Looking into all my options...thanks
post #1 of 10
10/10/08 at 4:28pm
Dr. Schindler is a family practice doc, yes? If so, it certainly can't hurt to ask if he'd be willing to write the script and bloodwork. The worst he can do is say no, right? I would of course, make an appointment and pay the office visit, if he said yes, as it's only fair that he get paid.
Otherwise, I think it could be worth the one hour drive for one visit to Stacia's suggested OB to make your life easier in general!!
Can't say for Dr. Schindler, but I tried to get Dr. Sayed in W Bloomfield (also a family practice doc, also homebirth friendly) to do this during my last pregnancy and after some investigation on her part she ended up refusing. Apparently, family docs have a different sort of liability insurance than OBs (who pay much more $$ for their insurance), and prescribing something like rhogam is not within the normal scope of practice for a family doc. I'm not sure if her insurance expressly forbade her to prescribe it, or if she chose not to for fear of raising red flags.
That said, my dd2 ended up being O- so we didn't need it anyway. My dh is O+, but his dad is O-, so there was a 50/50 chance the baby would be negative. So depending on the blood types of your dh's parents, this might be true for you too.
Stacia (Defenstrator) was my midwife, and our plan was as follows:
* Test baby's cord blood right after birth. If O-, then no worries.
* If baby tests O+, then we were going to draw my blood and do a lab test to check for the presence of the baby's blood in my blood. This test is not 100% accurate (no test is), but it's reasonably accurate so I felt comfortable with it. If there was no sign of the baby's blood, then I would decline the rhogam. If baby's blood was present, then I would get the rhogam.
That said, we are not planning on having any other children anyway, so I felt comfortable with the small risks inherent with this plan (which, again, were moot due to dd2 being O-).
FWIW, there are risks to getting the rhogam shot (it's a human blood product, so it can therefore transmit human diseases, which it did with HIV and hep B until they knew to test for them, etc.), so you may want to look into that as well. It's normal protocol to get it during pregnancy, but the risk of becoming sensitized during pregnancy is very, very small, especially if you don't sustain an injury, so I decided not to get the prenatal rhogam either.
Anyway, I've wandered off topic. In short, I'm not sure if a family practice doc can or will do prescribe or administer the rhogam. As for the bloodwork, your midwife can probably do this. Stacia was able to for me.
Thanks for your concern about the Rhogam, but I have researched it and have only chosen to get it after the birth if the baby is positive (that is also what we did with DS). So I would still want to get the script after the birth, or atleast have it available. At this time I do not believe this will be our last child.
Some of the midwives in the area do the blood tests and some don't... some used to and don't anymore. I have interviewed 3 midwives and only 1 out of the 3 can/will do bloodwork and it is most likely I will choose one that doesn't do the bloodwork.