Posted by My OB said WHAT?!?.
Dec
5
Posted by My OB said WHAT?!?.
“Those Charting Dates Usually Aren’t Very Accurate Anyway.”
“Those charting dates usually aren’t very accurate anyway.” – OB to mother who was worried about her twins being born too early because the OB insisted on using the 18 week ultrasound EDD that dated her 9 days ahead of her EDD based on charted ovulation.
Kara
There are 40 comments to this post.
Doula Brandi had this to say,
Dec 5, 2011 @ 2:49 pm (Quote)
Why Doc? Because they make you little “Wheel dates” look ridiculous?
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Ha Ha ha ha ha ROTFLMAO! I love when people who are supposed to be smart and also good at science say things like this. As though u/s technology has been perfected and also, women couldn’t possibly observe phenomena and record them accurately.
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Skyfire Reply:
December 5th, 2011 at 3:11 pm (Quote)
Using public health I get a lot of Drs and Nurses who insult my intelligence every time I speak with them. I do my own research, I ask intelligent questions, I tell them exactly what I need, and I get looked at like I’m a crazy person, lied to, ignored. Sometimes the ridiculousness is amusing, but mostly it pisses me off.
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Selia Reply:
December 5th, 2011 at 3:12 pm (Quote)
So true! Women are smart enough to do anything, except of course determine when they ovulate *eye roll*, even though it comes with clear indicators if you are looking for them. What then pray tell doctor is the point of your medical texts discussing mittelschmerz, spinnbarkeit, BBT and other such well documented, scientifically explained occurrences indicating ovulation?
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Jane Reply:
December 5th, 2011 at 3:57 pm (Quote)
That’s what I don’t get. If you go to the doctor with an upper respiratory infection, the doctor will ask whether you have a fever and whether you’re coughing up mucus or have a runny nose. If you say yes, the doctor will ask you how high the fever and what color and consistency is the mucus.
And based on those (which are called “symptoms”) the doctor will diagnose whether you have a bacterial or viral infection and possibly prescribe antibiotics.
But you go to the doctor with a chart of temperatures and mucus observations and suddenly they’re no longer symptoms — they’re voodoo and have nothing to do with ovulation.
What has to do with ovulation? The Wheel of When. Which is dialed to the day you say your period started.
The irony? Bleeding…is a symptom reported by the mother. The doctor wasn’t there to observe the period, and yet somehow that counts whereas the observations on the chart don’t.
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Sheva Reply:
December 5th, 2011 at 4:37 pm (Quote)
You’re so right, and it’s almost creepy how dismissive they could be.
Are they really not clever enough to understand it the whole “every woman’s cycle is different” thing, or are they so full of themselves that they refuse to accept it?
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Jane Reply:
December 5th, 2011 at 5:21 pm (Quote)
Based on my own experience alone, I think it’s refusal to accept it.
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Robyn Reply:
December 10th, 2011 at 5:36 pm (Quote)
Except that they have a tendancy to seek to control a woman’s cycle artificially so the woman’s cycle is what they expect it to be. For some reason, they don’t seem to understand that cycles outside of the realm of 28 days can be normal and that a woman who has a history of 28 day cycles (due to hormonal birth control) couldn’t possibly have anything but.
Anytime a woman has an issue with her cycle, it’s recommended she go on birth control to “correct” that issue. They seem to think that by chemically controling a woman’s cycle, it will reset and make her body do what they want. They dismiss the “every woman’s cycle is different” thing because they are under the illusion that “every woman’s cycle SHOULDN’T be different and if it is there is something wrong”.
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Rebecca Reply:
December 6th, 2011 at 8:45 am (Quote)
Try explaining to a doctor that you were running a fever but took tylenol so now you’re not. I was told by one office I shouldn’t have taken anything if I knew I was going to the doctor. I spent plenty of time trying to explain my knee problems to doctors until I finally got the orthopedist referral and he was aghast that no one had considered what my problem actually was- and that was despite falling in one doctor’s office. (and there were physical signs observable by the doctor- but because it was connective tissue that was the problem it was missed) or convince my older child’s father and pedi that the side effects of his medication are as bothersome as DS and I say.
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Jane Reply:
December 6th, 2011 at 9:38 am (Quote)
I went to my PCP once with an ear infection and he gave me ear drops to put in the ear. When it hadn’t cleared up after a few days, per his instructions I made an appointment and went back. And got scolded for using the ear drops that morning because they obscured his view of the ear.
A) I hadn’t known for sure I’d get an appointment that day, and
B) They ALWAYS tell me to finish antibiotics after I’ve started them. So now I’m at fault for following instructions?
But it sounds as if you’ve had more than your fair share of incompetent doctors. 
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I was arguing with the docs about my scan EED based on charting and they told me I was wrong so I went to a new doctor and told them a date I wanted. When they told me I was wrong I just mentioned that my husband was away (he wasn’t) and I couldn’t have possibly conceived then unless they were accusing me of infidelity. It worked, they took my date (which was actually 41 wks) because I wanted to give myself some breathing room.
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Funny story… With my second, I was told I was wrong about my dates by everyone I saw for the first half of my pregnancy. I just shrugged my shoulders and said, whatever, call it what you want, I know what’s true. Then my daughter had some serious health concerns, so we were sent to one of the nation’s leading perinatologists for an evaluation and a fancy-schmancy high-res scan. He said there was a way to measure parts of the brain mid-pregnancy that can very accurately date the pregnancy. So he did it and, guess what, he dated it exactly the same as I did. Nobody bugged me about dates again after that.
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This makes me laugh because with my last pregnancy I ovulated in early August an Ultrasound confirmed it but I had my period a month before my ovulation was extremely late and the dr refused to go by my ovulation date just because I couldn’t know when I ovulated! I had severe abdominal pain which was why they did an ultrasound and found out I ovulated so I am pretty sure I ovulated then. However as far as measuring a baby my daughter never measured appropriately she was a small baby and always measured that way!
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Mama Wrench had this to say,
Dec 5, 2011 @ 5:04 pm (Quote)
This is where it pays to be a military spouse. I can just say I or my husband were deployed and only had sex on/around my ovulation date.
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If you are a woman lucky enough to have regular “like clockwork” cycles, I envy you. All I can do is guess.
Like how I guessed that when I found out on July 2, 2010 that I was pregnant, I figured I was about 3 weeks along.
And you know what? Even though my cycles could go any where from 2 weeks to 6 months apart, I was right on the money. My doctor told me at my first appointment that I was 11 weeks. Turns out I was barely 4…
And the doctor should have to sing: “I am so smart! I am so smart! S-M-R-T! I mean S-M-A-R-T!”
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jaed Reply:
December 6th, 2011 at 9:47 am (Quote)
Kristin, if you learn how to track your ovulations, you won’t need to guess. If you are still wanting/open to having more children, I’d recommend learning it – if your cycles continue to be irregular, this will give you helpful information.
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LIss Reply:
December 6th, 2011 at 5:56 pm (Quote)
Fertility Awareness Method is especially useful for women with very irregular cycles, whether or not they are trying to conceive. You will never have to guess when you’ll get your period. You might not ovulate for 40 days, but you will see when you ovulated, and know to expect your period in about 10-12 days. Toni Weschler’s book, Taking Charge of your Fertility, is a great resource.
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Holly Reply:
December 10th, 2011 at 12:08 am (Quote)
This does not work for PCOS patients. I do not ovulate every month and bleeding is not necessarily followed by an ovulation. I can also ovulate and NOT start bleeding at the end of the cycle. Charting, for me, is worthless… and I used TCOYF like a Bible for a decade before I gave up. I, like Kristin, can have “periods” every two weeks to every six months.
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jaed Reply:
December 10th, 2011 at 9:39 am (Quote)
Er… not sure what periods have to do with it? (I do know Kristin said hers were very irregular.)
My impression was that Kristin was guessing when she became pregnant based on intuition, as opposed to the counting-days-since-last period method (unreliable for anyone and useless for someone with very irregular periods), but if she knew her latest ovulation date, she’d know her conception date without having to rely on when she last bled.
Where am I going wrong?
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Robyn Reply:
December 10th, 2011 at 5:54 pm (Quote)
What Holly is referring to is a condition called polycystic ovarian syndrome (PCOS). It is very difficult for women with this problem to conceive. They often don’t ovulate for long periods of time, have anovulatory bleeding, and from what Holly is describing she also dealt with something called lutinizing unruptured follicle syndrom (LUFS). With LUFS, your body will go through all the symptoms of ovulation, but the egg becomes trapped in the ovary and it becomes a cyst; so even though your chart shows you’ve ovulated you won’t get your period and you won’t conceive that cycle. Charting is very difficult when you have this condition and may not work.
While Kristen is simply saying that she has irregular periods and people are rightly suggesting that she look into fertility awareness, Holly is suggesting that there might be a deeper condition that may make charting ineffective.
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Holly Reply:
December 10th, 2011 at 6:18 pm (Quote)
Thank you Robyn!
I am still getting through emails today after spending the day in the ER with my four year old. Catching up after a full day of not checking forever some days.
You did pretty much hit the nail on the head.. but I was also commenting to Jaed that not all women are able to simply “learn to track your ovulation” and to Liss that pointed out that ” you will never have to guess” I was pointing out that it is simply not that easy for all women. Those of us with irregular cycles cannot simply be “fixed” by TCOYF or FAM as they implied. While it can help some women, it can be a big disappointment to women who are encouraged to try these methods to “fix” themselves or “learn themselves” as if they are just too out of touch with their bodies and “miss” ovulation. I agree TCOYF and FAM are great methods but they are not the be all, know all, fix all of every irregular cycle Every woman that has to guess isn’t just “out of touch” and in need of “learning her body”. I was trying to point out what you said, Robyn. But a bit more there too 
Thanks for stepping in and helping me out while I was away and couldn’t answer 
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Liss Reply:
December 11th, 2011 at 5:25 am (Quote)
Holly and Robyn, thanks for educating me on a few of these points. I feel much better informed now.I didn’t figure that Kristin could be talking about a condition like PCOS, and I should have taken that into account. I assumed (bad idea, right?) that she was talking about a general irregularity to her cycles, and I related to that, and used to feel like I had no idea when I’d get my period. My ovulation can be all over the place sometimes. TCOYF didn’t “fix” me (i.e. change my cycles any), it just made me feel empowered. And I am fascinated to learn about LUFS – I didn’t know about that. I certainly have the occasional anovulatory cycle, but it is totally anovulatory, not confusing like LUFS.
Holly, I never intended to imply that you needed to be fixed, were out of touch, or didn’t know your body. In fact, that is the last thing I’d ever want to say about any woman. If I came off that way, I am deeply sorry and would love to learn how to better express myself.
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Robyn Reply:
December 11th, 2011 at 10:24 am (Quote)
It’s often difficult to think of a problem when you don’t think about it. Making the suggestion to learn FAM is the right thing to do with the information that was given. However, we often draw from our own life experiences in order to give advice to someone else; if PCOS or LUFS isn’t something you have experience with, you wouldn’t think about it right away.
Kristen, getting the book Taking Charge of Your Fertility by Toni Weschler is a great first step for understanding your cycles. You may find that you simply have supremely irregular cycles. Or you may find by looking at your chart that there is something else going on. If you were ever to go to a fertility specialist, they would probably have you chart for awhile as a starting place. When you have problems, your chart can show signs of it and give your provider an idea of where to look for problems. I firmly believe that learning how to chart your cycles should be taught in high school Health class for all women.
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This is mine. They actually left out the part that really bugged me. I hadn’t had an early u/s and the midwives I was seeing insisted on using LMP, even though I knew my ovulation date. Since I didn’t even know my LMP I just told them it was at the end of April and they gave me an edd just 2 days before the edd I was using, which I didn’t mind too much. Fast forward to my u/s at 18wks when we found out I was having twins, and they were measuring big (not a surprise, all my kids were around 9lbs at birth) so they moved the edd to 9 days earlier than my edd. I had to be switched to the high-risk OBs and got this guy who knew nothing about twins (and even told me so).
Anyway, I tried to discuss the due date issue with him because they wouldn’t stop labor after 36wks which meant if I went into labor at 34.5wks according to me they wouldn’t stop it and I could have babies in the NICU, and on the other hand they wanted me to deliver by 38wks, but I would only be 36.5 wks according to me and didn’t want to be pressured to have them earlier than necessary. So I brought it up my edd being earlier than I thought it should and he said this:
“That just means you will definitely have your babies earlier! (As if this was something to be happy about when there’s already potential for preterm twins.) Those [charting] dates aren’t really that accurate anyway.”
He then dismissed that and went on with the appt. Not the only dumb thing that came from him either. He did a quick u/s to check heartbeats and I asked if he could tell if they were breech/vertex and he said one was breech and the other head down when even I could see they were both head down (and from their movements I could tell too, just wanted to confirm), he even mentioned their heads were right by each other. He had to keep leaving the room to ask another dr for answers to my questions since he didn’t know.
I ended up transferring to a great MFM (I posted a thoughtful thursday from her months ago) who specialized in multiples, took me seriously, and was very supportive of me trying vba2c with the twins. She didn’t move my edd, but listened to my concerns and was willing to be flexible about when I should deliver (because I’d had 2 c/s and had twins and they were big, I was ok with inducing by 38wks if necessary because of the stress on my scars).
I had a natural vba2c at 36w3d (according to my dates, 37w5d to them) to healthy boys weighing 7lb1oz and 7lb9oz.
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With my secpond child I had a very good idea of when he was conceived since we didn’t get the opportunity to try that often. I told them three consecutive days in which he could have been conceived and they looked at me like I had three heads. Then proceeded to do a “more accurate ultrasound” and gave me a date that was almost two weeks later than the one I had come up with.
Surprise surprise when my son started measuring “Two weeks ahead” at all my appointments and was born at 37 weeks and 3 days. They tried to say he was too large for his gestational age and insisted on an extra long hospital stay. However, by our conception date he was only 6 days early, and perfectly sized.
More accurate ultrasounds my ass.
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Lauren Blue had this to say,
Dec 6, 2011 @ 9:02 am (Quote)
I hate how uninformed Dr’s are about this stuff. I’ve been using NFP for years, I have a handwritten chart and TCOYF software. But yeah sure, there is no way to know when I conceived. And since I chart intercourse too, I know which act of intercourse led to conception. Of course that can’t be accurate either. I must have conceived during the period of abstinance because that’s what the wheel says. Ugh.
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Whereas ultrasounds, because we can bill for them, are always perfectly accurate.
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Selia Reply:
December 5th, 2011 at 3:06 pm Selia(Quote)
My 20 week ultrasound (only on I will be getting, barring any problems) was denied by my insurance as medically unnecessary for a normal pregnancy! Go figure! They are so important and necessary and infallible(sarcasm of course)! but my insurance and a few others won’t pay! And I have pretty good PPO insurance too. And it is amazing how they always seem to forget later ultrasounds (beyond the first few weeks) are accurate for dating only to +/- 1-2 weeks! That is a huge variation! Helpful if a mom has no clue when she cycled/ovulated, but really should be ignored if she is sure.
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