Working around the prenatal care mill
April 14, 2007 10:28 PM Subscribe
My wife needs some prenatal care and we're having trouble finding a doctor that isn't trying to soak us for thousands of dollars.
My wife is 14 weeks pregnant with our second child and is having a small amount of brown spotting that's been going on for 2 days, plus minor cramping. We have a home doppler device but to date we have been completely unable to find the heartbeat of this fetus. So yeah, we're concerned.
Basically all we want is a health care professional to check her with an ultrasound to diagnose how her pregnancy is coming along. We called all the doctors around here (Tyler, Texas region) and no matter who we call, it's all the same deal: $1500 to put us on a prenatal care program, plus $500 in cash (yes, one place said it had to be cash). And I get the impression it doesn't stop there -- when we mentioned her condition one of the practices said they "might have to send us to the hospital for a bunch of labs and ultrasounds", which gave me a poor impression and implied things could snowball into a massive medical bill (no, we don't have any generous health insurance). We've also been getting very bad vibes from some of the places, with some of them apparently run like mills.
In short, I'm looking for advice on how we can find a qualified doctor here (or in Dallas or Austin if needed, or San Antonio later this week) and not automatically put us on the money treadmill. I won't get into the aspects of why we don't want to be on that treadmill, but suffice it to say we used a midwife for our first child.
Also will Planned Parenthood help as far as this goes? My sister in law said they do ultrasounds, but I don't know under what conditions.
My wife is 14 weeks pregnant with our second child and is having a small amount of brown spotting that's been going on for 2 days, plus minor cramping. We have a home doppler device but to date we have been completely unable to find the heartbeat of this fetus. So yeah, we're concerned.
Basically all we want is a health care professional to check her with an ultrasound to diagnose how her pregnancy is coming along. We called all the doctors around here (Tyler, Texas region) and no matter who we call, it's all the same deal: $1500 to put us on a prenatal care program, plus $500 in cash (yes, one place said it had to be cash). And I get the impression it doesn't stop there -- when we mentioned her condition one of the practices said they "might have to send us to the hospital for a bunch of labs and ultrasounds", which gave me a poor impression and implied things could snowball into a massive medical bill (no, we don't have any generous health insurance). We've also been getting very bad vibes from some of the places, with some of them apparently run like mills.
In short, I'm looking for advice on how we can find a qualified doctor here (or in Dallas or Austin if needed, or San Antonio later this week) and not automatically put us on the money treadmill. I won't get into the aspects of why we don't want to be on that treadmill, but suffice it to say we used a midwife for our first child.
Also will Planned Parenthood help as far as this goes? My sister in law said they do ultrasounds, but I don't know under what conditions.
The website for Planned Parenthood of North Texas doesn't mention ultrasounds, but it couldn't hurt to call. The Tyler clinic's phone number is (903) 581-8277. If they don't do it, they might be able to help you find someone who does.
You say you "don't have any generous health insurance." Does that mean you have some insurance, but it's not generous? The state has a website to help you find health care options that might be useful.
If you get bad vibes from a doctor, you should avoid him/her, absolutely. Requiring payment in cash is bizarre, and you're right to see that as a red flag.
You can always go to the ER at your local hospital, too. Hospitals are required to treat people even if they don't have health insurance if it's an emergency. I don't know if this would qualify, but it might.
Best of luck!
posted by cerebus19 at 10:48 PM on April 14, 2007 [1 favorite]
You say you "don't have any generous health insurance." Does that mean you have some insurance, but it's not generous? The state has a website to help you find health care options that might be useful.
If you get bad vibes from a doctor, you should avoid him/her, absolutely. Requiring payment in cash is bizarre, and you're right to see that as a red flag.
You can always go to the ER at your local hospital, too. Hospitals are required to treat people even if they don't have health insurance if it's an emergency. I don't know if this would qualify, but it might.
Best of luck!
posted by cerebus19 at 10:48 PM on April 14, 2007 [1 favorite]
Requiring payment in cash is bizarre, and you're right to see that as a red flag.
Since the question suggests that anonymous wants to pay for the services out-of-pocket, not with insurance, I don't understand how the doctor requiring certain terms of payment is "a red flag."
A professional wanting to get paid for his/her services is not bizarre. Alternatives to cash often result in the doctor not getting paid.
posted by jayder at 11:05 PM on April 14, 2007
Since the question suggests that anonymous wants to pay for the services out-of-pocket, not with insurance, I don't understand how the doctor requiring certain terms of payment is "a red flag."
A professional wanting to get paid for his/her services is not bizarre. Alternatives to cash often result in the doctor not getting paid.
posted by jayder at 11:05 PM on April 14, 2007
Okay you know how republicans are about their fetuses. If your family (of two) makes less then $2,282 per month, you'll be eligable for the CHIP Perinatal Coverage. This covers up to 20 visits with the doctor.
posted by delmoi at 11:53 PM on April 14, 2007
posted by delmoi at 11:53 PM on April 14, 2007
Can you find a midwife who has a doctor friend she works with?
posted by konolia at 5:34 AM on April 15, 2007
posted by konolia at 5:34 AM on April 15, 2007
fwiw, it is unlikely that these doctors are trying to "hose" you. obstetricians have to pay such high malpractice insurance that they are as motivated as possible to make sure they satisfy you with their care.
that said, sometimes you just need a doctor. pregnancy is natural, but it's not always safe. until the beginning of this century, childbirth was the number one cause of death for women and children. see a doctor. get the tests. if everything's fine, switch back to a midwife. if not, well, then you may have to make some concessions.
posted by thinkingwoman at 6:18 AM on April 15, 2007
that said, sometimes you just need a doctor. pregnancy is natural, but it's not always safe. until the beginning of this century, childbirth was the number one cause of death for women and children. see a doctor. get the tests. if everything's fine, switch back to a midwife. if not, well, then you may have to make some concessions.
posted by thinkingwoman at 6:18 AM on April 15, 2007
beginning of the 20th century, i meant.
posted by thinkingwoman at 6:19 AM on April 15, 2007
posted by thinkingwoman at 6:19 AM on April 15, 2007
If she's cramping and spotting, and you can't find a heartbeat, I would quit fooling around with the OB shopping and go directly to an ER. They WILL work with you. They WILL work out a payment plan. If she's miscarrying, she'll end up at the ER anyway, and if she's not, they WON'T insist on continuing care.
This is not the first time you'll go into debt for your kids. Just go into it knowing that you can ask for an itemized bill, you can ask for a discount when you get the bill, and they will work out a payment plan for you.
posted by headspace at 7:18 AM on April 15, 2007 [1 favorite]
This is not the first time you'll go into debt for your kids. Just go into it knowing that you can ask for an itemized bill, you can ask for a discount when you get the bill, and they will work out a payment plan for you.
posted by headspace at 7:18 AM on April 15, 2007 [1 favorite]
Can you just go to an emergency room? When my wife had some spotting early on, our OB sent us to a nearby emergency room for an ultrasound.
posted by alms at 7:44 AM on April 15, 2007
posted by alms at 7:44 AM on April 15, 2007
Spotting + can't find baby's heartbeat == get thee to the ER NOW and stop screwing around on the internet.
posted by ilsa at 10:15 AM on April 15, 2007
posted by ilsa at 10:15 AM on April 15, 2007
Yes, Planned Parenthood does do prenatal care. If you want to verify the health of the pregnancy without the massive costs of uninsured medical care, that would be the route to go. There will still be costs, but they are typically done on a sliding scale.
And FYeverybody'sI, not all miscarriages necessitate a trip to the ER. And not all spotting means anything is wrong. And on the flip side, not all childbirth can be "natural" without extremely high costs, financial or otherwise.
posted by e to the pi i at 10:35 AM on April 15, 2007
And FYeverybody'sI, not all miscarriages necessitate a trip to the ER. And not all spotting means anything is wrong. And on the flip side, not all childbirth can be "natural" without extremely high costs, financial or otherwise.
posted by e to the pi i at 10:35 AM on April 15, 2007
The Association of Texas Midwives
A midwife will have you in for an office visit and may be able to find the heartbeat with a handheld doppler (but we aware that often the handheld units are not powerful enough to pick up a heartbeat in early pregnancy). She should also be able to refer to to a local ultrasound tech if possible.
Or, certainly, visiting an ER or other urgent care center may be an option.
While I agree with you that a lot of the prenatal care that is offered to women these days is basically lawsuit avoidance, some of it does genuinely save lives. Please do get at least a minimum of prenatal care.
Best of luck to you and your wife.
posted by anastasiav at 10:47 AM on April 15, 2007
A midwife will have you in for an office visit and may be able to find the heartbeat with a handheld doppler (but we aware that often the handheld units are not powerful enough to pick up a heartbeat in early pregnancy). She should also be able to refer to to a local ultrasound tech if possible.
Or, certainly, visiting an ER or other urgent care center may be an option.
While I agree with you that a lot of the prenatal care that is offered to women these days is basically lawsuit avoidance, some of it does genuinely save lives. Please do get at least a minimum of prenatal care.
Best of luck to you and your wife.
posted by anastasiav at 10:47 AM on April 15, 2007
My wife had trouble finding our baby's heartbeat with her doppler device throughout the entire pregnancy. The fact that a lay person (non-medical) couldn't find it doesn't strike me as the least bit bizarre. Still, get to a darn doctor and bluntly, $1500 seems like chump change compared to the value of your wife and/or child's life.
posted by Octoparrot at 1:36 PM on April 15, 2007
posted by Octoparrot at 1:36 PM on April 15, 2007
The really worrisome spotting is the red (fresh) kind.
Assuming you two are not planning an unassisted childbirth, I would call your local midwife. An ultrasound may not be required if she can find a heart beat and is statisfied with your wife's bloodpressure and possibly urine.
If there is a threat of miscarriage, there is usually not much that can be done to alleviate it at 14 weeks, except lots of fluids and bed rest, but the health of your wife should be the priority here, and I really recommend you get to a healtcare practitioner, starting with your local midwife.
posted by DarlingBri at 4:53 PM on April 15, 2007
Assuming you two are not planning an unassisted childbirth, I would call your local midwife. An ultrasound may not be required if she can find a heart beat and is statisfied with your wife's bloodpressure and possibly urine.
If there is a threat of miscarriage, there is usually not much that can be done to alleviate it at 14 weeks, except lots of fluids and bed rest, but the health of your wife should be the priority here, and I really recommend you get to a healtcare practitioner, starting with your local midwife.
posted by DarlingBri at 4:53 PM on April 15, 2007
This thread is closed to new comments.
posted by acoutu at 10:46 PM on April 14, 2007