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Old 09-16-2012, 08:32 PM   #11
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What is BPP?

Cost is just one element of my concern. I just don't understand the "why" behind some things. When I was pregnant with DS, and he mentioned testing/screening for Down's (among other things) and said it was good to know so it "can be taken care of". He has probably never had a patient ream him out so thoroughly after such a statement. I was absolutely horrified, especially because he calls himself a Christian!
The more I read and learn about the "crunchy" side of things, the more I am perplexed by the over medicalization (I know that's not a word... Hopefully you know what I mean) and high incidence of unnecessary intervention with what should be normal, healthy births.
My son was severely jaundiced after birth and it took a loooong time for my milk to come in - and I seriously regret being induced, because I think that was part/most of the reason behind that. But that's "normal" if you're 39 weeks and tired of being pregnant. Ugh. I'm still having a hard time letting go of not wanting an epidural this time, though.

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Old 09-16-2012, 08:36 PM   #12
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Re: What comprises "unnecessary" prenatal care?

i personally only want to listen to the HB until i feel movement. blood pressure checked and fundal height measured. i dont want anything else done.
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Old 09-17-2012, 05:59 AM   #13
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Re: What comprises "unnecessary" prenatal care?

Unfortunately this question can sometimes only be answered retrospectively.

What would I consider bare minimum? At least one ultrasound, blood work and regular monitoring of blood pressure. That is what we do here where everything is basically on an "best outcome for the lowest price" basis. It is proving to be inadequate if you look at our perinatal and maternal mortality rates and the reasons behind the numbers (a huge part is inadequate assessment of risk levels. It is indeed difficult to determine you or baby are at elevated risk for something you aren't tested for it).

If I had the option of paying out of pocket for something I personally deem necessary, it would be a GBS test.
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Old 09-17-2012, 06:12 AM   #14
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Re: What comprises "unnecessary" prenatal care?

Don't assume that a home birth would include less testing. I'm having a home birth this time around and there are certain tests ( like glucose test and bstrep test) that you HAVE to have in order to have a midwife attend your home birth in my state. These are state laws and I have tried to get around them but there is no way to get around them. That said, interventions during your home birth ( fetal monitoring, heplock, nurses wanting to keep you in bed, pitocin, epidural, not being able to eat,and then circumcision, heel stick,vit k and the erythromycin eyedrops) do not have to happen. We never did any of those things though even when we were in the hospital so we aren't planning on doing them at home either.

Sometimes it is easier to refuse tests during pregnancy when you are seeing an OB- at least it was for me.
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Old 09-17-2012, 06:37 AM   #15
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Re: What comprises "unnecessary" prenatal care?

It's ultimately what you feel comfortable with and want done. It's not (or shouldn't be!) up to your care provider what tests you do.
I would likely want to do a urine dip (and depending on that I would decide on the GD test, ie. if I was spilling protein, I'd want the GD test done, kwim?), check blood pressure and baby's heartrate, and do the 20wk u/s (not for gender, but for checking baby and placenta). I have done the GBS swab, as their "policy" is to treat with antibiotics if there's a positive result or if there's no testing done.

I am uncomfortable doing paps during pregnancy, so I decline that whole thing - which would mean I'm also declining the STD screening. No HIV testing done either.
I decline any vaginal exams until very late in the pregnancy, or during labor - with Levi I had one done at 41wks, IIRC, and then not until laboring.

For me, it is important that I do bloodwork at each appt - I get that "big draw" done at the beginning of pregnancy, for an idea of where my levels are starting, and I get my platelets and iron levels checked at each appt thereafter.
This is because I tend to have low iron during pregnancy, and because of my ITP we need to keep an eye on my platelets. Oh, and because of the platelet issues, I did have transfusions during labor/delivery with DS2 and DS3, and have had pitocin shots after each vaginal birth.
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Old 09-17-2012, 07:18 AM   #16
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Re: What comprises "unnecessary" prenatal care?

Just from my experience, initial prenatal testing, a 20 week ultrasound, GD testing and GBS testing are the bare minimum. Otherwise, you really risk being dropped.
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Old 09-17-2012, 11:52 AM   #17
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Thanks so much for everyone's input!

I think we've decided to stick with the anatomy scan, Rhogam injections, and GBS test, and I will probably do the rest of the monitoring on my own until I'm further along. We're getting a fetal doppler heart rate monitor and we already have a blood pressure monitor and I think we will be set. Anything else we should have?
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Old 09-17-2012, 12:02 PM   #18
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Re: What comprises "unnecessary" prenatal care?

HIV test. Not because I think anything negative about you and your history. But because if you were positive, approrpriate steps can be taken to GREATLY reduce the risk of transmission to the baby.

I knew it didn't have it but I still got it done in the general bloodwork just in case.
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Old 09-17-2012, 12:06 PM   #19
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Originally Posted by AniMommy
HIV test. Not because I think anything negative about you and your history. But because if you were positive, approrpriate steps can be taken to GREATLY reduce the risk of transmission to the baby.

I knew it didn't have it but I still got it done in the general bloodwork just in case.
So are you saying that's necessary? Since we were on Medicaid when I was pregnant with DS and NC law states recipients have to have an STD panel run, I really don't see any need for it 16 months later when nothing's changed. It's just DH and I.
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Old 09-17-2012, 12:08 PM   #20
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Quote:
Originally Posted by KelseyH

So are you saying that's necessary? Since we were on Medicaid when I was pregnant with DS and NC law states recipients have to have an STD panel run, I really don't see any need for it 16 months later when nothing's changed. It's just DH and I.
I'd rather be safe than sorry.
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