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Old 09-17-2012, 12:20 PM   #21
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Re: What comprises "unnecessary" prenatal care?

Personally, this is what I find important.
Testing urine
Testing blood pressure
Fundal Height
GBS test

If you are healthy, young, and low risk I don't find a 20 week US, GD testing, screen for downs, ect. to be of much importance - but check with your doctor because you could be at risk for being dropped.

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Old 09-17-2012, 12:27 PM   #22
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Re: What comprises "unnecessary" prenatal care?

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Originally Posted by KelseyH View Post
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.
From my understanding, it can lay dormant for up to 12 years.
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Old 09-17-2012, 04:46 PM   #23
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Re: What comprises "unnecessary" prenatal care?

My Midwife has only checked my urine once this pregnancy and I'm pretty sure that's only because I mentioned having to pee to the nurse while I was waiting. I finally remembered to ask her about it last week and she said she hasn't routinely done it in years.
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Old 09-17-2012, 05:20 PM   #24
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Re: What comprises "unnecessary" prenatal care?

I'm not saying an HIV test is necessary by medical standards of care or under state law. I don't know.

You asked what tests I thought were necesary so for me it was. it was one of those things that I would rather be tested for because ... well it took two to get pregnant. I know what I've been up to but could I say with 100% certainty what my DH did before I knew him? No.

Given the ability to affect the outcome of my kiddo's life (meds during pregnancy, c/s, no bf'ing) to avoid transmission, I'd get an HIV test. I'm getting the bloodwork anyway.

But then I understand why drs want to spend 25 cents to give every baby the eye ointment to avoid blindness rather than test every baby and mom for clamydia/gonahrea.

I think I try to have a balanced approach to what testing I get. I do understand your original post, that it didn't provide good information and scared the be-jeezs out of you for no reason. I declined any pre-natal testing of the baby for downs or spina bifida or other type stuff. It wouldn't change what I would do and in my mind doesn't help you with a "fixable" problem.

But I did do the 20 week u/s for placenta issues and stuff like that.

I agree w other pp, find a dr/midwife that you trust and can build a relationship with. I've gone through 3 with this pregnancy and if I feel like I don't like something this dr says, I'll switch. I had a bad experience with my first when I played the good patient and did what ever they said. I think if I had asked the right questions instead of just thinking, that can't be what they mean, I would have had a better personal outcome.

You as the patient have a right and RESPONSIBILITY to ask questions about what test/procedure they're recommending and why. I think if you find the right provider, build a relationship of trust, you can have these discussions with a person who can provide you with the answer to the very question you posted here.
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Old 09-17-2012, 08:16 PM   #25
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Re: What comprises "unnecessary" prenatal care?

For my second pregnancy I did no testing other than 20 week ultrasound and screening for iron levels. Wait, I think I did the GBS also, just in the event of a hospital transfer. That's it. I just didn't see a need for anything other than that.

My first pregnancy was with an OB but I still managed to skip all genetic testing, most STD tests, and the GD test. They would tell me to go to the lab to get the tests and I just didn't, because I didn't feel that they were necessary and didn't want to pay for them. I do think that different offices might be less lenient, though.
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Old 09-17-2012, 10:24 PM   #26
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Re: What comprises "unnecessary" prenatal care?

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Originally Posted by leyash View Post
From my understanding, it can lay dormant for up to 12 years.
That's actually not true. The window period is generally accepted to be 6 weeks.
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Old 09-19-2012, 01:49 PM   #27
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Re: What comprises "unnecessary" prenatal care?

In regards to the HIV testing - A lot of states require it, and your doctor will talk about it like you don't have a choice, but they do have to get your signature giving the okay to test for HIV, so if you don't want them to you can opt out. I just went along with all the tests they were doing at the beginning including the HIV and the chlamydia/gon. screening, but in hindsight I wish I wouldn't have because I KNOW that I have none of those and it felt a little like an invasion of privacy, not to mention a waste of time, to have it done. And if we were paying totally out of pocket I would have refused, but since I know we'll meet our deductible with the birth itself the cost wasn't as big an issue for me.

I do like to get the initial bloodwork so that they can make sure everything looks normal at the beginning - I have hypothyroid and have to make sure that is under control the whole pregnancy, though, so that's my biggest concern. But all the genetic screening of the baby and even the ultrasounds should be elective. GBS probably depends on your hospital policy whether you can decline it or not.

But yeah, I would just echo the other ladies - sit down and talk it all out with your doctor, just asking WHY they want to do each thing before you agree with it. Then you can make an informed choice instead of just going with it. Doctors often present things as if you have no choice about them when really it's just their routine, and if you talk about it more you can realize that there actually is a choice there.
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Old 09-19-2012, 05:04 PM   #28
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Re: What comprises "unnecessary" prenatal care?

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Originally Posted by leyash View Post
From my understanding, it can lay dormant for up to 12 years.
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.
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Old 09-19-2012, 05:05 PM   #29
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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.
I didn't see your post, sorry! I posted the same thing!
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Old 09-19-2012, 05:34 PM   #30
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Re: What comprises "unnecessary" prenatal care?

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Originally Posted by holly6737 View Post
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.
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.
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