Medicaid and over managment of pregnancy - Mothering Forums
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#1 of 4 Old 12-17-2011, 02:26 AM - Thread Starter
 
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I have been unhappy with my current hospital based midwifery care. I feel like all they do is order tests, get good results and then order more tests to look deeper. I have refused some testing (all related to birth defect screening) and I have gotten a lot of crap for it from the practice (despite being assured that I could decline everything, no problem, at the initial interview.)

 

I'm 22 weeks and I've been tested for STD's 2x, had 2 types of diabetes tests, been asked to do a 24 urine collection, had a CBC at each visit (4 in just 8 weeks), had 2 ultra sounds with a request for another, etc... I'm scheduled for more of the same in the next 2 visits.

 

Each test comes back normal, than I'm asked to do another one or do the next level of testing for the same thing.

 

I've been upset by all of this, but Friends and family seem to think it simply because of my age.

 

After talking to a much younger friend who is pregnant and due 2 weeks after I am, I found out she is going through this same thing. Crazy amounts of testing despite everything being normal.

 

The only thing we have in common is that we are both using medicaid for or insurance.

 

I'm starting to think that perhaps the practice is trying to max out their profit here by ordering every test they can get covered.

 

Any thoughts?

 


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#2 of 4 Old 12-17-2011, 12:20 PM
 
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Do you have any other options of care providers?

 

It is within your right to refuse the testing, but you have to be prepared for the possibility of hostility if you do so.  Some medical practitioners don't take it kindly when patients attempt to have a say in things. 

 

I would honestly start looking for other options, even if that meant paying out of pocket, but I don't know how feasible that is for you and your situation. 

 

You could try scheduling an appt with the head of the practice and discussing your concerns, but you may not get anywhere positive, and you may in fact be "fired" for being a "trouble client". 

 

Not sure that is at all helpful. 


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#3 of 4 Old 12-18-2011, 07:24 AM
 
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You can refuse  the tests you  dont think are necessary. Im 44,  so doc ordered a heart test for me and a glucose test at  6  WEEKS PREGNANT.  I refused both. I mean, im not drinking that glucose stuff  in the first trimester, and i have no worries about my heart. Im one of the fittest people i know.

 

Then come all the diagnostic tests for abnormalities. I was advised those  with ds 1 and ds2 when i was  elderly at 38 and 40. I declined them, because they are not about prenatal care, they are about giving you the choice to terminate if  something comes up. I had no intention of doing that , so why waste my time and cause unnecessary anxiety? The amniotcentesis has its own risks, so i wouldnt do that anyway. I refused them at 44 for the same reason.

 

 

I do the 20 week ultrasound though, because that seems like a relatively non invasive, low risk, and informative test to do.

 

After my first trimester, i switched to my homebirth midwife, someone who actually knows what she is doing.

 

 

I should add, that on medicaid, you will get a bunch of interns, who dont have much experience. I found  google to be more reliable than them. 

 

Also, for a visit of 10 mins or less, with a person of not much experience, the hospital was charging almost $400.

 

That seems like alot,. I think they make alot of money on these unnecessary tests.

 

Also, if you are on medicaid, you might just be in a zipcode which puts you at  high risk. For eg, my zip code has a high risk for obesity. Never mind, that i myself dont have this issue.

 

Just do your research, work out what tests you think you need, and decline the rest.  Who has time for that? Not to mention, if you are on medicaid, you are probably waiting for hours to do the tests right?

 

You can certainly change care providers on medicaid. Im doing a homebirth. Ive tried different hospitals.  You do have flexibility.

 

Good luck!

 

 

 

 

 

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#4 of 4 Old 12-18-2011, 04:11 PM
 
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You can report them to medicaid to tell them that they are wasting money if they don't give you valid reasons as to their ordering the tests and you can look up with acog(american college of obstertica and gynocology) what is really reccomended in your case
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