Biophysical Profiles/Non Stress Tests's « Back to Group Discussions

[cocoanib]

Is anyone doing these?

To make a long story short, I'm no longer seeing a homebirth midwife, but an ob. It has to do with insurance mostly. We are planning to UC, but I'm seeing them for prenatal care.

Just for background, my babygirl was born at home and I saw a homebirth midwife the entire time, except for a bleeding scare at around 10 weeks.

Anyhoo- I don't particularly like my ob or their practice, but go because that's who takes my insurance and also the fact that I am not planning on birthing with them, so I just grin and bear it and pick my battles on what poking, prodding, testing I will do.

So, yesterday after my appointment (weight, BP, heartbeat, belly measure), I was out in the waiting room making my next appt. when the ob came out and said "oh yeah, we are going to have to start you on twice per week BPP's". I asked why and she said because of your age. I asked if that was the only reason and she said yes. She said they would get approved with my insurance and then call me with the appts.

I sat their dumfounded for a minute, before I left. I mean, I knew that they would try and get me to do these at a certain point(which I would decline), but starting at 32 weeks and twice a week? All because I'm 36....That's crazy to me!

I'm healthy, BP, urine, weight is great. I've had 3 u/s and baby is wonderful. There is no way, I'm doing BPP's twice per week because I'm 36.

Does this sound unreasonable to anyone else?

Well, the receptionist called me today with an appt for the first BPP this Friday. I can't make it and even if I could, I would not go. I told her that I thought about the BPP's and I think it's unecessary for me, so I won't be going. She said I would have to discuss that with the ob at my next appt. So, of course I will. I'll tell her that I will go once or twice, but twice per week is unecessary for me.

[Chapsie]

Oh my! Twice per week BPPs and NSTs at 32 weeks! Are they nuts??!

Yeah... I'm totally with you on this one. Seems like a scam to get more insurance reimbursement. (Is that too cynical of me?).

I would be pretty mad if my OB made appointments for me like that too and just expected me to show up.

What are you going to do?

[buko]

No way-- that is some bull.

[spughy]

This seems ridiculous.  I'm over 40 and have a few risk factors and I'm pretty sure there won't be any NSTs in my future until I get past 41 or 42 weeks.  Yay socialized medicare.

[cocoanib]

Okay, I was beginning to think I was the crazy one, but it looks like you Mamas had the same thoughts as me!

Originally Posted by Chapsie 

Oh my! Twice per week BPPs and NSTs at 32 weeks! Are they nuts??!

Yeah... I'm totally with you on this one. Seems like a scam to get more insurance reimbursement. (Is that too cynical of me?).

I would be pretty mad if my OB made appointments for me like that too and just expected me to show up.

What are you going to do?

I think they are nuts!

I can't beleive that my insurance didn't want to cover a homebirth midwife, but they apporved a twice per week waste of time and money.

Originally Posted by buko 

No way-- that is some bull.

My exact thoughts.

Originally Posted by spughy 

This seems ridiculous.  I'm over 40 and have a few risk factors and I'm pretty sure there won't be any NSTs in my future until I get past 41 or 42 weeks.  Yay socialized medicare.

Seriously, that would be at least 18 NST's fron now until birth!

[jodieanneanton]

Uh.. I would decline in a heartbeart.  I even get annoyed when my baby's heartbeat is checked at every appt via doppler.  I know my baby has a heartbeat... She is kicking/punching/spinning in me.  lol.  So, yeah.  I would definitely decline unless I a)went overdue by over a week or more or b) had had a stillbirth in the past and the NST would offer me a degree of comfort that would be worth the risk of (what I think is) overexposure to ultrasound.  Twice a week for 8 weeks?!?!  That's insane!

[Melany]

I'd question the OB like crazy. Since there are no indications other than age, I'd even try to play it dumb and tell him that is such a huge time commitment for something that will not add any benefit. Tell him you're "willing" to discuss this if there is any indication that your baby needs it, but you just don't have the time to take off from work for this right before you go on leave. (assuming you have leave). Or, tell him you're not willing to expose your other child to this type of stress and would have to hire a babysitter. What a hassle. 

Of course, I do like your method of telling the receptionist to cancel the appointment because you will not be able to make it. That, alone, could go on for weeks. :)

[cabbitdancer]

That's ridiculous. Even as an insulin-dependent diabetic, which is far more high risk than simply being 36, I only have one NST a week + one BPP, supposedly starting this week. (The High Risk OB--who is supposed to be doing my BPPs--said he won't see me again until next month, which would mean we'd start those weekly at 36 weeks? I have to ask my OB about this, because there seems to be some sort of disconnect between the two of them.)

[cocoanib]

Originally Posted by jodieanneanton 

Uh.. I would decline in a heartbeart.  I even get annoyed when my baby's heartbeat is checked at every appt via doppler.  I know my baby has a heartbeat... She is kicking/punching/spinning in me.  lol.  So, yeah.  I would definitely decline unless I a)went overdue by over a week or more or b) had had a stillbirth in the past and the NST would offer me a degree of comfort that would be worth the risk of (what I think is) overexposure to ultrasound.  Twice a week for 8 weeks?!?!  That's insane!

I don't like the heartbeat check either. It's silly, when the baby is moving so much right now.

Yes, if I go overdue or something comes up, I will go for my own peace of mind. I'm just so surprised for them to think that twice per week starting now is a good idea.

Originally Posted by Melany 

I'd question the OB like crazy. Since there are no indications other than age, I'd even try to play it dumb and tell him that is such a huge time commitment for something that will not add any benefit. Tell him you're "willing" to discuss this if there is any indication that your baby needs it, but you just don't have the time to take off from work for this right before you go on leave. (assuming you have leave). Or, tell him you're not willing to expose your other child to this type of stress and would have to hire a babysitter. What a hassle. 

Of course, I do like your method of telling the receptionist to cancel the appointment because you will not be able to make it. That, alone, could go on for weeks. :)

Yes, now that the shock has worn off, I'm prepared to discuss at the next appt. I don't like how it was sprung on me after the appt either.

Like you said, I will say I'm willing to do one later in pregnancy or if anything comes up that indicates it.

Seriously, I really don't have time to spare an hour twice per week right now anyways. Even if I did...ummm still no.

Originally Posted by cabbitdancer 

That's ridiculous. Even as an insulin-dependent diabetic, which is far more high risk than simply being 36, I only have one NST a week + one BPP, supposedly starting this week. (The High Risk OB--who is supposed to be doing my BPPs--said he won't see me again until next month, which would mean we'd start those weekly at 36 weeks? I have to ask my OB about this, because there seems to be some sort of disconnect between the two of them.)

Now, that sounds very reasonable.

I think maybe the ob didn't even think it through and just told me this because of a practice standard.

I wonder how many women actually go through with what I was told, for no other reason than being "advanced maternal age".

[madelaine]

 Quote:

Seems like a scam to get more insurance reimbursement.

Yes, this. Seriously. When I had high blood pressure last time towards the end, I think I had one BPP and maybe twice a week NSTs, which I found excessive, but this is ridiculous.

[ancoda]

I would refuse that early if there is no other reason then age.

Here in texas I have to start having them after 40 weeks and that is even annoying to me since my last two both came at about 42.5 weeks. 

[withlittlelungs]

That is ridiculous!! I would definitely refuse it. If it was really that important/concerning to her, she would have mentioned it in your actual appointment.
 

[cocoanib]

Originally Posted by madelaine 

 Quote:

Yes, this. Seriously. When I had high blood pressure last time towards the end, I think I had one BPP and maybe twice a week NSTs, which I found excessive, but this is ridiculous.

Now that you and Chapsie have mentioned it, seems like that could be it. That would be at least 18 of them, that's a lot of money!

Originally Posted by ancoda 

I would refuse that early if there is no other reason then age.

Here in texas I have to start having them after 40 weeks and that is even annoying to me since my last two both came at about 42.5 weeks. 

Quote:

Originally Posted by withlittlelungs 

That is ridiculous!! I would definitely refuse it. If it was really that important/concerning to her, she would have mentioned it in your actual appointment.
 

I'm refusing for sure.

You're right about her mentioning it during the appt. If there were concerns, she would have said it during the appt.

I think she probably looked in my chart after the fact, saw my age and decided it was time for NST's without any other reasoning.

[akind1]

I agree with everyone here. I usually end up having them because my babies never come before their due dates, so I have one  a week after 40 weeks. I've done 1 NST with my first pregnancy. Both were born at 41+6.

But just random ones because you are 36? I'd fight as tactfully as I could - and I would want to maintain a cordial relationship JIC you do need to transfer, even though you plan to UC (it doesn't hurt to have a back up plan).

FWIW: the doppler checks don't bother me. I find the swoosh-swoosh gallop of his heartrate reassuring, even as he is kicking me in the ribs. The OBs I see rarely keep it there more than 30 seconds - just long enough to get a good read - they don't dally, and nearly every time pick it up immediately.

[cocoanib]

Originally Posted by akind1 

I agree with everyone here. I usually end up having them because my babies never come before their due dates, so I have one  a week after 40 weeks. I've done 1 NST with my first pregnancy. Both were born at 41+6.

But just random ones because you are 36? I'd fight as tactfully as I could - and I would want to maintain a cordial relationship JIC you do need to transfer, even though you plan to UC (it doesn't hurt to have a back up plan).

FWIW: the doppler checks don't bother me. I find the swoosh-swoosh gallop of his heartrate reassuring, even as he is kicking me in the ribs. The OBs I see rarely keep it there more than 30 seconds - just long enough to get a good read - they don't dally, and nearly every time pick it up immediately.

Yes, I have been open to compromise with them just to keep a nice cordial relationship. Picking my battles wisely as to not rock the boat too much :)

Well see how the convo goes at my net visit.

If I go much past 40 this time around(babygirl was 41 +4, no NST's) I'm willing to do them to keep the ob's happy and also check in on things.