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AIBU?

Share your dilemmas and get honest opinions from other Mumsnetters.

To really hate OBEM USA?

154 replies

VanGogh · 11/09/2014 01:02

Don't get me wrong, beautiful safe deliveries. Wonderful.

I had OBEM set up to series record and now I see my magic box thing has recorded the USA series too.

How different can labour and delivery be in two developed countries? All I seem to see is women on their backs, epidurals, "you can't deliver without your OBGYN" it seems so... So... Well, medical I guess. I dislike it. All I see is drips and close monitoring and beds.

Why???

Please tell me I'm not alone?

OP posts:
Wibblypiglikesbananas · 11/09/2014 02:34

I've had a baby in each country. I did find the US system hyper medicalised, but I'm sure an American in the UK would find the NHS lacking. The main thing I hated in the US was being a pawn in the health insurance company's money making game. I don't think it was a coincidence that every expat I know, with fabulous insurance coverage, needed 'additional' tests that would have been deemed entirely unnecessary at home. My British midwife friend was appalled...

Bulbasaur · 11/09/2014 02:37

I don't think it was a coincidence that every expat I know, with fabulous insurance coverage, needed 'additional' tests that would have been deemed entirely unnecessary at home.

The US is very litigious and because of that hospitals need malpractice insurance. So, if it ever comes to court the hospital needs to be able to cover their ass and say that they did all the tests and did everything possible to make sure their care was the best they could do.

steff13 · 11/09/2014 02:45

I have amazing health insurance, and I never had any extra testing.

The US is very litigious and because of that hospitals need malpractice insurance.

Ugh, yeah, we're terrible about that. We're sue-happy for sure.

Wibblypiglikesbananas · 11/09/2014 02:46

I knew someone would make that point Bulba. In my experience though, all the additional testing did was serve to make me more stressed than I should have been, for eventual negative results on every single one. Even the nurse who took my bloods for the gestational diabetes tests laughed and told me there was no way I had it. Entirely wasted morning but someone cashed in...

steff13 · 11/09/2014 02:51

Every pregnant woman here gets a gestational diabetes test, that's standard whether you have insurance or are covered by Medicaid. How did the nurse know you didn't have it?

Shakshuka · 11/09/2014 03:16

Wibbleypig

How did the nurse know you didn't have gestational diabetes????

Wibblypiglikesbananas · 11/09/2014 03:31

I'm sure she didn't know 100% - in fact she probably shouldn't have made the comment that she did, given the sue me culture - but I'm very tiny and statistically very low risk. There wouldn't have been a test in the UK at all. I didn't just have the first test that everyone has in the US, but the extra one where you drink sugary stuff every hour over the course of 3/4 hours too. I still don't know why. I also had seven(!) scans, at approx $600 a pop according to the Cigna invoices we got later... Call me a cynic but I don't doubt I was being used as a cash cow.

steff13 · 11/09/2014 03:34

They only give you the extended test if you tested high on your first test.

Didn't they explain to you why they were doing all that? I had two ultra-sounds during my last pregnancy, and I would have only had one except I had spotting early on and they wanted to look for a heart beat. Oh, and I had the 3-D one, but I paid out of pocket for that.

Bulbasaur · 11/09/2014 03:35

Every pregnant woman here gets a gestational diabetes test, that's standard whether you have insurance or are covered by Medicaid.

Yeah, I think we need to establish what is considered "unnecessary" tests are.

Typical tests in the US include:

  • Gestational Diabetes
  • Chromosome abnormalities
  • Blood work for other fetal abnormalities
  • Preeclampsia if you have high blood pressure
  • Urinalysis
  • Pap Smear
  • Group B strep test
  • Other blood tests depending on family history
Bulbasaur · 11/09/2014 03:41

I had two ultra-sounds during my last pregnancy

I had 3. One to establish pregnancy during the first trimester. One at 20 weeks. One right before I went into labor to check on the placenta because I had heavy bleeding.

There must have been a reason for 7 scans, they don't hand them out like candy as they're not good for the baby. Do you have a family history of something? Did previous scans show abnormalities?

My friend had multiple scans because she had a tumor in her uterus and had to operated on.

sleepywombat · 11/09/2014 04:47

This reply has been deleted

Message withdrawn at poster's request.

Bulbasaur · 11/09/2014 05:02

I guess the difference is we are within our rights to turn down whichever tests we don't want, whereas some insurance companies in the US might not allow this?

They do, but you have to sign a waiver. You always have the right to refuse medical treatments though.

Insurance used to be able to drop you if you didn't do one little thing, but that's against the law now.

LittlePeaPod · 11/09/2014 05:28

Why are you bothered about other people's birthing experience?

Personally giving birth is simply a means to an end. I don't get the whole 'it's a wonderful achievement' thing. People can give birth under a tree or in a hospital for all I care. I think the amazing achievement is the babies development and the new life not how the new life is delivered. So people can deliver how they please.

I live in the UK and I choose to have an ELCS and I had no medical reason which stopped me having a VB. that doesn't mean I am not capable of listening to my body or trusting it. The CS was no where near as painful or life restricting as people said it would be (BF immediately, home the following day, driving after two weeks and back at the gym after 4 weeks with full consultant/GP and insurer approval).

I am all about women having the choice to deliver how they which and not been pushed/guilt tripped into a VB (home/MWLU/hospital) or CS.

LittlePeaPod · 11/09/2014 05:43

Wish not which... Blush

Tryharder · 11/09/2014 05:45

I've never seen OBEM either the UK or the US version.

But as others have suggested, the highly medicalised births and plush hospitals are clearly as a result of expensive private insurance.

I would like to see the birthing experience of poor Americans or people without insurance. I'm sure that would not be shown on OBEM.

CheerfulYank · 11/09/2014 05:47

I had a lot of scans because I had a whopping case of influenza whilst pregnant. So they did a scan to make sure all was okay. That scan revealed a large placental lake. So they did additional tests to make sure the baby was growing properly.

Only one close friend of mine has had a CS. In her case the baby was breech. I have a friend who's had two out of three babies born at home with a midwife. Another friend is due to give birth in two weeks or so, with a midwife.

It's not just labor we don't have gas and air for, we don't use it for anything. :)

steff13 · 11/09/2014 05:50

I didn't have insurance when my first son was born, due to an error that took months to correct. But, I digress. I gave birth at the same hospital with the same ammenities then as I did with my other two. My exeperiences were no different, other than I received a bill after my oldest son was born.

steff13 · 11/09/2014 05:52

It's not just labor we don't have gas and air for, we don't use it for anything.

Yeah, I don't even know what those are, actually.

SoonToBeSix · 11/09/2014 06:10

It's entonox Steph. You are missing out, I live gas and air Grin

SoonToBeSix · 11/09/2014 06:11

Love

SoonToBeSix · 11/09/2014 06:11

Ahhh missing words out , it's also called " laughing gas"

steff13 · 11/09/2014 06:19

Oh, we call laughing gas nitrous oxide. You can get it at the dentist, I think.

mathanxiety · 11/09/2014 06:33

I had all five of mine in the US. I had my own OB/Gyn practice doctors for the first three deliveries and a hospital resident for my fourth as my practice doctor who was on call had a CS to attend to at 2.30 am just as DD3 made her appearance. For DD3, who was born about 40 minutes after I arrived at the hospital, my doctor arrived just in time for me to push, and a resident supervised the first 20 minutes of hospital labour. I went with a midwife practice and different hospital for DD4.

Throughout my pregnancies I had seen all of the practice doctors at one time or another so we weren't total strangers. Similarly, I met all of the midwives in the course of my pregnancy.

I had an epidural for DD1 -- my choice. I also had a pitocin drip to speed things up, and was monitored as her heartbeat was a bit dodgy, and she had a fetal scalp monitor too as there was a little meconium visible when my waters broke. I had an episiotomy and a few stitches bit I have no idea how many. My mother and all my Irish friends wanted to know exactly how many stitches I had and I sensed they were disappointed when I had no clue. I think they ranked birth experiences according to number of stitches.

I was induced for DS but had no epidural even though I asked for one as the hospital was snowed under that day. DS had a fetal scalp monitor too, as well as external monitoring; this was thanks to the pitocin. The anesthesiologist arrived just as they were weighing DS and announcing '9 lbs 4 ozs', and the poor man apologised profusely. Weirdly, he was a red haired Scot... My doctor used a vacuum extractor to keep DS moving in the right direction and I had a room full of students watching -- two of them allowed me to crush the bones in their hands as I pushed. I was asked if I would consent to students watching and had said yes.

After delivering DS I figured I could go without an epidural in future. For DD2 I arrived at the hospital too late for any pain relief anyway, but I had an episiotomy and a few stitches. DD3 was a fairly straightforward delivery and I snoozed for most of labour -- she was induced, gel worked immediately, I had an episiotomy and a few stitches. DD4's induction went slowly - gel pessary didn't result in much progress so I was on pitocin, monitoring, and confined to bed for about 36 hours but allowed up for the bathroom as long as I kept my cannula below the drip as I wheeled it along to my private loo in my own private labour and delivery room..

All pregnancies involved courteous treatment, getting to know the doctors and midwives, and hospital tours (the first hospital was remodelled twice over the years). All hospital stays involved nice food delivered with a smile, chosen from a menu that featured three choices for every meal. I had my own private room 3 out of 5 times, and the other two times I shared with one other woman and her baby. The rooms came with clean loo and shower ensuite. They also came with hospital robes for me and each baby, hospital supplied all diapers and maternity pads, perineal chemical ice packs, bed liners, knickers made of netting, a medela breast pump and nipple shields, a perineal water bottle, and a few little 2 oz glass bottles with ready mixed formula that came in handy at home when I expressed and stored milk. I never once brought a nightie of my own to hospital and just brought a onesie for each DC to go home in, and a big duffle bag for the freebies.

Above all, I experienced kindness from the nurses, and more than a perfunctory nod to my own preferences where delivery was concerned, and where there was a need for some medical action or intervention it was all clearly explained to my satisfaction. The no eating rule was explained to me as necessary in case a CS was required at some point. I had a drip for fluids and for pitocin when I was induced and pitocin was used. If necessary, the cannula would have been in place for a transfusion if it had become necessary. With DD1 I had the epidural needle inserted at a point early on in labour so it was there if I wanted it later, and also in case I had needed a CS I could have been partially numbed instead of knocked out.

My doctor's policy was only one ultrasound per pregnancy at 24ish weeks, but for DS I had three, one because I had bleeding early on due to suspected placenta previa and another when he showed signs of distress after his due date on top of the routine 20-24 week ultrasound. For DD3 I had four because I got pregnant immediately after MC so needed to establish dates, a routine scan at 20-24 weeks followed by another a few weeks later to see if the technician had been right and DD3 did in fact have a knot in her cord, and another at 40+5 as she was showing signs of distress in my non-stress tests, and with DD4 I had two because I was an old lady of 37 and a level 3 ultrasound was done in preference to amniocentesis to determine if there were any birth defects, as well as the routine 24ish week one. I had non-stress tests right at the end of each pregnancy.
(DD3 did in fact have a knot in her cord but the second ultrasound technician couldn't see anything but a blur as DD3 wouldn't stop with the somersaults. The resident marvelled at it when she was born, and he and the very experienced OB nurse there to assist him for the delivery chatted about odd cords and placentas the nurse had seen -- very entertaining for me..)

I had all of the tests listed by Bulbasaur during each pregnancy. For DD3 I had the second glucose test as I was borderline GD in the initial test, but passed. For DD4 I was diagnosed with GD after the second test.

I could turn down any test, and turned down amnio for DD4. I saw no reason not to have the tests recommended but amnio seemed to me to come with more risk than any other testing.

I was really glad to have the routine testing for GD and the follow up visits to the dietician who gave me great nutrition advice and who was always available for questions about food, my blood sugar testing, etc., when I was sent home with a testing kit and full instructions on testing.

The hospital I had DD4 in had bad soundproofing so throughout the night as I dozed and laboured I heard two other women delivering, along with much encouragement from family who seemed to be in the room with the women, and great cheering at the end along with crying of the babies. One family spoke Spanish and the other was from the Caribbean, judging from accents. It was all in all a happy night nice to eavesdrop on such joy. I had my midwife and her student and exH with me, along with a neo natal nurse, and DD4's arrival was a quieter affair. Apart from DS, all my other deliveries had only me and exH and the doctor or MW and nurse/s. Oh and a youthful and spotty lab technician bumbled in on the hectic scene just as I got to the pushing stage with DD2 he was supposed to do the routine bloodwork necessary upon admission. He was told in no uncertain terms to get out.. I can still see the look of astonishment on his face.

The only thing I found fault with in my first hospital was their policy of taking babies to the neo natal nursery for observation for a few hours after birth and recovery. The second hospital didn't do this.

Apart from that, I always felt I had choices, and that I was being listened to. Just a small example, but during DS's birth in front of an audience of OB/Gyn med students I asked for a student with small hands to do my internal exams after consenting to let a student do one, and also asked the small handed student to wait until a contraction was waning before getting going. There was only one nurse I encountered whom I thought was a lazy bitch. My sister's experience in Ireland was very different.

mathanxiety · 11/09/2014 06:36

Bloody hell, can anyone else see the links - that I did not post - there?

CheerfulYank · 11/09/2014 07:35

No Math :)

Ah, the netting knickers! That's just brought back a huge flashback for me from DD's birth 15 months ago. First time I was allowed to go to the bathroom after she was born, and stumbling along and feeling that curiously deflated feeling in my midsection. There'd been a 6 year gap between her and DS and I'd forgotten it all.

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