Prenatal care {by me} IS prenatal care... {rant-ish} - Mothering Forums

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Old 04-05-2007, 08:12 PM - Thread Starter
 
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Well- I just got home from our first visit for Sebastian with our family Doctor for him, he is 2 weeks and 4 days. There is nothing wrong with him, I just wanted to establish with a doc should we need one. I also am a little paranoid about him having urinary reflux as my daughter before him had it, and my girlfriend's baby boy {she had 2 weeks before me} was just diagnosed with reflux.

The doc: is super 'cool' in that he is into alternative things like probiotics, and nutrition, and the what I would call "normal" route before the western route.

The visit: When he got in the room- we did the "why are you here" "just to establish" thing.

And then the questions.
"where did you have the baby?" "home"
"who delivered?" "We were not attended".
"Did you have prenatal care?" {in my head I say- well - 'technically'...}then out loud I say "no."
"huh. Hold on, I need to think about this one... This is just a lil outside my realm of comfort...."
I can appreciate this. I know everyone in the medical field is all into CYA.. {I would be too ...} He says he will think about it and draw up a waiver of some sort since we were not attended by a "certified" person. He says in a informing way {not rude or apologetic, just informative} that in this day, its just one of those things that 'needs' to be done. He went ahead and did the exam and had a normal "any questions?" at the end of the visit dialog.

My problem here? Once you answer "no" to the "prenatal care?" question - that's it. There is no more dialog. It seems it is assumed that you have not / would not know how to do anything to take care of /monitor yourself.

Why aren't there more questions? Like:
"Did you do any monitoring of your / baby's health?"
"great! What did that include?"


As far as I know, since I have had 2.5 midwifery cared-for pregnancies... The list of things completed as far as "prenatal care" would include:

Weight monitoring
Urine dipstick monitoring
Blood pressure check
pulse check
Fundal height check
Heart tones of fetus check
Ultrasound referral
Blood work
Glucose tolerance test
STD screening

In this pregnancy I performed for myself {because I wanted to}:

Weight monitoring can do/did, scale
Urine dipstick monitoring can do/did, have sticks
Blood pressure check can do/did, have my own cuff
pulse check - can do/did
Fundal height check can measure, midwives showed me how in past
Heart tones of fetus check rented a doppler
Ultrasound referral {would have refused}
Blood work Did not do, however had Doc of Chinese Medicine test/check for Iron/anemia.
Glucose toleran
ce test
can do/did
STD screening {would have refused}

So I am annoyed about this. I know I could probably blurt this all out at a Doc., but either it would fall on "yeah right" ears, or it wouldn't matter anyway. I am a proud person, so- I imagine part of it is insult for me.

Thanks for letting me vent, I knew you would understand.

Next- I get to get the BS from Vital Statistics for a birth certificate....

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Old 04-05-2007, 09:27 PM
 
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Hmmm, well, if you could turn back time... I would have said, yes, I had prenatal care. If he said where, I would have said my former midwives taught me how to do it myself. I don't know if it would have helped though...

The questions seem kind of weird to me though. Our doctors have never been so nosey about where our babies came from. I've never been asked if I had prenatal care. It's a mute point at this point, right? No going back and getting it now!
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Old 04-05-2007, 10:03 PM
 
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I imagine its hard for a doctor to assume that a normal person could do their own care without one. I mean, if that were the case, doctors would be out of work right? (OH THE HORROR!!)

Not having been in the field of ob/gyn I doubt he'd even know all of the things involved in prenatal care. TBH I thought it would be way more technical and involved than mine actually was. I was amazed when I analyzed them all and came to the realization that I could do 99% of it at home by myself.

When I went in for my first well baby visit, my ped asked us about the birth, and when I told them, they just said .... oh, wow.... and looked at the nurse with a "she's nuts" look, and that was the end of it. Well they did tell me I had to have the heel prick because its illegal not to, which I went ahead and did even though they were lying about the legality (was our first time in the hospital other than a very scary delivery ward tour)

Its hard to believe that people give birth outside "the norm". I think if more people did it, they wouldn't freak out about it so much. Its just not something thats discussed very much. When I went to get my birth certificate, they actually had to search at the state records place for someone who had been there long enough to know how to process a UC, because most of the workers had no clue what to do with it, because it was so rare. It took us an extra 3 months of processing just because they couldn't figure out how to do it.
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Old 04-06-2007, 01:12 AM
 
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My last birth ended up as a hospital transfer, unfortunately. The experiences was surprisingly mellow. One nurse asked if I'd had prenatal care and I told her, "Yes, I did my own." and that was it.

Another later snidely asked what that entailed. I toold her exactly what you'd said in the OP. Plus I added that with my first dd they'd only checked my iron once, and I monitored it monthly and later weekly when I discovered I was slightly anemic and fixed the problem, so my own prenatal care with dd2 was actually more involved than with dd1.

SHe looked sheepish and admitted she'd put "No" for the prenatal care check box, but quickly changed it after my schpeil. She also later asked my husband if we were nurses because we knew so much about pregnancy and birth.

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Old 04-06-2007, 01:45 AM
 
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Frustrating isn't it? I'm now doing all my own prenatal care and it seems like the questioners/naysayers are coming out of the woodwork. Maybe it's the twins factor? But as you listed with what you do with prenatal care, we really can do 99% of it ourselves. OBs don't want women to know that because they would be out of a job for a lot more women.

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Old 04-06-2007, 11:08 AM - Thread Starter
 
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I thought about this a lot last night. It was so big on my mind, I actually had to call my husband before I drove away from the Doc's office yesterday. So all night I worked it over in my mind.

I have decided to write him a letter telling him why I said "no", and what I did do for myself, because I want him to know what was done for our baby, what I did for him and myself. I will not delve into what I think about UC, that is not at point here.

I will do this because I think he does want to know, but that maybe he assumed the answer was "nothing", and it would likely ease his conscious/and make the 'waiver' easier to do / or a moot point altogether. I also would like it to be of record/put into the chart.

As far as saying "yes" and the "I was taught/I did it myself".. I have previously admitted that I am just not blessed with 'good comebacks/responses' to things like this. I often know just what to say...later. Boy does that suck .
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Old 04-06-2007, 03:32 PM
 
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I never say I didn't have prenatal care, always that I did it myself Doctors are doctors. Even w/out any evidence that prenatal care improves outcomes, it is MEDICAL so they think it's good.

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Old 04-06-2007, 03:41 PM
 
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When I am asked if I had prenatal care I answer, "Yes, I did my own prenatal care."
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Old 04-06-2007, 03:48 PM
 
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Right, what she said. Although, you'd probably have gotten the same reaction, because what you were assuming he meant (did you have prenatal care from a medical professional) *is* what he meant. What is strange to me is that he thinks he needs to cover himself. He's not providing care for your pregnancy or for your birth, so what does it have to do with him? What, he's going to lose his license because he is providing a service for someone who did something totally unrelated to that service and that is completely legal anyway?
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Old 04-06-2007, 04:01 PM
 
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Mama, I personally wouldn't be signing any waivers. I would find a doc that would treat my child on an as needed basis, without a waiver. (unless you're going to be doing the well baby thing) How the baby came into the world isn't relevant to receiving care at this point, and I wouldn't see what I would need to sign that would help ME in any way.

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Old 04-06-2007, 04:04 PM
 
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I agree it's odd about the waiver. If you had gone in when the babe was closer to one I doubt he would ask about the birth all that much and want a waiver in your file about it. I've never heard about that. I'd reconsider the dr. personally.

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Old 04-06-2007, 05:30 PM
 
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I agree with the above comments, the waiver thing is a bit odd. Are you asking him to sign anything related to getting a birth certificate? I can see how that would freak him out in terms of "did this baby really come out of this lady and associated other horrific possibilities" sort of way.

Hang on, I have a thought and I think it needs it's own thread!
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Old 04-07-2007, 12:26 AM
 
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BirthingGoddesses, if I remember correctly you just moved back to Florida?

I moved back here last year too. I have found doctors in this state to be way more CYA and uptight about birth and babies than in the midwest. My DD was born in Indiana and I did not encounter anything like the attitudes here. Maybe homebirth is more common in the midwest (and less regulated!) so doctors see it more.

I am consulting with my midwife from Indiana so I will just says yes to that kind of question. Silly...I am doing all the real prenatal checking though. Just discussing it over the phone with a midwife (unlicensed at that!) .

One reason I don't bother with taking a newborn in for a get established check up is to avoid these issues. I have in the past just taken DD to my family doctor when an issue has come up. The focus has always been on the illness. Never any questions about other stuff.

I am seeing my family doctor in a few weeks for a non pregnancy issue and I am asking him to "confirm the pregnancy" for the birth certificate. I will let him know at that time my plan to bring baby to him if there is an illness. I really hope it goes well. It never occurred to me that he might get weird about it (he knows DD was a homebirth, we don't vaccinate, we prefer natural approaches to illness before bringing in the big pharmaceutical guns).

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Old 04-07-2007, 01:24 AM
 
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I find it weird about the waiver.

I have had similar experiences with doctors- dead silence when i tell them we had a homebirth, or worse, we did it all by ourselves- on purpose. We just kind of avoid the whole subject if possible.
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Old 04-07-2007, 12:47 PM
 
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I would ask him why he thinks it's relevant. (And then you can tell us because we're dying to know. ) But I wouldn't sign anything either. The point of waivers is to absolve them if you do not follow their medical advice. That's not applicable for an event that's already happened.
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Old 04-07-2007, 01:20 PM
 
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Well and not only all of that ~ even though the doc appears to have good intentions, one never knows how another will interpret a signed document. To protect yourself, I wouldn't sign anything. I hope you don't think we're ganging up on you! We just want to protect you.

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Old 04-07-2007, 10:28 PM
 
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What on earth does prenatal care have to do with the health of your already born baby? I wonder what he would have said if you'd answered "No, that's why we're here, for *post* natal care. You do know you're a pediatrician, right?"
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Old 04-08-2007, 01:05 AM
 
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Quote:
Originally Posted by sapphire_chan View Post
What on earth does prenatal care have to do with the health of your already born baby? I wonder what he would have said if you'd answered "No, that's why we're here, for *post* natal care. You do know you're a pediatrician, right?"
Love it!

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Old 04-08-2007, 01:21 AM
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Please get a copy of that record.
If they decline and actually "lose" it, then consider yourself lucky.
Docs and nurses write all sorts of objective (their note) stuff in the record that could "label" you.
I would consider a different doc.

Good luck!
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Old 04-08-2007, 01:26 AM
 
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what does the waiver say or cover?
any birth accidents, birth related injuries or stds that may be pre-existent -no vitamin K given at birth, or eye ointment... so he may need a vitamin K refusal form, and a eye ointment form and probably a refusal for metabolic screening -- and then it will just be probably the first in a long line of additional refusals like no vax could be worse , some people get fired from their doctor's care..


so what you will find out on the vital stats stuff-- not refuseable and not HIPPA applicable ---
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Old 04-09-2007, 08:40 AM
 
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Originally Posted by BirthingGoddesses View Post
I know everyone in the medical field is all into CYA.. {I would be too ...}
Please forgive my ignorance...but what does CYA mean? I keep seeing it on this board.
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Old 04-09-2007, 10:19 AM
 
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CYA = cover your butt

Its unfortunate but OBs generally care more about CYA than about their patients. In a court case, the more interventions they do, the more they have technically "CYA'd" regardless of if those interventions helped or hurt. The US legal system does not see "letting momma birth naturally" as a method of "doing everything you could to assure a positive outcome".
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Old 04-09-2007, 10:46 AM
 
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Originally Posted by Jenlaana View Post
CYA = cover your butt
Right. Thanks. It is unfortunate that they feel the need to do so, instead of...you know...caring for their patients. :
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Old 04-12-2007, 12:20 AM - Thread Starter
 
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hi ho ladies.

been stuck in nursing a newborn-all-darn-morning-land

I haven't received said potential waiver yet. This is a family practice Doc, not a "ped" specifically. I personally feel this helps out with the obnoxious normal ped stuff. I am pretty annoyed the more I have thought about it, and reading your responses.

I choose to establish because I don't want to try to find/get the Doc on call {from hell} if something happens to my kids. I also established because I have a previous child that has urinary reflux, and I want to be prepared/looking for this potential problem - our prev ped we had with my daughter did not catch it, she nearly died from it and the infection she had resulting from it. {he insisted she had excema and gastro-esophageal reflux {that that was why she was vomiting, she NEVER had a fever once} It was scary, and everyone was pointing the finger at me, wondering how I did not notice she was so sick. I did, we just thought we were fighting excema and Gastro reflux.

Ped's in FL are rough. Period. I have been through several. (6th one now) I don't want to look (unless I have too), I have 4 kids, like I have time for it. We also do not caryy medical insurance - so - its full cash for establishing visits for 4 kids. What? Write letters to them adn ask a few questions to see what there responses are..? Like what?

Hi-
I am interviewing pediatricians for our family. We choose alternative care/eastern treatments whenever possible, herbs, homeopathics, and often - nothing. We just let nature take its course. We acknowledge sometimes Doctors are needed, and can save lives, but we don't think we need them to make it through everyday life.

By the way, we birth our babies thus far at home, with a midwife, or by ourselves. We also do our own prenatal care that we learned from midwife friends and from the many many books we have read and research we have done...not to mention we JUST PLAIN TRUST BIRTH.

We don't want to do "well baby" visits all the time either. Maybe at 6 months and a year, and then yearly -if we have to -after that. We would prefer to call in with stats and talk about how they are doing, or just do a one big family visit.

We hope this all sits well with you and you are willing to/interested in working with us.

Pleasantly signed;

The natural-care seeking family that probably scares the sh*t out of you and threatens the meaning of your position of power.

Have a nice day!!

What do you think? Print a bunch out and send them to all the Doc's in town?

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Old 04-12-2007, 01:36 AM
 
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laughup That is the most *awesome* *letter* *EVER*! :



OK, now that I've pee'd myself just a bit (6 mo pg), totally go ahead and send some out! Who knows? Maybe someone will take the bait.

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Old 04-12-2007, 02:50 PM
 
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Originally Posted by BirthingGoddesses View Post
Well- I just got home from our first visit for Sebastian with our family Doctor for him, he is 2 weeks and 4 days. There is nothing wrong with him, I just wanted to establish with a doc should we need one. I also am a little paranoid about him having urinary reflux as my daughter before him had it, and my girlfriend's baby boy {she had 2 weeks before me} was just diagnosed with reflux.

The doc: is super 'cool' in that he is into alternative things like probiotics, and nutrition, and the what I would call "normal" route before the western route.

The visit: When he got in the room- we did the "why are you here" "just to establish" thing.

And then the questions.
"where did you have the baby?" "home"
"who delivered?" "We were not attended".
"Did you have prenatal care?" {in my head I say- well - 'technically'...}then out loud I say "no."
"huh. Hold on, I need to think about this one... This is just a lil outside my realm of comfort...."
I can appreciate this. I know everyone in the medical field is all into CYA.. {I would be too ...} He says he will think about it and draw up a waiver of some sort since we were not attended by a "certified" person. He says in a informing way {not rude or apologetic, just informative} that in this day, its just one of those things that 'needs' to be done. He went ahead and did the exam and had a normal "any questions?" at the end of the visit dialog.

My problem here? Once you answer "no" to the "prenatal care?" question - that's it. There is no more dialog. It seems it is assumed that you have not / would not know how to do anything to take care of /monitor yourself.

Why aren't there more questions? Like:
"Did you do any monitoring of your / baby's health?"
"great! What did that include?"


As far as I know, since I have had 2.5 midwifery cared-for pregnancies... The list of things completed as far as "prenatal care" would include:

Weight monitoring
Urine dipstick monitoring
Blood pressure check
pulse check
Fundal height check
Heart tones of fetus check
Ultrasound referral
Blood work
Glucose tolerance test
STD screening

In this pregnancy I performed for myself {because I wanted to}:

Weight monitoring can do/did, scale
Urine dipstick monitoring can do/did, have sticks
Blood pressure check can do/did, have my own cuff
pulse check - can do/did
Fundal height check can measure, midwives showed me how in past
Heart tones of fetus check rented a doppler
Ultrasound referral {would have refused}
Blood work Did not do, however had Doc of Chinese Medicine test/check for Iron/anemia.
Glucose toleran
ce test
can do/did
STD screening {would have refused}

So I am annoyed about this. I know I could probably blurt this all out at a Doc., but either it would fall on "yeah right" ears, or it wouldn't matter anyway. I am a proud person, so- I imagine part of it is insult for me.

Thanks for letting me vent, I knew you would understand.

Next- I get to get the BS from Vital Statistics for a birth certificate....

I've always said "yes, I had prenatal care." If pressed for details, I freely admit that I did my own care. Sometimes the medpros smile, sometimes they go back and change the previous answer to "no prenatl care" which burns me up. Had I been seeing a MW during my pregnancy, she would have been permitted to weigh me, listen for hb with fetoscope, and take my bp, plus advise me on my diet and lifestyle choices. Which... is exactly what I did for myself.

Mama to Raina (9/06) and Peter (8/09)!
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Old 04-13-2007, 10:22 AM
 
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Oh, i love the letter- mind if I use it if we ever need to find a new doc?
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Old 04-13-2007, 10:31 AM - Thread Starter
 
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Originally Posted by mama in the forest View Post
Well and not only all of that ~ even though the doc appears to have good intentions, one never knows how another will interpret a signed document. To protect yourself, I wouldn't sign anything. I hope you don't think we're ganging up on you! We just want to protect you.
I will have to agre with you - people can do weird things {<referring to the Gov't} in their efforts to 'protect' you.

I have a friend who was persecuted by the local child protection agency, simply because someone made a completely fraudulent anonymous phone-call claim against them. The result: medical exams/legal expenses/etc. all to be paid for by them. They too were requested to sign some sort of waiver... until they clearly stated that they had a lawyer that weoudl draw up what ever the Doc wanted regarding something absolving him of previous things done - or not done - to the child.

FL is a very medically litigious State, every where you go- billboards, on buses, on bus benches, all over the phone book, and more are almost all covered with lawyer phone numbers and ads re: medical malpractice.
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Old 04-13-2007, 05:44 PM - Thread Starter
 
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Oh, i love the letter- mind if I use it if we ever need to find a new doc?
oh yeah- anyone whom feels this fits themselves- you are welcome to use letter to save yourself time

If this sounds like you- you might be as successful as I am finding a ped/fam Doc...
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Old 04-13-2007, 07:27 PM
 
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I would just love to see the look on someone's face as they read the letter.

*sigh* Oh, I really needed that laugh today, thanks!

Jfly-by-nursing1.gif, partner-in-crime to Dfamilybed2.gif, mama to run.gif4, including our brand new rainbow1284.gifbaby.gifmissing my 7-wk-er

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