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happymama
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Just looking for opinions - am I being stubborn and prideful about this issue, or am I just using common sense?
here's the issue - following the "recommended schedule" of prenatal visits. I do have a medical background, including a stint in med school, so I am not at all opposed to "modern medicine". I think that an early check-up and monthly visits are great for first-timers and anyone with any pregnancy complications.
That doesn't describe me - 13 weeks along with my 4th completely uncomplicated pregnancy. I haven't called the OB yet and really don't want to. They don't even let me schedule an appnt. with a dr. until I've first come in for a blood test to confirm my pg. COME ON! They insist on a pelvic exam/ pap smear at the initial visit and following the schedule to a T.
I do want to have my 20-week ultrasound, and I do want to go in for checkups during my 8th/9th months. But that's it. (Obviously, unless I have spotting or cramping or something.) I just hate being treated like I've got a disease or something... All those tests, pelvic exams, measurments... I don't need that right now. Am I just being stubborn?!
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hylabrook1
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Probably the OB who wants you to follow a strict exam and testing schedule would say there are good medical reasons for doing so. Some may want you to follow a schedule like that because your insurance company or their malpractice insurer insists on it. And I will say that, although having previous uncomplicated pregnancies and births might decrease the chance that you will need lots of intervention or specialized care this time around, it is not impossible that on exam they will find something that warrants a different course of action for this pregnancy. They probably won't, but sometimes there are problems short of bleeding, cramping, etc. that they might need to be aware of.
That said, if you consulted an OB or a midwife who didn't think it so important to go through all the hoops and hurdles, that person would probably say they were unnecessary and that doing all that is just overkill. And they would undoubtedly give reasons to support that position. And I'm guessing you would probably be more comfortable with those health care providers (unless, of course, their reasons for the way they do things sounded flaky to you or something...).
Anyway, bottom line, can you find an OB or midwife who thinks more along the same line as you? That, imho, would probably be a better decision for you. 
Congratulations and prayers for a healthy and happy pregnancy!
Peace,
Nancy
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Kathryn UK
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HappyMama - I would agree most of that isn't necessary. Here in the UK I have *never* had a pelvic exam (or pap smear) during pregnancy.
Routine medical care during pregnancy for a second or subsequent pregnancy in my area would be a booking in visit usually around 8 weeks to review past obstetric history, discuss delivery options - choice of hospitals or home birth and check bp (no requirement for any sort of test to confirm pregnancy!). After that there are routine visits roughly 8 weekly until 28weeks, then monthly and finally two weekly from 36 weeks. Routine visits are bp check, listen to heartbeat, measure bump and urine tests. Blood samples are taken at 12 wks and twenty something weeks and there are two routine ultrasounds - a dating scan at 12 weeks and the 20 week one. All routine care is with a midwife, so it is possible to go through an uncomplicated pregnancy without seeing a doctor at all. Obviously if there are complications or bad past history everything kicks up a gear.
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Mrs.K
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Just because you haven't had a problem in the past doesn't mean you won't have one this time. For example, you could need hormone supplementation to maintain the pregnancy and you wouldn't know it until it was too late. The blood test is important to check your hormone levels.
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mary theresa
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Happy Mama,
No help here, but I laughed when I read your post. I totally feel the EXACT same way -- only i just got done having my second. 
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Helen
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I thought one of the main reasons for having pre natal visits was to check blood pressure. Pre eclampsia is a serious complication which is easily monitored by a monthly blood pressure check and urine sample.
It's something that one doesn't feel in the early stages.
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teachingmyown
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I go to my first appt, then tend to "stretch" the time between appts. So, instead of going back in four weeks, I might go back in five or six weeks. I really can't stand the weekly appts at the end. I don't have time for that.
But, it is important to occasionally monitor things like BP, protein in urine, and even baby's size. Once the baby is moving noticably the doppler isn't really necessary.
I do agree about finding a doc or midwife more in line with your thinking. You can always decline any procedures, although this can be awkward. I did some good reading during my pregnancy about natural pregnancy and childbirth. It was helpful to read the research behind prenatal care and birth to help you make educated decisions about what you are willing to do and not do. My brain is blank and I am typing one-handed, I will have to look up the books later. One was something like "A Smart Woman's Guide to Pregnancy", another one was by a midwife named Ina May, I think, and the last one was by Dr Sears.
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insegnante
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teachingmyown wrote:
| One was something like "A Smart Woman's Guide to Pregnancy", another one was by a midwife named Ina May, I think, and the last one was by Dr Sears. |
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Was it The Thinking Woman's Guide to a Better Birth by Henci Goer?
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JodieLyn
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that's the one I'd recommend Theresa
Most of the exam sorta stuff is *preventative* because you don't need it at that time but is to catch any problems before they can escalate.
My midwife is pretty hands off.. so I'll just tell you what we do.
Urine stick showing any sugar and protein and keytones and such, blood pressure, and we check size of uterus (yes it can catch problems early) and baby's heart rate AND recovery.. again it catches problems early.
that's it.. oh we would keep track of my weight.. except I don't own a scale so we only do weight if I go to her place for an appt.
You could probably do most of this at home yourself.. but it is stuff that gives you information on your health and the baby's health.. and knowing how you are normally will also give info.. If I started a pregnancy with say a bp of 128/78 or so then it creeping up a bit may not be allarming but if my bp was typically 110/70 (which it is) then it would be much more alarming to see it go up to 135/84 or something (iI'm making up numbers here)
But as you can se.. not only will it show when a problem might be starting.. but it can also show that something is normal *for you* and not a sudden change that might signify problems.
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teachingmyown
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insegnante wrote:
teachingmyown wrote:
| One was something like "A Smart Woman's Guide to Pregnancy", another one was by a midwife named Ina May, I think, and the last one was by Dr Sears. |
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Was it The Thinking Woman's Guide to a Better Birth by Henci Goer? |
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That's the one! Thanks. It is a great book!
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Barbara C.
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I think it is important to get the early bloodwork done. They always monitor my blood like crazy anyways because I have mild thrombocytopoenia which could cause a problem if I ever needed an epidural for a c-section. But this time around, they found that I had contracted Group B Strep. So they went ahead and put me on a round of anti-biotics to help lower the bacteria count, and I have to be at the hospital four hours before I deliver for an anti-biotic IV.
I believe the rationale behind the pap smear is that by the time you have the baby and come back for your 8-week check-up it will be over a year between having pap smears, depending on when your previous one was. I don't think they like doing pap smears from the middle of pregnancy on because the way your cervix changes through pregnancy.
I could understand why some people would want to wait longer between visits; personally, I look forward to my monthly check-ups. Maybe it's because I have so few social outlets otherwise. It's also because I really like my OB/GYN office. The midwives are great and even some of the doctors are like midwives in disguise. They don't insist on vaginal checks at the end of pregnancy because they realize there is no real point. And since I've already been diagnosed with GBStrep I won't even have to be cultured at 36 weeks.
I will admit, though, that I refused to attend the new informational sessions they've developed. It basically goes over all the stuff you are and are not supposed to eat and all those things that first-timers worry about. The only time that was close to fitting in our schedule was Tuesday night from 6-8, the same time as my daughter's dance class. "Sorry, we've already paid for these classes and don't want her to miss." 
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Lisbet
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I'm not one to go very often. I have had 8 babies with the same midwife (at home) though, so that has something to do with it. I haven't had any rountine testing done since my first. I have had my hcg levels monitered in 2 pregnancies though - one ending in miscarriage, one with twins and only one (MB!) survived.
When you say they 'insist' on this and that test/exam, remember that you always have the right to refuse!
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helene
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I have had eight babies also and have been pretty religious about the whole "recommended schedule" as you put it. I do think it's important. I am older and have learned not to take life and health so much for granted. I am very much relieved to hear that baby's heartbeat every month and would go even more often if I were able to in those early months. There are so many complications, ranging from mild to severe, that could crop up at any time. Many are treatable or preventable (using natural means)if known about. The older you are and the more babies you have had the likelier it is that something could happen. I used to be peaved by the whole medical community. But after a good number of years, some miscarriages, and a good bit of experience I have decided to jump through all the hoops. I haven't had a miscarriage since deciding to do this. I am truly and humbly grateful to the doctor's, nurses and midwives who have helped me bring these beautiful children into the world in good health.
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happymama
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I thank you for your comments!
The main thing peeving me right now is that they won't let me see a dr. until I've come in to have a pregnancy test. It isn't bloodwork of any other kind (I asked) just a pg. test. I don't think I should have to pay for that OR go through the hassle of dragging 3 kids 20 minutes across town and then waiting on the lab techs.
All the OB's in my town (8) belong to this practice except for 1. I'm going to try to contact him, but I don't know anything at all about him except that his office hours are obviously nothing compared to the group practice.
A recommended schedule of visits standardized for every single pregnant woman in America is bound to not be applicable to everyone. I just wish they permitted some flexibility - by my own choice, of course, and with my own accountability. I know their malpractice premiums are insane and they have to be prudent, too. But with each normal pg. I've had, I had 3-4 pelvic exams and I think, would the Blessed Mother have permitted this? Assuming there's no other reason than "checking to see if I'm dilated yet?" etc.
Again, I'm not going to skip everything - I will have the u/s and go in for occasional checkups. I just don't want to be treated like I'm a 16 year old prostitute or a 48 year old with diabetes, for example... all put on the same schedule of tests and exams.
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dollylima
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mary theresa wrote:
Happy Mama,
No help here, but I laughed when I read your post. I totally feel the EXACT same way -- only i just got done having my second.
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I posted some similar sentiments when I found out about my current pregnancy.
Fortunately, I have found a wonderful midwife who specializes in home birth and does not consider ANY testing to be "mandatory". We talk about my perspective, how Im feeling and what it is my husband and I want and then we decide from there what we will and won't be doing in terms of care.
To contrast this -- my first visit to the midwife my PCP recommended included her handing me a folder with information about when I was expected to come back, how much blood I was expected to let them draw and the "first trimester screen" it was assumed I wanted to have done, including an early ultrasound to screen for down's syndrome.
My husband and I saw no point in having this "screen" done because if it was positive we would not be interested in amnio (why go down that road and wonder for nine months about false-positives?) I felt almost guilty for not having it done, and it would have been nice to hear the heartbeat at eleven weeks when my midwife couldnt find it, but my current midwife completely understood my line of reasoning and has been nothing but supportive of my choices the whole time.
If there is an indication of a problem at some point, I would be more than willing to step it up in terms of care, but as long as everything goes smoothly, I dont believe you are being selfish for not wanting to tow the line with the medical model of prenatal care.
Best wishes and prayers from our family to yours.
Heather
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doris
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As Kathryn said, things are very different here in the UK -- partly because of the cash=strapped NHS, and partly because, as an American friend put it, they genuinely see it as a normal physiological process -- ie you're pregnant, not unwell.
I've never had a pelvic exam or smear (pap) test in pregnancy. In fact, they put off the latter until you've had the baby (presumably because of the risk of infection). I think all this intervention can do as much harm as good.
OTOH, I was beginning to get a bit slapdash about bothering to fix up appointments and got a telling-off from DH (a doctor) who reminded me that it's very important to be regularly checked because of pre-eclampsia, among other things. But that can be done with a simple urine test. Early blood tests will reveal other things and after that it's just iron they need to look at -- here, at least.
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Mari
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I have not have a long track record of babies - only 2! But for what it is worth.... I had my first one in the UK because I wanted to escape the French system which insists on something crazy and you end up with having scans almost every month, blood tests all the time, and people treating you as if being pregnant means you need medical intervention from the day you know about it. Also, if you don't follow their timetable of tests, you are not covered by the system.
So I decided to go to my country of origin, the UK, for the birth. They offered me tests and things but I was never pushed into doing any and they always reassured me when I said I preferred not to. I felt that they gave equal arguments for having or not having the tests. In France it was NO OPTION and that I was being IRRESPONSIBLE  .
I was convinced that it was a totally normal thing to be happening to me and that if I listened to my body I would know if I had to go for medical help (just as if you would if you realised that something was wrong in your everyday health). I really feel that I want to keep in touch with my body and that our societies are making us loose that instinct - just as it is making us loose contact with nature. I then went on to having a natural birth.
For my second I tried the medical services in France again - hoping that things would have advanced. But no. So I had absolutely no tests done. I had to illegally get someone to come and help me to give birth at home (becuase they say that not getting a woman giving birth to a hospital is non assistance to someone in danger...) I did not like this, but I had to keep my dignity and my rights over my body and the child that the Lord had entrusted me with. Of course, I would have liked to have the option to go for help if needed, but I did not want things forced on me either.
From both experiences, I have learned that God has given us our bodies to look after and our minds to choose and that we must act in the right way as He leads us. Of course we should use our minds and question things and inform ourselves. I think that it is good you are asking these questions, and that ultimately you know your body more than anyone else and you are in God's hands. You have access to tests and medical help if needed. You also have been designed by God to carry children. Many things we know about you can ensure yourself by eating iron rich food / taking iron suplements, looking out for swelling, etc; If you need more assurance you can have some tests. If you feel peaceful about it all, maybe testing and worrying is doing more harm than good to this miraculous time of preganancy.
I pray that your experience with this preganancy will be a real blessing.
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4Real Forums : Our Lady of Good Remedy and Care
Topic: pre-natal visits necessary?
