Originally Posted by gurumama
Miscarriage certainly can be prevented, in some cases, with specific prenatal care - progesterone supplements/inserts, for instance, can prevent help some mothers to prevent loss.
In other cases, mothers with known antiphospholipid profiles can take anticoagulants to prevent blood clots disorders from causing miscarriage, and go on to have viable pregnancies and live births.
Thyroid disorders that were previously undetected and implicated in miscarriage can be corrected with simple hormone replacement to prevent miscarriage as well
This has been covered, but I have to agree... The miscarriage stuff you listed does not get run as a regular thing during pregnancy. In fact depending on where you are you have to ask for it (or beg for it) even if you are higher risk. I am on pregnancy #10, with two living children and one that I am still gestating and if I wanted those run I would specifically have to seek out a care provider to do them, they still aren't just offered. If I wanted to UP but I had the same history as I do now I would do the same... seek out those tests if I wanted them and then possibly continue the pregnancy with no further prenatal care. Absolutely no difference.
Originally Posted by gurumama
- Gestational diabetes - uncontrolled, can lead to macrosomia and problems with vaginal birth/shoulder dystocia.
- Polyhydramnios - can lead to cord prolapse and possible oxygen deprivation (CP can result), and can (about 1/3 of the time) be a marker for more serious issues. Proper monitoring can prevent fetal/neonatal issues.
- Oligohydramnios - the flip side of poly, can lean to cord compression, musculoskeletal abnormalities if not caught and monitored.
- Omphalocele - if detected via prenatal care, and ultrasound specifically, a surgical care team can be assembled to prevent neonatal death and repair organ issues.
- Thyroid disorders - failure to treat can lead to mental retardation in the baby.
All of these, if caught early in pregnancy, can be monitored and either prevented or seriously mitigated to provide the best possible outcome for mother and child.
GD - Doing the gestational diabetes screen is optional where I am. You make the choice. And there are lots of reasons why not to do it... accuracy being the biggest IMO. As for doing dipsticks for sugars or blood sugar testing with a monitor (which is more reliable than the GTT)... both are easily done at home without any health care provider.
Amniotic fluid issues that are significant enough to be caught by fundal height or palpation can still be caught during a UP. Those that require ultrasound to diagnose or any birth defect that requires ultrasound to diagnose might still not be caught in standard prenatal care given that the issue may not develop/be able to be caught later than the 18-20 week mark which is for many people their only ultrasound. Also even ACOG doesn't recommend ultrasound for all pregnant women in the absence of an indication and their guidelines on ultrasonography during pregnancy states that discovering abnormalities in amniotic fluid volume as an outcome during ultrasound in pregnancy is based on limited or inconsistent evidence.
Originally Posted by kittywitty
I agree. And don't worry about that guilt trip. You can make anything into one. My intervention/care almost caused me to die at least once during a birth, so I would probably be very upset if someone said that to me. It doesn't mean I'm anti-intervention or anti-prenatal care by an OB, but it's really nobody's business. I think your friend was trying to be helpful and caring, but I would not take any offense from it seriously.
Me too. For me it really shaped how I feel about this pregnancy. But I still would not negatively judge someone who makes the choice to transfer into a hospital for the same reason I did as not caring about their baby or being negligent with their care, even if I do feel like it was unnecessary and the wrong call for me.
As for the "what ifs" OP you have to weigh that out for yourself. I can say, speaking for myself only, that I feel guilty still over going to the hospital during my second labour. I walked in to the hospital with a healthy Mom and healthy baby and due to my choice to be there (which really wasn't presented as a choice but still, we always have the choice to say no) could've lost my life if not for a bit of luck and chance swinging the other way. Due to nothing more than an overzealous resident who got annoyed with how my labour was progressing and decided to go off label with a drug. I didn't choose that part, but I chose to be in the place where that could happen and it weighs terribly on me. For me, something going "wrong" at home wouldn't be any worse than something going "wrong" at the hospital... we may all make the best choices we can at the time, but that doesn't mean we don't have guilt. We just have to decide what we can live with.