Standard Policies Ma’am

I am 26. something weeks and today I had a pregnancy appointment. I was there for about an hour and I learned a) I gained some weight (don’t know, don’t care, I don’t look at the scale.) b) I’m measuring right on track c) baby’s heartbeat was perfect d) I should take Vitamin D supplements e) I don’t know who my doctor is f) They want more of my money g) They will do stuff on me just cause. Because you and I and our babies and our pregnancies must be EXACTLY alike.
I have been at a new hospital since we moved and had to find a new doctor. I have met a midwife and a doctor, trying to decide who I liked better and which direction I wanted to go and who I wanted to deliver my baby. I decided to go with the midwife.
Today, I found out that “whoever is on call will deliver the baby, which is totally frustrating to me. In my previous experience, you have a doctor, you see the doctor through your pregnancy, and when you give birth, the doctor you’ve been seeing is there for delivery.
That’s why we ask you to meet all the midwifes here because you don’t know who will be on call when you go into labor.

Right. That makes tons of sense.

I’m almost 27 weeks and, I guess, starting now, I’m suppose to be seen every 2 weeks.
Why?

It’s standard policy.

Yeah, but why? I don’t need to be seen every 2 weeks. I’m not high risk. I don’t need to come in every 2 weeks to have you weigh me. I’ll call you if I don’t feel movement or something.

(At my old doctor we were seen every 4 weeks until we hit the 36 mark. I get so irritated when people do everything because it’s just “normal standard policy.” )
Well, let’s schedule your next appointment….

Okay, how about this date?

Your midwife isn’t here that date. She’s not here that date either…

Well, tell me, when IS she here?

Great, that day sounds great.

Well, ma’am, that’s 3 weeks from now, not 2.

3 weeks is fine. I’m not even 30 weeks yet. You can see me in 3 weeks.

Well…. it’s standard policy that at 25 weeks we see everyone at 2 weeks from this point in their pregnancy…

I will see you in THREE.

So, then, my next appointment, or the other before that or after that or whenever, is the testing for gestational diabetes. I have to drink this yummy juice at the doctors office and then wait an hour and then my doctor will see me. (Which means I will be there for approximately 2 hours.)
Why can’t I take the juice home?

We have to monitor you here. So you drink it here and then wait in the waiting room for an hour.

Monitor me? Monitor me doing what? Are you afraid I wont take it or something? Why would I lie about drinking this yummy juice? I would just decline the test if I didn’t want it.

It’s standard policy ma’am.

Do you have wireless internet? Can I bring my laptop? Do you have a movie theater here?

(I would be going to a birthing center, but my insurance doesn’t cover it, and it’s something like $4,000+ that I would have to pay out of pocket and that isn’t up my alley. I would also deliver at home but my husband isn’t for it. Secretly, between you and me, I’m going to try and labor at home as long as possible so when I get to the hospital, there will be no time for monitoring or heplock or whatever. It will just be GET THIS BABY OUT OF ME NOW!)
The end.

Published by Samantha Mellen

Certified personal trainer & health coach helping women transform their lives through fitness, abundant mindset coaching and internal peace. Mom of two boys, living life in Alaska.

31 thoughts on “Standard Policies Ma’am

  1. hugs…..

    I have only went every 2 weeks that early with my son. I was on bed rest at 28 weeks.

    I have never been able to take the yummy juice home….

    Keep your head up! If I did not have trouble carrying my DD1 I would have had the other 2 at home!

    Good luck

  2. I hate that doc on call thing. My last doctor did all his babies – it was a small practice, just 2 docs and a CNP – BUT he ended up being on vacation the day my last baby was born! Gah.

    About the diabetes thing – it's because sooo many people forget and accidentally eat something, and it screws the whole thing up. They'll be out and grab a drink or a piece of candy or something. Bring a book, LOL!

    Totally with you on the labor at home thing. Hospitals really, really annoy me when I'm in labor. My last baby, my doc sent me over to the hospital from my appointment but I didn't want to labor there. So I went to Chili's and then Target first, and showed up three hours later.

  3. How frustrating! I go every 3 weeks and I'm high risk! Well, I'm only 20 weeks now and I might have to start going every 2 at 25 I don't know, but with my last pregnancy I don't think I went every 2 weeks till 30 weeks and I was high risk then too. Seriously, I'm getting frustrated just reading your post.

    This hospital where I'm at also has the rule that whoever is on call when you go into labor delivers you and I hate it. Like you, with my last pregnancy I had one doctor all the way through. I feel like if I'm high risk enough that I have to see this one particular doctor, then he ought to be the one delivering my baby. It makes me nervous that he probably won't be.

    I am really sorry that your hospital is so stringent about policies. Maybe you can talk them out of some more?

  4. I didn't mind that our midwives were on call. It usually figures that your doctor goes on vacation/has a family emergency/etc when you're in labor anyway, it seems, so at least in this arrangement you definitely know who will be there, instead of maybe ending up with a stranger replacement.

    I was going to labor at home as long as possible, but I ended up going before my first real contractions started- but only because I thought i was dying/labor in my family goes super quick (my grandma averaged 45 minutes from first contraction to birth, and i wasn't far behind her!) it's definitely a good idea, though!

  5. Oh dear- not a fun day! I have to say your lucky to get the GD test done at the office though. Here you have to go to a lab, take a number, wait just to register, then wait to get the drink, then sit there for an hour then get the blood drawn. I did mine 2 weeks ago- it wasn't fun. Then again I didn't have to pay a cent I guess that's the love/hate relationship of socialized medicine.

    I've never heard of going in every 2 weeks after 25 weeks. I'm high risk and just now at 30 weeks will start to go in at 2 week intervals.

    Most docs/midwives here work in groups of 4 or 5 so that they can have some sense of normalcy with their families. It makes sense.

    If you're not comfortable keep looking… and your not alone in trying o stay home until the last minute- that's my plan too =o)

  6. Just reading this made me feel frustrated for you. I don't know if it's too far along for you to think about going to another midwife/doctor that isn't so frustrating. There was only 1 time that I couldn't take the gross juice home (and that was the first time) the 2nd time I was able to and then they suggested I do it a 3rd time and I declined (more than once)…2x was Enough!! I hope it gets better for you…I don't understand why they would argue with a pregnant woman!!

  7. here are some links you might want to check out about GD
    http://www.drbrewerpregnancydiet.com/id33.html
    http://www.drmomma.org/2010/06/gestational-diabetes-emperor-has-no.html

    Have you asked the birth center if they would discount their fee if you saw your own midwife/doctors for most of your prenatals and had any labs done through them where your insurance pays for it? We didn't have a homebirth last time due to the cost, but just found a midwife here whose fee is half her normal rate if we do that! Worth asking about.

    That really sucks about having to go with whoever is on call. ๐Ÿ˜ฆ

  8. Hugs, I also find non-answers so frustrating. Don't know if you want to change providers at this point, but you could double check with you insurance ~ I believe if the center is accredited and within a certain distance they have to cover it if they cover maternity care.

    I was able to drink the glucose drink at home and have my blood drawn at the visit, but will also be cared for by whoever is on-call when I'm in labor.

  9. Have you asked your husband to just go with you to talk to a home birth midwife? After we visited with our CNM my husband was more than on board for a home birth (he was totally against it at first). She answered all of his tough questions. And having the Certified Nurse Midwife just reassured him even more of our choice to go the home birth route.

    If you stay with the hospital birth – I seriously recommend you get a doula. Having someone there you're comfortable with and who is there for you and your husband will definitely be an asset to your birth experience!

  10. I think at my doctor's office they have you start going every 2 weeks at 28 weeks. I really liked going every 2 weeks. I loved hearing my baby's heart beat.
    Gestational Diabetes can be serious if you don't know you have it. There aren't really any symptoms to it most of the time. Having to sit there for the short test isn't a big deal. The part that's frustrating is when you have to get the 4 hour test. I think mine ended up being like 5 hours.
    As far as the doctor on call thing goes, how many are there? If it's just a few, like no more than 5, I'd say it's not a big deal. If that hospital is anything like mine your nurse is the one that's there with you through the labor. My doctor came in to break my water, and when it was time to deliver the baby. Since you probably won't have to have your water broken then your doctor will be in there when it's time to deliver the baby. As long as you've seen the doctor before even if it was only once or twice then I think it should be fine.
    Don't stress about it. Everything will be fine and in like 14 weeks you will have a beautiful baby and none of this will even matter anymore.

  11. Sending you hugs, Samantha. Obviously, there's nothing much that can be done about it from my end apart from keeping you in my prayers and wishing you the best birth experience possible.

  12. I agree with Robin- call your insurance about the birth center. Have you thought about switching doctors as well? I went to a midwife and you delivered with whoever was on call, so they scheduled you with a different MW each appt. I was okay with that because most of them were wonderful. In your situation though, I wouldn't be too happy.

    I don't care if I switch the day before i give birth, if you're not happy with the care you're getting change it. You deserve the best ๐Ÿ™‚

  13. I would recommend trying to find another doctor or midwife that you like, but I don't know how rife with options your area is. I live right on the edge or a major metropolitan area, so I have TONS of choices and I know that many mommas aren't so fortunate. ๐Ÿ˜ฆ

  14. Do you have the option of having a private practice doctor?they are the ones that are more likely to deliver personally.

    I don't go for that on-call thing – I think it is frustrating!

    And standard practice in California is every 4 weeks until 36 weeks. Strange.

    You'll be more comfy at home, so I say do it at home or as long as you can. You already know you want to have a natural birth so you should be able to wait until you are about 5 cm before going in. For me, once I was at about 5-6 and my water broke I was delivering a baby within an hour!

  15. So frustrating, isn't it? Thankfully, the midwives I go to now are very flexible with tests and scheduling. I can decline anything I want and they often break from the standard 2 weeks or 4 weeks or whatever. However, I had to go to a lab to have my gestational diabetes test done. They acted like I might do something funny if they didn't watch me. (Just a little trick: since you aren't allowed to leave, keep moving as much as you can in a sitting postition. Swing you legs or rotate your feet at the ankle or move your arms. Moving keeps the blood flowing and helps metabolize the sugar faster, just as it would in a normal setting after you ate a meal at home.)

  16. I also wanted to add that you can refuse any treatment or tests that you do not want. I think if it puts your or the baby's life in immediate danger they can over-rule you, but those situations are few and far between.

    That being said, I wouldn't recommend refusing the glucose test for Gestational Diabetes screening. If you have it, and you don't treat it, complications of it can be fatal.

    The other major one I personally wouldn't refuse is the Group B Strep test – if you are positive, the baby can become infected from you during birth and they can develop a life-threatening infection from it. If you do test positive for this common vaginal bacterial infection, my understanding is that the treatment for you is simply antibiotics – and this can save your baby's life.

    If the only birth location option for you is a hospital, and you are afraid your birth plan may not be followed or they will push unneccessary interventions on you, you might consider hiring a Doula (interview them first). They are experienced at getting you what you want from the hospital staff and making sure that any medical interventions are done because they are NEEDED, rather than because they are convenient.

    Also, tour the maternity ward of the hospital you will be delivering at in advance. We were fortunate that ours was very progressive and even handed out birth plan forms during the tour/pre-registration.

  17. Where did you go for your appointments with Lucas? With both my kids I went every two weeks starting around 28 weeks…I was at a different clinic for each. I think its pretty typical most places. So try not to let it ruin your day:)
    Also, it was the same way both places with using the on call doc. My ob this time tried to be on call the week I was due but she can't please everyone…can you imagine if your ob or midwife delivered every single baby of every single patient? They might as well live at the hospital!!!
    Like the person who posted just before me, my labor and delivery was SO fast that I honestly don't even know the name of the doc that delivered Kendall, nor could I describe what she looked like!!!
    Your labor and delivery will work out perfectly…Hope things are looking up!!

  18. Traci,
    I can tell you in an email if you'd like. It was not the main Hospital there though. ๐Ÿ™‚ I saw the same doc every visit and he was on call and at my birth.That's what I expected unless he was on vacation or something. I went every 4 weeks until I was 36 weeks and then went every week until Lucas was born.

  19. I had the same doctor whom I chose thru the whole pregnancy. My water broke at 38 weeks and my doctor was on vacation. (Before she left on vacation she told me there was no way I would have the baby early being a first time Mom)

    The doctor that did deliver my baby was on call that night. Turns out she was way better and I switched to using her as my regular doctor.

  20. I know how you feel! I am so sorry you have to go through it. The only 2 options for me are the local women's center with OB/GYNs or a birth center with midwives 1 hr away. Both places have the “on call person will be there” policy. But the birth center only has 3 midwives so that was the MUCH better option vs. 10 OBs you had the luck of getting.

    I loved how the birth center handled the diabetes test. They sent me home a menu and said I could only eat one of those breakfasts and then to come in 1hr after eating it. Wonderful! I took the test immediately after getting there! And no yucky juice!

    I guess the ONLY good thing thing about having a 3rd c-section is that I will definitely have my doctor of choice……sigh…..

  21. Having a doula is a great idea! I had one, as I was shooting for a natural hospital birth. Unfortunately I wound up with an epidural (my labor went fast and was much more painful because of it! Wasn't prepared for that one!) Without Barbara there I don't think I would have lasted a minute in the hospital. With her help I was able to wait a until 6-7 cm (I came in at 4.5cm when my waer broke).

    Look for a doula who's new…they need to have 3 volunteer births before they can get accredited. Interview heavily of course, but mine was spectacular and I was her first birth!It didn't cost me a penny but we would have paid anything for her, and will do so for our next birth, whenever that will be.

    I know things are frusterating right now Sam, but try to think positive. Your baby's healthy, the pregnancy is going well, and your insurance is covering everything so far. But again, all that doesn't matter much if you're not happy. It's NEVER too late to switch!

  22. They told me I had to stay in the waiting room because if you exert yourself at all (walking, stairs, etc.) that will change your sugar levels. Good luck with everything. Anything to do with health and doctors gets a little frustrating!

  23. I absolutely dislike having to go back every two weeks! All they do is weigh you, check your blood pressure, and ask if you have any concerns.

    Hang in there! ๐Ÿ™‚

  24. I was in a different boat, I had 3 high risk pregnancies, I had a doctor appt once and sometimes twice a week and on the weekends usually in the hospital, all 3 pregnancies I was on bed rest as well. they make you stay for your diabetic testing if your someone like me who passes out after drinking it! Its a “better safe than sorry” situation. Keep your head up!

  25. That sounds super frustrating!

    I opted not to do the GD test, myself. There are generally signs of GD that show up without putting your body into a sugar stress state, and that is an uncomfortable and expensive (and time-consuming) test! Read up and see if it's something you want to do or not.

    I agree, “it's standard policy” is not a good enough reason to do something if it's not something you feel is necessary or important for your situation. In terms of number or visits, tests performed, whatever.

    Good luck in a better visit next time! And bravo for not looking at the scale ๐Ÿ™‚

  26. Ugh! I feel you! I had my previous 2 children in 2 different states, 2 different hospitals/doctors, and was not happy with either situation. Now I'm in another city pregnant with my 3rd and there is only 1 option! One OB office and one hospital. I hate large practices and that's all there is here. So… I'm having a home birth with a midwife. Hubby is on board thankfully. Though, we also increased our deductible this year (not expecting to get pregnant) so… deductible is $5000 or we can pay the midwife $2800 cash. If I have to go to the hospital I'm fine with that but at least I'll have my midwife there with me to help fight the “norm”. Good luck!

    Oh and I had to do the gestational diabetes test in the office with my first but was allowed to take it home with my second. There's no reason they can't let you take it home. This time I'm not even bothering with it unless there are signs of gestational diabetes.

  27. I am 13 weeks and so glad to be using the same midwife I've had for my last two deliveries. But I totally agree there are too many standard policies in prenantal care these days. I hate the glucose test and she usually wants me to take it twice! Have you ever had the 4 hour glucose test? It's horrible! And like you I was tempted to just stay home and wait it out, but my midwife was awesome she let me go home even after my water broke! I came back in the morning and we did what we had to do, but by then I was okay with it.

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