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Old 09-20-2012, 10:46 AM   #41
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Originally Posted by songbird516
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 do that anyway, so that's why I think we will be fine!

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Old 09-21-2012, 02:01 PM   #42
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Re: What comprises "unnecessary" prenatal care?

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DH is positive. I am negative. are the shots super expensive?

We are definitely staying away from genetic screening/testing.

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.
My reference is the Tarascon Pharmacopoeia from 2010 and it says >$200 for a Rhogam injection. I've seen $150-200 in the doctor's office and a hospital's charge of $6-700 (billed to insurance, not what the pt is responsible for).

You can refuse any treatment, yes, but you may be paying for a longer hospital stay for observation for you and baby. The antibiotics are a standard of practice for a reason. The research that has been done on the subject shows that the benefits far outweight any risks to the baby and I'm sure there are many more sources for consideration than what the average person can get their hands on to make the most informed decision about the use of antibiotics in GBS positive mothers. Consider your reason for refusing the treatment carefully. Is it just financial? Is it principle? Is it just your belief? Are you afraid for the harm to your baby? The decision you make can help your baby as much as it can hurt them. The easiest way around this I would think is just to have the GBS test done to even see if you need to consider whether you will need antibiotics or not. If the GBS is negative, then you don't really have to worry about antibiotics for that. Best of luck to you!
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Old 09-26-2012, 08:35 AM   #43
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Long update!

I saw my OB yesterday and we had a nice long appointment and talked in depth about most of what was discussed here. Luckily he was on board with 99% of what I was thinking - there were actually a few times where DH and I looked at each other like, "did he really just say okay that quickly?" since he is quite "main stream".

We decided to opt out of urine dips, GD testing, AFP/genetic testing and any other further blood work, flu shot, and some of the "check up" appointments where not much will be done.

The 20 week ultrasound will also be delayed until January when I will be 25 weeks (mostly for insurance reasons). His main concern with delaying this was if a major abnormality of some sort developed that would prevent the baby from surviving outside of the womb, that delaying the ultrasound would be more difficult to "take care" of the issue - meaning, induce miscarriage. Ugh. He was so uncomfortable and wanted to stick with speaking in euphemisms, but it really irritated me that he wouldn't just say what he was thinking. When I made it clear that we would never induce a miscarriage and I believe if God intends for me to miscarry, I will - he was totally fine with delaying the ultrasound.

And, honestly, I'm not even sure that I want to have that ultrasound done. I asked him WHY it was necessary, really, and he said if I'm not concerned with having a "bad baby" (oh my gosh, I was so frustrated when he said that!) then there really was no reason for it. When he was in the Navy (can't remember where he said he was stationed) the OBs on base were delivering 600+ babies A MONTH. Omg! And they just didn't have the time/money for ultrasounds, so they stopped doing them, and there were no adverse affects on prenatal care or mother/baby health (aside from, I'm assuming, mothers who would rather have "taken care" of their "bad babies").

The only misgiving I have about skipping the ultrasound is that they won't know where my placenta is attached, which could be problematic during delivery if it's not in a good spot.

We had a good conversation about GBS testing and he would rather err on the side of caution, and I'm inclined to agree. Although if I do test positive for some reason, I think I will have them re-test before delivery after trying home remedies... Not exactly crazy about the potential of being pumped full of antibiotics, when I can count the # of times I've taken them on one hand.

The only thing I could tell he was a little miffed about was me refusing the flu shot. I refused it with DS, so he wasn't surprised, but he still thinks I need to be vaccinated for last year's flu. *rolls eyes* I've never had the flu shot and never come down with a serious case of the flu.

So, all in all, I'm really happy that he is on board with what we wanted to do. He called me "outside of the box" once and DH and I laughed so hard... I have ALWAYS been "out of the box", since day 1, so I told him I have no problem with that. Lol. Of course he said he wasn't crazy with being out of the box... But whatever. I'm also really happy that DH is 110% supportive of what I want, even though he is also quite medically "main stream" as an EMT. He admitted to me that if he was the pregnant one, he would be getting all of the screenings, tests, and probably a few extra, but he would support whatever I wanted since he trusts my judgment and knows I do my research and don't make snap decisions. On anything. love him!
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Old 09-26-2012, 09:22 AM   #44
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I'm glad he's on the same wavelength w your care and hopefully it stays that way!

Irked me a lot about his view on "bad babies" and taking care of them by "inducing miscarriage" b/c my daughter had a fatal diagnosis. Drs IMO are too quick to suggest termination.
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Old 09-26-2012, 11:13 AM   #45
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Re: Update! What comprises "unnecessary" prenatal care?

So glad it worked out so well! It's great that your OB is willing to work with you, even if he doesn't agree necessarily. And your DH sounds wonderful
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Old 09-26-2012, 12:31 PM   #46
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Originally Posted by hohaas
Irked me a lot about his view on "bad babies" and taking care of them by "inducing miscarriage" b/c my daughter had a fatal diagnosis. Drs IMO are too quick to suggest termination.
Yeah, I was really irritated by that, too. He INSISTED on doing whatever panel of screening with DS that included Downs, and I was like knock yourself out but don't tell me the results! I really wish I could find an OB who I like and who shares my values. My PCP is AMAZING - I just need him in OB form haha
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Old 09-27-2012, 07:39 AM   #47
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Re: Update! What comprises "unnecessary" prenatal care?

Just wanted to throw my 2 cents in on a few things :-)

Regarding ultrasound for placenta location - there is really only 1 position that matters, and that's a previa. I am not a medical practitioner, but previas typically show symptoms (i.e. bleeding). Anterior, posterior, whatever - doesn't matter. Just so long as it isn't covering your cervix. Maybe someone else can chime in, but I'm going to guess that the chances of a previa with no symptoms is very low (though not impossible).

Also, they sometimes check for other placenta / cord issues in an ultrasound, but not always. These are issues with how the cord attaches to the placenta and such. Not all ultrasounds / technicians actually do this though. So if this were a concern to you, you'd want to make sure this would actually be done, otherwise it would be a moot point.

Regarding some of the blood work and such, I always scoff a bit at all the ridiculous blood work they do - like, okay people, I'm O+ and that hasn't changed in the last year - but I found out this time that if the results of parts of the blood work aren't in my chart, the pediatricians usually want to do more stuff to the baby - since they can't say definitively that I'm HIV negative, for example, they might want to do extra tests and observations of the baby. So to me, it's easier and better to just go along with the testing than to deal with any junk like that after delivery. I already know I'm HIV negative, but getting in my record is only going to help me, not hurt me, KWIM?

And regarding Gestational Diabetes testing - one can exercise, eat well, and feel good, and still get GD. Personally, I don't agree with the glucose challenge test. I think it's absurd to push someone's body like that, especially if they *are* diabetic. But, I *do* think it's important to monitor for GD in some way. The reason the GTT is used is because it is relatively quick and easy for providers to have the "masses" do. But there are other ways to check for GTT. I use a glucometer and monitor my blood sugars first thing in the morning (fasting) and one hour after meals for three days around 28 to 30 weeks usually. This is simple, easy, cost-effective, and much healthier, IMO. And then I know I am not having blood sugar problems. There are *substantial* risks to GD, and it can't always be controlled by diet alone, so for these reasons, I feel that some sort of monitoring / testing is valuable.

Glad you were able to talk to your OB and come to a mutual agreement. HH9M :-)
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Old 09-27-2012, 08:54 AM   #48
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Re: Update! What comprises "unnecessary" prenatal care?

here's what I (personally - as someone who has researched this on my own) find to be important to me:

Blood tests - I tend to be very anemic during pregnancy, so I do 2 blood checks for iron levels.

fundal height - tells me my uterus (and theoretically, baby) are growing properly

baby's heartbeat - to check on baby

20 wk anatomy scan - to look for things that could be life threatening at delivery, like placenta previa

I don't (personally) feel the following are necessary, but I do them anyway b/c they make my caregiver more comfortable and that is important to me b/cI think it gives me the best care:

HIV/STD screening - I know I have neither of these.

GBS test - IMO, GBS risk is so low that is does not warrant blanket testing of every pg woman.

Blood pressure - I have low blood pressure almost always. I also (personally) think pre-eclampsia is caused by poor diet and not enough protein during pregnancy. I don't feel I am at risk for developing this.

urinalysis - I can usually tell when I have a UTI, and mostly, I don't treat them anyway. I wouldn't consider abx anyhow, so no point really.

This I do not submit to, no matter what:

AFP screening or any other tests for abnormalities - These are pointless to me and serve no purpose. I will not abort, I do not want more complex care, and I am low risk, with no family history of any disease/disability anyway.

1 hr (or 3 hr) blood glucose screening - I never do this and never will. I think it is a faulty way to test for this, and I think gestational diabetes is over-diagnosed, and I also have read research that indicates that women who go on the GD diet do not fare much better than those that do not. I also know I have typically LOW blood sugar, and I eat a normal diet with little sugar. As a compromise, I do finger sticks at home to test my blood glucose level, for about a week before and after every normal meal.

I can't think of any other tests.... I might be missing some.

Also, many women may disagree with my opinions on these. That is OKAY with me. This is how I feel personally, based on my own experiences and research. Anytime you are considering declining a medical test of ANY kind, you should always do yourself the favor of taking the time and effort to research it yourself. Look up studies, read research papers, speak to other medical professionals, and consider the outcome of the test. You have to make your own medical choices.
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Old 01-16-2013, 10:48 PM   #49
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Re: Update! What comprises "unnecessary" prenatal care?

Great thread! Subbing to re-read later thank you OP
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Old 01-17-2013, 07:06 AM   #50
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Re: Update! What comprises "unnecessary" prenatal care?

I want to preface that I haven't finished the thread.

The most unnecessary prenatal text that you mentioned is a gender ultrasound. Everything else you mentioned is designed to help your doctor make sure that you have a healthy baby and are prepared if there are problems. Baby's gender is of nonimportance and is the first I would skip related to prenatal care.
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