My OB was suspended---need help! Advise!! - Mothering Forums

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#1 of 37 Old 05-02-2008, 08:33 PM - Thread Starter
 
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First off, we're great friends. I've had him for 9 years. He and dh don't shut up when we have an appt. and we've closed the office before, talking for hours. He doesn't necessarily agree with HB and doesn't know we *intentionally* UCed last one, but he supports me no matter what, agrees to be there for me day or night in the event of transport, he does any testing I need, which used to make it very easy for my mw (when I used one), as she was 90 min. away, he'd call in any script I might need, etc.

So this pg we didn't even know we were pg till 16 weeks (I was still nursing a babe), so I went to confirm pg, try to get an idea of dates, and my placenta was less than 2cm from the os, so he had me come back after 4 weeks, and again after another 4 weeks (placenta moved up, and you know I needed to see that, to feel OK about UCing again, as I am a good 30-40min. from any medical facility) to make sure it moved up--which it did. So after that was ascertained, I was pretty much done seeing him. He assumed I was seeing a mw. I was just gonna call him and ask him to fill out dh's family leave paperwork, would have called him after the birth for the proof of pregnancy note for the birth certificate, and also had him call in a script to the pharmacy for Rhogam, for postpartum (I don't get the prophylactic one at 28 weeks).

Well, I won't go into the whole suspension thing. It's just a travesty, it's totally a witch-hunt, basically, because he wasn't doing c-sections when the board at the hospital thought he should. He is much beloved by all his patients, and everyone is upset by this.

At any rate, I'm 33 weeks, and have no one to fill out family leave papers, provide the proof of pg note post-birth, and no one to give me Rhogam. I don't know what to do. I called a few mws--they don't want to have anything to do with me, because I'm UCing, and they're all trying to establish relationships with the medical community here, and don't want to have their names linked to a UC. I could go to any OB, I guess, under the guise that I was gonna use my old OB and birth at the hospital, have them fill out the paperwork for family leave, but I don't know how they'd respond to the proof of pg note, and I know I couldn't get Rhogam, obviously, if they think they're gonna see me in the hospital. I just can't even foresee myself lying like that, anyway. I'll just be looking at this total stranger, and they'll be looking at my records, and I just, I feel already very indignant at the thought of having to lie about something I just feel very convicted about.

And the Rhogam thing. Now I'm just considering whether or not to even get it. I know most of my kids, if not all, are Rh+ (dh is +, and they all look like his clones, anyway, so it doesn't surprise me that they're all + as well!).

What would you do? Suggestions? Also, any Rh- moms want to share any info, sites, personal experiences about getting the shot, not getting the shot, etc. I feel totally without resources at this point.

Thanks so much, and sorry so long! I'm very wordy!
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#2 of 37 Old 05-02-2008, 08:37 PM - Thread Starter
 
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I just wanted to add that I'm in NYS. And that this will be my 4th HB, 2nd UC. I didn't say that, and I thought my sig said it, but it doesn't.
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#3 of 37 Old 05-02-2008, 09:18 PM
 
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http://www.unhinderedliving.com/rhogam.html

NAK... sry!!

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#4 of 37 Old 05-02-2008, 09:37 PM
 
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Is the OB suspended as in losing his privileges just at that hospital, or suspended as in he might lose his license to practice? Because if it's the first case, he can still write prescriptions; he just can't practice for the moment at that particular hospital.

If you really want the Rhogam shot and can't find anyone to write a script for you, you can always go into your family doc a few days after the birth (or just walk into the ER, or whatever) and ask for one. It's just a pain to have to go out of the house so soon after the birth.
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#5 of 37 Old 05-02-2008, 10:17 PM - Thread Starter
 
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Hi Rixa! How can I not recognize you, from one or two of the Yahoo groups! There's no name like Rixa Freeze!

No he's good and suspended, I think. His office told me he is no longer able to fill out any paperwork, so I think the script's a definite no-go. I emailed him a few times (yeah, we have each other's emails), but he hasn't gotten back to me. Last thing he said was that he was probably going to relocate. He is such an incredibly caring and supportive and interested doctor--any state will be lucky to have him.

Yeah, I considered the ER thing, but I just don't want that, ya know? I had asked my old mw, with my last birth (first UC) at the beginning of the pg, if she would just be willing to come over after the birth, check us over, stitch me up if needed, administer the Rhogam. She agreed, but did let me know she was anti-UC. I updated her a few times during the pg, called when I went into labor, and called after the birth. She didn't come. She hemmed and hawed and made every lame excuse there was, but point blank: she went back on her word to me, and she had been my mw with my two prior births. I was upset. I thought the baby sounded a little "wet," and it was making me nervous. We ended up going to the ER about 10 hours after he was born, and it was for nothing. He was fine. With all the poking and prodding the hospital staff did to him, he cried like mad for an hour, and that brought a bunch of mucousy crap up and he sneezed a bunch, and that about did it. But the looks, the questions, I left there AMA, as they wanted to keep him overnight for observation--for NOTHING! They even said, there's nothing wrong with him, but just to be safe!

So no, I just don't want to go through that again. I mean gee, a major point of it all is to be in your own element, in your own home. If you've got to leave for a stupid shot, and especially to go to the ER, and deal with all the attitude...no thanks. That's why I'm even considering NOT getting the shot. I mean, my 7th kid, I don't vax, we homeschool, homebirth...you know. I'm just a target in a place like that, in my opinion.

But please...any other links or info anyone has, I'd appreciate.
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#6 of 37 Old 05-03-2008, 09:47 PM
 
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I'm sorry your good OB got suspended! I know how you feel - my backup OB stopped practicing obstetrics after my 2nd baby was born because his insurance company basically raised the rates too high for him to afford. He'd been able to get my Rhogam after the first two babies.

When pregnant with my 3rd I saw an OB/GYN that I'd seen before my 1st pregnancy several times. He did not like the idea of hb at all but in the end his office came through for me and he got me the Rhogam.

This time around I am in a different state and using a mw, but it looks like my only option for Rhogam is to go into the hospital within 72 hours. Last place I want to go with a newborn is the ER. I may talk to my mw and see if my family doctor can order the Rhogam. I'm not sure if they can or not - but it seems they'd be able to since family docs can give prenatal care (and thus order the 28 week does, which I also refuse).

Do you have a family doctor you can talk to? It's really hard and I have no good suggestions, but I did want to offer my support.

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#7 of 37 Old 05-04-2008, 01:03 PM
 
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What a shame. Though it's not too surprising that they're getting rid of docs for doing too few sections.

iirc, you only need the rhogam if you're planning on having more children. If you happen to be done, then you can skip it. Possibly even if you're not, I think it depends on how well you can assess whether there was any possibility of blood mixing.
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#8 of 37 Old 05-04-2008, 02:03 PM
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reading the link above about thr rhogram shot, it seems to me that if you're having a natural, noninterventive birth, you don't need the shot. it's only if you have interventions (and thus the risk of "blood mixing") that you may need the shot.

so, it seems to me that it's nothing to worry about.

it's odd that i didn't know this factually, but i did know it intuitively. recently, a woman asked me abotu the shot and i said that i felt it wasnt' necessary. she asked if i knew our blood types and all that, and i said that i didn't.

she said that it was necessary. i asked her why, and she brought up a bunch of bogus stuff like "because that's what is done." so, i said "what about before those things were done? did women and babies die from rhogram incompatiability or something? do you know?"

and then i sort of "realized" that it's not at issue. i didn't know why it wasnt' at issue, but i realized that it wasn't an issue. and i just felt good about not worrying about it.

this article gave me some good info to back that up--but it just makes sense. i mean, long before we even knew about blood types, women had babies with different blood types and i'm sure that most of them survived just dandy.

so, i wouldn't be too worried about it and i'd only get it if i went in for interventions anyway.
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#9 of 37 Old 05-04-2008, 02:05 PM
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oh, and what happened to your OB friend totally happened here as well. the OB here did all vaginal births, honestly. i think she'd done about 3 c-sections in the year, all because of necessity. well, the hospital where she worked has a 40% section rate and wanted her to start scheduling her patients for them, evne though she didn't believe in utilizing the technology except for emergency.

they suspended her priviledges at the hospital, and then because the whole office where she was working (which was a group of OBs) was also going to be suspended if they didn't take some action against her, she was suspended from there. She could still practice--technically--but she didn't have an office or a hospital in which to practice.

she ultimately moved out of state as well--after writing to the media and giving them the "confidential" letter explaining why they wanted her to do more c-sections (which was all about money).
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#10 of 37 Old 05-05-2008, 12:18 AM
 
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Originally Posted by zoebird View Post

"what about before those things were done? did women and babies die from rhogram incompatiability or something?
Yes. Thousands of babies died every year in the US alone before it was discovered.


There are things that are fairly ridiculous in the medical community, particularly in the US and particularly in regard to birth. Rhogam is not one of them.

Sara, you can wait until after the birth and then just see someone about getting your baby's blood typed and then you can get the shot if necessary.


ETA: from Michel Odent

http://www.mothering.com/sections/ex...-archive1.html

Quote:

The objective of this injection is to prevent the formation by the mother of 'anti D' (= anti RH) antibodies that might be detrimental for the babies in future pregnancies only. In other words it is a way to reduce the risks of accidents caused by a conflict between mother and babies. The most typical accident caused by this sort of blood incompatibility is a severe jaundice related to the destruction of fetal red blood cells. Today these accidents are exceptionally rare in developed countries, first because women don't have many babies (only children who have older siblings are at risk), and also because the prevention is routinely recommended.

Such explanations are necessary, so that informed women can decide if the injection is really useful in their particular case. For example if a pregnant woman knows that the baby's father is also Rh negative, she does not need the injection. Another woman might also decide not to have the injection because she knows that she will never be pregnant again (e.g. a 'miraculous' unexpected conception in her late forties).

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#11 of 37 Old 05-05-2008, 12:34 PM
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i would be interested to read more materials about what the origin of the problem is.

the first article linked says that blood doesn't mix in natural birth, and therefore wouldn't be a problem. apparently, the problem arises when the birth is interventive (medical).

So, i'm curious if the 'thousands who died' due to rhogam issues were modern medicalized births or if they were natural or likely to be natural.

or, if that simply isn't the issue at all--that all birth leads to contamination, or that the issue is different in origin.
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#12 of 37 Old 05-05-2008, 02:31 PM
 
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Unfortunately that page is very inaccurate. Among other things it claims you can change your Rh type and this is not possible.

Blood mixing can happen in all kinds of ways--trauma, for example. A natural birth may reduce the likelihood of mixing, but it is no guarantee.

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#13 of 37 Old 05-05-2008, 02:53 PM
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i would like some sources, if possible.

i'm rooting through google a bit, but it's not giving up much by way of any information beyond that it's somehow "necessary."

i get odent's argument about children after the first (but i admit that i don't understand it), and so i'm looking for different information on the topic. so if you have a source you're willing to share, then i'd be very happy to have it.
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#14 of 37 Old 05-05-2008, 03:42 PM
 
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Originally Posted by AlexisT View Post
Blood mixing can happen in all kinds of ways--trauma, for example. A natural birth may reduce the likelihood of mixing, but it is no guarantee.
I agree. IME, there are no guarantees in birth. Planning and preparation are certainly helpful and can be so important, but in the end, there isn't a guarantee that things will go the way we assume/hope/wish/envision.

Quote:
and i'd only get it if i went in for interventions anyway.
But if a homebirthing/UCing mother is going into the hospital it's not going to be for "interventions" it's going to be for medically-necessary treatment in most circumstances. I can't possibly see myself going in for "interventions," y/k? I'd be going in because I needed medical assistance. Probably just semantics, but there's my .02


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#15 of 37 Old 05-05-2008, 03:56 PM
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well, i consider a medically necessary treatment in the intervention category. perhaps it was just misuse (or over-expanded use) of the term. i would go in seeking treatment, and then i would get the shot because of the increased risk of contamination.

but, i still can't find any information that is clear about what the origin of the problem is, and how often it affects women who are having natural births (if at all), or how often it did, and then from there, what the situation is with second children (though not with first--which is what the odent article seems to assert).

again, anything you can point me to would be great. i'm not having much luck with the search engines.
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#16 of 37 Old 05-05-2008, 04:13 PM
 
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My husband and I are both O+, so this is not something I have to worry about, but back when I thought I was O- for some reason, I only planned on getting the rhogam shot if there was some kind of trauma during pregnancy, if I had a miscarriage, or if there was an emergency during birth (cesarean, needing medical assistance, etc.).

I was under the impression that as long as you have an uncomplicated pregnancy and birth (and this usually means homebirth, as hospital births are rarely uncomplicated), the likelihood of sensitization was fairly low.

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#17 of 37 Old 05-05-2008, 04:23 PM
 
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zoebird, it can't occur in a first pregnancy (unless, through some huge error, you received an Rh+ transfusion earlier in life) because the mother has never been exposed to Rh+ blood. You only develop antibodies after exposure. So your first baby can't be affected by them, under normal circumstances.

What happens is:
Mother gives birth
Mother is exposed to Rh+ blood
Mother develops antibodies to Rh.

In her NEXT pregnancy, those antibodies will attack the baby.

See http://www.emedicine.com/EMERG/topic507.htm

I don't think there are any accurate statistics on how often it happens, since Rhogam is routine. I don't think women are routinely tested for antibodies or if this is possible. What is known is that any Rh- woman who delivers an Rh+ baby may have had blood mixing and it may have occurred before birth.

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#18 of 37 Old 05-05-2008, 04:28 PM
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I was under the impression that as long as you have an uncomplicated pregnancy and birth (and this usually means homebirth, as hospital births are rarely uncomplicated), the likelihood of sensitization was fairly low.

that is my understanding from what i am reading now--from a variety of google sources.

here is what i do not understand:

1. assuming that everything is normal and healthy, why is the mother innoculated after the birth? what is the illness that will befall her if she is not innoculated?

2. how does this innoculation help in regards to future pregnancies such that she needs to take it now, but it may be years before another pregnancy, and then she may need to take it again after that pregnancy? (this is referencing the Odent article linked before.)

i'm finding much of the information to be quite confusing.

Alexis:

thanks for the link. i'm reading it now, which is explaining the situation of 2. but i'm still confused about innoculation--doesn't it create antibodies, and wouldn't that then move across. it's interesting to read about.

of course, now i have to go and pick up my husband from work, so i won't be able to finish reading about and thinking in depth.

of course, as i said, i really don't see it as that much of an issue for me. i'm not sure of my blood type, but my intuition tells me that everything is fine.

and with this, what i'm reading is that unless there is a trauma it's fine for the first birth, but if one plans on birthing again, it's a good idea to get the shot.

i also read that one can get the shot within 72 hrs of birth, and some as much as 13 days following and still get benefit.
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#19 of 37 Old 05-05-2008, 04:31 PM
 
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Left untreated in subsequent pregnancys
http://www.kidshealth.com/parent/pre...gnancy/rh.html

Quote:
if Rh Disease Is Not Prevented?
Rh incompatibility rarely causes complications in a first pregnancy and does not affect the health of the mother. But Rh antibodies that develop during subsequent pregnancies can be potentially dangerous to mother and child. Rh disease can result in severe anemia, jaundice, brain damage, and heart failure in a newborn. In extreme cases, it can cause the death of the fetus because too many red blood cells have been depleted.
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#20 of 37 Old 05-05-2008, 04:46 PM
 
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Rhogam kills the foetal blood cells before your body has a chance to make antibodies of its own. Since the antibody cells are never created, your body doesn't 'remember' it.

It has to be given within a time interval to prevent natural antibodies from being created. As with most things they tend to have a conservative recommended interval.

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#21 of 37 Old 05-05-2008, 10:20 PM
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ok, that makes sense. i was curious about how the "vaccine" actually worked, since vaccines typically help the body create antibodies without actually going through the whole illness.

but if it, instead, simply kills the rh+ cells that have come into the body, such that hte body cannot make antibodies, and it's those antibodies that are the problem. . .then it makes sense.

and the subsequent pregnancies, then, makes some sense. i'm curious about the issue of contamination in there--how the mother's antibodies cross the barrier (when their isn't trauma, etc) in subsequent pregnancies, or how that works.

of course, this is all theorhetical--as we're both rh+ so for us it isn't specific (good ole intuition).

but i do see how it is specific to that 15% or so of the population that is rh- particularly if you're talking about first vs subsequent births AND you're looking at issues such as did this person have a miscarriage before and what is the situation of this birth and so on.

all of that is really valuable.

and, to get back to the topic, our family doctor said he would be willing to write the script. so that's an option.
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#22 of 37 Old 05-06-2008, 04:15 AM
 
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Somewhere I read, and I don't have a source just what is in my head, that a lot of Rh incompatibilities began when drs began "managing" third stages of labor by early cord clamping. Making the mixing of blood much more prevelant.

Not that there was never any problems with it before hand, but that that was a big factor in it now. And it makes sense, too.

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#23 of 37 Old 05-06-2008, 11:38 AM
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Originally Posted by zoebird View Post

she said that it was necessary. i asked her why, and she brought up a bunch of bogus stuff like "because that's what is done." so, i said "what about before those things were done? did women and babies die from rhogram incompatiability or something? do you know?"

.
Um, yes. That's exactly what happened. The babies died.
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#24 of 37 Old 05-06-2008, 11:39 AM
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of course, this is all theorhetical--as we're both rh+ so for us it isn't specific (good ole intuition).

.
You've intuited your baby's blood type? Fascinating.
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#25 of 37 Old 05-06-2008, 11:42 AM
 
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Can this thread get back to the OP now?

She did have a question.

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#26 of 37 Old 05-06-2008, 12:05 PM
 
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I was under the impression that as long as you have an uncomplicated pregnancy and birth (and this usually means homebirth, as hospital births are rarely uncomplicated), the likelihood of sensitization was fairly low.

that is my understanding from what i am reading now--from a variety of google sources.

here is what i do not understand:

1. assuming that everything is normal and healthy, why is the mother innoculated after the birth? what is the illness that will befall her if she is not innoculated?

.
There is a really good thread from a while ago where MsBlack explains about tests they do to check for blood mixing that would tell you if you needed to get rhogam after the birth. I started it because my blood did mix and we discovered it because my OB (yes, I am not a UCer, don't shun me, ok? I support the concept and believe in trusting your body so lurk here) did the tests "routinely." I wound up having to have additional testing because there was alot of fetal blood in my blood stream and needed to get extra rhogam to protect against antibodies. BTW, the test they did was prior to my natural birth, so the mixing occurred during my uncomplicated, trauma-free pregnancy (somewhere between when they did the tests at 28 weeks and labor)...
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#27 of 37 Old 05-06-2008, 12:06 PM
 
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Can this thread get back to the OP now?

She did have a question.

lol, sorry OP for continuing the derailment of your thread
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#28 of 37 Old 05-06-2008, 12:41 PM
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i looked up my blood donor card and learned that i am rh+.

the issue of rh contamination only pertains to women who are rh- status who may have a rh+ child. this pertains to 10% of caucasian pregnancies as other populations have lower incidence of rh- status (wiki).

the value of prenatal innoculation is still up for debate from what i read, but the value of innoculation within 72 hours of birth or trauma of an rh- mother and an rh+ baby is extremely valuable particularly to the health of subsequent babies (they are at greatest risk for RHD--which has mild to extreme symptoms that increase with each subsequent sibling).

since an rh- mother can give birth to either an rh+ or rh- baby, the standard of care prior to use prenatally was to type the baby after birth to determine if the innoculation is needed.

i found researching this to be very personally rewarding. thanks for the information and sources that you all presented. while i still believe that contamination during natural birth is less likely, i do think it is important for parents who are at risk (rh- mothers) to be informed and have access to this innoculation.

and, as i mentioned before, when i talked to the family doctor's office, they said they would be happy to give the innoculation within 72 hrs of birth.

so, a family doctor may be a good resource.
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#29 of 37 Old 05-06-2008, 12:51 PM
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gini:

people who use obs are not shunned here. for my own part, i want women to feel informed and empowered about their choices--whatever that is.

admittedly, for my own part, i often question "routine" testing of all kinds--in and outside of pregnancy, female health, etc. i mean, i even question what my dentist does--and that's definitely routine! LOL

in this instance, i simply researched out of real curiousity. i learned a lot!
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Originally Posted by ThreeBeans View Post
You've intuited your baby's blood type? Fascinating.
I have to admit that I've found many of your responses here and in the past to be quite rude, but I'm not sure if I'm misinterpreting. Please let me know if I am, and if so, I apologize. I do realize that it's difficult to portray feeling and meaning through written words, but honestly, I cannot read anything other than sarcasm in your comment.

Are you truly fascinated by your (mistaken) assumption that zoebird was intuiting her baby's blood type? Because if not, I do not see how your comment adds to this discussion.

One of the biggest reasons I love the UC forum so much, and visit here more than any other forum on Mothering, is because of how much support I feel here. Nowhere else, in my opinion, can women ask such deep, personal, and spiritual questions and receive nothing but validation and helpful responses. I do not think I'm the only one who would like to keep it this way.

Sprat , Certified Professional Midwife, loved very much by Sprig , the most open-minded, loving, gentle man in the world, little Sprout and now someone new! on begins with .
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