Getting Ultrasounds

[MegBoz]

I've decided on an HB with a CPM & CPMs are illegal here in Maryland. She is experienced at billing insurance, but can't do ultrasounds.

At this point (not even 7 weeks!) I think I'd like the testing I had before at the 11-12 week point to check for nuchal fold & nasal bone, as well as the 19-20 week anatomy screen (&, OK, I admit, I want to know the gender! - but that is not my sole motivation by any means.)

Insurance covered these things 100% before, so I'm expecting the same - I just need to know how to navigate the system to get the right paperwork! My HB MW is familiar with the hospital-based CNM who attended my DS' birth. I've called the office & left a message for her to see if that's something she can help with. Hopefully this isn't a rude request. The receptionist said she's in the office Monday, so she'll give her the message then.

Any input?
TIA!

[misidawnrn]

no advice on how to get u/s in Maryland but as far as the first u/s goes would you do something about the pregnancy if the baby did have Down Syndrome qualities on the u/s? if not, I wouldn't get that one but that is just me. Many places have U/S's for "fun" so you can try to check into that for the 20 week one.

[Climbergirl]

You could do shadow care with an OB until you have done the 20 week ultrasound and then no longer go to them. Hopefully, the CNM will order for you. What does your CPM say? You can't be the first person who has wanted ultrasounds???

Is your CPM from MD? If she is PA based, you may be able to get tests there?

[jennica]

I had difficulty finding someone to do the NT ultrasound being I was having a homebirth. My normal clinic wouldn't do it. I ended up going to a women's clinic that had CNM's on staff.

Also, to respond to misidawnrn, the NT scan checks for 3 types of trisomies, not just Down Syndrome. From what I recall, the other two trisomies it checks for are much more severe than Down Syndrome. With the other two, the baby may not survive the pregnancy, and if it does, it will probably live less than one year. Also, I totally disagree that one must know what they would do before gathering all the information. Some people like to know if there is a high risk first which they get from the NT scan. If so, they might go on to have amnio or CVS. If they then find the baby has a trisomy for certain, they can research the type it has and what the care and such would entail before making any decisions on the matter.

[sattygirl99]

Which MW are you using? (PM me her name LOL). I am also in MD and the CPM's I interviewed were able to order US no problem...

I am curious though as to wanting to have an NT scan... are you in a higher risk group? Even OB's aren't quick to do an NT scan unless you have risk factors. At least, I had to beg mine to order one with DD because I'm not considered at risk. No flames, just curious
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[TabithaB]

I don't live in Maryland. I live in Illinois and HB is practically "illegal" here. I had to leave the state and go to Missouri to one of the private places to get one. One of the ones that do the 3-D and 4-D scans. They also do the anatomy scans and look for issues.

They had no problem with taking a little extra time to take a few extra pictures of the placenta, etc. They even offered to send all the information to my midwife for me.

[XanaduMama]

I had my HB in North Carolina where CPMs aren't licensed either. My MW just referred me to a standalone ultrasound center, and we had no problems at all. Insurance paid for it, no questions (they didn't pay for the birth).

Presumably your MW has had to deal with this before? If nothing else, can't you just call up and make an appointment with a radiology center on your own?

[MegBoz]

Here’s my MW:
http://www.womanwise.info/who-we-are/
I actually didn’t discuss US with her too extensively, so I’m not sure what she normally recommends. But I know she’s somewhat friendly with the MWs who attended DS birth, so I thought I’d start there.

So apparently I’ve sorta signed myself up for shadow care.

Here’s the deal: I had DS with MWs at a very NCB-friendly hospital. But I only switched there from OB care at around 24W. So I never had what they refer to as “OB Intake” appointment (receptionist kept referring to it as “OB intake” even if you see the MWs since you’re an “OB patient.”)

OK, I called to reschedule the apt from one MW to another who my HB MW said was friendlier to her & HB. My intent had been to immediately tell the MW I’m planning an HB & just ask if they can help with referrals for US. I hadn’t known the first OB apt was a full hour! I told the receptionist, “I don’t want to come in for an hour. Could you just leave a message for this MW to call me please at her convenience?” When she asked what it was regarding, I told her the truth (planning a HB, just need her help with US referrals.)

The receptionist instead called back and said if I want them to refer me for ultrasounds, I still have to come in for the one-hour "OB Intake" appt to kick things off
I said, "That's fine, I don't mind coming in for an hour, I just didn’t want to waste their time since I was planning a HB"

She said, "Since your MW isn't licensed, they need you to come in since they're 'taking responsibility'"

Yeah, nevermind the fact that **I** am responsible for ME! But anyway, yeah yeah, I know, they have all that legal BS to worry about. I get it.
Of course, I felt the need to point out the fact that my MW IS licensed - just not in Maryland (CPMs are illegal in our stupid state but legal in the neighboring states. She is NOT unlicensed. She holds licensure in VA.)

Anyway, then I said, "Well, I want the US at 12 weeks & the other one at 19 weeks, would I have to come in for all the regular prenatals in the interim?" (i.e. full-on shadow care.)
She said she didn’t know.

Actually, if I have to come in for a few apts, that's not a big deal anyway since HB MW said I could do some apts elsewhere (if I had a "friendly provider") in order to not have the make the longer drive every time. (But only pre-36W.) Obviously I wouldn’t want to do that on a regular basis since the point of prenatals is to get comfortable with her, not JUST to have the BP, urine, FHR checks, etc. But to do a FEW with the hospital-MWs instead & save an hour on the road would be nice.

[russsk]

My Baltimore CPM ordered an ultrasound for me no problem. I do remember when I interviewed the MW you are using, however, that she couldn't order one and suggested shadow OB care. Perhaps she can call the mw I'm using to ask her how she does it? Also, since she is licensed in Va can she order one for you there?

[MegBoz]

Originally Posted by russsk

My Baltimore CPM ordered an ultrasound for me no problem. I do remember when I interviewed the MW you are using, however, that she couldn't order one and suggested shadow OB care. Perhaps she can call the mw I'm using to ask her how she does it? Also, since she is licensed in Va can she order one for you there?

Well I live just north of Bmore city so I wouldn't want to have to drive to VA. Ugh - that traffic!!

If the CPM you used lives in the city & has a name starting with K, I interviewed her as well. I felt I clicked better with KW, but I did like her too. (Which is good, since she might be back-up if KW is at a birth!)

I asked K-in-the-city about the 12 week scans, it was a last minute head-out-the-door Q & she said, "Couldn't you go to any perinatalogist for that?"
Honestly, I don't know. When I got the 12W scan before, I was seeing OBs at Hopkins & they sent me down to the hospital where a tech did the scans & an OB reviewed the images. Then the OBs discussed it again in the office visit.
For the anatomy scan at 19W, they sent me to American Radiology. So I don't see why a perinatalogist would be necessary.

Of course I suspect I could just make an apt at American Radiology again, but I'm concerned about all the insurance stuff. Ugh - that's the tricky part. I never had to think about it at all the first time around. It was so simple.

[XanaduMama]

I would start by just calling the Radiology place directly and asking about insurance billing. Personally I would not go through the whole OB nonsense just to get an ultrasound...there's got to be a better way.