Can/do hospital based midwives "turn you in" to CPS for not continuing care?

[AbbieB]

Here's my situation:

I'm pregnant with my 3rd baby. I qualified for medicare this time around and I had a few worries in the first trimester so I decided to seek shadow care from an midwife/OB practice.

My first 2 children were born at home with a midwife, the second time she was out of state so not legal in my state. I did self care with phone consults for my second baby and was prepared to UC, but in the end went with some help.

This time around the plan is to again work with the same out of state midwife. She has been consulting with me by phone again, and the only "care" I have been receiving from the MW/OB practice is a ridiculous amount of lab work and ultrasounds.

I've been with them for 10 weeks and have been seen at an appointment, for lab work, or for an ultrasound 5 times. They have set appointments and canceled them on me 2 times, both times calling me the day of the canceled appointment because I was a "no show". One of my appointments, that went very badly and involved a lot of lab work and 2 calls to the office later in the day to complain about how it went somehow does not show in their records (except they do have all the labs dated from that day.) They have refused to treat my low progesterone and my rising thyroid, the 2 biggest reasons I elected to get traditional care, and have actually told me to stop taking the progesterone proscribed by my family doc (he did the lab and caught the extremely low hormone level early in my pregnancy) because that lab number "does not matter." They are convinced I am diabetic and have tested me for diabetes every time that have seen me despite results that show not only not being diabetic but being in the "low risk of developing GD" category. The reason they are convinced I am diabetic? I am 40 and my DD was 10 pounds at birth, 8 years ago. The fact that she was 43 weeks at birth "was not a factor" in her large size according to them. The fact that GD testing in both of my previous pregnancies was negative does not matter either.

So, at 24 weeks this week, when they called to cancel an appointment set for the next day, one that had been rescheduled by them already, and was extremal difficult to schedule in the first place (they did not want to "allow" me to push it back one week so my DH could come with me, then after 2 days of debate they did, only to cancel it and push it back 2 more weeks!) and then getting a call on the day telling me I missed an appointment, I decided I was done, done, done with them.

I received another call from one of the midwives today telling me I must come in in the next 7 to 10 days for diabetes screening, it is very important to do this test, blah, blah, blah, and that we will need to have a talk if there is an issue. She mentioned they have not seen me in awhile (I was in less than 2 weeks ago to turn in a 24 urine collection, blood pressure, weight and they did a CMP and CBC.)

Sounds like I am about to be fired. According to my medicaid advocate they can fire me before 30 weeks and after 40 weeks.

My concern is that they may also report me for medical neglect or something since they are under the impression I have not been seen and I am diabetic (again, no labs have shown that) and high risk (one midwife tried to pressure me into a fetal echo-cardiogram by saying I was high risk, but when I asked when I got that label and why was I still seeing the midwives and not transferred to the OB's or the high risk OB she could only say, "Well, you are 40.")

Can they do that? Should I worry that CPS will show up at my door and make trouble for me and my family? My homebirth/out of state midwife was concerned that if I kept seeing them up until my due date and then did not birth with them that they would, she has seen it happen. But could it happen at this early date?

UC is still a real possability for us too. It makes me double worried.

[WaitingForKiddos]

What if you just said that you've found a different care provider and stop going to them?

[cristeen]

I would walk in there and ask for a copy of your medical file, all labs, and all notations of phone calls and canceled appointments.  You have the right to a copy of the file.  You may have to pay for copying fees, but I wouldn't warn them, and I wouldn't leave without it (these things have been known to mysteriously change or disappear with warning).  Then I'd go through your calendar and write down all the times you've been in, the times they've canceled and rescheduled, the phone calls, what you remember of what was said at the appts, and keep everything together.  You can also request a copy of all the submitted bills from your insurance company.  All on it's own it proves you sought care should the subject come up. 

You do not owe them an explanation, and if you've walked out of there with a copy of your file and told them that you are seeking care elsewhere (they don't have any right to know where elsewhere is), they can wash their hands of you.  Do not just cancel, not get your records and not fire them though, since that combo may raise flags. 

[Almi]

If they wanted to, they could certainly make a stink about it.

However, you don't legally have to receive prenatal care, or any care for that matter.  The only time they can get you for neglect is if the baby has a problem after birth and you don't take the baby to the doctor/hospital for treatment.  Which obviously you would do.  Lol.

Just remember your rights. :)

[Youngfrankenstein]

I agree with your first two replies.  Don't give them a chance to fire you, just go in, get your stuff and say you've found someone else.  And it may be a good idea to find someone else who can attend to the reasons you wanted shadow care to begin with. 

I had a homebirth and did shadow care and even scheduled an induction that I never went to.  I cancelled it but no one got the message and called looking for me after dd was born.  I just told them I'd had my baby and no worries and the office never called me again.

So the short answer is no.  I really don't think anyone will call CPS on you.

[mrsteapot]

You are considered "advanced maternal age" after, like, 35 (I think) Which means you are "elevated risk". That's what the hoopla over the echo on the baby's heart was all about. My last 3 have all had me AMA. Way to make me feel old, LOL! Anyway, like the pp said, get your records from them, and leave their care. Call your family doc and ask him for a recommendation for a different practice. Clearly this one is too busy and disorganized to provide proper care in the first place. That way you have the back up you need from hopefully someone more reliable. I'd personally be scared to death to have to deliver with the practice you are describing anyway, if it came to that. 

[Almi]

Oh yes, and for the record I did exactly what you described, OP, I saw my OB until 32 weeks, and I had an appointment scheduled at 36.5 weeks.  I gave birth the day before my appointment, so I just called them, told them I had had the babies, and that I'd like to cancel my appointment and schedule a post partum one instead.  I didn't get any grief over it.  Zero.  None.  The only thing my OB said when I told him that I had indeed had them unassisted was that it was "risky."  That's all he said about it, and he's currently seeing me for this pregnancy.

I did, however, have CPS investigate me because my mom called the cops on me when I was in labor after I wouldn't let her in my house.  She tends to do that when she doesn't get her way.  Which, she tried to get me to do a hospital birth throughout my entire pregnancy.  Big mistake telling her I was in labor.

[babycatcher01]

Any one can call CPS for anything with no valid proof or reason. IF someone calls they have to fallow up. As for the doctors, just dont go or call there is nothing they can do. Dont give them any details, remember you are employing them. Uc in all state is legal. Ignore them all and enjoy your pregnancy, if you need them you know were they are. 

[AbbieB]

Just an update.

I called the practice and told them I was seeking care else where. No big deal. No follow up calls. No one asked me any questions.

Since doing that I have been so much more relaxed. I'm sleeping better. I feel healthier. I find I am all of a sudden much more in tune with the baby and the pregnancy in general. It was so stressful being constantly treated like a ticking time bomb and being treated like I had no say in my own care.

I have all of my labs and ultrasound reports. I will continue charting and consulting with my out of state midwife so should I need to go to the hospital for any reason there will be a record of prenatal care, and labs to prove my health status (I will do more blood work with my family doctor and do a beta strep screen using a kit my midwife will send me.)