasn't necessary then just to forget about it but I say it doesn't hurt to have the information. I am still hoping to change her mind today.

[MaerynPearl]

Originally Posted by smartycat

I say it doesn't hurt to have the information.

in my shoes I would have to disagree.

when my nurse called me and told me that my levels are lower than the doctor would like to see, though in the range of normal and as long as Im still getting morning sickness I should be fine... has had me worry every day I do not feel sick as a dog that something is wrong with the baby.

so yeah, it CAN hurt to have that information.

[~Adorkable~]

i do think that two things help influence doctors not giving the test,

there is a lot of disagreements as to whether progesterone will actually stop most miscarriages, most like other folks have said, most early miscarriages are caused by other things. even those that are because of low p might not be helped much by additional progesterone. this is not to say it is useless, just that there is debate

i also think that they take into consideration that numbers can really spook folks, a slightly low HCG probably means nothing and not everyone doubles in 48hrs. and preggo ladies can be amazing worry warts, and some folks like to "save us from ourselves"

i'm not saying that i agree with this, i just think that it does in fact influence health care folks.