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Old 07-18-2013, 05:50 PM   #1
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dual care? refusing routine blood tests?

Although I have a homebirth midwife and we will be attempting an HBA2C, we plan to seek out a back up OB and do dual care my pregnancy. I have been referred to a local OB that is very VBAC friendly(though cannot support it because the hospital is small, local, and doesn't have 24/7 anesthesia - she refers her VBAC patients an hour away)...though I'm not sure if she'd be back up for a homebirth. If baby is breech or other problems arise that risk me out of midwifery care, I'd like to have an established relationship with a doctor. If we have to go in for emergency, it'd be nice to have the possibility of getting my doctor.

However, I'm nervous to actually schedule the appointment. I will refuse all blood tests. I am O+, not anemic(hemoglobin was 14.4 at midwife appointment), do not have STDs, and do not care if I am immune to rubella or not. It is just one more poke I don't need, and quite frankly, don't want to consent to, no matter how harmless it is. I'm not sure how I will be responded to, and wonder if I'm going to be treated badly. My sister refused a pap smear during her first pregnancy and was treated so terribly that she was in tears. I will also be refusing a pap smear. I suspect the nurses will treat me badly, but the doctor might be more open to my requests.

Anyone else seek out limited dual care and refuse certain common blood tests and practices? Or for that matter, anyone that refused it even if they didn't have another care provider?

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Old 07-18-2013, 06:22 PM   #2
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Re: dual care? refusing routine blood tests?

I always get routine blood tests, BUT I feel like you could just keep forgetting to get the test done and no one will really care. How many appointments are you planning with this doctor? If it's just one, they probably won't follow up with you. Also, they just changed the guidelines for PAP smears. For women with a history of normal results, they only recommend doing it every 3 years. So you may be off the hook anyway. IME they only test for STDs if you are refusing the eye goop, except for HIV.
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Old 07-19-2013, 05:31 AM   #3
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Re: dual care? refusing routine blood tests?

I've only ever had 1 pap back in 09, so they likely might give me trouble. I'll probably just fib and say I can get it done after pregnancy. I won't, but they don't have to know that. I do not feel they are safe to do while pregnant.

I won't have to mention during my first appointment that I'll be refusing the eye ointment if baby is born in hospital, and can just offer to get old records from first two pregnancy and the first routine bloodwork they always do to show my negative STD status, blood type, etc.
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Old 07-19-2013, 10:06 AM   #4
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Re: dual care? refusing routine blood tests?

what is the point in refusing the blood tests?
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Old 07-19-2013, 12:21 PM   #5
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Re: dual care? refusing routine blood tests?

Because it is unnecessary extra cost when I've already received the testing in either previous pregnancies, have no risk to need the test once again, or have already been tested by my homebirth midwife. This will be a back up doctor only.
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Old 07-21-2013, 04:09 PM   #6
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Re: dual care? refusing routine blood tests?

I had blood tests done with my first (miscarriage at 9 weeks) and a pap. Both were fine. Then with my oldest I had an extensive blood test (viles and viles, my veins kept bursting so they had to keep re sticking me and I am a needle phob as it is) but no pap since it was the same year. I don't have great veins, they are are to get into and they tend to burst easily so blood tests and iv's are a horrible experience for me. Mid pregnancy with my oldest I switched Dr's (the new one was awesome and I had him for all 3 of my kids). With my next pregnancy (my dd) I told them I didn't want any blood tests and they actually said okay no problem, we know you and we know your lifestyle isn't one that you would get an std or anything. Same with when I got preggers with my ds2 (dd and ds2 are only 11 months apart). I also have never taken a GD test. I did a finger prick for ds2 after eating a certain way so my Dr could check my levels because my dd was big at birth (but no issues, she was 10 days past her due date and I don't make small babies) and my levels were great so no more was said about it.

I am pregnant again now and we don't have insurance this time. We are using midwives and a birthing center. I am refusing all of it this time as well (unless I feel like I am having GD symptoms). The midwife I saw this last time wants me to have my iron and hemoglobin levels checked next visit but the lab costs will be out of pocket so I very well may say no thanks. I have hyperemesis and we are having to cover my meds out of pocket and it's quite pricey.

Good luck and I hope they respect your wishes and don't make a stink.
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Old 07-21-2013, 04:41 PM   #7
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Re: dual care? refusing routine blood tests?

That's great that you had such an easy experience. I'm not expecting similar, but I might be pleasantly surprised! My first appointment is not until Aug 9th, but I am not sure I will receive my records in time as they are giving me troubles and will not send them to me. My records with my first pregnancy will be in the same medical center, so they should actually be able to look into them themselves if they are concerned with STD status, blood type/rh factor, and immunity. I am sincerely hoping this doctor will be open to being my OB although my primary care provider will be a midwife. I've heard good things, so I'm hopeful. I'm most worried about how the nursing staff will treat me.
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Old 07-26-2013, 08:48 PM   #8
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Re: dual care? refusing routine blood tests?

I have had the same doctors for all 3 pregnancies (currently on my 3rd) and I have been told that if I refuse blood work, I will have to find another doctor. I HATE needles with a passion. With my first DS they actually gave me a time frame to have the blood work done. They told me if it was done by my next appointment I would be dropped as a patient and I would be forced to find a new doctor. As far as not having it done, I think you should have all the required tests done. Stds can lay dormant, so that is why they test every pregnancy. Also with bloodwork, they make sure you aren't a diabetic and make sure there aren't numerous other conditions that could affect pregnancy. I know what blood type I am and know that I am not anemic, however every pregnancy is different. It's personal preference, but expect to be met with some resistance. A friend in PA where I live, refused blood work and they actually called CPS on her when the baby was born. Not sure what the outcome was of it all, but they felt she was putting the baby's life at risk. I wish you all the best.
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Old 07-26-2013, 09:01 PM   #9
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Re: dual care? refusing routine blood tests?

Anemia shows up in pregnancy, its not something you can test for once and be okay for forever.
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Old 07-27-2013, 09:36 AM   #10
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Re: dual care? refusing routine blood tests?

Quote:
Originally Posted by Tris View Post
Anemia shows up in pregnancy, its not something you can test for once and be okay for forever.
Tris, the first routine bloodwork they do tests hemoglobin/anemia. I have never been tested multiple times in pregnancy for anemia by either of my two previous OB offices. I have never even been tested more than once through WIC services. My midwife has already tested me and I will gladly share the results with them. If I transferred from any other doctor and had the records in hand, they wouldn't require me to retest. I have never heard of anyone else being tested multiple times in their pregnancy for anemia.

I have finally received my records from my first pregnancy back in 09 that shows my blood type/rh status, immunity to rubella, and negative for Hep B. I have only ever had 1 sexual partner (everything including to hand holding and kissing) in my entire life, and he as well, and I am absolutely not at risk for having any "dormant" STDs. Back in 09 they gave me the option of refusing HIV test, and I did, and had I known then they would be testing for other STDs, I'd have refused those as well. If not for the first pregnancy for their peace of mind, certainly would have refused them for subsequent pregnancies once my negative status was confirmed and could have those records for proof. I've already been tested twice for an STD I've never been at risk for contracting and will refuse any further testing as it is simply not necessary. Dual care isn't absolutely necessary, just what I'd prefer, but if I cannot refuse tests and be in control of my own care and make choices for my own body and baby, then I will fire them. I hope it doesn't come to that, because I'd really prefer dual care so that if my baby is born in the hospital, I can have a care provider that is aware of my plans and wishes, and abides by them. Such as being sent back to my room immediately to breastfeed instead of separating me from my baby for an hour or more, not bathing baby, letting cord pulsate, etc, etc etc, .

I *may* consent to GD screening, simply because I do not want them poking and prodding my large baby at birth IF it is born in the hospital, and if they assume I must have had GD because I wasn't tested. I'd rather be poked and prodded during the pregnancy, then my baby being forced to at birth. I tested negative for GD with both my previous pregnancies. Because they had the bloodwork and records and knew I was negative when my oldest baby had a large birth weight, no testing was necessary. So long as he was feeding and showing no symptoms, they let us be. Yet with my second born he was tested frequently the entire time we were in the hospital, and I will not allow it this time if my baby is showing no symptoms (he never was). At the time they made it sound necessary, but now that I have the records in hand and more knowledge, it never was.
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