Your professional Opinions needed, Would you suggest changing Dr's late in pregancy?

[can'twait2B1]

Sorry, this post may be long. Thanks in advance for your advice.

I am a nursing student, I am also expecting my 4th baby. I was on the pill when I became pregnant. LMP was 3/26/03, due date orginally set for 12/31, Ultrasound done at between 16-17 weeks LMP, u/s set Due date for 1/24/04, Had a bleeding episode and a previa scare at 21 weeks, ultrasound done, due date estimated 1/26. Never confirmed or denied presence of previa to me at u/s, I asked dr at follow up appt. she said oh its moved .Measurements of fundal height have consistantly been 3.5 sonometers ahead of time (coniciding with orginal due date)

Appt yesterday, dr requested another u/s to guessitmate fetal age, cannot get scheduled until after Christmas. Also found protein and glucose in my urine, I measure 37 wks 2 days, according to u/s dating I should have been 33 wks 4 days, Dr says its "probably" just a big baby and I shouldn't worry, but if I have any contractions or signs of preeclampsia (had this with my first pregnancy) that I should go to L&D, and since they can't schedule me until after Christmas for the u/s don't worry about it its "probably"okay and my due date for 1/24 is "probably" correct. I transfer from this clinic to the hospital in two weeks, I have not been checked for dialation since my bleeding scare at 21 weeks, I have had some mucus discharge and some sharp stabbing pains in my crotch area as well as lots of braxton hicks. She also said my baby is probably in the 8lb range now and will probably weigh about 10 lbs at birth (my last son weighed this and it was agonizing) Can they not induce me earlier to prevent another near cesarean section and episitomy from hell?

WHAT?

I don't know if I have previa or not or when to expect this child? Is it too late in the game to find another provider? Shouldn't they be a little more confident than this? Is there anything they can do to better "date" this pregancy? I am worried not knowing if I am close to full term or not and if I go into labor soon I will be terrified that my baby is premature and that I may have a bleed out or abruption with my placenta. What would you do?

[dragonfly954]

The best thing you can do for you and your baby is relax.A lot of anxiety isn't good for either of you.Have you tried talking to the nurse in the office about your concerns?

[can'twait2B1]

Originally posted by dragonfly954

The best thing you can do for you and your baby is relax.A lot of anxiety isn't good for either of you.Have you tried talking to the nurse in the office about your concerns?

I have called back and spoke to a nurse but all she said was whatever the dr said is correct. Actually this doctor is a NP I don't have a problem with that I just wish they could be a little more accurate b/c even though this is not as dangerous as the little kids with the flu it is extremely important to me. I have been going to this government ran clinic and hospital and they are so swamped with flu cases right now that thier prenatals aren't a big concern. Once I go to the hospital it should be different, its still just so far away. I have insurance and can go to another ob/gyn but I hate to at this point in my pregnancy.

[CRZ]

Let's take a step back and think clearly about your situation. First of all you pay a provider for their expertise and to provide care for you and your baby. Write down all your questions and next time you go to the doctor, ask the nurse for answers. Do not leave until you feel all questions have been answered to your satisfaction. If you cannot get answers then perhaps you do need to try another provider. I do agree that you need to relax a little and trust your body. The baby will come when it is ready. Do not ask for an induction of labor. You will be in a hospital and they are there to provide safe care for you. If there is a previa or an abruption or a large for gestation baby or a preterm baby they will know what to do. I doubt very much there is a previa. Any doctor that saw a previa on ultrasound would be talking to you about a scheduled c/s. You may be a little too emotional right now to deal with this so find some one to support you and go with you to the doctor's office next time. Good luck.

[hrrizen]

When I was pregnant 24 weeks, I went to the doctor and told him I wasnt feeling well, (previous pregnancy eclampsia delivered baby 35 weeks ) having same symptoms as before. dr tells me he doesnt think so because eclampsia doesnt present before 28 weeks. long story short i followed my instincts went to another doc w/i 2 weeks i was admitted into the hospital with htn preg induced 3 weeks later(still in hospital) had to be induced . my pressure was through the roof. Good thing I followed my gut instead of dealing w this crazy doc. anyway i say that to say go with your gut feeling.... if you arent satisfied and dont feel comfortable do what is best for you... Good luck

[Dayray, RN]

My opinion differs from the other posters, I don't think you are wrong to be concerned. At the same time (as I am sure you know) it's important to keep a handle on anxiety. I think the best way for you to do this is too get solid answers.

1st early ultrasound is the best way to date a baby (I cant remember the optimum time but its before 20 weeks) LMP dates can and are often off by quite a bit. So I would go with the 1/24 - 1/26 dates. The fact that your belly is measuring out higher then this isn't a good dating tool especially if you have an hx of big babies.

2nd the previa ? I really sympathize with you here. It is likely that when you have the U/S no previa was seen. However, I am disgusted that this was never communicated to you. You as the patient have a right to be told that you absolutely do or do not have a previa at this time. The fact that you haven't been told leaves 2 possibilities

A. your care provider is satisfied that you don't have a previa but doesn't feel the need to communicate this with you. Expecting you to be comforted by "don't worry its ok" isn't enough. This is wrong and is totally against the way an NP should act

B. is even worse and would be malpractice imo- they don't know weather or not you have a previa but assume the stenographer would have told them if a previa was seen on the U/S.

Whichever is true you have a right to know and put ease to your mind, you are not wrong to be angry about this and it is hard not to worry when information about your body and your baby are not shared with you.

I can offer a little encouragement (but please don't take my word for it). One bleeding episode doesn't mean previa, also the pains and discharge you have described sound normal based on what you have written here. If you do go into labor early it doesnt mean that you will deliver early. We have tons of patients that go into labor, we stop it, they go home then come back the next week, we stop it, they go home.... if you do deliver early there is nothing you could have done to stop it and you will get threw it.

My advise. Make an appointment with your provider. Calmly explain to them that you don't understand what happened with the previa and that you never received an answer. You can be nice but press them until they give you a solid answer. Don't accept vague promises of everything being ok. If they aren't sure it can be solved with a simple office U/S it doesn't have to be a formal U/S. I would make them get you in this week as it is very important you have this answered.

Don't let them make you feel like you are unreasonable because you are defiantly not unreasonable. Its your body you need to know whats going on. If this is not answered to your satisfaction, go elsewhere.

As for the early induction, its too early now but it wouldn't be a bad idea later as long as your cervix is favorable. I will caution you that attempts to induce unsoftened/undialated cervixes are very often gruling and diffacult. Discuss this with your provider.

Also you say you are seeing an NP? is it an NP or a CNM? I know it differers but in my area NP's get only very basic education on prenatal care. Only you can decide if you need to change providers.

please let us know how it turns out.