Am I risking my baby's well being? (X-posted in "I'm pregnant") - Mothering Forums

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#1 of 38 Old 09-26-2011, 07:23 AM - Thread Starter
 
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I just canceled my weekly check up at the OB's office due to not having a ride. His practice is clear across town, no convenient bus connection available, no money for a cab (which would probably add up to about 35 bucks one way) and I really really cannot hack having my inlaws over for the whole day again after putting up with them all day yesterday. I'm sure they won't mind coming over to take me, but they won't leave, and I just can't deal with them again after an incredibly long day yesterday.

 

I didn't think it was a big deal, after all everything has been fine ever since I started going there. Blood pressure, urine checks, weight, fundal height, fetal heartbeat, everything. My appointments generally don't last for more than 10 minutes and then I'm out the door.

But when I told the receptionist (who is normally very upbeat and easy going) that I wanted to cancel, she told me that it was really really really not recommended at this stage (39 weeks 2 days today) to skip a week, that I needed the check up, and that she couldn't tell me it was okay to cancel it. She kept asking me if I could come in another day this week, and kept saying how it's really not a good idea to skip an appointment and it is very very important to come in.

 

It made me feel equal parts worried and pissed off. Why is she trying to bully me into an appointment that I don't really see the need for? Or am I missing something? She made me feel like I am purposely putting my baby's health at risk by canceling the appointment. I don't know what to think. Any input very very much appreciated!


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#2 of 38 Old 09-26-2011, 07:46 AM
 
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Maybe call back and say "would you routinely tell this to any woman at my stage in pregnancy? Or is there something specific that you need ME to come in for? Is there something you know that I don't??"

 

Women have been having babies for thousands of years without weekly appointments. (Heck, my midwives don't even do weekly appointments-even in the end.)

This could just be the OB mentality, getting their panties in a knot over routine. (They're quite dependant on their routine;)

All your tests have been normal so far, and you aren't high risk.

Unless there's some underlying issue, i'm sure you're fine!


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#3 of 38 Old 09-26-2011, 07:58 AM - Thread Starter
 
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The thing is, she's brought it up before. A few months ago I told her that my husband can only drive me on Mondays, and that it was quite possible that I'd have to skip an appointment at some time because there would be no one available to take me (he needs the car for work and he cannot take a day off because it won't be paid for and we can't afford to lose a day's pay). She also gave me the "oh no that is way too risky" spiel then, so I doubt there is any underlying issue they need to talk to me about. Besides, there are no outstanding test results to be evaluated. The more I think about it, the more I feel like she is trying to scare me into showing up, and I really really hate that. 


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#4 of 38 Old 09-26-2011, 07:59 AM
 
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Sorry you are going through this, mama. It's hard not having transportation. What would you do if you were in labor today? I hope you have a way to get to your provider?


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#5 of 38 Old 09-26-2011, 08:03 AM
 
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It's likely at least part of their reason are "cover your butt" related. If the standard of practice is to see mom every week, and mom skips a week and something happens to the baby- they don't want anyone suing them saying that they should have caught the issue, ya know?

 

Can you get a ride for later this week? If not, I wouldn't stress too much about it.


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#6 of 38 Old 09-26-2011, 08:13 AM
 
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I missed that bit about your inlaws. Surely you'd be able to get to the birthing place if you needed to with family around.


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#7 of 38 Old 09-26-2011, 08:30 AM
 
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Is there a drugstore you can walk to to check your blood pressure? That's the only thing I'd be concerned about at this point, because BP can go up suddenly the last week of pregnancy. Maybe you could also do a fetal kick count for an hour?

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#8 of 38 Old 09-26-2011, 08:49 AM
 
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I would try to find a way to go, but not because I think your baby is in danger and definitely because of some pushy receptionist. I'm just the sort who likes my OB appts. and can't wait to get that weekly reassurance that all is well. My only two ideas which I'm sure you've already thought of are to ask your in-laws to drive you to the appt. but say up front that you're so sorry but you can't have them in afterward, that the doc told you everything is fine but that you need to go home and rest for the rest of the day ... OR, is there a friend who wouldn't mind taking you? Tall order probably, I know. I think it's good late in the game to get confirmation that all is well, but, not necessarily something to panic over ... comes down to your own comfort level more than anything else, right? Let us know how it goes.

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#9 of 38 Old 09-26-2011, 09:16 AM
 
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I would also find a way to go, but that's me.  Accept the in-law drama in exchange for the ride? Eat the taxi fare, knowing that it's not a continued expense?  Entice yourself with a promise of a decaf mocha for the bus ride back?  At the very least, I'd go to the drug store for the pressure check. 


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#10 of 38 Old 09-26-2011, 10:05 AM
 
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Is there a drugstore you can walk to to check your blood pressure? That's the only thing I'd be concerned about at this point, because BP can go up suddenly the last week of pregnancy. Maybe you could also do a fetal kick count for an hour?

I was going to suggest the same thing.

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#11 of 38 Old 09-26-2011, 10:09 AM - Thread Starter
 
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Thanks for the input, ladies, I appreciate it! I went to Walmart this morning to check my blood pressure, and it was 111 over 68, pulse 65. A little lower than last week at my appointment, when it was 120 over 75 if I recall correctly. I am conscious of the little dude's movement throughout the day, I keep tabs on it very diligently because I am just a little bit paranoid that way.

It's not that I am concerned about getting a ride (I know I can always ask the inlaws, I just don't want to), the thing that bothers me is the feeling I am somehow completely underestimating the importance of a weekly check up at this point. Combined with the fact that I feel like the receptionist is trying to scare me into coming in. I feel like "why is it such a big deal to have the ten minute check up on Tuesday or Wednesday instead of the following Monday?" if you know what I mean.


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#12 of 38 Old 09-26-2011, 10:10 AM
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There are problems that can arise suddenly, and they are more likely at the end of pregnancy, which is why appointments pick up in frequency. So yes, technically it's a risk. Not a big one, but it's there.

 

For what it's worth, I personally missed a set of weekly appointments with all my various specialists a few weeks ago. (And I do mean all of them -- I had five appointments booked that day.) No one gave me a hard time about it, and I *am* high risk. I just rescheduled them all for the following week.

 

At this point, though, I would be a little uncomfortable going for two weeks without a BP check. But I'm at higher risk for pre-e and my BP spiked at the end of pregnancy last time, so I am extra concerned about that issue. (And drugstore machines are not terribly accurate.)

 

I totally understand what a hassle it is to get all the way out for an appointment when it is overwhelmingly likely that everything is fine.

 

Ugh. I wish the bus system was better for you. What a pain. hug.gif


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#13 of 38 Old 09-26-2011, 10:25 AM
 
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I don't think you're risking your baby's well-being, and I definitely agree that the rhetoric is all motivated by CYA.  

 

That being said, though, I love getting the attention of a prenatal visit and never skip them.  I'd see if there's a friend who will take you.  I know how hard it is to ask for help, but it may be worth it in this instance!


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#14 of 38 Old 09-26-2011, 12:57 PM
 
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DDCC but.... i wouldnt let it bother me i know how hellish a really bad transporation system could be, its really draining, and sometimes if its a system depends on the city that really specifically caters low low income and goes through sketchy neighborhoods, then i can completely understand not taking the bus.  its stressful anyways! i would stay home and watch a movie and eat some really powerfully nutritious smoothie : )

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Thanks for the input, ladies, I appreciate it! I went to Walmart this morning to check my blood pressure, and it was 111 over 68, pulse 65. A little lower than last week at my appointment, when it was 120 over 75 if I recall correctly. I am conscious of the little dude's movement throughout the day, I keep tabs on it very diligently because I am just a little bit paranoid that way.

It's not that I am concerned about getting a ride (I know I can always ask the inlaws, I just don't want to), the thing that bothers me is the feeling I am somehow completely underestimating the importance of a weekly check up at this point. Combined with the fact that I feel like the receptionist is trying to scare me into coming in. I feel like "why is it such a big deal to have the ten minute check up on Tuesday or Wednesday instead of the following Monday?" if you know what I mean.



 


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#15 of 38 Old 09-26-2011, 02:18 PM
 
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I would try not to worry about it.  As long as you feel ok and the baby is moving then chances are really good that you both are just fine.  

 

Sit back and relax.  They would just do the normal stuff and then possibly just want to check for dilation and that jazz.  Unless that is something you want then don't worry about not going.  

 

 

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#16 of 38 Old 09-27-2011, 06:16 AM - Thread Starter
 
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The question is moot this morning, because on the way home from taking my oldest to school, my three year old started throwing up. Not sure if it's a fluke or a stomach bug, but I'm not about to take that bug out to a doctor's office teeming with pregnant women. We'll see about tomorrow, and if she's not better, or I get sick too, that's all she wrote for this week (the OB won't be in the office on Thursday and Friday).

I thought my oldest was acting a little understated this morning, right now I'm hoping she won't start throwing up at school.  


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#17 of 38 Old 09-27-2011, 06:20 AM
 
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well I am surely sorry your little one is sick, but its funny b/c I posted on your xposted thread that I lied about my kid being sick once to avoid going to an OB appt.


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#18 of 38 Old 09-27-2011, 06:33 AM - Thread Starter
 
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I saw! In my case it's ironic, because I had more or less decided to make the trek across the city on a bus (well, a few buses, what with transfers and all) this morning. She was really excited about it. Now she's lying on the couch with her blanket, pillow, and a big bucket sitting on the floor next to her. Poor thing. 

 


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#19 of 38 Old 09-27-2011, 10:32 AM
 
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Chiming in late....I just cancelled an appointment and also got push back. I am 35+ weeks and somewhat high risk (gd). I was just at the hospital on Friday for an ultrasound/nst/perinatologist visit and it seemed ridiculous to go to the ob four days later. I have another appointment and nst next week. I am second-guessing myself now because they warned me I was going against medical advice. But really I feel like they are in CYA mode and wanted me to come in to check the box, not because it's actually essential to baby's health.

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#20 of 38 Old 09-27-2011, 12:34 PM - Thread Starter
 
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Nica, they took it one step further here and called me back today and asked me to go to L&D to get assessed if I really can't make it into the office this week. So I asked:"Exactly what is it that you guys are so afraid of happening? Is there something I need to know, something you haven't told me about?" And she said no, it's just that at this stage in pregnancy it is very important to get checked weekly. And that they would call again and check in with me tomorrow if I didn't go to L&D tonight. Sigh. You know what? At this point I am thinking it is just not worth the hassle. I will drag my 3 year old (who fortunately seems much better at the moment) and my 9-month-pregnant butt over to their office tomorrow, just to get them off my back. The bus trip should be fun, it will take about an hour not including time spent waiting at the terminal for the transfer. But I can promise you this, if my water breaks on the bus, there is going to be one pissed off pregnant lady kicking up dickens at the OB office. irked.gif


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#21 of 38 Old 09-27-2011, 01:15 PM
 
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Nica, they took it one step further here and called me back today and asked me to go to L&D to get assessed if I really can't make it into the office this week. So I asked:"Exactly what is it that you guys are so afraid of happening? Is there something I need to know, something you haven't told me about?" And she said no, it's just that at this stage in pregnancy it is very important to get checked weekly. And that they would call again and check in with me tomorrow if I didn't go to L&D tonight. Sigh. You know what? At this point I am thinking it is just not worth the hassle. I will drag my 3 year old (who fortunately seems much better at the moment) and my 9-month-pregnant butt over to their office tomorrow, just to get them off my back. The bus trip should be fun, it will take about an hour not including time spent waiting at the terminal for the transfer. But I can promise you this, if my water breaks on the bus, there is going to be one pissed off pregnant lady kicking up dickens at the OB office. irked.gif


Yuck, I SO feel your pain.  My doctor is in another part of town and our bus system SUCKS.  So it only takes 15 min by car but the bus takes a whole hour or more, with transfers.  And it's a sort of sketchy part of town so those buses are always PACKED, very hot and full of unsavory dudes and people who see absolutely no reason to offer a seat to the very pregnant lady carrying a 2yo.  shake.gif

 

I have been really dizzy and having wierd spells where I almost faint if I walk too far so I have informed DH that I don't care what it does to his schedule, I need to start taking the car to the appts, especially because they're every week now.  

 

Good luck to you, Mama - the things we do, eh?

 


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#22 of 38 Old 09-27-2011, 01:39 PM
 
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What a pain! So sorry they are coming down so hard on you. Good luck with that bus trip. Maybe you'll get lucky and just go into labor tonight!

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#23 of 38 Old 09-27-2011, 09:56 PM
 
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How frustrating!! It feels to me like they are bullying you and personally I wouldn't like that one bit. Maybe you can call them in the morning and tell them you would be happy to come in, if they could just call and let you know what time they will have some to pick up you and your child and ensure that you will have a ride home as well. If they think it is that important than maybe someone can take their lunch break to come get you.The worst they can say is no and then you are in the same position of deciding to take the bus or skip the appt. Maybe worth a shot.


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#24 of 38 Old 09-28-2011, 05:47 PM - Thread Starter
 
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So I went in today, to get my doctor and his assistants off my back. It took us 3.5 hours for an appointment that lasted all of 10 minutes. irked.gif Don't get me wrong, I am thrilled everything is fine. But I am not all that happy about having to go in for a NST this Friday (at 39w6d, I haven't even hit my due date yet!), another prenatal appointment on Monday, and from then on 2 NSTs a week, as well as a weekly OB appointment. For crying out loud, this is a PREGNANCY, not a potentially fatal affliction!

And of course at the end of the appointment, the doctor said:"At your next appointment we will discuss what we are going to do if baby isn't here yet."

Yeah, you know what, dude? We are going to wait. And wait. And then wait some more. When I am at 42 weeks and the placenta is showing signs of deteriorating, THEN you can induce me. Up until then, back the f!ck off. 


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#25 of 38 Old 09-28-2011, 06:29 PM
 
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Glad baby is ok. How frustrating about your dr. Why are they doing a net o soon and so many of them? Personally I would decline. Hope baby gets here soon and this all mute

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#26 of 38 Old 09-28-2011, 06:50 PM - Thread Starter
 
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 Why are they doing a net o soon and so many of them? 


That was my question too. The OB says it is standard practice and that the placenta starts to deteriorate at 40 weeks. Which I think is a crock. And why start when I am not even at 40 weeks? And have another appointment three days later? It just seems unnecessary, and it feels like panic mongering. Ugh, so frustrating! I'm trying to convince the little dude to start his evacuation process, just to get these annoying medical professionals off our backs, but he doesn't seem to be in any hurry. Even the prodromal labor has all but ceased. He seems very comfortable in there, and he moves like he has all the space in the world (yeah, ouch!). Sigh. 


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#27 of 38 Old 09-28-2011, 07:39 PM
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Iris, weren't you diagnosed with GD? Or am I misremembering?

 

GD does change the thinking around placental age, and also protocols for testing.

 

Sorry to hear it was such a hassle to get there. My first pregnancy was like that -- all the testing and appointments and traveling to and fro took hours and hours every week. So frustrating. This one has been still taken a lot of time, but so much less that I am not going to complain!


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#28 of 38 Old 09-29-2011, 03:44 AM
 
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yes, if you have a GD dx, that is why the extra testing. Also, many OBs don't like for GD moms to go past 40 weeks. But it sounds like there is a problem with communication with your doctor. He should be explaining this to you if this is indeed the case. If you do have GD, you may want to bring/print out your diet and blood sugar monitoring logs for your next appt. If your numbers are very good, you may be able to get them to back off a little. IME, they don't want to deviate far from their protocols, but in my last pregnancy, I did get them to put off the start date for a lot of the NSTs, extra appts, and that bought me enough time for DD to be born.


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#29 of 38 Old 09-29-2011, 04:53 AM - Thread Starter
 
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No, that's the thing. I was never diagnosed with GD. One of my levels at the 2 hour test was wonky (the 2 our one, actually, the first two were on the low side), so I was diagnosed with being glucose tolerance impaired. Then at my next appointment I was sent for a random glucose draw and an A1C, and both came back completely normal. I never even saw a dietitian, was just told to not eat cake, ice cream and cookies. Weight gain, fundal height and fetal growth have all been exactly on par with my dates. 


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#30 of 38 Old 09-29-2011, 06:42 AM
 
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Hmm. You might have a particularly cautious OB practice, or for some reason they have flagged you as high risk. I would ask for (demand?) better communication about all of this! At your next appt, can you just say to the OB, "I really am confused about xyz" you know, do it in a non-confrontational way but try to get him to spend more than a couple of minutes explaining it to you (and I'd ask the doc, not necessarily the nurses, unless you particularly have a good rapport with one of them). Are they considering you high risk? Do you know why? Can the doctor explain it better? I have also been told that there is evidence for increases in "unexplained fetal demise" past 40 weeks. Both of the midwifery practices I have been to who do homebirth (so, fairly low-risk women only) feel that there is not good evidence that routine testing on schedules actually prevents these rare but tragic outcomes, however, the OB practice I was also seeing with my last pregnancy felt the opposite. My current MWs recommend, but do not insist, on starting routine monitoring at 41 weeks in my case (due to age), at 42 weeks for all moms, and earlier if I desire it or if there is any cause for concern. And, if I *wanted* to start biophysicals and NSTs at full term, they would order them for me.

 

As for scheduled induction... I am pretty sure you can refuse that. At least in the US, even though the doctors might act differently, I have been told by quite a few health care practitioners that its ultimately my choice to consent to these treatments.

 

Other than the inconvenience, the tests themselves are, as I understand it, non invasive. Advice I've read is that if there is ever a result that indicates some worry/concern, definitely ask for a repeat test before rushing to other interventions.

 

With my test that got me my GD dx, (I never did one this pregnancy, just went straight to monitoring) my 1-hour result was elevated and the rest were normal. It might be that the Dr is concerned that there has been hyperglycemia. In a way, too bad they haven't had you self-monitoring, that can go a long way to reassuring caregivers that you are, in fact, doing fine.


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