new screening test for shoulder dystocia performed without informed consent - Page 2

[turtlewomyn]

Woo hoo!!! Congrats on that big beautiful baby!

[kkar]

Congratulations!!!!

[khaoskat]

Under HIPPA, they have to have your consent to share the results of any tests with anyone other than yourself. So, unless you consent to the test results being shared, they cannot and they cannot force you to tell anyone the results.

I would just conveniently "forget" the test results at home. And then after the baby is born just accidentally happen to find it in the bottom of your bag.

A lot of "non-invasive" studies do not require consent. A certain medical group is doing research into a study, and they just take some numbers/measurements off your US. By consenting to treatment, you are in a way consenting to be in their test that is going on.

Where the real issue comes is that she had no right to call your OB with these results, as there is no scientific data showing up to prove their theory right or wrong, it is just a research study on a new proposed technique. The results should be used only for their internal monitoring. The reason they may be asking you to share the results at the hospital, is so that the OB who delivers will return the results page noting weather or not there was validity to their results or not. It is how they are tracking weather or not their research is producing the desired results or not.

[mother culture]

Hi, I am so sorry you are being scared into a c section! This is one great reason to call on a doula with a strong will. Meditate on the birth you think you want and go in to the hospital well into labour. Stay off the bed and say no to all numbing drugs and Iv's. There is no reason to hand the staff any such info on your ability to have a normal birth. Bring in your healthy labouring self and show them where babies come from. Find your power mama otherwise they will take it from you!
Your baby will be born safley and don't let them pull on him/her in any form. Let him take his time and stay on your hands and knees. Just being on your back can get a small baby stuck especially when there is a Doc pulling on baby's head.
I live in CA if you need a doula in Northern CA otherwise post to find one here. Or DONA.org
Oh and say no to induction! That is the first step to a c section! Painful too! And once again will take away your power and hand it to them to manage. Blessings Gentle Mother You can Give Birth to a 10 lb baby it happens many times per day in this country alone!

[mother culture]

I was a little late with my reply but sounds like you did beautifuly! Congratulations! That is super fast!

[sapphire_chan]

What.the.:?

Let us know how big your baby actually was after you have a wonderful, problem free birth.


The study's still being run? And they gave results to a doctor participating in the study? :

ETA:
Congratulations!
9 1/2 lbs? Pretty good technician then.

[sapphire_chan]

So, just for fun, I wrote a nice long email to the company that made the screening test system. I complimented them on their amazing accomplishment of being able to predict the effect of hormones during labor. It really is quite astounding that they were able to take into account all the different things that can affect how a woman's pelvis opens during labor, don't you think?

It ended with:
"Because, frankly, if you did not consider these factors your screening test is about as accurate as me looking at a pregnant woman and guessing."

I'm betting I get back a form letter.

[cristeen]

:

[MsElle07]

Congrats on your baby and easy birth!

[lyttlewon]

Originally Posted by anrui

I just wanted to let everyone know the outcome of this story.

My GP agreed with me that we didn't need to heed the screening test. She confirmed that it's a very new test that hasn't been validated at all, and also said it does not include an estimate of the size of the woman's pelvis. She said I had the "pelvis of a queen" and was not worried about shoulder dystocia.

She also agreed to only break by waters and then wait and see before starting Pitocin. Almost no fluid came out when she broke the bag, but very soon afterward I started having regular contractions that picked up steam very quickly.

Two hours later, after a pushing stage of only 10-15 minutes, I gave birth to a 9 1/2 pound baby. He slipped right out with no problem at all!

Is she going to remove the test from your file?

[wifeandmom]

Originally Posted by anrui

I recently read somewhere that in the US, an OB gets around $3,000 for a vaginal delivery and over $30,000 for a c-section. Does anyone know if this is true? I'm sure the hospital gets a lot more as well. It's easy to see that an OB has a huge vested interest in boosting his c-section rate a few notches, especially when the hospital is probably rooting for him every step of the way.

I just took the time tonight to look up reimbursement rates for OBs doing vaginal deliveries vs. c-sections.

For Tricare Standard patients (and these rates are supposedly comparable to other reimbursement rates, though I have no clue if that's true or not):

Vaginal birth with all prenatal visits: $1641.03

C-section with all prental visits: $1854.81

So they are making a grand total of what? $213.78 more to perform surgery on a woman that takes a good deal more time than simply arriving in time to 'catch' the baby. Doesn't make sense to me that doc would have any desire to do surgery from the standpoint of hoping to get rich off of it.

Out of sheer boredom, I just looked up what they paid for my last c-section. The hospital got $2846.62. The second surgeon got $182.45. The anesthesiologist got $194.26. And my OB got $1854.81 (which included all prenatal visits, ultrasounds, lab work, etc and my 6 week follow up appt as well). That totals less than $5100. A far cry from the $30K being thrown around, though I'm sure OBs wouldn't argue with getting paid that much.

The hospital also got $450ish for well baby care and we paid $240 out of pocket for 2 pediatrician visits that weren't covered under our insurance because the doctor isn't verified through Tricare. Those two visits would normally cost around $100 IIRC.

Still well under $6K for absolutely everything, from positive pg test through delivery and follow up appt. Wonder if they'll send me the other $24K?

[Storm Bride]

Originally Posted by fourlittlebirds

I'm astounded that they totally dismiss the hands-and-knees maneuver as impractical and unproven in favor of much more invasive procedures, including (as a last resort) symphysiotomy or pushing the baby back up and performing a cesarean.

If this is the site I think it is (can't recall the name for sure, but I think that's it), I'm doubly astounded because they totally dismiss after mentioning one study in which it had a...80% (?? close to that) success rate...higher than any other intervention mentioned on the site.

I read it all to dh one night, and he said it was a clear case of "NIH" - Not Invented Here.

[Storm Bride]

Originally Posted by wifeandmom

So they are making a grand total of what? $213.78 more to perform surgery on a woman that takes a good deal more time than simply arriving in time to 'catch' the baby.

I can't see why they wouldn't. Go to their forums sometime - many of them are totally in love with c-sections, because of the convenience for them. Several of them were talking once about how great it would be if they could work at a 100% c-section hospital, and they wouldn't have to deal with the scheduling issues involved in obstetrics. $200.00 extra a pop might not be much - but when you get the extra for doing what you already prefer, anyway, that's a pretty sweet deal.

[Kathryn]

Originally Posted by wifeandmom

I just took the time tonight to look up reimbursement rates for OBs doing vaginal deliveries vs. c-sections.

For Tricare Standard patients (and these rates are supposedly comparable to other reimbursement rates, though I have no clue if that's true or not):

Vaginal birth with all prenatal visits: $1641.03

C-section with all prental visits: $1854.81

So they are making a grand total of what? $213.78 more to perform surgery on a woman that takes a good deal more time than simply arriving in time to 'catch' the baby. Doesn't make sense to me that doc would have any desire to do surgery from the standpoint of hoping to get rich off of it.

Out of sheer boredom, I just looked up what they paid for my last c-section. The hospital got $2846.62. The second surgeon got $182.45. The anesthesiologist got $194.26. And my OB got $1854.81 (which included all prenatal visits, ultrasounds, lab work, etc and my 6 week follow up appt as well). That totals less than $5100. A far cry from the $30K being thrown around, though I'm sure OBs wouldn't argue with getting paid that much.

The hospital also got $450ish for well baby care and we paid $240 out of pocket for 2 pediatrician visits that weren't covered under our insurance because the doctor isn't verified through Tricare. Those two visits would normally cost around $100 IIRC.

Still well under $6K for absolutely everything, from positive pg test through delivery and follow up appt. Wonder if they'll send me the other $24K?

Sounds like a steal! When I was pregnant with my daughter, I was calling hospitals to show my insurance company how much cheaper a homebirth would be. The hospitals around here for a normal, vaginal delivery, with NO drugs or complications was $9000. C-section was $22,000.

[applejuice]

When a doctor does a caesarean section delivery, he/she has a patient for life. Mothers will continue to go to that doctor because he/she "saved my baby!" for their annual checkups, any minor surgical procedure as cytosurgery or hysterectomy.

I do not know where you got your figures, but a surgical delivery here is $20-30,000. The costs for the baby are excessive also as many surgically delivered babies need resuscitation and care in the neonatal intensive care unit. Insurance usually covers it, so few people feel the financial pinch. In Canada, the government pays doctors the same per birth whether they do a caesarean or vaginal birth, yet the caesarean section rate parallels that in the United States. Doctors simply believe that what they do helps people.

Congratulations to the OP of this thread. I am glad another woman has triumphed over medical technology and managed to give birth normally in a hospital setting.

[NursingStudent]

I am so glad that your birth went so well, and that your care provider didn't give too much weight to the test.

Informed consent is tricky- it seems pretty standard with surgeries, and totally overlooked with medications and tests. I certainly have more studying to do in that area.

Rest well!

to Adelle, born 01/06 :

[wifeandmom]

Originally Posted by Kathryn

Sounds like a steal! When I was pregnant with my daughter, I was calling hospitals to show my insurance company how much cheaper a homebirth would be. The hospitals around here for a normal, vaginal delivery, with NO drugs or complications was $9000. C-section was $22,000.

Oh, the hospitals and docs can charge a million bucks if they want, but insurance companies are only going to pay the allowable charges, which are *much* less than what a hospital is going to quote you.

One prime example is when my DD had a septic work up that included IV with antibiotics started in the ER, urine catheter, chest x-ray, spinal tap, blood work, and RSV/flu snot tests. The ER billed over $5000 for those services. They got paid less than $200. And that's not a typo either. So they got approximately 5% of what they billed.

My c-section was similar. I posted what our insurance PAID (which the hospital takes as full pmt), not what they were charged. I believe the original hospital bill was for over $9000. Doesn't mean that is what was actually paid though.

[Kathryn]

Oh, I know all about reimbursment rates. Our insurance has paid about 80% of my daughters hospital bills thus far.