Update: Dr. Appt Today - no HB - Mothering Forums

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#1 of 39 Old 11-05-2010, 12:47 PM - Thread Starter
 
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Okay, so, long story short:

I'm doing HB under the care of a midwife. But, my HMO is silly and won't cover any expenses incurred in the event of a hospital transfer if I don't see a doctor there at least once, prenatally.

In order to see that doctor, I had to go through an intake appointment with their NP. It was completely awful in every way. The whole spiel is here http://www.mothering.com/discussions...050&highlight= but suffice to say, not fun, my friends, not fun.

Today I am past the intake appt and can finally get the MD appt over with.

Considering the judgement and nastiness that went into the appointment last time, I am scared to death to meet this doctor. Seriously. I know I have to- it would completely break us if we had to transfer to the hospital then cover that bill on our own. But mamas, I just can't go through another 3 days of crying post-visit.

Just looking for some love, I guess. Tell me I'm strong enough to handle this. Tell me that I am right to trust my instincts as a mom and to standby my choice to have the birth I want, at home, with my husband and my midwife. Tell me these people don't have a right to tell me my weight if I ask them not to, and they don't have a right to scare me into unnecessary tests.

"The Mothers are the brave ones." - Call the Midwife

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#2 of 39 Old 11-05-2010, 12:57 PM
 
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I remember your ordeal. Unbelievable. I would be feeling dread to for sure (heck, I dread doc appointments and have never had such an awful experience!)

15 minutes. That's about how long it will take. Think about the unbearable excruciating pain of childbirth (I am being facetious...I read back through your story :P) and how long that lasts. You can do 15 minutes with an annoying and presumptuous doctor, you totally can. And although it's possible they will be a big pain in the bum, it's not a guarantee - maybe it will actually be better than last time. After all, this time you are dealing with an actual practicing doctor and not a 'consultant' that spends all day throwing HMO rules and expectations at clients

I would remind the doctor at the beginning about the weight thing, before he/she utters a word.

I hope it's behind you fast
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#3 of 39 Old 11-05-2010, 01:05 PM - Thread Starter
 
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15 minutes. You're so right. What a great thing to remember. Thank you! I can't believe I hadn't thought of it like that. I mean, only getting 15 min with the docs was one of the many reasons I wanted midwife care. I get a whole hour with my MW everytime I go in.

And yes, this time, I'm going to get a head of the curve and just be like, 'before I step on this scale, I'm giving you fair warning, don't you say a word.'

Also- got a good chuckle at your quote from their book "excruciating pain of childbirth." haha

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#4 of 39 Old 11-05-2010, 01:21 PM
 
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DDCC

1. you do not NEED to be weighed. Seriously. I went the entire pregnancy with my most recent daughter never once stepping on a scale. You do not HAVE to do anything you do not feel comfortable with.of course opting out of them weighing me meant i had to keep an eye on my weight at home... but if you tell them "I regularly see a midwife who weighs me, I do not feel comfortable being weighed here" you might not get a fight. Then again, you might...

so if you do not want a fight, yes make sure you tell them before you get on the scale to keep the number and comments to themself

2. just remember this is the doctor not the consultant. I had an AWESOME AWESOME doctor. but for a long time she had a nurse there I hated with a passion. I specifically requested not to have appointments on the days that nurse worked. They are different people, just because they work together does not necessarily mean they will be the same.

3. good luck

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#5 of 39 Old 11-05-2010, 01:33 PM
 
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so sorry you have to deal with this. how sad that we have to jump through hoops just to get the birth we want (and deserve). i remember your first ordeal (i would have been crying too).

hoping your appointment is quick and painless.

clearly you are strong enough to handle this.

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#6 of 39 Old 11-05-2010, 02:03 PM - Thread Starter
 
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Thank you so much. I just wanted so much to hear someone say that I could do this, and that it was ok to say no to stuff I don't want.

I'm gonna get a little misty here, but seriously, I have to gush. I love this forum. I just love it. I come here every day. And I read and post and read and post, all the while feeling so supported. There is no one in my family who feels a woman can choose her own birth. I am the first of all my friends to have a baby. All this has made me feel so alone with no one to really talk to. DH is great, and totally behind me. But he is not a community of wise, wonderful women.

You are, and I thank you so much for this awesome group where we are all so smart, kind, and generally wonderful.

xoxo

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#7 of 39 Old 11-05-2010, 04:06 PM
 
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...I thank you so much for this awesome group where we are all so smart, kind, and generally wonderful.

xoxo



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#8 of 39 Old 11-05-2010, 04:35 PM
 
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oh my... i just read what you went through the first time. i think you should write a letter about her... that was really unacceptable!

i hope that the visit with the doc was less traumatic. sometimes nurses can be so much worse.

either way, most likely you won't have to see those people again after today!

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#9 of 39 Old 11-05-2010, 05:35 PM - Thread Starter
 
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Thanks again, you cool people.

So here's how it went...

The doctor came in and said she hadn't read my chart, except the part about going off my depression meds. So, basically, "hi, I'm assuming I'm your doctor. I will take you through the transition from maidenhood to motherhood. But I haven't bothered to even read your chart before I walked in here."

Great...

Anyway, the short story is that she wanted to do a bunch of tests I refused, including an ultrasound, the test that helps screen for down's, and a pap smear (I had one in May).

She did a pelvic exam to feel my uterus, which she mused was "tilted," but didn't really elaborate on it to tell me what that meant. She also said my cervix is high. Still- no idea what that means.

She felt my abdomen and concluded I have a fibroid. First I'm hearing about this, so I was a little stunned.

She tried to find a heartbeat, then stopped and said she was getting too frustrated to continue.

Because she couldn't find a heartbeat and is convinced I have a fibroid, she pushed hard for that ultrasound. I said I would come back in a week, and left confused, fearful, and totally unsure of what to do.

Time to call the midwife, I guess.

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#10 of 39 Old 11-05-2010, 05:37 PM
 
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Ack, I'm sorry you left feeling like you had something to worry about Definitely call your midwife, I bet it will be really reassuring.

Do you HAVE to go back? How many times do you have to see her before your insurance will be happy?

I was at an appointment with my doctor's nurse last week and she couldn't find a heartbeat. It's no fun Incidentally, I have a tilted uterus as well (retroverted). If yours tilts back, that might be factoring into the heartbeat difficulty.
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#11 of 39 Old 11-05-2010, 06:15 PM - Thread Starter
 
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Really? That factors in? What a relief to hear that. Seriously. DH is so freaked out right now. I acted like I wasn't bothered, and was totally confident, and I told him well, what's going to be, will be. Our worry will not change reality.

But the truth is I'm feeling so scared.

BTW this was the LAST appointment. Insurance is satisfied. Whew.

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#12 of 39 Old 11-05-2010, 06:25 PM
 
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When are you due? I was 13 weeks last week when the nurse couldn't find it. Granted, in that case I think her inexperience played into it - I don't think it is something she does every day. But in your case it sounds like you can substitute impatience for inexperience and end up with the same result!!

I hear you on saying you're fine but being scared - I was exactly the same with the nurse (part of me wishes I said "No, I'm not fine, so order me a stat ultrasound for viability please" It was HER idea to check for the heartbeat in the first place. grrr).

Can you get in to see your midwife for a quick heartbeat check, just for reassurance? I am still not set up for care with anybody (sigh. don't get me started - it has been quite the experience this time around!!) and have been toying with the idea of just going to a walk-in clinic to get them to listen...but I don't want to be disappointed again, either, if I get someone else who's not really skilled at doing it! If I could walk into a midwife's office to have it checked, though, you had better believe I'd be there in a New York minute!
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#13 of 39 Old 11-05-2010, 06:37 PM
 
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I dont understand how she identified a fibroid by bimanual exploration, yet you dont have any symptoms?

How big did she say it was and where?

I think it all sounds like bunch of BS. I dont understand why she even did a pelvic on you.. Do you have any gynecological history that might warrant that? I have a slew of crap and didnt have a pelvic until I was 40 weeks last time at my request.. and even with OB care this time she had no intention of doing any pelvic exams until my "due date".

Your cervix should be high. That is good. A tilted uterus is completely normal.

I think you freaked her out that you didnt want any US or tests and so she started down the path of showing you just all the scary things that could be wrong so you'd be a nice compliant little patient in the future.

But then again, Im a bit jaded.

Im sorry you are scared, Mama. Try to remember that those docs love using technology and they'd rather send you for a US then use common sense. Im glad your insurance is satisfied. Im curious as to what your midwife thinks of it all.
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#14 of 39 Old 11-05-2010, 06:52 PM - Thread Starter
 
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MamaChef, thank you. You too, bluepetals. This is making me feel better.

The doc didn't say how big my so-called fibroid is. She's just pretty sure it's there. *sigh... I will say that everytime she pressed there I thought, oh god, I'm about to fart all over this woman. hahaha sorry if that's TMI. But maybe it's just a gas pocket? Don't know.

She said the pelvic was the feel the uterus. And I said, can't you do that from the outside? She said no, she couldn't tell how big it was, just how high. She also said she needed to see if any bones were jutting out on the inside that would make it hard to vaginally birth. I was thinking to myself...what?? You are looking for bones in my vagina?!?! What are you saying?

Here's the thing, MamaChef, I just really think you are right. Have you seen the Cohen Brother's latest film, A Serious Man? It's about this guy, Larry Gopnik, who values reason and logic above everything, and cannot stand uncertainty or chaos. At one point, another character says to him, "Accept the mystery."

That is what doctors, imo, cannot do. They cannot just accept the mystery. They usually won't wait and see. They have these crazy machines and they are GOING to use them, by god, to eliminate any questions, no matter how out there they might be. So maybe you're right. Maybe they're just tryna scare me.

That's why I declined the ultrasound. I was feeling bullied, and didn't want to make a fear-based decision.

Put in a call to the midwife and and email. We'll see what she says.

Here's something else, maybe I'm nuts, but okay, I was super scared for this visit, as you know. When I got in, my blood pressure was through the roof and my heart was racing. I could feel it in my chest. When I acquiesed to this pelvic exam, my whole body was tight and I felt stressed. After that, the doc used the doppler and said she could hear my heart beating mega fast.

Part of me wonders, maybe naively, was little bean just hiding because mama seemed afraid? I don't know, that's probably nuts, but I did have that thought.

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#15 of 39 Old 11-05-2010, 07:06 PM
 
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I have a super tilted uterus (even still, after having a son) and my doc says it would make finding the HB difficult early on. It did take her a tiny bit of time w/ Z at around 14 weeks? I think? Maybe even 13. After that though it became easy (uterus straightens out)

I can't believe all these terrible doctor experiences! Makes me want to go hug mine ! They seem to have no bedside manner at all. Mine always makes sure she explains everything she's suggesting/asking/wanting to do, etc. and asks me if I have any other questions, etc. Seems like common courtesy!

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#16 of 39 Old 11-05-2010, 07:06 PM
 
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ugh it really does sound like she was trying to scare/force you into doing things her way.. aka if I scare this lady bad enough she'll do a u/s and if we scare her with how bad things could be she'll forget that silly homebirth plan..

let us know what your midwife says.. I bet she's much more sensible about all this!

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#17 of 39 Old 11-05-2010, 08:22 PM
 
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Big hugs! I hope your MW contacts you soon and you can go in and meet with her. I agree with the others and think that your theory could be right too...baby could've been hiding. I just had my appt today with my MW at almost 12 weeks and it took them a bit to find the baby and heartbeat so it could be just too early as well.

I'm so glad you don't have to go back to that office...it just overall sounds like a miserable place to be. Hugs again!

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#18 of 39 Old 11-05-2010, 08:46 PM
 
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Here's something else, maybe I'm nuts, but okay, I was super scared for this visit, as you know. When I got in, my blood pressure was through the roof and my heart was racing. I could feel it in my chest. When I acquiesed to this pelvic exam, my whole body was tight and I felt stressed. After that, the doc used the doppler and said she could hear my heart beating mega fast.

Part of me wonders, maybe naively, was little bean just hiding because mama seemed afraid? I don't know, that's probably nuts, but I did have that thought.
not nuts at all. i think there's a lot of truth in this.

couldn't hear my baby's heartbeat at 11 weeks, and she said it was normal to not hear it before 14 or even 15 weeks with the doppler.

good news -- it's your LAST APPT! hooray!

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#19 of 39 Old 11-05-2010, 08:55 PM
 
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MamaChef, thank you. You too, bluepetals. This is making me feel better.

The doc didn't say how big my so-called fibroid is. She's just pretty sure it's there. *sigh... I will say that everytime she pressed there I thought, oh god, I'm about to fart all over this woman. hahaha sorry if that's TMI. But maybe it's just a gas pocket? Don't know.

She said the pelvic was the feel the uterus. And I said, can't you do that from the outside? She said no, she couldn't tell how big it was, just how high. She also said she needed to see if any bones were jutting out on the inside that would make it hard to vaginally birth. I was thinking to myself...what?? You are looking for bones in my vagina?!?! What are you saying?

Here's the thing, MamaChef, I just really think you are right. Have you seen the Cohen Brother's latest film, A Serious Man? It's about this guy, Larry Gopnik, who values reason and logic above everything, and cannot stand uncertainty or chaos. At one point, another character says to him, "Accept the mystery."

That is what doctors, imo, cannot do. They cannot just accept the mystery. They usually won't wait and see. They have these crazy machines and they are GOING to use them, by god, to eliminate any questions, no matter how out there they might be. So maybe you're right. Maybe they're just tryna scare me.

That's why I declined the ultrasound. I was feeling bullied, and didn't want to make a fear-based decision.

Put in a call to the midwife and and email. We'll see what she says.

Here's something else, maybe I'm nuts, but okay, I was super scared for this visit, as you know. When I got in, my blood pressure was through the roof and my heart was racing. I could feel it in my chest. When I acquiesed to this pelvic exam, my whole body was tight and I felt stressed. After that, the doc used the doppler and said she could hear my heart beating mega fast.

Part of me wonders, maybe naively, was little bean just hiding because mama seemed afraid? I don't know, that's probably nuts, but I did have that thought.
It could be a fibroid, I guess.. and you could have had not a single symptom.. it's just that most of the time when they are big enough to feel on a woman from the outside then the woman often has some type of symptom. Did she feel it from the inside or outside? Typically fibroids are dxed through U/S.

Was it on your lower right side? If you had a pap in may, Im guessing you had a pelvic.. you woulda thought they would have caught it then when there wasnt a confusing pregnant uterus to throw it off. Then again, I will say that the estrogen of pregnancy can make a fibroid grow quickly from nothing to something.. I dont mean to be so skeptical, but Ive just had and heard of so many crappy experiences like yours at this point that I cant help but be.

She is looking for your ischial spines, most likely. To rule out any deformity, which is UBER rare. Id just about die if that doctor actually knew how to do pelvimetry.. Because if she did, she would know that you should be atleast 20 weeks before even trying to do a measurement. The relaxin actually is mostly released in the beginning of your pregnancy.. right now it's increasing and getting everything all loosey goosey so that your pelvis can open. Measurements wouldnt even start to be accurate until later. Ugh.

Im super sensitive to that one because I had some jerk doctor tell me I had a deformed tailbone from a pelvic and that's why my first didnt come vaginally. So I went and got a series of xrays and my pelvis is fine.. tailbone is fine.. then I did my first pelvic on a women during our lessons on pelvimetry and realized what a jerk he was and how he couldnt have possibly felt what he said he did unless his fingers were like 14 inches long.

Alot of docs are horrible about finding early hb via doppler. They just arent patient, they move the doppler too quickly and all over. You are talking about a heart smaller then a pinto bean at 12 weeks. You need to be pointed right at it and have a good ear because alot of the time it doesnt show up on that little read out. Plus, they always have you pee in a cup first, which makes it harder to get the lower uterus, especially if yours is tilted or retroverted. Most of the time baby is hiding behind an artery or the placenta and the docs just hear the wooshes and they dont heart that tiny little gallop because they move over them so quickly.


I havent seen A Serious Man yet, but it's on the list.
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#20 of 39 Old 11-05-2010, 09:08 PM - Thread Starter
 
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WOW. This message made me feel so much better. No kidding. Thank you so so much for taking the time to share this incredibly helpful information.

Still no word from the midwife. I did elect not to dial her cel, but leave a message in her office instead, so I might not hear back until Monday. I guess part of me is refusing to see this as an emergency.

And it sounds like I've been right not to give in to a freak out.

DH and I had a great conversation about it, and I'm feeling loads better after reading the posts.

Plus, did I mention this lady didn't move the doppler down near the pubic bone? It was up near my belly button. Now, okay, Im totally not an expert, but when I read about these, I thought I read that you're supposed to look down there first?

Anyway, MamaChef, you really know your stuff. And I am so sorry a jerk doctor tried to tell you that you had some deformity. Good for you for not accepting the first thing told you, and doing the work to find out for yourself.

Time for a load of chinese takeout and a good movie. It's Friday, after all!

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#21 of 39 Old 11-05-2010, 09:30 PM
 
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Just want to offer *hugs* and reassurance... with my last pg it took my mw a really, really LONG time to find the bub's hb around 12-13 weeks. I was starting to get nervous, actually. She said it's common to have a hard time finding it at that point

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#22 of 39 Old 11-05-2010, 09:55 PM
 
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she was using the doppler up near your belly button?? i'm 11 weeks today and when we listened to the heartbeat yesterday, the mw only listened up against the pubic bone and that is, in fact, where she found it.

so sorry you had to go through all that. hoping you hear from your mw soon!

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#23 of 39 Old 11-05-2010, 09:58 PM
 
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What? You are 12 weeks and she was listening at your belly button? Did she feel for the fundus first? At 12 weeks, she should have been reaaaallly close to your pubic bone, even trying to angle under it a little...especially since this is your first babe (which I think it is, right?). The uterus is at your belly button around the 20 week mark (on average)!

How bizarre. Was this a GP or a OB/GYN? I hope the former, one that doesn't do that much prenatal care? Either that, or she was purposely trying to freak you out, like someone else suggested.
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#24 of 39 Old 11-05-2010, 10:22 PM
 
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Glad it helped.. That's what a whole buncha money, time and a half finished midwifery degree gets ya ..

Yeah, if she was checking up near your umbilicus it totally voids every other thing she said Of course she heard your heartbeat... A first time mama at 12 weeks isnt gonna have anything at her umbilicus but her own iliac artery.

I never know if these doctors just dont know how to find a fundus that didnt jump up and bite them at 20 weeks or if they are doing stuff like this on purpose to get you to do a US.

I really think they dont teach them how to find anything in early pregnancy without a hand in your vagina or an ultrasound machine on your stomach.

Enjoy your chinese food and movie and try to forget about that. Yay for it being your last appt.

Eat an eggroll for me with extra hot mustard and "duck"/plum sauce mixed together.

My hubby is gone, Ive got a sick toddler and am counting the minutes till Monday
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#25 of 39 Old 11-05-2010, 11:53 PM
 
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Mmmmm....Chinese food and a movie....

You go girl! Don't let them shake you up!
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#26 of 39 Old 11-06-2010, 01:01 AM
 
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I dont understand how she identified a fibroid by bimanual exploration, yet you dont have any symptoms?

How big did she say it was and where?

I think it all sounds like bunch of BS. I dont understand why she even did a pelvic on you.. Do you have any gynecological history that might warrant that? I have a slew of crap and didnt have a pelvic until I was 40 weeks last time at my request.. and even with OB care this time she had no intention of doing any pelvic exams until my "due date".

Your cervix should be high. That is good. A tilted uterus is completely normal.

I think you freaked her out that you didnt want any US or tests and so she started down the path of showing you just all the scary things that could be wrong so you'd be a nice compliant little patient in the future.

But then again, Im a bit jaded.

Im sorry you are scared, Mama. Try to remember that those docs love using technology and they'd rather send you for a US then use common sense. Im glad your insurance is satisfied. Im curious as to what your midwife thinks of it all.
I agree with the bolded. I think she threw "fibroid" out there in an attempt to get you to agree to an ultrasound.

I'm so sorry you had a bad experience with her.

With my first pregnancy my doctor had trouble finding the heartbeat at 14 weeks (and I was much thinner then!)... he did finally find it (and everything was fine--I have a 7.5 year old healthy DD), but it took him a while. It sounds like she was, again, trying to pressure you into an ultrasound, hence her "frustration." My guess is if she didn't so badly want you to have an ultrasound, she would have exercised a little patience and been able to find the heartbeat.

Beth
Mama to DD 2.18.03, DS 3.18.06, DD 5.7.11

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#27 of 39 Old 11-06-2010, 03:49 AM
 
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Glad it helped.. That's what a whole buncha money, time and a half finished midwifery degree gets ya ..

Yeah, if she was checking up near your umbilicus it totally voids every other thing she said Of course she heard your heartbeat... A first time mama at 12 weeks isnt gonna have anything at her umbilicus but her own iliac artery.

I never know if these doctors just dont know how to find a fundus that didnt jump up and bite them at 20 weeks or if they are doing stuff like this on purpose to get you to do a US.


I really think they dont teach them how to find anything in early pregnancy without a hand in your vagina or an ultrasound machine on your stomach.

Enjoy your chinese food and movie and try to forget about that. Yay for it being your last appt.

Eat an eggroll for me with extra hot mustard and "duck"/plum sauce mixed together.

My hubby is gone, Ive got a sick toddler and am counting the minutes till Monday
Thank you ladies for the laugh. I totally laughed out loud Partaria when you said she was up by your belly button looking for a HB...you are right...she wouldn't find one there at 12 weeks. My MW today was down low near my pubic bone when she found my little beans HB and she had to be very patient to get it.

Big Hugs and I hope you enjoyed your Chinese.

S, mama to L(DD)-12/04, K(DS1)-12/06, C(DS2)-03/09 & B(DS3)-05/11

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#28 of 39 Old 11-06-2010, 08:37 AM - Thread Starter
 
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My hubby is gone, Ive got a sick toddler and am counting the minutes till Monday
Oh that doesn't sound fun. Hope the weekend goes quickly for you, MamaChef!

Thanks for all the good info, everyone.

So after reading your comments I looked up information on how to use a doppler. She was no where near the right place, you are right. She never got anywhere near the pubic hair line, even. So okay, yes. That has to be why she couldn't hear anything. I feel like the pieces of what happened this afternoon are falling into place.

Someone asked if she felt for the height of the fundus first. The answer is no. I am sure, because when she wanted a pelvic I asked her why. She said she wanted to feel the uterus's shape (and feel for jutting bones). I said, can't you feel from the outside? And she replied, "oh well the height I guess, but that's not going to tell me anything, I don't need to know the height."

But you do if you are using a doppler.

Hahahaha if this were an episode of Murder She Wrote, this is where the cops would bust in, just after Jessica reveals the whodunnit!

I feel cool as a cucumber now. Wow. Thank you so so much you great people. I would have remained so scared and confused if it wasn't for your knowledge and insights. A community of women is an awesome thing.

xoxo

"The Mothers are the brave ones." - Call the Midwife

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#29 of 39 Old 11-06-2010, 10:06 AM
 
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Just want to throw in some more reassurance for you!

At 12 weeks when we found the hb the goo was all in my pubic hair... there is no way she would have found it up that high. It does sound like she was trying to freak you out so you would get the ultrasound.

The other thing that is funny, is that A. measuring the pelvis is just not used anymore. and B. even if you had a slightly "off" pelvis... you are 12 weeks!! The wonderful hormone relaxin is designed to help your pelvis relax. I never take into consideration the shape of someone's pelvis at 12 weeks. If I am even doing a pelvic exam at 12 weeks. Heck, I don't even really take it into consideration (as far as capability of a vaginal birth) when I do a pelvic exam at 40 weeks. One of my textbooks said: "the baby is the only true pelvemeter", and that was a medical textbook.... not a midwifery textbook!

Also, I have been able to feel fibroids in the non-pregnant uterus, but I have never been able to feel one in a pregnant uterus. The biggest indication of a fibroid is an enlarged uterus (aside from other symptoms the woman may have)... So, I have no idea what she is talking about. I mean was the uterus enlarged because there is a baby in there or because there is a fibroid? My guess... because there is a baby in there.... Again, I think was another fear tactic. Even if you happen to have a fibroid it really should not pose any problems for your birth unless it is low down by your cervix. If no one has ever mentioned it at a routine pelvic exam then I would not even worry about it anymore.

She sounds like an idiot. Just be glad that you don't have to go back!

Heather
mama to E (4 years) and J (2 years) and K (born in May)
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#30 of 39 Old 11-06-2010, 10:50 AM
 
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Hi mama-
Even more reassurance...at my 11 week appt the dopper was probably 3-4 inches below my belly button. (I can't believe she even tried there- sounds like there were lots of intimidation tactics being used.) So glad you feel better and hope Chinese/movie night with your DH was fab!

J - Birth doula and *very* grateful mama to bouncy Q, fancy F, and mighty F!

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