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Old 09-19-2012, 05:45 PM   #31
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Re: What comprises "unnecessary" prenatal care?

Also, after reading some other posts...if you skip testing that an MD ordered, he/she may perform those tests when you are admitted for delivery because they need to be documented. For example: your Rh status. They need to know whether or not you need the Rhogam shot. Also, if there is not documentation of your GBS testing, they may opt to administer the antibiotics since your status is unknown and they are erroring on the side of caution. GBS is a bacteria that take a few days to culture, which is why it's a test that is done well before delivery. When you are admitted to the hospital and if you don't have a documented birth plan for what you don't want, you give the physician/hospital permission to treat you to the best of their ability. They need to know your status before they can adequately treat you, so they may perform the missing tests then.

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Old 09-19-2012, 07:31 PM   #32
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Re: What comprises "unnecessary" prenatal care?

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Originally Posted by holly6737 View Post
That's actually not true. The window period is generally accepted to be 6 weeks.
Unless something has drastically changed, I learned this in a medical class about 4 years ago. Just going based off of what I've been told by professionals, is all.

ETA: Not trying to be snarky. Was just stating where I got my info.

Last edited by leyash; 09-19-2012 at 07:33 PM.
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Old 09-19-2012, 07:32 PM   #33
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Re: What comprises "unnecessary" prenatal care?

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Originally Posted by clothdiapercrunchy View Post
This is not true, what people mean is the virus does not turn to AIDS for sometimes 10-12 years but the HIV test will show positive if you are infected within a short time period, I believe its weeks if not a few months. I may have to break out my nursing books though.
That explains it a bit better. I knew what I was trying to say, got the dates mixed up. Thanks for clarifying.
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Old 09-19-2012, 08:05 PM   #34
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Originally Posted by A21Lee
Agreed that these are the bare minimum you should have in addition to UA to check for bacteria (UTI-can be asymptomatic) and proteins and BP checks (because of ecclampsia after 20 wks). It's not about the MDs making money or forcing you to do things. It's about practicing preventative medicine and anticipating concerns like anemia. Also, knowing HIV status and GBS requiring treatment to prevent transmission to baby. GD is necessary testing to make sure that blood sugars are controlled so that baby is not affected by high blood sugar of Mom. Undiagnosed GD can cause a lot of problems in baby-one being increased baby size which can make delivery very difficult for Mom and OB. One other thing I want to add since you had said something about Rhogam shots ($$$$$). If you've had the shots with previous children, it's because you are Rh negative. If you have the father's Rh tested and documented for the MD to be NEGATIVE as well, you don't need the Rhogam shot. You only get the shot because of the potential for the father to be Rh positive and pass it onto baby. If you and the father are both Rh negative, there's no need for the Rhogam shot and you can refuse that. You can also check the blood tests on your previous children that they run at birth. If baby #1 is Rh negative (i.e O+/-, the Rh is the +/- part), then Dad HAS to be RH negative as well, but it would be good to document if Dad agrees to the test. Blood test is much cheaper than the shot (which if you are negative and baby is positive-you get twice-once prenatally and w/in 72 hours postnatal). Hospital has a legal obligation to give the shot in those cases because of detrimental effects to baby with blood type incompatibility. It's really ALL about having the safest pregnancy and delivery for both you and your baby. I agree that if you are going to take home whatever comes out of you and genetic information beforehand is not going to change your mind, then don't have that genetic screen performed.
DH is positive. I am negative. are the shots super expensive?

We are definitely staying away from genetic screening/testing.

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Originally Posted by A21Lee
Also, after reading some other posts...if you skip testing that an MD ordered, he/she may perform those tests when you are admitted for delivery because they need to be documented. For example: your Rh status. They need to know whether or not you need the Rhogam shot. Also, if there is not documentation of your GBS testing, they may opt to administer the antibiotics since your status is unknown and they are erroring on the side of caution. GBS is a bacteria that take a few days to culture, which is why it's a test that is done well before delivery. When you are admitted to the hospital and if you don't have a documented birth plan for what you don't want, you give the physician/hospital permission to treat you to the best of their ability. They need to know your status before they can adequately treat you, so they may perform the missing tests then.
Can I not refuse administration of antibiotics? So far, the research I've done over the past several days is showing the same infant death rate in infected mothers who did and did not receive antibiotics, largely because that strain of bacteria has developed antibiotic resistance (presumably because of preemptive antibiotic use?). It also seems that there are several home/herbal remedies that are much easier (and more effective) than a huge dose of antibiotics.

We will definitely have a documented birth plan. We had that last time - it was just much different, along with copies of our powers of attorney/healthcare powers of attorney. Apparently it's unfortunately uncommon in this area (rural, very uneducated, low income, large percentage of citizens relying on government support) because all of the staff - except our doctor, haha - was quite surprised at the sheaf of papers we handed over at check in.
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Old 09-19-2012, 08:07 PM   #35
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Re: What comprises "unnecessary" prenatal care?

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Can I not refuse administration of antibiotics?.
i think if you refuse they will keep the baby for 3 days to observe. they did that with ds2 even though i had the abx
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Old 09-19-2012, 10:23 PM   #36
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Re: What comprises "unnecessary" prenatal care?

I have medicaid, and I didn't have to do any tests that I didn't want to do. Your OB basically lied to you to get more money, that would be my guess anyway.

I always consent to the GD test. This was my fourth baby. I never had GD with any of my previoius pregnancies, but did develop it this time. While diet DOES play a role, even the healthiest person can develop GD, and left undiagnosed can have serious complications for mom and baby. Aside from the risk of a really big baby, it can cause the placenta to spontaneously detach from the uterus. So in MY opinion, it's not one of the tests to skip.

I don't do any of the genetic screening, because those blood tests are notorious for giving false positives. I consented to the Quad Screening with ONE pregnancy (DS2) and it came back with an elevate risk of Downs Syndrome. I was a friggin nervous wreck for two weeks waiting for my Level 2 ultrasound.. just to find out that baby looked completely normal, and they STILL tried to get me to an amnio "just to be sure."

I believe in Texas they HAVE to check you for HIV. But I'm not 100% sure on that.

So my personal opinion is to consent to the GD test... yes, it's a little inconvenient, but isn't it worth it to make sure you and baby stay healthy? I was diagnosed with GD this time, and I did not need meds to control it. I just knew that I needed to eat healthy and as I checked my sugars several times a day I learned what foods spike my sugar and what foods don't, and how to safely "cheat" when I did want something sweet. For instance... I could have a slice of toast if It was slathered with peanut butter, or eaten with two eggs for breakfast. I learned that I could put sugar in my coffee with no adverse affects... I learned that potatoes didn't bother me, but carrots spiked me, etc...

So I feel strongly that the GD is DEFINTELY a necessary test.
All the blood tests for genetic screening are not.
Anything you are at an increased risk for, should be allowed to be tested for.
And I definitely consent to the 2 or 3 ultrasounds.

So, that's my opinion. I'm GLAD that I knew I had G.D. Before I was diagnosed, I was SURE I would pass the test with flying colors just as I had the 3 previous times. I'd hate to think about the type of complications I could have put myself or Baby through if I hadn't known I had GD!

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Old 09-20-2012, 05:16 AM   #37
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Originally Posted by Michelle_M
I have medicaid, and I didn't have to do any tests that I didn't want to do. Your OB basically lied to you to get more money, that would be my guess anyway.

I always consent to the GD test. This was my fourth baby. I never had GD with any of my previoius pregnancies, but did develop it this time. While diet DOES play a role, even the healthiest person can develop GD, and left undiagnosed can have serious complications for mom and baby. Aside from the risk of a really big baby, it can cause the placenta to spontaneously detach from the uterus. So in MY opinion, it's not one of the tests to skip.

I don't do any of the genetic screening, because those blood tests are notorious for giving false positives. I consented to the Quad Screening with ONE pregnancy (DS2) and it came back with an elevate risk of Downs Syndrome. I was a friggin nervous wreck for two weeks waiting for my Level 2 ultrasound.. just to find out that baby looked completely normal, and they STILL tried to get me to an amnio "just to be sure."

I believe in Texas they HAVE to check you for HIV. But I'm not 100% sure on that.

So my personal opinion is to consent to the GD test... yes, it's a little inconvenient, but isn't it worth it to make sure you and baby stay healthy? I was diagnosed with GD this time, and I did not need meds to control it. I just knew that I needed to eat healthy and as I checked my sugars several times a day I learned what foods spike my sugar and what foods don't, and how to safely "cheat" when I did want something sweet. For instance... I could have a slice of toast if It was slathered with peanut butter, or eaten with two eggs for breakfast. I learned that I could put sugar in my coffee with no adverse affects... I learned that potatoes didn't bother me, but carrots spiked me, etc...

So I feel strongly that the GD is DEFINTELY a necessary test.
All the blood tests for genetic screening are not.
Anything you are at an increased risk for, should be allowed to be tested for.
And I definitely consent to the 2 or 3 ultrasounds.

So, that's my opinion. I'm GLAD that I knew I had G.D. Before I was diagnosed, I was SURE I would pass the test with flying colors just as I had the 3 previous times. I'd hate to think about the type of complications I could have put myself or Baby through if I hadn't known I had GD!

God bless!
I'm fairly certain my doctor wouldn't LIE to me about requiring certain tests if I was on Medicaid.

Thanks for your input.

Last edited by KelseyH; 09-20-2012 at 06:52 AM.
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Old 09-20-2012, 06:10 AM   #38
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Originally Posted by Michelle_M
I have medicaid, and I didn't have to do any tests that I didn't want to do. Your OB basically lied to you to get more money, that would be my guess anyway.
Medicaid coverage varies wildly from state to state. I believe there are some states that dont cover the genetic testing. So I highly doubt that her OB lied, but would guess the two of you don't live in the same state.
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Old 09-20-2012, 06:49 AM   #39
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Re: What comprises "unnecessary" prenatal care?

Re: GBS + antibiotics.
Their general rule is that if you're negative, they do/require nothing. If you are positive, or if you are not tested, they require a minimum of one dose of antibiotics at least 4hrs before birth. If this isn't done (whether you refuse the antibiotics or there isn't enough time between the IV starting and birth) they can may things... not so nice for you/baby.
I've heard of them requiring baby to be under observation for 48hrs after birth - some hospitals would allow baby to room-in with mom, but you would have to stay for the 48hrs (not so big a deal), but some hospitals will "require" baby to be under observation in the nursery (a very big deal). Also, in some cases they start baby on antibiotics as a preventative measure. to all that, imo.
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Old 09-20-2012, 08:19 AM   #40
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Re: What comprises "unnecessary" prenatal care?

If you don't want to do the GD test, you can choose to eat like you might have it, and exercise. I opted out both times so I understand where you're coming from. I monitored my health closely, exercised, and ate a diet with balanced whole food, almost nothing processed.
I think that GBS status is a good thing to know.once you know you can decide on a course of action, but the chances of infection can be high with certain circumstances.
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