Posted by My OB said WHAT?!?.
Sep
3
Posted by My OB said WHAT?!?.
“How Are We Supposed To Know If Your Baby Is Alive…?”
“How are we supposed to know if your baby is alive if we don’t use a Doppler to hear the heartbeat every time you come in?” – Nurse Practitioner at the first prenatal visit, when mother declined the fetal heart tone check.
There are 30 comments to this post.
At the first visit there is such a huge chance that you won’t catch the heartbeat anyways.. And if the don’t some Drs are very trigger happy when it comes to telling you the baby has passed and to do a DNC. So if that is why she declined I’m completely understanding!
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Lisa Reply:
September 4th, 2011 at 5:03 am (Quote)
That’s what I was thinking! My midwife doesn’t even usually try to find the heartbeat until about the 16-week visit anyway because she doesn’t want a mom to have to worry about her baby if they don’t catch the heartbeat before that.
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Lysana Reply:
September 8th, 2011 at 1:43 pm (Quote)
Yikes. I had a d/a at 12 weeks with this pregnancy, and the dr couldn’t find the HB with the doppler. First time that’s ever happened so late (with my other 3, it was at 9-10 weeks, no problem) – except for with my 11 wks loss this past March, and in that case, there was nothing to hear, anyway. 
This time, they had me in the ONLY ultrasound room in their office within about five minutes, and we found out – to my shock, at that point – that everything was fine.
Point being, I can’t believe there are providers who would order a D&C without doing an ultrasound first. I’d refuse and find a second opinion, but I know there are many moms to whom it wouldn’t occur that maybe the doctor just missed something.
I can, however, understand skipping the early-ish dopplers altogether, to avoid the potential for not finding the heartbeat, causing fear, and doing an unnecessary ultrasound to ease the mom’s mind.
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I didn’t even make an appointment until 11 1/2 weeks. The pregnancy before had ended in a miscarriage, and I was scared I wouldn’t hear anything.
You can’t hear anything with a stethoscope at 12 weeks, but at later visits (20 weeks or so) you can, so that’s an option. And feeling movement, and rising HCG are good indicators, too.
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You know, at many first appointments the baby is too early to hear a heartbeat. So why fuss over it now?
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Jane Reply:
September 4th, 2011 at 4:35 am (Quote)
You fuss over it now because if you can get the mother to yield in her first disagreement with the medical practice, you have established a precedent and she might yield easier in later ones.
The nurse probably wasn’t thinking that way. She knows ONE way to do things and ONE way only, and when someone wants to do something different, she’s at a loss for how to proceed. No check for FHT? Well, you could write “Patient declined doppler to check for FHT” in her chart. Or you could stand there, flummoxed, trying to figure out how to get fetal heart tones without any equipment. Or you could argue.
Note the dead-baby-card in play here. She’s not saying that getting FHTs will protect the baby against death, but she’s raising that image in the mom’s mind.
Someone who declines an early doppler check to look for a heartbeat has clearly done some thinking. That’s not the kind of thing you’d automatically question if you had never been in a doctor’s office before and never read about pregnancy care. That might also be part of why she’s fussing over it now: because the objection was unexpected and she doesn’t have a ready comeback.
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KICK COUNTS -What? If it is too early for kick counts then it is probably too early to worry about the doppler either. In my day you went in as soon as you could for the vitamins. Nobody bothered you with doppler until 3 months. and then nobody ws shocked if nothing was heard.
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Lil had this to say,
Sep 4, 2011 @ 7:13 am (Quote)
I thought long and hard about whether I wanted the midwives to listen into my baby during pregnancy. Having lost babies previously, I would love to have the equipment to check on my baby myself constantly, just for reassurance, but tbh early on, finding a problem this way, does not usually mean you can do anything to remedy it. Plus, due to my size, listening in to my baby involves a large amount of complaining, rude and smart mouth comments from the midwife usually ending with an exasperated (and exaggerated)sigh and ‘well that was a waste of my time’ from her. Aside from being physically uncomfortable, it is extremely embarrassing (often there are up to 5 other mums-to-be there too) and just ends up sending my BP sky high. After a lot of consideration, I decided that I would refuse all attempts at listening to the baby, monitoring (even worse than listening in) and just have a dating and 30 week scan. Now, baring in mind the attitude of the midwives has always been that I have deliberately put on weight just to cause them more hassles, and I am wasting their time, you would have thought that they would be grateful for me declining…but no, is as though, by refusing to allow them to do something they didn’t want to do in the first place, I’ve issued some sort of challenge!
OP I’m sorry this nurse didn’t think before opening their mouth. You obviously had reasons to decline and had thought it through. I hope the rest of your pregnancy was filled with medical professional that both listened to and respected you and your wishes.
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holly Reply:
November 17th, 2011 at 12:21 pm (Quote)
I couldn’t for the life of me figure out why the original woman didn’t want to have her babys heart heard until I read your story, I am so sorry to hear that someone treated another human being the way that you have been treated and by several different ones. It’s really sad.
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Jespren had this to say,
Sep 4, 2011 @ 9:35 am (Quote)
When I asked the OB at a large teaching hospital that supposedly garners high risk pregnancies from several surrounding states if they had a fetuscope to listen to heartbeat instead of the doppler she looked confused for a few moments then tenatively said ‘i don’t think they make those anymore’. *facepalm*
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How about applying this little bit of logic?
If it won’t change the care options at this moment – it is extraneous information. If I don’t get a heartbeat at 10 weeks or 20 – if that won’t change my decisions… I don’t need it. If there is fetal demise, there is no reason to wait until the inevitable consequence (as long as you are not developing a fever or other secondary symptoms). If the baby is fine – then, there is no reason to subject them to the side-effects of ultrasound.
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I refused all doppler checks and it was a carefully considered decision. Upon hearing this, the nurse was like whatever, but the obgyn barged in and yelled at me for not wanting the standard of care and that she cannot care for me as a patient if I do not adhere to standard of care (makes you think, what else is standard of care to you Ms obgyn – maybe she thinks routine epis are standard of care, yanking out the placenta and so on?).
I left, called my health care plan while still in the parking lot and transferred to a freestanding birthing center. Nobody batted an eye at not wanting the doppler. We used a fetoscope (yes, they still make them!) and the doppler only in labor for intermittent heart rate checks.
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I didn’t even have an appointment until about 10 weeks, and then my MW did use the doppler to listen to his little heartbeat. Personally, I didn’t feel like it was invasive (no vaginal exams unless I requested, and I didn’t) and then later appointments our MW showed us how to use a fetuscope and we purchased one to use at home (it was so much fun!). My hubby and I loved knowing how to find the position of the baby and hear his little heart whenever we wanted to, and it also meant that my in-laws and co-workers who were interested could hear the heartbeat, too.
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Interesting. I never declined a fetal heart check, but if I had known what the doctor would do to me to listen to the heart rate I’d have declined. I was 9 weeks along and he really manipulated my uterus to try to get the doppler to hear it. It took around 10 minutes to get it and it really hurt. I threw up when he was done.
I know lots of moms that decline using the doppler to use a fetoscope at later visits. I can totally see that.
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helen Reply:
September 3rd, 2011 at 7:35 pm helen(Quote)
omg…that’s horrible! so sorry you went through that. did you at least get some of that vomit on his shoes?
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Heather P Reply:
September 5th, 2011 at 3:33 pm Heather P(Quote)
No such luck. I threw up after he left the room. I should have left him then, but as luck would have it he was on vacation when my baby was born and the OB resident was tolerable.
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Jade Reply:
September 6th, 2011 at 6:52 am Jade(Quote)
not under these circumstances but I did vomit on an OBs feet
he wanted to do a blood test, I asked him to wait so my DH could come back from the loo and also asked that I lay down (I pass out and vomit every single time I have a blood test/vaccination). He assured me that my seated position would be fine and that no he couldn’t wait. I reminded him about my reaction. He proceeded anyway, I passed out and while he was standing next to me making sure I was ok and regaining consciousness I woke up and vomited on him 
he deserved it for not listening to me!
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helen Reply:
September 6th, 2011 at 8:28 am helen(Quote)
omg that’s awesome! not that you went through it, of course, but that he got what he deserved. next time he’ll listen when a patient tells him what she needs. i hope….
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Jade Reply:
September 6th, 2011 at 8:36 am Jade(Quote)
My DH came back into the room while I was unconscious so he saw what happened and then heard what I said immediately after vomiting (I didn’t really remember vomiting or then talking clearly because I was still only partially conscious). first words out of my mouth said in a slurred but cranky voice “I told you I would!”
I really hope that he learnt from this. one thing I have discovered is that it is a rare health care practitioner (whether they be Dr, Nurse, phlebotomist or whatever) who actually listens when I tell them that I will almost definitely pass out and if that happens then my chances of vomiting are quite high too. (I think the reaction is as a result of a combination of reasons, it all starts with smelling the alcohol wipe, very low BP, fear of needles which is exacerbated by the fact that my veins are terrible so even if I can steel myself for one stick, by the 3rd or 4th I am losing composure) I am getting better with them but still prefer to lie down because it usually avoids the whole falling on the floor thing.
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Jade Reply:
September 6th, 2011 at 8:40 am Jade(Quote)
I have also told a Dr to not draw blood once before because I had driven myself and ahd the 2 kids with me and I know that there is no way I can drive for a number of hours after a blood test. I agreed to come back later that day, I would go home and hubby would bring me back. She refused and insisted that I got the test done now. She had to ring my husband to come and collect me and the children and to bring another adult to drive our car home, she then had to look after me and my 2 young children while we waited. HAHAHA I told you so you dumb cow!!
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lilmrsmchenry Reply:
September 6th, 2011 at 8:59 pm lilmrsmchenry(Quote)
I had similar problems. In fact once, I passed out during a blood draw (I told them that I probably would) and the tech freaked and thought I was having a seizure for some reason. Glad my hubby was there to calm her down.
My advice is to ask for a butterfly needle to be used during a blood draw. Since I started doing that, it has reduced the number of attempts made to catch my veins since they are easier to control.
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Jade Reply:
September 6th, 2011 at 9:08 pm Jade(Quote)
yeah i do ask for a butterfly needle, occassionally I even get listened to. I also hate the feeling of the little vacuum containers that they attach, I can feel the blood being sucked ouit
EEWW. Most of the time they just insist that the needle they are using will be fine. If I get a skilled practitioner who actually listens then it is a fairly simple process.
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Jade Reply:
September 6th, 2011 at 9:10 pm Jade(Quote)
I even find that if the person ahs listened and lets me lie down, uses a small needle etc and it doesn’t work first time, I tend to handle it better because I know that they really have lsitened and are doing their best whereas if they just ignore me then I probably get a bit worked up and stressed right from the word go.
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Sheva Reply:
September 6th, 2011 at 1:40 pm Sheva(Quote)
He most certainly did deserve that.
Serves him right for not respecting a person’s knowledge of their own body.
Maybe he even learned something…
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