[ariahsmum]

Knock on wood...

1)But if I have to go for any reason, what do I tell them upon admission? I have no prenatal care provider... I am not really looking to blow a UC/CPS horn on myslef

2)In addition, I have one previous c/s. I have my operative report from last time in case I need to prove I have a double layer suture, but I am thinking I will not even bring up the c/s thing. Would I need to? Could I just present in labor for whatever reason I needed to, and forget to mention the previous surgery. I don't see why it needs to be relevant unless there is some care i need specific to it.

TIA

 

[wonderwahine]

I would just tell them you've had no prenatal care provider, and you will have to disclose the previous c/s since it could put you at possible risk of uterine rupture.

 

[Finch]

Just tell them you got NPNC, disclose the previous c/s. In most hospitals it will flag you for a visit from the hospital social worker, but not a CPS referral.

Hope that makes you feel a little better.

 

[wonderwahine]

also, if you say that you didnt have pnc because of financial reasons, it will all blow over, they will probably suggest clinics around the area and medicaid.

 

[arlecchina]

I dont think you have to worry about disclosing a chosen UP, sweetie. even in the event of an issue (which there wont be <3) they'd have to prove beyond a doubt that the prob was caused due to no medical prenatal care. which so far as I can ascertain, is completely impossible, cause anything could happen even with med care.

 

[Finch]

Quote:

Originally Posted by arlecchina I dont think you have to worry about disclosing a chosen UP, sweetie. even in the event of an issue (which there wont be <3) they'd have to prove beyond a doubt that the prob was caused due to no medical prenatal care. which so far as I can ascertain, is completely impossible, cause anything could happen even with med care.

The reason she would have to disclose having no PNC is because we keep the records of patients who are expected to deliver at our hospital on the L&D unit, and if we don't have records, we will fax your care provider to get them. So it's not a matter of trying to nail her for anything, it's a matter of having medical history documented, that's all.

I agree, say it was for financial reasons and they'll leave you alone.

 

[arlecchina]

Quote:

Originally Posted by Finch The reason she would have to disclose having no PNC is because we keep the records of patients who are expected to deliver at our hospital on the L&D unit, and if we don't have records, we will fax your care provider to get them. So it's not a matter of trying to nail her for anything, it's a matter of having medical history documented, that's all.

right, I realise there is reasoning behind it. as she said "not really looking to blow a UC/CPS horn" on herself then I addressed her worry

 

[wonderwahine]

regardless of her not having prenatal care etc......CPS wouldnt take the baby away.....shes not some teen mother who gave birth and put it in a drawer or something.

And most states say its not medical neglect if it was for religous or finanacial reasons.

 

[normajean]

I've been looking into this also. My insurance requires your doctors office to precert your hospital stay, or they don't pay. I'm not sure how we are going to pull this off in the event of an emergency transfer.

Since we are in the middle of nowhere, as far as admission into the hospital w/o a local dr, It would be pretty common for them to think I have a provider in a large city a few hours away, but didn't have time to drive to their hospital. I don't see any harm in their thinking you are "between doctors" or something.

 

[Intertwined]

Jen, I would think in the case of a true emergency transport, you would admit through the ER. I could be totally off base, but I would think that would be like any other emergency admission. The hospital would contact your insurance and they would then precert an extended stay if required. Maybe?

 

[Finch]

Quote:

Originally Posted by Chantelhayes Jen, I would think in the case of a true emergency transport, you would admit through the ER. I could be totally off base, but I would think that would be like any other emergency admission. The hospital would contact your insurance and they would then precert an extended stay if required. Maybe?

This is exactly correct. You present to the emergency room and they will admit you under the "unassigned" OB on call.

 

[boscopup]

While I was getting PNC from a midwife (and she was able to fax my medical records to the hospital), I had no trouble with insurance paying for my hospital stay. I entered via the LDR (PPROM at 29 weeks, and had *just* started contractions 10 hours after the PPROM occurred, so it was not an ER type case, but an "I need to be here" case). I had not preregistered at the hospital or anything, but it just wasn't an issue at all. I filled out the paperwork and my insurance company paid for my antepartum unit stay, my delivery, and my DS's NICU stay. The hospital contacted my insurance company and got the preapproval right away. Not a problem.

And I don't see how they could ding you for no prenatal care, as to my knowledge, it's not illegal to not see an OB/midwife? You might get lectures (I had a student tell me at my PP checkup that "Next time you should get prenatal care", to which I responded "I DID have wonderful prenatal care with a midwife"

, but they can't take your child away or anything. There are lots of women who don't get prenatal care for financial reasons. I just wouldn't tell them that you were purposely planning UP/UC.

 

[laohaire]

Quote:

Originally Posted by romans_mum regardless of her not having prenatal care etc......CPS wouldnt take the baby away.....shes not some teen mother who gave birth and put it in a drawer or something.

It's happened. There's a thread in this forum about it. A UC that is, not NPNC.

 

[wonderwahine]

well yeah.....a UC is different..... and wrong if they do that, but she shouldnt worry about it if she goes to the hospital.

 

[2bluefish]

If you transport for a reason that isn't an immediate emergency like I did (like prolonged labor, a gut feeling you need help, etc.), you can try calling a doctor (referred from a friend) and asking him/her if they will consult with you at the hospital. That worked well for us. I would only do the ER route if I someone was dying.

I told them I had a midwife from out of state, and I wasn't allowed to give out her name. I told them I had prenatals once a month (didn't tell them that I administered them myself.) I was never bothered about it.

Only trouble we had was our local hospital is really bad about taking babies off to NICU for 5 days of "observation" - it happened to us and several of our friends who had planned hospital births. Once they get your kid, then they give you a big fight if you question their "care". And most people just go along with it, so it's very hard for an individual family to fight it.

Best thing to prepare is to ask around and listen to local families experiences. It doesn't take long to see how things go down, and if you do have to go there, then at least you know what you are signing up for.

 

[freebirth2]

Don't let them give you pitocin,prostaglandin gel or cytotec as they can cause uterine rupture. Uterine rupture is never a problem unless these drugs are given.

 

[ariahsmum]

Just for the record, UR unfortunately does happen even in the absence of induction agents. It is rare, but it does happen. Just don't want misinformation out there...

I am curious as to why some of the pp think I would need to disclose the c/s? What if it has nothing to do with my reason for being in the hospital? I am trying to avoid any automatic repeat c/s issues, which I *will* get if they know.

I already have medicare JIC I decided I wanted an attended homebirth... so I am not sure the NPNC for financial reasons would help?

I guess I would like to have a quick response prepared if they ask who my PC provider is, etc. Hmmm...

 

[wonderwahine]

because if you disclose it, they might comply with avoiding certain meds to "hurry you along" etc.

since you have ins, i would say you got care out of state.

 

[2bluefish]

You are right Jaya, you can have uterine rupture without intervention - *even* without a previous c-section - like in a true case of CPD or obstructed labor. Very very rare of course.

You could just disclose the c/s if they start talking about inteventions that would put you at risk for UR. That might solve your problem. I agree, I would be nervous about walking in and saying I'm VBAC - and then possibly having to fight that battle.

 

[doula mary]

Quote:

Originally Posted by freebirth2 Don't let them give you pitocin,prostaglandin gel or cytotec as they can cause uterine rupture. Uterine rupture is never a problem unless these drugs are given.

Uterine rupture IS a problem no matter what and can happen to any PG women but is VERY VERY rare. With pit, gels and especially cytotec..the risk increases.

Mary