Posted by My OB said WHAT?!?.
Aug
16
Posted by My OB said WHAT?!?.
“I Can’t Let You Go Past 39 Weeks Because I Don’t Want To Deliver A Dead Baby!”
“I can’t let you go past 39 weeks because I don’t want to deliver a dead baby!!” – Maternal Fetal Medicine physician to mother at 19 weeks.
There are 29 comments to this post.
Wha? How would you *know* at 19 weeks that the baby would not be doing well at 39 weeks?
Why borrow trouble like that?
I could understand saying something like:
This [specific condition you are seeing a MFM specialist for] raises the risk of [XYZ dangerous condition], and you will need close monitoring towards the end of your pregnancy. If we see signs that the baby is being negatively affected, it may become necessary to induce before 40 weeks for his safety, as XYZ may increase the risk of stillbirth.
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Exactly what would be my meidcal problem and what should I be looking for over the next 20 weeks. And what are the alternatives? I don’t work well with people who threaten me and I’m perfectly capable of finding another care provider. So if you aren’t willing to treat me like a responsible intelligent adult then I will take my file and move along. thank you okay bye
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first time mommy had this to say,
Aug 16, 2011 @ 11:46 am (Quote)
I’m getting really sick of the dead baby card. Remember that old story about the boy who cried wolf? Eventually people are going to stop believing you when you pull the dead baby card and then when it’s really serious and is actually a risk, nobody is going to believe you.
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Details Reply:
August 16th, 2011 at 11:53 am (Quote)
That is pretty much where this site it. No matter what the problem this woman is going to a specialist for we still pretty much give the knee jerk reaction of Liar Liar pants on fire because this foolish doctor didn’t have any more sense than to pull the dead baby card rather than speak to the mother like a rational intelligent human being. What if this mom really did have a serious problem and she decided to UC rather than put up with anymore arrogant doctors and the baby died. Then Dr. Amy would say it was the mother’s fault rather than the doctor’s fault when clearly it is the lack of communication skills on the part of the doctor that is causing the problem.
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Abby Reply:
August 16th, 2011 at 2:03 pm (Quote)
Then you have the reality that people like *me* who were classified as ‘high risk” simply because of age, who are sent to MFM for *NO REASON* are also receiving the same threats.
I have extremely little faith in the medical community, or in any “professional” to behave in a professional manner and practice evidence based medicine… MY situation was the same as most of the other “High Risk” (very young mothers, with NO other indicators) moms- there was no reason for us to be there, except for the fact that they could milk the system by referring us.
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Jane Reply:
August 16th, 2011 at 1:38 pm (Quote)
I’d like to believe that if the doctor has a reason to pull the dead baby card, the doctor will provide that reason, and there will be compelling evidence to back up what the doctor says. For example, “Your blood pressure is 200 over 150, and that can cause very serious problems to the baby. We have to deliver you immediately.”
But the airy “Oh, the baby will DIIIIIEEEEE!!!!” bit with nothing for backup? It’s a load of nonsense. If you have facts, doctors, provide them. We’re smart. And we’re also smart enough to tell when you don’t have facts.
Oh, and don’t make up facts, either. Because this is the information age. We’ll find out.
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NaturalBirthGoddess had this to say,
Aug 16, 2011 @ 1:26 pm (Quote)
This is pretty much what I was told when I was pregnant with my twins. They need to be born sooner because they can have real problems. This is very true for mono/mono twins, but not for di/di twins (which mine were). They wanted a c-section scheduled for 37 weeks. I ignored them and had my twins at home at 40.3 weeks and they were very healthy. The dead baby card is so overkill and old news…next! 
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Jenny Islander had this to say,
Aug 16, 2011 @ 2:35 pm (Quote)
What condition do you suspect that would produce more severe consequences than probable mild prematurity due to induction? What is this condition called? What are its effects if untreated? What are the most likely outcomes of induction as a response to this condition? Are there any other medically accepted treatments for this condition and if so where can I read about them?
Use your words, Doc. Use your words.
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The MFM’s concern is grounded in truth, though it may not apply in this case and that was an unprofessional way of saying it.
High risk conditions, such as high blood pressure, diabetes, higher order multiple pregnancy, can cause advanced calcification/deterioration of the placenta. It is standard to recommend delivery by 39 weeks in women with pre-gestational diabetes. Like me. My doctor told me that we could go farther if I really felt strongly about it, but 41 was her own limit, I would have to find another doctor, and she was pretty sure the other doctors in the practice felt the same. And she felt strongly about the 39 week recommendation too, and laid out the reasons, including her personal experience. I went with her advice, at least until exigent circumstances arose and my son had to come out at 37 weeks. (He’s fine).
It’s not always the placenta. In high risk pregnancies, things just get crazy at the end of the pregnancy. That’s why my son came early, my blood pressure went insane. The dead baby card isn’t an appropriate way to suggest/recommend/discuss the idea of delivering a little early if the doctor thinks, based on experience, that sh*t is likely to get crazy, but it’s not an unreasonable thing to discuss.
I am guessing, though, that since she is here, the OP was not in a situation where the above suggestion made sense. There a lot of high risk conditions where making that suggestion at 19 weeks is VERY premature. Not all high risk pregnancies are equally risky. Mine was as risky as it gets, so I think recommendations like in the OP don’ t make any sense at all for most high risk patients.
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Jane Reply:
August 16th, 2011 at 4:21 pm (Quote)
Sorry, the comment below was supposed to appear as a reply. What is pre-gestational diabetes? Are you talking about diabetes that a woman has before she’s gestating? Or are you talking about blood glucose numbers that are in the high-normal range but not high enough for the doctor to diagnose GD?
And if so, are there any studies about pregestational diabetes?
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this one was mine. I was “high risk” more because of my history than anything. At this point i had has 13 first trimester miscarriages (unexplained) ALL before 8 weeks. I have seen over 30 drs looking for advice had more blood pulled than you can count and more tests than you can imagine. finally *I* asked a hematologist to please try me on lovenox and baby asprine (blood thinners) even though I have no signs of a clotting disorder. He really did not think it would work but said medically it would not hurt me (but physically the shots are pretty painful) so he wrote me the script. Shockingly I had a pretty uneventful pregnancy! I still saw a mfm from the beginning because no midwife i interviewed would take me NOT because of the lovenox but because of my history of early miscarriages 
He shot this doosy at me when I was discussing my desire for as natural of a birth as possible (my dream would have been a home birth but on blood thinners and with my history there was no way.)) He told me that because of my History there is no chance he is letting me go past 39 week. again NOT because of the blood thinners I was on but because of my miscarriages before 8 weeks! He had some other dooseys during my time with him but I honestly could not find anything better in my area. No one would touch me with a 10 food pole because of all the early misses. Finally I could not handle it anymore. Every time I called with an issue it was “go to the er immediately!” I found out it was because of my “history” I was in the er atleast once a week! by 25 weeks I had had enough and Just left telling my Dh I was tkaing a full time job at finind another care provider. I went in and interviewed with 9 Midwives – turned down by them all. 13 OBGYN’s (all wanted early inductions half wanted C sections – Um HELLO on blood thinners?!?!?!?) and 7 MFM’s they got even worse. Finally I called the nicest midwife back crying BEGGING her to take my case on that I had no where to go. She said she had one other recommendation a “MEDwife” that did use medical interventions more than most but was known to be outstanding. How I didn’t find her on my own I don’t know. I interviewed with her. When she heard the MFM i was coming from her exact quote was “Ahhhh him? He wets his pants just walking the dog he is such an alarmist!” We talked about risks and she pretty much said what I needed to hear. That there ARE risks but as long as I agree to extensive end of pregnancy monitoring (2 NST’s every week ultrasounds to watch my placenta VERY closely etc) that she would let me go as long as 42 weeks. I had an amazing delivery with her She was there with me 100% of the time – though her personality drove me so crazy i actually asked her to leave for 20 mins to give me a break form her- She was AMAZING and yes though she was more medical made me be on monitors the whole time.. She also asked for an extension cord to be brought in for the monotors so I could walk the halls.. So Not the home birth I wanted but Still so much better than what I was going to have.
On a side note. I got pregnant again 5 months after this baby was born I was very hormonal and decided NOT to go on lovenox just yet and let what happens happen… I was not ready for the whole thing all over again. I DID go on baby aspring and an noy 24 weeks along with a TOTALLY uncomplicated pregnancy! Honestly my midwife thinks it might be all I needed all along! She says if this borth goes beautifully then she will be calling around the other midwifes in the area who do homebirths and try to get someone to take me on for number 3 (hopefully a few years from now LOL)
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Susan Peterson Reply:
August 16th, 2011 at 6:50 pm (Quote)
You have an amazing amount of spunk and persistence! Deciding what might help you and finding a doctor who would give it to you. Going to so many midwives and doctors, hearing “no” so many times and not giving up. You are an inspiration to all of us. And, congratulations!
Susan Peterson
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Rebecca Reply:
August 16th, 2011 at 6:52 pm (Quote)
So glad this came out with a good outcome, even if you had to wade through so many troubles to get there.
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Telula Reply:
August 16th, 2011 at 10:05 pm (Quote)
Way to persever Channa! You knew what you wanted and needed and you didn’t stop until you got it!
I kinda went through a similar thing when I was trying to be diagnosed with cancer. I knew something was wrong, suspected it was cancer while my doctor wasn’t acting very fast, so I changed doctors and went through the needed tests immediately, and my suspicions were unfortunately true. But it was caught early and my treatment wasn’t that difficult and I’m healthy now, waiting to see if I’m able to still have children. We’re going to start trying in January, after my CT scan.
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Wow, this doctor’s office has an amazing ultrasound machine, don’t you think? I mean, obviously it’s sensitive enough to see the calender hanging on the wall of the OP’s uterus! Not only could it see the calender, it could see that 39 week date circled in bright red with the words “I WILL DIE” written in bold letters!
Sheesh, stupid doctors.
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not understanding had this to say,
Aug 18, 2011 @ 2:33 pm (Quote)
After 13 miscarriages, I would let them pull the baby out of my nose, if it decreased risk to the baby even by 1/2%
But, that’s just my opinion.
I support your right to choose to give birth however you want, even it if increases your chance of losing another pregnancy.
(that is the supportive version of the “dead baby card”)
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Melissa Reply:
August 18th, 2011 at 4:02 pm (Quote)
But her choice wasn’t between (on the one hand) pulling the baby out of her nose (or any natural or unnatural orifice) at 39 weeks and (on the other) losing the baby because >39 weeks is automatically dangerous. A c-section at 39 weeks increased her risks…hello major surgery while the woman is on serious blood thinners? And he didn’t give her any actual reasons or even a sad little rationale…just some nice, unhelpful, inappropriate manipulation.
It’s not about a mom playing a risky game with her baby’s life. It’s about doctors playing risky games with women and their babies. If there actually HAD been a real increase in risk to the baby, and absent any other overriding concerns (maternal death anyone? Wouldn’t want to leave those babies motherless, now!) just about everyone would cut off their own arm if that’s what it took.
Come on, people…we’re talking about MOMS here. And the insinuation that a mom who had already lost THIRTEEN babies to miscarriage was doing less than *you* would have been willing to do to save your hypothetical child…well, that’s disgusting.
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Well, that is a pretty tactless thing to say no matter what, but if MFM care is necessary, there must be something going on. Curious about the story behind this one…
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