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Old 11-13-2012, 03:21 PM   #1
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Denied Prenatal Care?

I went in for my first OB appointment today. When I told him my goal was a HBAC, he said he cannot provide prenatal care at all unless I agree to a hospital labor and birth. He also told me no doctor in the group will provide me with prenatal care if I plan to attempt a home birth (my insurance does cover complete prenatal care).

I was shocked to hear him say that I have only a 10% chance of ANY VBAC, let alone HBAC, and they won't even see me because I could put their practice at risk!

If I were a smoker and refused to quit smoking, they wouldn't just say "sorry, we can't give you any medical care unless you quit?" I'm fuming and crying at the same time.

The midwife I am seeing is far away and doesn't include testing, I had planned to have a relationship with the OB throughout the pregnancy. Doesn't this stance seem wrong???

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Old 11-13-2012, 03:24 PM   #2
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Why don't you just plan a hospital birth and them at the last second change your mind for the homebirth?
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Old 11-13-2012, 03:28 PM   #3
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Re: Denied Prenatal Care?

Yeah, I think I'd just "change my mind" at the end. I'd go to a different OB though since you already have bad feelings about this one. And then if for some reason you needed a hospital transfer, you wouldn't want to deal with this guy.
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Old 11-13-2012, 03:32 PM   #4
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Re: Denied Prenatal Care?

Your midwife doesn't have someone she regularly works with that she sends you to for the testing that you want? I get minimal testing (like blood only, really), so I wouldn't know the usual method when it comes to the quad screens and such, but I'm pretty sure my midwives would generally send people out to clinics and not actual OB offices....
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Old 11-13-2012, 03:38 PM   #5
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Re: Denied Prenatal Care?

I know it's not what you want to hear, but in a world full of crazy litigious people, the OB (and the practice) needs to protect himself. He sees your plan as medically risky and if he provided prenatal care like you wanted and (God forbid) anything were to go wrong during your HBAC, you could feasibly sue him. And that's a risk he's (understandably) not willing to take.

Can your midwife perhaps help refer you to a clinic where you could receive any prenatal testing that you need/want that she doesn't provide?
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Old 11-13-2012, 03:42 PM   #6
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Re: Denied Prenatal Care?

If he agreed to what you plan he may still be considered responsible if something goes wrong. Due to people suing and winning for silly reasons the doctor does have to protect his practice. It stinks but be does have to consider himself as well. This is how he pays his bills.

I would ask your midwife what she recommends you go for whatever testing you wish to have done.
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Old 11-13-2012, 03:49 PM   #7
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Re: Denied Prenatal Care?

I can get testing done somewhere else, but it would be OOP because it wouldn't be a covered provider. Basically, any provider in my insurance is going to refuse care, and any other provider would not be covered. My midwife actually recommended this OB, so he either changed policies recently or has been mis-labelled as HBAC-friendly.

I would rather not lie to a provider, regardless - my goal was to have someone who would know my case should I need to change my plans and go to the hospital, rather than whoever was on call. Lying would definitely come out in the end, and I don't need the extra stress of hiding my intentions.

I am trying to see if my PCP could order just the testing I need (glucose, U/S, UA), but I think after some soul-searching that this has made me more determined to avoid the OB/hospital experience entirely.
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Old 11-13-2012, 03:59 PM   #8
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Re: Denied Prenatal Care?

Quote:
Originally Posted by Leiiki View Post
I went in for my first OB appointment today. When I told him my goal was a HBAC, he said he cannot provide prenatal care at all unless I agree to a hospital labor and birth. He also told me no doctor in the group will provide me with prenatal care if I plan to attempt a home birth (my insurance does cover complete prenatal care).

I was shocked to hear him say that I have only a 10% chance of ANY VBAC, let alone HBAC, and they won't even see me because I could put their practice at risk!
First off - bullsh!t on his 10% chance of a successful VBAC. I get so disgusted when I read about many OBs opinions on VBACs. Just ridiculous.

Secondly - personally, I would talk with your MW about what this OB said and see what other suggestions she has. Hopefully she'll have someone else in mind who could provide the tests or whatnot you want that would still be covered by insurance.

Good luck!
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Old 11-13-2012, 04:05 PM   #9
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Re: Denied Prenatal Care?

I am sorry. It's really not fair how difficult it is for a woman to attempt a "normal" birth rather than a repeat C.

Is their any other OB that is in network besides this one? I know you've said they will all refuse care but do you know that for sure or are you just assuming because of what this doctor has said?

Have you asked if their is a waiver you can sign for the OB? Stating you understand the risks of a home birth and do not hold him liable for your decision?

I admire you wanting to be honest with your provider and I would try to be upfront but if it came down to you paying OOP for what should be covered tests or lying I'd probably just have a change of heart at the last second and do my home birth. But that's a decision you'd have to make...
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Old 11-13-2012, 05:10 PM   #10
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Wait, what?!?! How could the DR be sued if you deliver at home?? That's just bogus. They are just providing prenatal care. That's like saying you could sue them if last minute you changed DRs and something bad happened. Laaaaame. I'm sorry. I am planning a HB and am doing dual care and told the OB I was planning a HB and they were fine with it. I would for sure ask your MW for a reference. Sorry!!
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