I have a question (sensitive topic)

[bowies]

This is for my own edification. I will try to phrase this as sensitively as possible.

If you choose to terminate a pregnancy because there is a terminal medical condition preventing viability of the fetus, does your OB perform the procedure?

[Deleted]

A friend of mine had this happen. Her OB did perform the procedure.

[Deleted]

I think so. People have to get d&cs after miscarriages often so I thought the procedure was similar. It probably depends on how far along you are.

[Deleted]

My OB will do D&Cs but that's about it.
I know when we had the option to terminate my first, we were sent to an OB in a specialist hospital. We were later term though, which played into it.

[Deleted]

I assumed no, that only very few OBs do abortions.

I am interested to know too.

I know later procedures are not. I read a lot of the letters written by women who were treated by the Wichita OB that was murdered a few years ago--Dr Tiller. Those women came from all over the U.S. Many were women with babies that would either not survive to birth or would pass just after.

[dcn]

I know if I were being seen by a military dr no they would not. Can't use federal $$ for terminations.

My insurance doesn't cover termination (unless life of the mother is at risk) so I would have to find a clinic to do it and then pay out of pocket.

[centralsquare]

I hate that a doctor -- who is trained and paid to care for a woman's health -- can opt out of a legal medical procedure.

That said, it depends on the OB and the practice. In my case, the OB who did the cvs did the D&E.

[Velar Fricative]

I don't know about D&Cs, but relatively few perform D&Es. I had to go to the hospital in Manhattan for mine because no one in my borough did D&Es (this was shocking and frustrating for us, on top of everything else that happened). It was "fun" driving into and out of Manhattan during rush hour for three straight days from start to finish, while I was feeling pain and discomfort. I could go on a tirade about why so few do D&Es but it will piss me off too much right now. I will just say that by the time abnormalities show up in testing, the likelihood of needing the D&E instead of a D&C goes way up, so finding a doctor who can do the procedure isn't easy when you get the horrible news.

[konapoppy]

My D&E was done by an OB who is a perinatal specialist (so not my standard OB). My NT, ultrasound, amnio, and genetic counseling were all done through her. I think they are the only office in our county who does them, as the local pharmacy to them is the only pharmacy that carries the laminaria sticks needed for the full procedure (yes, we had to go get our own).

To be fair, for the termination part, I think you need to have high tech ultrasound equipment and the same skill as you would need for an amnio, so many regular OBs might not do it.

[konapoppy]

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

This is super fresh for me, but I just wanted to say THANK YOU for this post. (rant below)

I was fine that my OB/GYN couldn't do the D&E - in fact, I much prefer the perinatal specialist. But I haven't even HEARD from my OB, the one who I have been seeing for over a year, since the diagnosis. The perinatal specialist talked to my OB, and my doctor released the medical notes to me through the patient portal, but she has yet to send me a personal message about my loss or call me. The diagnosis was almost two weeks ago.

Needless to say, I am changing OBs. I won't deal with that lack of compassion. 

[Velar Fricative]

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

Trust me when I say that it's far more complicated than that. It's not about compassionless OBs at all (maybe in rare instances at most).

[konapoppy]

Aug 1, 2015 14:45:41 GMT -5 Velar Fricative said:

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

Trust me when I say that it's far more complicated than that. It's not about compassionless OBs at all (maybe in rare instances at most).

Agreed. Everything about it is more complicated.

My rant is compassionless-OB specific LOL. I am getting over it

[jln]

I was seeing a midwife but the OB in her office did my D&C. And I was very glad that he did because he was so caring and compassionate that it made a difficult time that much easier for us.

I should add: I should have had a D&E as it was 2nd tri, but they had to do pathology on the fetus (molar pregnancy) so he did a D&C instead.  

[Muddled]

Bowies, I think this is dependent both on state law and where you are in the pregnancy.

[bowies]

Thanks for the answers. All of this PP nonsense has made me realized I'm not as smart as I need to be on this.

My heart goes out to all who have been through this.

[chickadee77]

My OB could not perform the procedure, but referred me to someone who could (I think it was something about the hospital's policy, since there was still a heartbeat? Some of those details are a little fuzzy).

The doctor that did mine was so fantastic, but what sucked was that I'd already had a d&c several months earlier under general with my OB (missed m/c), and was anticipating a similar experience. Not so much. The doctor and staff were awesome, but it had to be performed in a clinical setting rather than at the hospital, which meant no general anesthetic - in fact, barely any pain meds at all. I think I got a shot of Demerol. That part was a bit more traumatic than it really needed to be, I think.

[rxbeth]

Another question that I hope isnt taken the wrong way. Do you have a choice of D and E vs an induction of labour? I'm kind of assuming so and that some choose D and E because labouring while knowing the outcome isnt a baby you take home is horribly emotional.

I'm so sorry for everyone who has gone through this.

[Poppy]

Aug 1, 2015 16:37:12 GMT -5 rxbeth said:

Another question that I hope isnt taken the wrong way. Do you have a choice of D and E vs an induction of labour? I'm kind of assuming so and that some choose D and E because labouring while knowing the outcome isnt a baby you take home is horribly emotional.

I'm so sorry for everyone who has gone through this.

I imagine it depends, particularly on how far along you are.

[redheadbaker]

I had pPROM (preterm premature rupture of membranes) 19 weeks into my second pregnancy. I chose to have a D&E. An OB did perform the procedure, however, she was not my OB. She was with a department in the hospital that specifically deals with pregnancy loss (it's a large teaching/research hospital).

[redheadbaker]

Aug 1, 2015 16:37:12 GMT -5 rxbeth said:

Another question that I hope isnt taken the wrong way. Do you have a choice of D and E vs an induction of labour? I'm kind of assuming so and that some choose D and E because labouring while knowing the outcome isnt a baby you take home is horribly emotional.

I'm so sorry for everyone who has gone through this.

I was given a choice of induction or D&E. I don't know that everyone gets that option, depending on the circumstances. 

[chickens987]

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

My sister had her water break at 17 weeks. She was at GW, and a certain # of staff have to consent to perform a D&E in order for them to staff the procedure. They couldn't get the staff needed, so she had to undergo an induction instead. I was SO SO angry about that.

[Queen Mamadala]

Most of those I know who chose to TFMR opted to induce labor, which was overseen by their provider -- OB or midwife. I think in some states the cut off is 24 weeks, at least this was the case for a friend of mine.

[Muddled]

Aug 1, 2015 17:13:37 GMT -5 chickens987 said:

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

My sister had her water break at 17 weeks. She was at GW, and a certain # of staff have to consent to perform a D&E in order for them to staff the procedure. They couldn't get the staff needed, so she had to undergo an induction instead. I was SO SO angry about that.

What is the rationale for this? I can't even imagine.

[centralsquare]

Aug 1, 2015 17:13:37 GMT -5 chickens987 said:

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

My sister had her water break at 17 weeks. She was at GW, and a certain # of staff have to consent to perform a D&E in order for them to staff the procedure. They couldn't get the staff needed, so she had to undergo an induction instead. I was SO SO angry about that.

Are you fucking kidding me? That is outrageous. I had no problem there whatsoever. I was a few weeks earlier than she, but holy crap. I am so sorry. That makes me livid. The last thing any woman needs at that time is a freaking VOTE on whether she can have a legal medical procedure. It's traumatic enough without that. 

[Queen Mamadala]

Aug 1, 2015 16:37:12 GMT -5 rxbeth said:

Another question that I hope isnt taken the wrong way. Do you have a choice of D and E vs an induction of labour? I'm kind of assuming so and that some choose D and E because labouring while knowing the outcome isnt a baby you take home is horribly emotional.

I'm so sorry for everyone who has gone through this.

When I went through the screenings, ultrasounds and genetic counseling during my fourth pregnancy, I was informed on two separate occasions that if I needed to, if I consented to the amnio and it came back with an adverse DX and I wanted to TFMR, I'd have the option to induce labor. This wasn't news to me, and I already knew I'd choose this route in certain situations.

My first son's heart defects were fatal and undiagnosed. He went into congestive heart failure at the end of my pregnancy. But had we known we would have chosen to induce as soon as his condition started to decline (failed BPP) to allow us more time with him.

[redheadbaker]

Aug 1, 2015 17:13:37 GMT -5 chickens987 said:

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

My sister had her water break at 17 weeks. She was at GW, and a certain # of staff have to consent to perform a D&E in order for them to staff the procedure. They couldn't get the staff needed, so she had to undergo an induction instead. I was SO SO angry about that.

I would have been lighting shit on fire. This makes me so, SO angry. 

[chickens987]

Aug 1, 2015 17:28:58 GMT -5 centralsquare said:

Aug 1, 2015 17:13:37 GMT -5 chickens987 said:

My sister had her water break at 17 weeks. She was at GW, and a certain # of staff have to consent to perform a D&E in order for them to staff the procedure. They couldn't get the staff needed, so she had to undergo an induction instead. I was SO SO angry about that.

Are you fucking kidding me? That is outrageous. I had no problem there whatsoever. I was a few weeks earlier than she, but holy crap. I am so sorry. That makes me livid. The last thing any woman needs at that time is a freaking VOTE on whether she can have a legal medical procedure. It's traumatic enough without that. 

It was a timing issue, unfortunately. Her water broke on a Thursday and her doctor took a wait and see approach - if she had gone in right away, she likely would have been ok. But her fever didn't develop until the weekend, which is when she went in and then it was emergent and they had to induce rather than wait for the staff needed.

Ironically, my mom had issues with me choosing a catholic hospital. Clearly a non secular one isn't a guarantee.

[Velar Fricative]

Aug 1, 2015 17:13:37 GMT -5 chickens987 said:

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

My sister had her water break at 17 weeks. She was at GW, and a certain # of staff have to consent to perform a D&E in order for them to staff the procedure. They couldn't get the staff needed, so she had to undergo an induction instead. I was SO SO angry about that.

I really don't understand this. GW doesn't have religious affiliation and I don't think DC has restrictions on abortion (wouldn't be surprised if that has recently changed though). I'm so sorry she had to experience that.

[GotWine]

Aug 1, 2015 17:13:37 GMT -5 chickens987 said:

Aug 1, 2015 14:30:54 GMT -5 @bunnybean said:

This is outrageous. I expected most OBs would perform D&Es. How compassionless to abandon a patient when they need care.

My sister had her water break at 17 weeks. She was at GW, and a certain # of staff have to consent to perform a D&E in order for them to staff the procedure. They couldn't get the staff needed, so she had to undergo an induction instead. I was SO SO angry about that.

Holy hell! They essentially voted on whether or not your sister got her medical procedure?!?

Name one other medical procedure that would be voted upon by staff.

I'm so sorry she had to experience that.

[konapoppy]

Aug 1, 2015 16:37:12 GMT -5 rxbeth said:

Another question that I hope isnt taken the wrong way. Do you have a choice of D and E vs an induction of labour? I'm kind of assuming so and that some choose D and E because labouring while knowing the outcome isnt a baby you take home is horribly emotional.

I'm so sorry for everyone who has gone through this.

Yes, I had a choice. My regular OB would have done the induction. I chose the D&E for relative speed (even though it took 2 days, most of it was at home) and I did not under any circumstances want to be on a floor with happy deliveries (which would have happened).