Penny-Pinching Pregnancy: Saying No To Expensive Tests
We didn’t have much cash to start with, but we just couldn’t wait. And then it happened on the first try.
I’m 6 weeks pregnant but I didn’t get a blood test to confirm our pregnancy. Two weeks worth of intuition and symptoms, two pee-sticks and a missed period were enough for me. I don’t have a problem with needles, I just have a problem with unessesary tests- even if they only cost a $20 co-pay. The co-pays add up fast. Some of our friends and family won’t believe it yet because “you need a doctor to tell you.” How I feel about what doctors know and don’t know is a different post entirely.
All of my intense symptoms, rapid weight gain and our knowing that I released both one egg before our insemination and one egg from the other ovary right after means we could be having twins. I’d like to know right away, but our portion of the intra-vaginal ultrasound which could tell us right now would be about $60 ($300 if we had no insurance). We’re not totally broke, I’m just totally cheap. So I decided to only have an affordable test to check the HgC hormone in my blood. Only if it’s high will be go for the ultrasound.
I’d really like it if we can keep the ultrasounds down to two throughout the pregnancy- one at 20 weeks to find out the sex and to check that everything is great and possibly one 1 or 2 weeks before our due date to check on the baby’s position, etc. With a midwife feeling my belly weekly at that point, that one may not be needed.
I probably won’t go for the constant blood monitoring of blood sugars and other chemicals. And I’m young enough not to have an amniocentisis but I probably wouldn’t if I was older (due to possible risk, price and the fact that knowledge is unlikely to make me want a late term abortion and would also be unlikely to complicate birth). They now recommend women of all ages take two tests for downs syndrome. The newest method for testing for Down’s includes a blood test combined with an ultrasound, called a “nuchal translucency test.” They are 80 percent accurate with a few “false positives”. I won’t be having those either.
We know that our donor had in his family a mild cosmetic genetic deformity and we could do Chorionic Villus Sampling of the placenta early in pregnancy to find out whether our baby has it- but we won’t be accruing these costs because it wouldn’t change any of our plans.
As I’ve discussed in a pre-conception post, we didn’t go the route most couples go when they do inseminations through a fertility clinic. By finding a midwife to do intra-uterine insemination at our home, we saved an estimated $1700-$2100 the month we concieved. This was also because I didn’t feel like spending money on pre-conception tests which I felt were un-nessesary for our circumstances. It might sound silly, but I do feel that being comfortable in my own home for the same procedure that would have been done by a stranger in a cold sterile room, and not excessively prodded was what helped me concieve so quickly.
There is a general feeling that if you don’t have every test possible (and every intervention offered, if hospital birth), that you are not doing the best for your baby. I hope this post will help others to consider whether they need the extra stress and cost if there are no symptoms of a problem. I wish pregnancy and birth weren’t treated like a disease in this country.
And for lesbian couples and straight people who need AI to concieve, I pray that more midwives skilled in insemination will pop up around the country.
Photo credit: stock.xchng.
Congrats, Moorea! This must be so exciting for you and your partner. Best wishes for a healthy pregnancy.
Well congratulations! I am studying to become a women’s health nurse practitioner (in fact I am done in 5 months). This means, for those who may not know, that I can do everything that a midwife does except for the actual delivery or most of what an obgyn does. I would like to say that you don’t need anything more than a urine test to confirm pregnancy, you only need that one u/s at 20 weeks to confirm dates and details about the baby (of course if that showed something you might want follow up) and you really only need a single one hour glucose test to be certain you are not developing gestational diabetes. If knowing does not change the outcome for you, then do not get the triple or quad screen (which determines downs syndrome risk among other things). Not getting the latest and greatest and most expensive test doesn’t make you a bad mom. Remember women have been giving birth successfully long before medicine stepped in to help. . .
And Moorea best wishes!
Congratulations! Yes, follow your heart and your pocketbook. You don’t need all those tests. You don’t need medication for whatever… and you don’t need a hospital birth. Do what works for you and your partner and baby. And again congratulations.
Good timing on this post: I’m going to my first prenatal appointment Thursday, and a friend who recently had a baby wrote today to alert me that I’ll probably be asked to make lots of decisions about testing. I will be talking to my partners about this over the next couple of days so we all know our priorities.
Do you have a doctor/nurse sorted out already? I’m going to my current OB’s clinic since I’m comfortable with them, but they sent me a list of predetermined appointments and things that are going to happen and estimated base cost. Doesn’t sound like I have the choice to opt out of these basic things. Do you think there’s any chance I could talk them out of some of it if it seems like overkill?
Congratulations Moorea! I don’t have children nor do I plan any but I could write a similar post about medical “care” in general. I fully appreciate Western Medicine for trauma care but I actually think you are a BETTER mom for taking the route that you are.
Bravo, my fertile friend! I’m so happy for you and your partner. You’re going to be wonderful parents!
OOOOHHHHhhhhh!!!! Congrats Moorea!!
I don’t recall them having all those tests (including ultrasound) when mom was pregnant with me or my brothers.
It (the medical establishment) all boils down to “Deep Throat’s” saying….”Follow The Money”.
Congratulations, Moorea, to you and your partner.
I agree with your desire to minimize the medical costs and the general prodding that comes with modern Western pregnancy. However, I am a very strong advocate of hospital births. My son was born through an emergency C-section. Had we not been on site with physicians standing by, there might have been terrible complications for him and, potentially, me.
I had no complications in pregnancy. Nothing. Nada. Zip. Not even morning sickness — ever. But the last few minutes were truly critical. I’m so glad we chose a hospital, and I encourage you to consider it, too.
Blood tests for pregnancy do more than just confirm “yes or no.” They are usually done to check out hormone levels related to the pregnancy.
There is a potential rare complication called molar pregnancy. This is usually discovered when hormone levels are surging way higher than expected. I apologize because its been a long time since I was involved in gyn care so I can’t quote you as to which hormones surge. Women do die from molar pregnancy that evolves into cancer- or they can bleed out from the molar pregancy invading blood vessels. Again, this is VERY rare- but since I worked in a gyn-oncology office, I saw this more than a few times.
What an excellent post! While my husband and I do not plan to have children (we might adopt, in the far off future), if I did have a child I would do it the same way as you. I recently watched ‘The Business of Giving Birth’ and am even more convinced that a midwife is the way to go. I am especially impressed with how a midwife knows her own limits and will (quickly) pass the baton to a doctor if it is needed. On the other hand, it seems that a lot of birthing doctors think only they have the magic touch to do the job. That makes me uncomfortable. Congrats and cheers to your natural decisions!!!
Thanks for the wishes, everyone!
CeeJay-the lists of tests at an OB office should not be manditory but you may have to fight hard if you don’t want them. Docs often assume they are the only ones who know what’s best for you and your child. The best thing you can do is become educated on all of those tests-read, read, read and Congrats! I have a midwife/natropath as a doctor and she’s allowing me to make all of the choices.
Carol, I totally agree that medicine is great for Trauma Care- and whenever there are actually sympsoms of something wrong.
I do believe that medicine is driven by two things:
Money and avoiding doctor liability/malpractice at all costs. The cost is sometimes a normal feeling pregnancy or birth experience.
Helen- I’m so glad you had a healthy baby and some people do need C-sections. My opinion, and that of many obstetrics associations too is that at least half of C-sections are un-nessesary. There are many reasons for that and I’ll write a post on it soon, but if a person lives 15 minutes or less from a hospital and an emergency c-section is needed, the mom can get one in exactly the same amount of time-(30 minutes from decision) that a woman in the hospital can. More babies are born needing help or dead in hospitals, and more moms have bleeding problems in hospitals too.
The actual name of the birth movie above is “The Business of Being Born”
This is a very interesting blog- I am from Canada and so I don’t worry too much about paying for tests because most are covered under our health care. This seems very helpful for Americans though. Congrats on the baby!
Congrats Moorea! It is wonderful to read a well thought out approach to a low risk pregnancy.
On thing that bothers me is your comment above-
“I do believe that medicine is driven by two things:
Money and avoiding doctor liability/malpractice at all costs. The cost is sometimes a normal feeling pregnancy or birth experience.”
Many/most of the tests given by OB’s are not so much to make money (doctors normally outsource to 3rd party labs are are therefor making no money on the labs) but rather to reduce risk and fetus/infant mortality.
Actually I think Medicine and Doctors are two different things. I think Doctors want to do what’s best for the patient, but Medicine is an institution and if we do all of these tests to prevent infant mortality- why does the USA rank 27th in infant mortality in the developed world?
It’s been a lot of years, but I didn’t have a blood test. First appointment, doctor did a regular gyne exam, said “yep you’re pregnant … with at least twins!” He was half right, although sometimes our son was as much of a handful as multiples.
Are you sure you have copays for pregnancy checkups? Many insurances cover those 100%, just like annual physicals.