8-week appt today UPDATE: NOT THRILLED with appt

[centralsquare]

This is my first appointment with the midwife (though I've had two u/s already.)

Anything I should ask about in particular? I'm planning to ask for an overview of care, appointments, and tests options. Wondering also about the next milestone, after waiting four weeks for this!

---

UPDATE: I was so frustrated with this appointment. I chalk some of it up to my feeling terrible, but there were a number of things that really didn't sit well with me. 

First, I was there for almost 2.5 hours, which seemed unnecessary, and no one told me it would take anywhere near that long. A nurse came in and did a huge long history, which was fine. Then she had me change into this paper gown; fine, since I expected the physical exam next.

Nope. I sat in that freakin gaping paper gown for an HOUR while the "midwife in training" asked me some of the exact same questions. She didn't have a great bedside manner. I wanted to be nice and patient b/c she is in training, and we've all been there. But damn. Did I really have to sit there, practically naked, and be asked all the same damn questions?

The midwife came in, and she was nice enough. But there were two things that really bothered me. 1) she commented on how my nipples don't stick out enough and might be problematic when I try to breastfeed, and then went into all the problems that could create. 8 weeks, people -- is this necessary to freak me out about right now? 2) she let the "in training" lady do the pelvic exam. Ms. In Training couldn't find my cervix. (HOW HARD IS IT?!) So she's moving the speculum around, saying 'Is this it?' to the midwife. I'm thinking, "honey, if you don't know, you haven't found it." She's there for what seems like forever, moving it in different positions, with both her and the midwife trying to look at the same time. I am so pissed that the midwife didn't take over sooner than she did.

I did not volunteer for some study, in exchange for free medical care. I am not there as a learning device. I am a miserable, bad-feeling pregnant woman who is already nervous. NOT HELPING. I'm going to tell the main midwife next time that I want her doing everything, b/c this "in training" shit does not fly.

I then find out that we run higher risk for Tay Sachs, etc. b/c my husband is half Jewish. And they covered the litany of things that could be wrong, genetically, and I have to decide in the next few weeks whether to have this test with a 12% margin of error, and if I do, would I have an amnio, should the screening be positive for something bad.

Ugh, I'm just so overwhelmed. I'm sure much of it is hormonal / lack of sleep / feeling bad.

In positive news, my uterus is the right size. But that's about all the reassuring information I got today. Now I wait for the bloodwork, and try to decide about genetic screening.

Not feeling the warm fuzzies I was hoping to feel after this appointment. Did anyone else feel this way at 8 weeks in?

[spankswife]

Yay!! Good luck!

I am sure she will go over everything with you. The only thing I can think of that might be "next" is to discuss the NT scan.

[VillainV]

Now is a great time to discuss your genetic screening options. Find out what she offers, what she recommends for you, how things get coded, whether or not your insurance will pay for them, etc. If she wants you to do NT screening (it's a combo of u/s and a blood test) then that needs to be done around 12-13 weeks (don't remember the exact window), and will probably be your next appointment. Otherwise there are some blood-test only options that your insurance might cover, or you might opt to skip genetic screening altogether.

[centralsquare]

Thank you both!

VillainV, that is super-helpful. There are so many options for screens/scans now. And it's hard to know how accurate things are. My cousin was told her daughter likely had Downs, but she was completely fine. It's so scary to think about acting on inaccurate information; but I wonder whether the accuracy has increased dramatically from 8 years ago.

Considering the worst possibilities... my husband thinks we shouldn't bother with any scan, because he would want to keep it regardless. But if it's something where my baby would be in agony for 2 days then die a painful death, I would want to consider our options. (As amazingly, horribly heartbreaking as that would be.)

Fingers crossed none of us have to deal with that kind of decision.

[starlily]

Honestly, I'd consider switching providers if that's an option.

[centralsquare]

@starlily, it's definitely on the table. I have several friends who have delivered there and loved it, so I am willing to give them another chance. I've also been very happy with my other interactions thus far (called at 5w for spotting/pain, and they got me in for an u/s that day to determine whether it was ectopic. the midwife on call called me that evening to follow up and check in.)

But yeah. If I didn't have those positive things, and if they weren't the only midwifery-in-a-hospital practice, I would be switching right now.

[smock]

I'm sorry, centralsquare, that really does sound stressful!

Does someone in the practice at least ask if you are willing to talk to the "in training" people first? My OB is through a university hospital, so I've had med students sit in on appointments, ask me questions, and do some exams, but they always, always ask if I am willing to talk to the students first.

[centralsquare]

smock, NO! They didn't ask at all, which is what cheeses me off. Honestly, I am such an overly helpful person, I probably would have said yes. But they didn't even give me the option. I think the midwife was running late, and they sent this other woman in so I wouldn't be kept waiting forever alone. I would much rather have waited and then had the midwife come in. The most upsetting part was the speculum situation. Women already feel vulnerable and exposed during that kind of exam; have the sense to not prolong the situation or induce unnecessary worry, for god's sake!

[shelbyann]

OMFG. No, it is not at all okay to have a student rooting around in your vag for an extended period of time. (A) You should have been asked for permission to let the student do the exam, and it should have been made clear that it was perfectly fine to say no; and (B) The midwife should have taken over immediately when it became clear that the student was having issues. Everyone needs to learn, but not at the expense of a patient feeling overly exposed and uncomfortable.

It sounds like you weren't a fan of the midwife's personality/approach regardless, though. Is switching practices an option? I would be seriously looking in to it.

[centralsquare]

You are totally right, shelbyann. It was not okay. I am going to talk with the midwife about how uncomfortable it made me feel.

One of my best friends LOVED this midwife, so I'm going to talk to her to find out more about her. I have the option of making someone else my "primary" midwife, as there are 7 different midwives in this practice. I see this one 2 more times, then rotate around to the other 6. In terms of delivering, it will just depend who is available when I go into labor.

[Deleted]

Feb 19, 2014 16:49:36 GMT -5 starlily said:

Honestly, I'd consider switching providers if that's an option.

This.

I read your post and went effff no!

[catsarecute]

I'm sorry you had such a horrible experience! That would have been enough to have me in tears since I was so nervous for my first appointment. The only advice I have is to stand up for yourself. You are your only advocate in this situation. I hope your next appointment is better!

[melsamoony]

centralsquare I would honestly call the nurse's line and voice your concerns tomorrow and not wait until your next appt. You need to be asked before someone in training does an exam on you! You should also not be forced to give your history for a lengthy period of time in a peper gown!

The waiting is just part of medicine especially ob. They have to fit people in for emergency appts and try to spend time with their patients most of whome have questions so I find Ob's tend to run a bit behind. I try to remember the doctor/midwife is going to spend adequate time w me after finishing w the other patients.

I had a good 8 week appt but I think it can be a very overwhelming visit especially under the circumstances of having someone in training present at your visit. sometimes when there is a student present the doctor/midwife forfets to cater/care for the patient and focuses too much on the student. it is important to point this out to prevent this from happening to others. ((((hugs))))

[amaristella]

Eww. It's not just you. That sounds like an unpleasant appointment through and through. Usually I'm a huge advocate of midwife care but I'd be writing them a detailed letter about your experience and why certain things bothered you. If you want, give them a chance to respond. Otherwise I'd start shopping around for another provider.

[centralsquare]

Thank you all; just hearing your responses makes me feel so much better that my reaction is appropriate and that was NOT ok.

I wrote to the midwife and requested she call me ASAP to discuss my concerns about the appt. her response will say a lot.

THANK YOU! <3

[zarapipe]

woah, crazy, especially for a first appointment. I would definitely think about switching.

[rbp]

Feb 19, 2014 16:49:36 GMT -5 starlily said:

Honestly, I'd consider switching providers if that's an option.

ITA. My OB made me feel super comfortable at my first appointment. 

[mrspost08]

I'm upset for you! That was insane! Why couldn't the in training girl find your cervix? Don't they learn this in school?

I would complain. The nipple thing also was inappropriate. You're 8 freakin weeks!

I hope your next appt goes much better.

[JayhawkGirl]

I'm sorry you had a rough appointment. I think you're well within reason to ask that only the fully trained staff examine you from now on.

Regarding genetic testing, do they offer the newer blood screening tests? Maternity 21 and panorama are the names I'm familiar with. Mine was run around 12 weeks along with my NT scan. I wasn't comfortable with cvs or amnio but the blood test was ok with us.

[jackie011]

About the Tay Sachs- are you both Jewish? I believe both parents have to be carriers for it to be an issue. I'm Jewish, born of two Jewish parents, and I'm a Tay Sachs carrier. DH is not Jewish and not a carrier, so it was never even brought up as a potential issue. Are they just checking some box b/c your DH is half Jewish??? If so, I would RUN to a different practice.

[centralsquare]

Feb 19, 2014 20:34:49 GMT -5 jackie011 said:

About the Tay Sachs- are you both Jewish? I believe both parents have to be carriers for it to be an issue. I'm Jewish, born of two Jewish parents, and I'm a Tay Sachs carrier. DH is not Jewish and not a carrier, so it was never even brought up as a potential issue. Are they just checking some box b/c your DH is half Jewish??? If so, I would RUN to a different practice.

Nope, I have no Jewish heritage. They ran a "Jewish panel" to rule things out that my husband could be a carrier of. Is that standard?

[chickadee77]

Most of that would piss me off. I will say, though, that the doctor asked me *many* of the same questions that were on my paperwork, and when I went to MFM, same story. So I don't think that's terribly unusual. An inept student all up in my business for that long would definitely have me initiate a conversation about what I am/am not okay with. And, yes, switching practices would totally be on the table for me, though I might try one more appointment. But, honestly, if you don't like them, you don't like them. No biggie.

[jackie011]

Feb 19, 2014 20:58:06 GMT -5 centralsquare said:

Feb 19, 2014 20:34:49 GMT -5 jackie011 said:

About the Tay Sachs- are you both Jewish? I believe both parents have to be carriers for it to be an issue. I'm Jewish, born of two Jewish parents, and I'm a Tay Sachs carrier. DH is not Jewish and not a carrier, so it was never even brought up as a potential issue. Are they just checking some box b/c your DH is half Jewish??? If so, I would RUN to a different practice.

Nope, I have no Jewish heritage. They ran a "Jewish panel" to rule things out that my husband could be a carrier of. Is that standard?

DH & I participated in a Jewish genetic testing "fair" (I don't remember what it was called, but basically they sent out a notice that they were offering free genetic testing and we participated b/c it was free and we were TTC).  They took blood samples and family histories from us.  I came back as a carrier but we knew it wasn't an issue b/c DH isn't Jewish and isn't a carrier. 

When we got pregnant we met with a genetic counselor as part of our Materniti21 screening.  She basically restated all of the above information and said that it wasn't an issue as only one of us is a carrier. 

In your case, I would suggest your DH find out if he's even a carrier before you subject yourself/baby to testing you may or may not even need. 

[speckledfrog]

Unless there were zero other options, I wouldn't go back.

[speckledfrog]

Feb 19, 2014 19:07:04 GMT -5 mrspost08 said:

I'm upset for you! That was insane! Why couldn't the in training girl find your cervix? Don't they learn this in school?

I would complain. The nipple thing also was inappropriate. You're 8 freakin weeks!

I hope your next appt goes much better.

Right?!  All I've done is read TCOYF and I can stick my finger in there and find it.  It's not like there's a bunch of other stuff hanging out in there!

That would definitely get the side eye from me.  The main reason I wouldn't go back is because I like to feel like I'm being taken care of.  Not coddled or anything, but I want to feel like a person and not like someone they are just going through the routine for.  The 2.5 hour wait, with no explanation, would have me fuming.  I get that things happen, but if something came up then tell me there was an emergency appointment or a birth or something.  Otherwise it's just poor office/time/appointment management.

[theatre4life]

**hugs** I am sorry it didn't go well. I would honestly be looking for another practice, or at the very least, a different midwife. The comments about your nipples were completely inappropriate for a first appointment. I'd be curious to see if she responds with anything helpful to your concerns. **hugs**

[obladi]

I always have to wait at least an hour at my OB so that would not make me too upset but the exam thing would have me pretty angry. I am so tense during pelvic exams and super nervous especially now that I just want them over with as fast as possible. I do not want someone who does not even know where a cervix is (wtf??) poking around down there- no way. Let us know if your midwife gets back to you. Also, I have "bad" nipples too. One is totally inverted almost all the time and the other one is usually inverted. My OB has yet to make any mention of them.

[ringstrue]

The 8 weeks apt is pretty long and it's a lot of info. I think mine was closer to 2 hours? I forgot that its typically that long but I dunno that they typically warn you.


Sorry about the crappy student! It happens to all of us at one point or another. We have a lot of hospitals around here so it's sort of par for the course, but that sounds especially bad .

[pinotgrig]

You're totally right to feel annoyed and everything else you described. It sounds the whole appt was a bit off-putting - one or two of those maybe I could overlook and chalk it up to an off-day. But all in one visit? I'd be really frustrated. Esp the exam piece. That's totally unacceptable.

I'm glad you're reaching out to discuss with the midwife. I'll be curious to see how she responds.