30 answers

"My Ob Doctor and I Disagree"

I am a mother of two and expecting my third child. I have a new Ob doctor and because of insurance purposes, I cannot change doctors. I am 13 weeks preg. and he is pushing me to get tested for the "down syndrome" test. I didn't do that test with my other children and to me, it doesn't matter if it is positive or negative, we will be blessed with whatever God gives us. Also, he has already tested me for Group B strep and it was positve. I thought I shouldn't be tested until late in pregnancy and then receive antibiotics during labor. He wants me to go ahead and take antibiotics now and during labor if I test positive later. I don't see the point in taking antibiotics now and later. My questions are, does anyone know how accurate the down syndrome test is and has anyone been tested for group b strep this early in pregnancy? I need advice.
Thanks,
R.

What can I do next?

So What Happened?™

Hello everyone! I just wanted to thank you all for your advice and support. This was my very first time using mamasource and I am well pleased. I have not seen my doctor since all of this came about, but I do have an appointment next week. I wanted to explain to you all about my situation with the insurance so you will understand or have more advice for me. My husband has just switched jobs and we do not have a private insurance now, so we applied for help and qualified. I live in Brunswick County, NC and I was given a list of practices that take medicaid. There were only 4 in my area listed. The first one I called was booked for Dec./Jan. deliveries, the second one I called was the hospital in New Hanover and they could not get me my first appointment until July 25, (I'm half way through my pregnancy Aug. 15), so I called this one I am using right now because the other choice was the health department. I feel stuck. This doctor is also the only doctor in the practice, so he will deliver my child if I can't find any other solution. I am also only 33 so I don't think age is a factor. I was asked to take the triple screen with both of my other children and I said no and my private doctor said fine and dropped it. The doctor who delivered my other two children no longer does ob, so I can't even ask her. Anyway, my decision is the same. I will not get the triple screen. I have not been stressed or worried during this pregnancy until I went to this doctor. I also never took the antibiotics that he prescribed for me. If I test positive for group b later on, I will receive antibiotics during labor just like I did with my last child. My conviction with this doctor is that he is taking medicaid, which is established to help women have adequate prenatel care. And I am thankful that we are receiving financial help at this time in our life because we could not afford to go to the doctor for regular check-ups if we did not have any help at all. However, I am 33 and already have 2 children. I just feel like their probably are a lot of young women or girls who qualify for medicaid and have doctors that just tell them to take every test available so the doctors can make a little more money. Can you imagine a 16 year old pregnant for the first time? It bothers me because now I don't know what his true motive is. Is it to pocket a little extra money from medicaid or does he have mine and my baby's best interest at hand? I did have a friend call her doctor who delivered 5 of her 6 children and ask his opinion. This doctor is well established, but no longer does ob either. He said, the triple screen is really for women who are at risk and really just opt not to keep the child. Most ultra sounds will show any major problems the baby might have. Also, he said there is no point in taking antibiotics this early for group b because it is not harmful to me or the baby at this time. Plus, I could test positive again later and will still have to take antibiotics during labor, plus taking antibiotics when not neccessary can deplete my immune system and is not advised. So, thank you all because my husband and I feel so much better and confident about our decisions. Thanks again and I will ask for more advice in the future if I need it.
Sincerely,
R.

Featured Answers

Hi,
I had the down syndrome test but I never felt forced. Also, I did not do anything but blood work and the ultra sound, no invasive testing. Also, I tested positive for Group B Strep and it was no big deal....I got antibiotics in the hospital. You need to have it 3 times I think before they will let you have the baby. I really can't remember the intervals, but maybe 30 minutes apart or something for the antibiotics. I hate that you can't change doctors, I changed in my 7th month because I was so unhappy. It was my 1st child though and I was lost!

FYI, it was highly likely I was going to have a downs syndrome child after testing....1 in 58. My boy is fine but I waited till he was born to find out!

Good luck!

More Answers

R.,
I agree with the other women on the Downs test. I have heard of many cases of a false positive. Not sure on the exact research, but I bet you could look it up online. You know that the result would not change your mind, so why do an invasive test? I found on my second pregancy that the doctors who were younger than me often tried to push their opinions on me especially during labor. KEEP STANDING YOUR GROUND! Actually, I had a nurse who got huffy with the doctor and helped me stand my ground. You sound like the strong type, not afraid to stand up for yourself. Definitely, if there is another doctor in the practice, give that a try and call your insurance company. You may try asking him why he is so adament about the test. Then, let him know why you have made your decision. Tell him you respect his opinion, but you and your husband have made your decision. Maybe the united front will help too! If all else fails, and you can't change doctors, write a birthing plan with your husband and present it to the doctor before delivery. Ask that he read and sign it. (You can look this up online too.) It really helped me have more of the delivery I wanted and not what the doctors wanted. Talk to hubbie ahead of time too so he can advocate for you as well. Keep standing your ground. It's worth it in the end.
Congrats on your pregnancy and best of luck.
P.

1 mom found this helpful

R.,
I agree with everyone else. The NT test (the downs test) is NOT 100% Reliable! And insurances are JUST now picking it up as a regular first trimester screening test. I chose to do it only to see my little baby and to prepare myself IF indeed I did have a downs baby or any other Trisomy baby. I am just a person who likes information. But I definately did my research going into it and knew the false positives on this test were high. It was just nice to hear the #'s of my "risks" of downs and Trisomy 13 & 21. If you don't want the test, they can't "FORCE" you to have it. I don't know your age, but usually before it's not offered till you're of AMA (advanced maternal age ~ over 35). Since the board passed the law, it's allowed by all 1st timester women now. But of course, all tests are "OPTIONAL".

Regarding the GBS test, I'm surprised it was given so early! We all have the bacteria sometimes, and it's ONLY important to treat during labor for your infant's sake. But still that only has like a rate of 4% of your baby contracting that during labor.

I hope that you stand your ground, and Please find a new OB! I'm sure that there IS someone who can take you! Having an OB that you don't like and disagree with is definately a stress on the pregnancy as you're more than likely to skip pre-natal care.

Hugs!
B.

P.S. I was reading the link that one of the responders posted below... Here's some that apply to you:

Every woman has the right to receive all or most of her maternity care from a single caregiver or a small group of caregivers, with whom she can establish a relationship. Every woman has the right to leave her maternity caregiver and select another if she becomes dissatisfied with her care.* (Only second sentence is a legal right.)

Every woman has the right to accept or refuse procedures, drugs, tests and treatments, and to have her choices honored. She has the right to change her mind.* (Please note that this established legal right has been challenged in a number of recent cases.)

http://www.childbirthconnection.org/article.asp?ck=10084
is the exact link.

1 mom found this helpful

I'm going to say this in the nicest way I can- your doctor sounds like an idiot. Where did he get his degree- Playskool? The DS test is a personal preference, and comes down to whether you want to know or not. It's not like if it comes up positive, the baby can be treated in utero, so what difference does it make? And I agree with everyone else about the Strep B- having it does not effect you or your baby, so there's no point in treating it. It only becomes an issue when the baby is born vaginally, that's why it is treated during labor.

Good luck, and I'm sorry about your situation.

1 mom found this helpful

Hi R.,

I would like to suggest that you check out www.childbirthconnection.org. It's a great resource. On the column on the left click on "The Rights of Childbearing Women"

Are you absolutely positive that you can not switch practices because of your insurance? Because most of the time there are choices. Is there more than one doctor in the practice? Perhaps you could switch to another doctor within the practice.

This is very early for GBS testing. Also research has shown that antibiotics during pregnancy have little to no effect.

Try to remember that you are the consumer and the doctor works for you. You do not have to do anything that he suggests. However you need to do your research and have good reasons for not doing them.

You are welcome to email me privately ____@____.com or to call me ###-###-####. I'm in Greenville, SC.

S.

1 mom found this helpful

I agree with you. I did not have the AFP test done with any of my four pregnancies. I believe that I was told that there is a 20% false positive result. Then you have to go through more testing if you get a positive result. I didn't see the point in having the test done and possibly finding out something was wrong and worrying my entire pregnancy. Just because your doctor has a degree doesn't mean you have to do what he says if you don't feel it is the right thing to do. Have you talked with your insurance company to find out if you have any options for changing to a different doctor? Good Luck!

Are you talking about the triple screen? There are many false positives with that. I'm not sure of the exact rate.

I was under the impression that GBS was tested around 35 weeks. Can't it recur before you deliver?

Have you asked why he wants to do the things he's doing? Is there no one else in your network? What about midwives?

If there is any test that you don't want to take, you have the right to refuse. The doctor can't make you do anything. Just stand firm and don't let anyone bully you.

I'm confused as to why you cannot switch doctors. I don't think there's any insurance that can legally keep you with a doctor not of your choice. You should be able to find another network doctor through any insurance. Also, I don't think anyone other than doctors can give you a correct answer on how accurate the down syndrome test is. I don't want to come off impolite. That is not my intention. I just think if your doctor saw a reason to test for the group b strep this early, than it should be fine. Obviously he/she was right in their assumptions, because you tested positive. Shouldn't you want to be treated to insure the safety of yourself and child? Also, I think you should reconsider the down syndrome test. Medically, it may be better to know. And after two children, things are always different in pregnancies and delivery. So I'm sure that has to do with why you're being tested earlier. Maybe the likelihood of being positive is increased with each pregnancy. Again, I don't mean to be impolite, I just think these are some things to consider. As you know, as mothers, it is our duty to insure the safety of our children. Hope this is helpful.

Sincerely,

A. Candelaria

Down Syndrome, forget the test if it doesn't matter to you one way or the other.. The Strep B. I had it with my first child. The antibiotics are for your protection and for the baby's development protection, as for giving you some durning labor, it's to protect the babies eye's because it can cause blindness in some cases.. My child is a Marine Brat and was born at the Navel hospital and so my doctor's didn't want to run test just because they get more money. They gave me a list of test I could have done and let me make the choice. My midwife did say the strep B test was one I should think about if either I or my husband had ever had other sexual partners in time in our lives because you can carry it around with you and never know it tell your tested. I even had them do another strep B test with my second child, came back clean. Any blood work offered to me, I must admit I did. As for sticking needles and all that kind of stuff into my bellie or child no way... I loved each of my girls long before I saw there faces...

I've never heard of the group B srep test being performed so early and would be hesitant to take more antibiotics than necessary (both early and late in pregnancy). Regarding the Downs Syndrome testing, it basically takes the standard statistics of risk based on your age and tweaks them after doing a blood test. I am 36 and pregnant with my fourth and we did the test simply to be informed. Then if there was a neural tube defect there was the possibility of performing surgery in utero to repair it. My test results came out just fine and my risks of things like down syndrome went from 1 in 250 (based on my age of 36) to something crazy like 1 in 2,000. So it really made it clear that the chance for Down Syndrome (and various other possible birth defects) went way down. So we can pretty much assume this baby is healthy. That being said, had my risks increased they would have recommended an amniocentesis or ultrasound at which point we would ONLY consider ultrasound due to the risk of miscarriage from the amnio. And, like you, we are going to love whoever God gives us. We would have just had some time to study up on the birth defect our child would have possibly had. Hope that helps you make a decision!

We have five children (four pregnancies- set of twins) and I never got tested. Our first son, my OB asked and I said No and he was alright with that. The next two pregnancies (one baby & twins)were with a wonderful OB who had six children of his own! He offered the test but said it usually comes back as a false positive. Meaning women who got it back positive usually proved negative and he had three women who got negative but the baby came with the down syndrome. It didn't matter to my husband and myself how the baby was so we opted not too. Our last baby we had in a different state so a different OB and when offered the test we said No, they made me sign a paper stating I had refused so they wouldn't be held liable in any way! Stand your ground and explain to the OB you will not discuss the issue further that the test is not happening and that you need to move on in this pregnancy without pressure from him. I wish you the best and Congratulations on the new baby!

If you don't want to know, then you don't want to know. He cannot force you to get tested. The results are always 1 out of something. So it is never positive or negative. I agree with your thinking, and that you don't care what the results are. You may want to share with him that you don't want the stress of worrying the rest of your pregnancy given what the results maybe. Regarding the antibiotics that is something I have never heard of. I thought the only chance of transmitting it to your child was during delivery, so why take any risks with an unnecessary antibiotic now. Do some research on the web about strep B and be educated the next time you go in. In addition, as a last resort he cannot force you to take the antibiotic, just like he cannot force you to take the test. Good Luck!!

I would do some research on the Strep B-I think that it can come and go during pregnancy, but it is only a worry in the end. I don't see why he would have tested you now for that. I would check on that one. I am not a medical person at all-but I remember talking about it with my ob. The other test for downs is totally up to you. I am the same as you and would love the baby no matter what-so the test would not change anything, then what is the sense in taking it.
Good luck!

I am 42 years old with a 7 1/2 month old daughter and a 3 1/2 year old son. I opted not to have any invasive testing done during either of my pregnancies (amniocentisis). It didn't matter to us either what the results were so there was no reason to take the risk of miscarriage. There is a non invasive test call nuchal translucent testing that can give you a very good indication if down syndrome is present, however, your window of opportunity to take this test is almost over. The test is performed anywhere from 10 - 14 weeks of pregnancy. That may vary slightly by doctor.

Don't let any doctor talk you into testing that you are not comfortable with. I was pressured too by doctors (we were seen by maternal fetal medicine, the high risk specialists, because of my age). Testing for down syndrome is absolutely not necessary if you are not willing to terminate your pregnancy. Stand your ground and feel proud of yourself for doing so!!

I'm not sure about the Strep B situation. I thought you only took antibiotics at the end of the pregnancy for this as well. I would definitely get a second opinion before taking any unnecessary drugs. I'm sure a phone call to another obstetrician's office will give you the answer.

Best of Luck !

L. Y.

i dont know much about your situation but i just wanted to offer my support and say to hang in there! Trust your instincts! and if there is anyway you can change I WOULD!! most insurance including medicaid wouldnt be opposed to you changeing, your doctor might have just told you that so he wouldnt lose you, i changed half way through! good luck:)

the triple screen is not reliable. it has many false readings. i am a former spec. ed teacher and have a sister and nephew with downs. my mom didn't have the option 25 years ago, my sister in law had the triple screen 6 years ago and it said my nephew didn't have DS. Ihave heard of many cases like this. i would do some online research for statistics and stand with your beliefs. No one can make you do something you don't want to. best of luck.
melisa j

Don't get the tests done. They are invasive and can cause birth defects and even miscarriage. If he wants to test for Down Syndrome, you can have a detailed ultra sound done - at least that is not invasive. I wish for you that you could change doctors, but maybe you can give him a little "education" and help out some other mom! God bless you.

First of all, congrats on the pregnancy!!

Stand your ground! You don't have to do the triple screen if you don't want too even if anything that it tests for run on your side or your hubby's side of the family. The rate of false positives is so high with that test that I think it does more harm than good! A friend of mine did it only because Downs runs in her family. Her test was so high for Downs that they were positive her baby would have it (we're talking an 8 out of 10 chance). Well, her baby boy is completely normal even for being 6 weeks premature!! I didn't do it with either of mine because like you, it wouldn't make a difference; there was plenty of love to go around! When I was prego with my son, my DR's wife was 3 months further along than me and they didn't even get it done!

I can't give any advice on the GSB cause I've never tested positive. But if you and your DR keep butting heads then I would talk to your insurance company and see what can be done. Especially if the other ladies are right about the Strep B testing, sounds like he is trying to stick it to your insurance for unnecessary stuff!

S.

If you do not want to have the test, do not have it. We had the test and it was a false positive. I have heard that the false positives can be as high as 50%. It was very hard and took a toll on our family. We knew that we would keep our daughter regardless of the test, but it was a difficult situation. We will never again have the test done. Good Luck with your pregnancy!

R.,
My niece was suppose to have down syndrome but she is a perfect healty little girl who walks and talks better than my 19 month old son and she just turned 1 so in my words i'd say no the test are not accurate

R.
That stinks that you can't change doctors. I didn't want the AFP test done with my 1st for the same reasons as you but my DH wanted me to get it so I agreed. But I said that whatever the results, I wasn't doing the amnio. He agreed to that. I have had friends get false results from it, I didn't tho with any of my 3 pregnancies.
I was Positive for Group B for my 1st and 3rd pregnancies. The 3rd I tested really early, it showed in one of my blood work or urine sample-I don't remember. But I knew before I was 16 wks PG. I was told taking the antibiotics early in the pregnancy was pointless because it would come back and I'd still need it before I delivered anyway so might as well wait. Would you be taking the antibiotics for the rest of your pregnancy? That would be alot to take! I know you need to get 2 full bags of antibiotics when you deliver, and I was told at least one full bag should be in you before you deliver. I had one trip to the hossy when I got 1 bag of the antibiotics but then I got sent home. My next trip, 2 days later, I got both bags. Each bag takes, if I remember correctly, 4 hours to drip in. So unless you have delivered your past babies super fast and this one will come quickly, you should have enough time to get the meds. With my first, I delivered him 5 1/2 hrs after I was admitted, and he was fine with however much I got in that time. I have heard before of maybe 1 person that got oral antibiotics while PG for Group B. Maybe it is a personal preference of your dr? IDK what else to tell you other than what I was told. Maybe you can find some info on the web and talk to him about it. Is there no other dr or midwife in the office that you can see for your check ups, and just let him show up at "showtime"??
I wish you alot of luck!
K.

I have known people to have the down's test and the results were NOT accurate. I am sure that plenty of times it is, but I agree with you, you are going to have the baby no matter what. What's the use of worrying yourself, possibly, unnecessarily, during your pregnancy? Have a happy pregnancy and leave the rest to God. BTW, Down's kids are some of the most wonderful children on this earth - they are loving, forgiving, faithful - - unlike our other kids who talk back and think they know more than we do sometimes!

Sorry, I do not have any experience with the strep antibiotics.

Your doctor should NOT pressure you into any tests you do not want. He should tell you about different tests and why you may or may not want them, but you should choose what tests to have. So many people have the test for Downs and other chromosonal abnormalities come back "positive," which usually just means your risk, although still small, is greater than the median. That causes a lot of stress, usually for no reason because the baby is fine. If you don't feel you need to rule out Downs, you do not need the test. With 2 kids already, you know what is right and wrong for you. Stick by your guns and don't take any tests you don't want.

Hi,
I had the down syndrome test but I never felt forced. Also, I did not do anything but blood work and the ultra sound, no invasive testing. Also, I tested positive for Group B Strep and it was no big deal....I got antibiotics in the hospital. You need to have it 3 times I think before they will let you have the baby. I really can't remember the intervals, but maybe 30 minutes apart or something for the antibiotics. I hate that you can't change doctors, I changed in my 7th month because I was so unhappy. It was my 1st child though and I was lost!

FYI, it was highly likely I was going to have a downs syndrome child after testing....1 in 58. My boy is fine but I waited till he was born to find out!

Good luck!

On the Group B-it is done late in pregnancy, and the antibiotic is only given during labor because it only works during labor because the bacteria grow so fast that if treated earlier the GBS might grow back before labor, so it is useless for it to be treated all through your pregnancy. Also, it is most useful to test for GBS between 35-37 weeks of pregnancy. I was GBS positive with my 2nd so I read alot about it, and my OB explained it to me. I had the IV antibiotic during labor, but I went so fast I wasn't able to get all of it-ha, and I was tested at 37 weeks. The above came from the book he gave me called "Your Pregnancy and Birth 4th Ed" The American College of Obstetricians and Gynecologist. The ISBN is 0-696-22591-3 if you wanted to order or purchase it from a book store.

I sure wish there was some way you could change Drs-can you maybe go to another Dr and explain your situation and let him I think they call it "grandfather" your insurance company into covering your medical expenses with him. I had a medical Dr do that for me one time, and I think a Dr's order's can over ride some insurance policies and still pay for your expenses, especially if you are not getting qualified healthcare.

I didn't do the screenings either because it didn't matter I was keeping my baby regardless of what the results were-just a way to make money if you ask me, and for some on the other hand it can be a anxiety reliever ect, a matter of preference.

Best wishes,
Amanda

Oh-Yeah I would CONTINUE to DISAGREE! and you stand your ground honey!

I would stand your gound on the Down syndrome. I did not test any of my three children because I felt the same way you did. Also, the group B test result only counts after 36 weeks, and I was positive with 2 of my pregnancies, and they simply gave me antibiotics in my IV before delivery. I am not sure where your doctor studied, but I would stand firm on how you believe. Good Luck!!!

I am not sure how accurate the "Down's Syndrome" test is. I know that it just shows if you have the likelihood of having a child with genetic problems. I am like you and never had the test done as it didn't matter what the results were, we were still having the baby. He cannot force you to have the test if you don't want to.

As for the antibiotics, there is no need to take them now. They are only for when you deliver..if vaginally...so that the baby isn't infected. I tested positive with my 1st one and wasn't given them until I was induced. I didn't have to take them for my 2nd one because I was having a scheduled c-section.

Good luck with your Ob and with your pregnancy.

Lots of good advice so far! Definitely check again about changing drs and don't let them bully you around. About the GBS, I am guessing that the GBS showed up in your *URINE screen* since you are so early in your pregnancy. The actual GBS culture is a little different...they take swabs from your vagina and rectum and culture them around 36 or 37 weeks.

I see midwives, and my urine was also GBS pos at my first prenatal appt with this (third) pregnancy. (I was GBS pos at 36 weeks with my first baby and received ampicillin during labor.) They did *not* treat me with any antibiotics at this time as I am not symptomatic, but said b/c of my history of GBS positive they will give me antibiotics during labor with this child as well.

I will say that I had a friend who saw an OB, and her urine screen was positive for GBS at her first prenatal appt. Her OB DID prescribe a course of antibiotics for right away, as well as saying she will have to have the amp during labor.

I tested positive for Group B Strep before my 12th week, can't remember exactly when, and from the research I did you don't need to get the antibiotics so far before delivery. I know I was tested early b/c I got 2 UTIs in early pregnancy. It won't do any good. You get the antibiotics when you're in labor as a general rule.

From the cdc website. You might want to print this out and show it to your doctor.

http://www.cdc.gov/groupbstrep/general/gen_public_faq.htm

As far as the Downs test. That's your call. Pressuring you to take a useless test, I say it's useless b/c you said you don't care about the result, is just not right. Stand your ground.

If you don't want to take the test, DON'T. My doctors ran over me during my pregnancy and didn't inform me about what tests were for or my option not to do them. You are obviously an informed mom and you know your choices. Do what your comfortable with.

I am suprised he tested you so early for the Strep B. Did you have trouble last time? I never got to do the test my daughter came 5 weeks early. But I thought the norm was to do the test 1 month before your due date. I wish you had a different Dr to ask for a second opinion, so you aren't taking uneccesary drugs during the pregnancy. Is there another Dr in that practice you can ask?
Congratulations!!!!
Steph

Congratulations!!!
Trust your instincts! If you don't want the test don't do it. Also, if Dr is worried about this pregnancy due to age, has he sent you to a geneticist who can better provide facts/figures on the different risks.
As you get older (magic number being like 37 yrs old when child is born), DR's get more worried about the age group risk factors. I qualified for "you really need to have the test" and are in "the high risk group for pregnancy"(that age thing). Truth is, "really need" is not a MUST DO. I decided the risks of the test far-outweighed the gains. Since my DD is a "miracle child" to start with, I felt I couldn't risk some test interferring. By the way, via the sonagrams & the fancier 3-D imaging Dr's can tell a whole lot about about the development.
Question the Dr. If you want, ask him to write down the tests & why needed so you "can discuss w/ husband without "hormone's interferring w/ decision making." If you think doc's trying to line pockets, then take the matter up w/ the insurance company. They DON'T want to pay any extra money out & could become an ally for why to change. The trick is having some sort of proof. The Group B test I definitely had at the end of the pregnancy --& if I recall correctly, the reason for at the end was because of complications while in labor. You could contact a hot-line to "fish" for answers on when it is given & purpose. (I don't know where you are, but MUSC (Medical University of South Carolina) in Charleston, SC has such a hotline website manned by nurses who assisted w/ answering questions but do Not diagnos. That might be a great avenue for you since that hospital is in the top 10 list for pediatrics. In fact, you might also ask what impact the antibiotics may have on your baby. No need for you to be a guinea pig.
Good luck & let us know how things work out!

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