Posted by My OB said WHAT?!?.
Jan
16
Posted by My OB said WHAT?!?.
“Condoms and Foam.”
OB: “What kind of birth control are you using?”
Mother: “I use the Fertility Awareness Method.”
OB begins to write on the chart, while muttering: “Condoms and Foam.”
Mother: No! I don’t use those!”
OB: ”Well, I’m not writing “FAM” on your chart. I don’t want to risk anybody thinking I’m recommending *The Rhythm Method.*”
There are 42 comments to this post.
Nicci P had this to say,
Jan 16, 2012 @ 10:53 am (Quote)
Why do so many docs and nurses have such a low opinion of FAM? Last year I went to talk to the nurse at my local docs about it. When I explained I didn’t want hormonal BC she assumed it was because I’m breastfeeding and started giving me a list of hormonal BC that is ok when breastfeeding. I asked about FAM and she had to actually go get a book to look it up. I appreciate that she could admit she didn’t know, but its strange that she knew nothing about it.
in the book, it said you can’t use FAM while breastfeeding (not sure how true that is as my nursling is 2.5 and my periods returned 19 months ago) and then she went back to talking about getting a coil fitted which I’d already said i didn’t want.
Is it just that they don’t get taught about it? Is it that they don’t get paid for it?
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Jennifer Reply:
January 16th, 2012 at 11:06 am (Quote)
I don’t know why they say you can’t use FAM while BFing. If your cycles haven’t returned you just track your CM and avoid sex/use a barrier method on days that have any type of fertile CM. There is a whole section in TCOYF on the special rules for LAM and also for tracking during any type of amenorrhea.
That said, for most doctors (until I switched to my most recent who actually had FAM as an option on their form) I do say I use condoms since that is what I use during my fertile times. It is just easier to avoid the lecture.
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Stephanie P Reply:
January 16th, 2012 at 11:22 am (Quote)
It’s notoriously more difficult to chart while breastfeeding, particularly if your cycle hasn’t returned. Difficult doesn’t mean impossible, however! I’m learning the Creighton Method while breastfeeding and although it’s confusing at times, all you really have to do is err on the side of caution.
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Ah, I see. So, it’s totally okay to falsify my medical records to protect your reputation. Got it. Hey, would you mind repeating that into this little tape recorder?
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Jespren Reply:
January 17th, 2012 at 6:14 am (Quote)
I’ve caught so many doctors falsifying, editorizing, omitting, etc on my and my children’s records I’ve gotten to the point that I wouldn’t/won’t believe someone’s medical records until the day *all* records are countersigned by the patient either day-of or within a reasonable amount of time.
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Here’s a solution. Discuss with the patient why you don’t like the FAM. If patient continues to want to use it, you can note “FAM, discussed failure risks and difficulties with patient who still elects to use it over my recommendation of XYZ” now you can tell the truth without the medical transcriptionist thinking that FAM is okay.
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Bonita Reply:
January 16th, 2012 at 1:01 pm (Quote)
Even this is offensive because it puts a HUGE red flag on the chart that the patient is in the habit of not listening to Drs and is now considered an uncooperative patient which can cause problems down the road.
Why can’t he just say “Patient opts to use FAM” rather than go into detail about what the patient refused and the ensueing battle the Dr put up?
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I think I’d follow up this visit with a certified letter to the practice stating that I wanted to make sure my records were complete and truthful, and that the doctor had initially refused to write the correct information on my chart. I would ask for a letter in response verifying that the information in my chart was correct.
Honestly, you’d think a doctor of all people would be more interested in learning new things, not less.
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Michelle had this to say,
Jan 16, 2012 @ 11:24 am (Quote)
Isn’t it illegal to knowingly falsify medical records?
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StaudtCJ Reply:
January 16th, 2012 at 3:55 pm (Quote)
Yes. It’s difficult to prosecute, but it’s considered fraud. If it leads to an adverse outcome, the penalties can be very severe, up to and including being prosecuted for manslaughter. A nurse recently went to jail for falsifying a medical record at a nursing home. The error was in the time she provided medication, and her patient died because the next dose was brought at the time indicated by the previous dose listed in the chart instead of the time it would have been based on actual medicine administration. I’ll have to see if I can find the news article again. I think it was in Pennsylvania.
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So you’re knowingly going to falsify my medical records because you actually don’t know the difference between FAM and the Rhythm Method? I’m sorry, what exactly am I paying you for?
…and the cynical part of me wonders if stuff like this is why it’s so incredibly hard to get your hands on your own charts…
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I plan on using Marquette after this next baby. It is very new in the NFP/FAM world and I doubt my OB has heard of it but unlike this boob I fully expect my OB to be curious and interested and he will probably ask me for literature because that is the way he rolls. “hey educate me!” not “let’s falsify records because I don’t understand something.”
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Ha! I read this one to my hubby (who is a doc) and he asked “what is fertility awareness method?”. But at least he didn’t scoff at it. In fact we used it both to avoid and to become pregnant, he just didn’t know the term. He is in the boat of “let’s review what the person knows about it and all other forms to make sure they have chosen what is the best fit for them” (based on their preferences though, not his! some people will discover there is something else they like better they didn’t know about) because there are more misinformed people than informed ones. However, if a woman knows how to do it and wants to he won’t think there is anything wrong with it! And it is funny that was the OBs first thought. I bet when she notes someone is a smoker/alcoholic/drug user, etc. she doesn’t expect anyone to think she endorses those.
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If a doctor is willing to falsify medical records just so that people don’t think he “supports” something, imagine how willing he is to falsify medical records to keep himself out of trouble. That’s downright scary.
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I had to look it up. I don’t understand how it is different than the rhythm method. I would love if someone could explain this to me. My husband and I use the withdrawal method, we are looked down on for it. But I can’t use the patch (my weight), The pill is too expensive, and honestly I don’t see the point. My hubby knows what he is doing. I like knowing that my period is coming on it’s own and not have something ‘make’ it come. Maybe this is just me.
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Teresa Reply:
January 16th, 2012 at 2:58 pm (Quote)
The rhythm method assumes that all women ovulate on cycle day 14 and the entire methodology is based around such. FAM is the art of becoming aware of your bodies natural cues that ovulation will/has occurred and combining them to avoid/achieve pregnancy. It recognizes that every woman’s cycle is unique to each individual, and unique even in different phases of her life. I highly suggest the book Taking Charge Of Your Fertility if you want to learn more on the topic =)
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adrienne Reply:
January 16th, 2012 at 4:14 pm (Quote)
I think the best way to put it is: rhythm guesses at when you might be fertile. FAM looks for actual signs from the body as to when you actually are fertile. both can be used to successfully avoid or achieve pregnancy by either abstaining or trying during the fertile time, but rhythm is wrong half the time about when that is.
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Bazile Reply:
January 16th, 2012 at 7:49 pm (Quote)
Check out http://www.fertilityfriend.com as well. It creates the charts for you, all you need is a basal body thermomenter which you can get for under $10. The standard version of the site is free, and they have a lot of educational information on there on FAM.
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Stephanie P Reply:
January 17th, 2012 at 6:29 am (Quote)
We use the Creighton method which is a kind of FAM. What you do is chart your cervical mucus and use it’s colour/consistency along with other physical symptoms to determine your fertility. If your goal is to avoid pregnancy, then you simply abstain for the few days of fertility, if you wish to achieve pregnancy you watch for that fertile mucus! It’s actually remarkably easy. I’m sure you could even google it.
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Why did the doctor even ask if she was going to write down something completely different anyway? Some people who use NFP are morally opposed to condoms. Writing that on such a person’s chart undermines the mother’s credibility at later appointments.
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jaed Reply:
January 16th, 2012 at 6:01 pm (Quote)
Not to mention that it could have medical consequences (for example, if the mother is allergic to the spermicide in the foam, allergic to latex, etc. and a provider doesn’t believe this because “see? on her records, it says condoms and foam!”). Imagine a provider blowing off a latex allergy because of this kind of disinformation in the records. (shudder)
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I had a similar convo with my OB at my annual when my LO was about 9 mo, she asked ‘which birth control pill I wanted’ I said I don’t want any, we are doing a natural family planning, if it worked for 4 years before baby 1 (and we consciously were trying #1 was on purpose) So, I’m pretty sure it will work for awhile until we decide to work in a baby #2.
she made a similar comment, ‘… so you are using condoms then… ‘ OK whatever gets you off my back lady
OBs seem like such a contradiction, we want to ‘sell’ you birth control, you cant just keep getting pregnant,
BUT we make more money on the people who are pregnant, prenatal apts and birth…
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What I want to know is, why are doctors down on the rhythm method when that’s what they use to guess conception and due date?
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Aron Reply:
January 18th, 2012 at 6:16 am (Quote)
That’s my thought, exactly! The almighty Wheel of Due-osity IS the rhythm method, pure and simple. And ridiculously inaccurate. I guess it comes back to the concept that when a doctor does it, it’s right and helpful; when a patient does it, it’s wrong and harmful.
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My doctor made fun of me for planning to use LAM and then FAM when my cycles came back. He said “well, I guess if you get pregnant…then we just…have another baby….see you soon”.
My second (planned just like my first) was born 2 and a half years later, at home with a midwife.
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It’s pretty sad when a doc doesn’t know that FAM and the rhythm method aren’t even remotely the same thing.
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