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El_Elegante: So you would opt for no information instead of some information just because screening tests are not diagnostic? That just doesn't make sense. In addition my understanding is that the newer maternal serum tests are more accurate (in both directions) so there's certainly no reason not to have them over the currently more conventional combined screening test. All emotional stuff aside this is a risk management situation and some data, espeically given we know a lot about the likely reliability of the data, is better than none. The only reason in my mind to NOT have the screening is if you would never consider termination anyway. I would also think that most people would have a diagnostic test prior to deciding on termination but even if they don't who are you to specify what risks they are prepared to take or not? E.g. if knowingly having a disabled child is an absolute no-go for a family then acting on the test is till more likely to be the right decision for them since the chance of a false positive is lower than the chance of the test being correct. If abortion is legal then this is 100% up to the family to decide and moral arguments they don't care about don't come into it meaning the potential issue that "[a] person has terminated a pregnancy on the basis of a false positive diagnosis" is irrelevant.
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Nov 1, 2015 23:26
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What shits me about screening tests here is that they assume that every single person wants only a modification to their risk profile. A lot of lay people don't even understand fully what a modified risk profile means. I asked about chorionic villus sampling for late first trimester chromosomal profiling but the public OB/GYN didn't want to touch it with a twenty foot pole. I was 'low risk' therefor they would offer the basic triple screen, which irritated me since by the time I would actually know the results (around 16 weeks) a termination would be much less easy to recover from. Great, thanks. I'd rather have had the diagnostic CVS done from the word go (with the miscarriage risk it entails), and terminate before 13 weeks if I had been given the option. So now I have a slightly lower risk profile, and that's the best they can do for me. Considering that someone else in our social circle went through all the screening, came back OK on the triple screen, ultrasounds, etc, and kid was still T21 I have to admit being slightly paranoid about the whole thing. I know it doesn't happen often, but I know personally I'd rather risk terminating on a false positive than false negative results all throughout to then have to deal with the consequences. Not to downplay the good work and positive experiences that can come from raising a kid with T21 or other genetic syndrome, but knowing my mental health history and my husband's mental health history I don't think I can maintain being the only breadwinner and still be ok to do everything else. It's why I wouldn't choose to foster a kid, or adopt a kid much older than about a year old, though I admire very much the people who can do so successfully and who contribute to the well being and enrichment of the kids that come through such systems. I just know my limitations.
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Nov 2, 2015 02:51
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I think the issue is that, in a low-risk population, the numbers may work out such that a positive result is more likely to be a false positive than a true positive. Here's an example: Test has a 1% false negative rate and 1% false positive rate. If the test is use only in high-risk patients, say a population that is expected to have 10% incidence of disease X, you would expect 1000 patients to have the following results: 900 patients are truly negative, but 9 of them get a false positive and 881 test negative 100 patients are truly positive, and 1 gets a false negative and 99 test positive Out of 108 positive results, 99 are accurate information and 9 are false positives Now you use your wonderful test in not just those specifically at risk, but in everyone else as well. In a larger, but overall lower-risk population, where the incidence of disease X is only 1% (likely even less but for the sake of numbers we'll say 1%) 10000 patients get these results: 9900 patients are truly negative but 99 get a false positive and the other 9801 test negative 100 of the patients are positive but 1 of them gets a false negative, and the other 99 test positive 99 real positives, and 99 false positives. In this scenario, a positive results is just as likely to be a false positive as it is real. Literally a coin flip. What information have you really gained, other than a 50% chance of worrying? If the incidence of the disease you are looking for is even less than 1%, or your false negative/false positive rate is higher, the numbers get worse. You can easily have a test and a population where a positive result is more likely to be false than true.
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Nov 2, 2015 02:57
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Dori posted:El_Elegante: So you would opt for no information instead of some information just because screening tests are not diagnostic? That just doesn't make sense. In addition my understanding is that the newer maternal serum tests are more accurate (in both directions) so there's certainly no reason not to have them over the currently more conventional combined screening test. All emotional stuff aside this is a risk management situation and some data, espeically given we know a lot about the likely reliability of the data, is better than none. The only reason in my mind to NOT have the screening is if you would never consider termination anyway. You put a lot of words in my mouth. For a given patient there are appropriate and inappropriate tests. For a low risk population the ideal screening tool would be the quad screen initially. If the quad screen was positive the patient should meet with a genetic counselor who can explain the significance of those test results and offer subsequent testing, such as non-invasive tests or diagnosting testing such as chorionic villous sampling or amniocentesis. Patients should be counseled thoroughly regarding the accuracy of the test and how their risk factors or lack thereof can affect the reliability of test results. In addition, they should be counseled regarding the purpose of testing-some couple might terminate a pregnancy based on a risk for Down syndrome or trisomy 18, while others might like to know in order to prepare for the planned term delivery of their child. You are right in that politics does play a role here, but you've got it framed all wrong. I am a pro-choice, Planned Parenthood-donating OB-GYN in a very pro-life environment. I would never counsel a patient against a decision to terminate for reasons that patient felt was appropriate. My beef is with the for-profit companies who offer these tests with minimal guidance and support to physicians and patients contrary to the FDA's recommendation. nyerf posted:What shits me about screening tests here is that they assume that every single person wants only a modification to their risk profile. A lot of lay people don't even understand fully what a modified risk profile means. I asked about chorionic villus sampling for late first trimester chromosomal profiling but the public OB/GYN didn't want to touch it with a twenty foot pole. I was 'low risk' therefor they would offer the basic triple screen, which irritated me since by the time I would actually know the results (around 16 weeks) a termination would be much less easy to recover from. Great, thanks. I'd rather have had the diagnostic CVS done from the word go (with the miscarriage risk it entails), and terminate before 13 weeks if I had been given the option. So now I have a slightly lower risk profile, and that's the best they can do for me. I am very sorry you went through this. If anyone else reading this should find themselves in a similar situation, I strongly recommend asking for a referral to a provider who would be comfortable with doing the procedure. There is nothing inappropriate about your desire-and nothing inappropriate with your OB/GYN's choice not to offer the procedure-but given how strongly you felt I think the physician had an ethical obligation to refer you. El_Elegante fucked around with this message at 03:13 on Nov 2, 2015 |
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Nov 2, 2015 03:04
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Nyerf: Yeah the fact that you can't access some tests without the right risk "stamp" does suck about the fully public system you and I both live in nyerf (I'm in NZ). And the way you get classified can also depend entirely on who you talk to/who catches your forms. When I got pregnant the second time round I asked to have my early USs etc done at Fetal Medicine at the hospital and for repeats of blood work to try and detect anti-body issues but I got turned down by the hospital admin because I didn't have the right letter from my specialist (no one asked him though...) and because the system didn't flag me at high risk despite my previous issues. When at 20 weeks I was back at the hospital with a second munted pregnancy none of the specialist staff could understand why I was turned down by admin (not that it mattered as the issues were completely different). As it turns out it's because my risk profile was not correctly updated cause our issues didn't fit one of their standard tick-boxes. This time I made sure to that a) all my risk profiles were properly updated and verified by my specialist and b) I had a better understanding of what letter exactly I need to show to admin to get hospital level care from day one. I also got the direct dial number of the specialist midwifery team so if admin turn me down in the future I can call them direct and get them overwrite the paper-pushers. Again none of this would have saved my baby but it might have meant a termination at 12-16 weeks instead of at 22 and needless to say this would have been preferable. El_Elegante: That makes sense - I apologies for thinking you disagreed with both the quad screen/combined screening as well as serum tests. To be fair the model here does seem to be different from that in the US. For a start I was positively bombarded with material about the different test options, how they work, the statistics etc and genetic counselling and/or diagnostic tests would have been the next steps taken here if our combined screen had come back positive - or at least this was the process that was explained to me. [I have since learned that many women simply ignore this stuff which is sad and just do what their doctors tells them instead of trying to understand the info]. In practice I haven't got to find out how that would have worked since all the issues we've had have not been chromosomal. Though we will getting genetic counselling now once the results of our array are back which is bound to be interesting and our initial meeting with the genetic counselor was certainly pretty comprehensive as well wrt what to expect from the testing we are having done. The biggest difference here I think is that tests etc aren't sold to individual doctors/hospitals. Our government buys wholesale and determines who gets what based on risk profile (see above) so the whole set-up of who get's what and why is quite different and I sometimes forget just how pro-profit the US system is.
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Nov 2, 2015 03:23
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I'm glad we agree-I don't think the science is well communicated to either doctors or patients.
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Nov 2, 2015 04:17
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El_Elegante posted:I would strongly recommend against the maternal serum chromosomal test unless you are a high risk patient. It is a screening test, not a diagnostic one. In a low risk population false positives are more likely than the population the test was developed for. I agree the test can cause more headaches than it's worth for low risk people, but I thought the next step after a positive result was to do CVS or amnio to ascertain the result. It seems incredibly foolish to make decisions based on the screening test alone, when you can get more information via diagnostic tests.
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Nov 2, 2015 04:21
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That may have been the intention with the test and those are the recommendations but not all providers are in lockstep with those guidelines.
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Nov 2, 2015 04:39
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Hi_Bears posted:I agree the test can cause more headaches than it's worth for low risk people, but I thought the next step after a positive result was to do CVS or amnio to ascertain the result. It seems incredibly foolish to make decisions based on the screening test alone, when you can get more information via diagnostic tests. Yeah we did the test because why not. The DR though said they would suggest an amnio if anything abnormal showed up.
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Nov 2, 2015 06:16
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Is there a resource I could look at showing the different pregnancy screening option? Would it be in the Mayo Clinic's Guide to Pregnancy?
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Nov 2, 2015 08:01
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Are these invasive tests standard in the US now? How often are regular ultrasound scans done?
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Nov 2, 2015 09:30
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peanut posted:Are these invasive tests standard in the US now? I think the genetic screening thing mentioned earlier is just a blood test, so it's not super invasive as things go.
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Nov 2, 2015 10:08
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peanut posted:Are these invasive tests standard in the US now? The screening tests are considered non-invasive since it's just a blood draw or ultrasound. I've had a total of 6 ultrasounds by now (24 wks). At the early doctor appointments they always did a quick scan to check heartbeat, switching to Doppler around 18 wks. I also has the nuchal translucency scan at 12 weeks, early anatomy scan at 17 weeks, and full anatomy at 21 weeks. It varies from practitioner to practitioner but this is standard at the practice I go to.
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Nov 2, 2015 13:56
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I'm 14.5 weeks. I am feeling cranky All the Time. Part of it is that we haven't had a break from school (I teach middle school) since Labor day and I am trying to not take any mental health days or teacher work days off to save as much sick days/personal days as possible to pay for no-pay maternity leave (America, gently caress yeah!). Part of it is I have no clue why, I don't want to be cranky, but I am. All the Time. I want to sew on my quilts but I don't. There are a couple movies I want to watch, but I haven't. I feel tired all the time (though that is getting better). I started going to prenatal yoga (even though I feel like a yuppie when I tell someone I do that). I went one time last week, will go again this week. I am thinking about going twice a week but I don't know if that's pushing it (which... seems like a joke, it's not intensive at all, I should probably just go twice a week). Also, my shoulders hurt like gently caress recently. I am guessing I need to up my bra cup size or something? My boobs don't seem that much bigger though. How many times did y'all size up during pregnancy? Did you get a couple in-betweener sizes? It feels too early to be buying a new bra. Sorry for the whine. But I needed it.
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Nov 4, 2015 02:02
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Hi_Bears posted:The screening tests are considered non-invasive since it's just a blood draw or ultrasound. I've had a total of 6 ultrasounds by now (24 wks). At the early doctor appointments they always did a quick scan to check heartbeat, switching to Doppler around 18 wks. I also has the nuchal translucency scan at 12 weeks, early anatomy scan at 17 weeks, and full anatomy at 21 weeks. It varies from practitioner to practitioner but this is standard at the practice I go to. wow you guys get a lot. Here in QC canada you get 2-3 ultrasounds (nuchal/early anatomy - full anatomy) total if the pregnancy is normal (of course you'll get a lot more if anything isn't perfect). + doppler at every appointment. Other tests (like the genetic test that was talked about earlier) can be done in a private practice if you want it done. How much does a pregnancy cost in medical bills to the non-insured in the US? And how much if you have lovely insurance? US health system always fascinate me. KingColliwog fucked around with this message at 15:27 on Nov 4, 2015 |
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Nov 4, 2015 03:21
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JustAurora posted:Also, my shoulders hurt like gently caress recently. I am guessing I need to up my bra cup size or something? My boobs don't seem that much bigger though. How many times did y'all size up during pregnancy? Did you get a couple in-betweener sizes? It feels too early to be buying a new bra. I'm 24 weeks and on my 6th new bra since getting pregnant. And no matter what I do (bra, no bra, sports bra, cheap bra, expensive bra) nothing seems comfortable at this point. I went from 34B to a 36D, and the boobs are not only big but very sensitive - sometimes even running water in the shower hurts. I do recommend wirefree bras - the most comfortable one I've had so far is a cheap Hanes one from Target.
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Nov 4, 2015 05:44
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KingColliwog posted:How much does a pregnancy cost in medical bills to the non-insured in the US? And how much if you have lovely insurance? US health system always fascinate me. I suspect that one reason I'm getting so many tests is because I have good insurance and the doctor knows it. I think many doctors would be more discriminating about what tests they do if they knew you were paying out of pocket. The uninsured probably also choose to get less prenatal care than they should. My husband's employer provides health insurance for us and so far this pregnancy has cost us $30 in copays (initial visit and a genetic counseling session, the rest of my regular visits and ultrasounds were free) but probably thousands to our insurance company. I honestly have no idea what the actual cost is and I think that disconnect is one of the problems in our healthcare system.
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Nov 4, 2015 05:59
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No one in a hospital knows what anything actually costs. Sticker price has nothing to do with costs, and their are different price sheets for different insurers vs self pay patients vs indigent payments on "charity" payment plans. It's insane.
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Nov 4, 2015 06:04
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Update on the boob situation: was trying to sleep last night and was disturbed to find a big wet spot on my shirt... I guess the leaking has begun! I knew this could happen but I thought it would be more in the third trimester. Ordered some nursing pads and now looking into sleep bras - any recs?
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Nov 4, 2015 17:01
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Hi_Bears posted:Update on the boob situation: was trying to sleep last night and was disturbed to find a big wet spot on my shirt... I guess the leaking has begun! I knew this could happen but I thought it would be more in the third trimester. Ordered some nursing pads and now looking into sleep bras - any recs? Bamboobies are the best nursing pads I've encountered- they are reusable and discreet. I found that the Target sleep bras are pretty comfy.
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Nov 4, 2015 17:03
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Good-Natured Filth posted:41+1 today, and my wife is getting very anxious. I'm not sure what I can say to reassure her other than everything I've already been saying (it'll be fine; her mom was two weeks late with her; plenty of people go past their due date; etc.). At 42 weeks, my wife was induced. After 21 hours of labor and having stayed dilated at 8 cm for about 10 of those hours, the doctor decided a c-section was the proper course of action. It was scary as hell, but a good decision in the end. Our daughter, Aria Jean, came out at 9lbs 10oz, and had a giant head that likely would not have fit through the cervix. Onto the parenting thread!
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Nov 4, 2015 22:56
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KingColliwog posted:How much does a pregnancy cost in medical bills to the non-insured in the US? And how much if you have lovely insurance? US health system always fascinate me. $100 on general tests (blood) $4000 midwife from pre to post natal and beyond $2500 on 5 or 6 total ultrasounds $1300 for a single ER visit That's pretty much lovely insurance, but we'd have paid 100% ourselves had it not been insurance approved. We got 90% back (100% paid upfront), including the midwife money.
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Nov 4, 2015 23:20
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Why the hell does an ultrasound cost $500?!?!  It's just jelly and photo paper... (things are not that insane outside the US)
peanut fucked around with this message at 01:03 on Nov 5, 2015 |
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Nov 5, 2015 01:01
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Hi_Bears posted:I suspect that one reason I'm getting so many tests is because I have good insurance and the doctor knows it. I think many doctors would be more discriminating about what tests they do if they knew you were paying out of pocket. The uninsured probably also choose to get less prenatal care than they should. My husband's employer provides health insurance for us and so far this pregnancy has cost us $30 in copays (initial visit and a genetic counseling session, the rest of my regular visits and ultrasounds were free) but probably thousands to our insurance company. I honestly have no idea what the actual cost is and I think that disconnect is one of the problems in our healthcare system. I was AMA with my younger son-I was 36. In addition to my age, we have a family history of a congenital heart defect (husbands mom), severe spina bifida (my brother) and down syndrome (my niece) so I was considered high risk. I have great insurance and had an uneventful pregnancy though I did visit the high risk practice that my primary OB sent me to for additional scans/monitoring. No issues except I was induced at 39 weeks due to a slightly elevated uric acid level and slightly elevated blood pressure. I responded well to the induction and delivered vaginally and was home in the usual 2 days. I totalled up the bills and was shocked at the $37k price tag. I paid just shy of $1500 out of pocket.
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Nov 5, 2015 02:54
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peanut posted:Why the hell does an ultrasound cost $500?!?! Because you're paying for the rent of a probably $200k ultrasound machine and software, a medical imaging professional that should have spent 2 years on a postgrad diploma and gets paid at least $40-45/hr, and then use of the imaging servers to store and transmit the images and reports, and also for a radiologist, a consultant doctor who had been in training for a minimum of 12 years, to look over the pictures and give your pregnancy the ok. And he/she probably gets paid $100s/hr. Also a typist and admin personnel to organise your medical file. And your scan takes 30-60 minutes, not including reporting and typing time. Except by the time you've had the machine 6 months, it's paid for its capital expenditure by your profit margin; the radiologist generally spends about 1-2 minutes dictating the report which is mostly prepared by your sonographer (who largely ticks boxes on a proforma), and might end up doing ~50-60 reports an hour; the typist takes the same time to type it; and when the PACS infrastructure is up and running it only needs to be maintained remotely by 2 IT guys in India and upgraded once every 12 months at best. Basically cha-ching, thanks see you later! E: for quote to clarify what I was referring to, and other thoughts on bullshit medical costs nyerf fucked around with this message at 13:08 on Nov 5, 2015 |
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Nov 5, 2015 02:58
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For our second kid, we arrived at the hospital at 4:20, the baby was born at 4:45, and we left after about 36 hours of staying in the hospital. My wife's insurance denied the claim, and we ended up paying something like $4500 for that. Granted, some of that went to the collection agency. That doesn't include the services of the midwife, which were about $4000. We're still in a payment plan for that.
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Nov 5, 2015 03:36
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notwithoutmyanus posted:HDHP here, so our employer gives us $$ towards cost, we pay the rest from the plans HSA but can deduct from taxes anything we put into the HSA as well: God, that's what you paid after the insurance money? and that does not include the hospital stay for the delivery? Do you pay extra to get the epidural or use a bathtub or whatever? This all sounds so insane and alien to me. Not trying to start a debate here, I was just really curious of how things went KingColliwog fucked around with this message at 03:55 on Nov 5, 2015 |
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Nov 5, 2015 03:51
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KingColliwog posted:and that does not include the hospital stay for the delivery? quote:Do you pay extra to get the epidural quote:or use a bathtub or whatever?
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Nov 5, 2015 04:05
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KingColliwog posted:God, that's what you paid after the insurance money? and that does not include the hospital stay for the delivery? Do you pay extra to get the epidural or use a bathtub or whatever? ^^^zono is correct, sadly. The amounts I listed were before insurance payback. That's because we have weird insurance such as this HDHP (high deductible) plan. In the end I'm only having spent $1k, roughly. This is far, far, far less than the average person - but we also elected to have our child born at home in a birth tub *and* happened to live less than a 5min walk to a hospital. We didn't even stay at the hospital, we were charged almost $800 just to have the ambulance take us to a different hospital nearby and bill us for poo poo they didn't even do like things my wife refused. The whole thing is nuts. Us (and our good fortune) aside, who really can afford to be out almost $8k that is paid upfront before you start getting money coming back to you, in addition to all the prep and things you buy to prepare for having a kid, etc? This is even while we we picked the inexpensive route (homebirth)! I don't even know how much hospital stays and/delivery are. Beyond it being variable depending on complications, I'd be scared to know the real numbers on this but I'd imagine it's far closer to Roxy's numbers and far above what I experienced. Had we not had the midwife covered by the insurance I'd have been out another $4k. notwithoutmyanus fucked around with this message at 04:25 on Nov 5, 2015 |
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Nov 5, 2015 04:21
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Sorry, nothing to see here except irritation about our litigous society and how it affects medical care.
Roxy Rouge fucked around with this message at 06:22 on Nov 5, 2015 |
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Nov 5, 2015 06:12
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I want to give each and everyone of you a big hug. I'm just imagining someone planning a home birth and then having to get a emergency C-Section be out of a surprise extra 6K or something like "woops" too bad you needed that not to die. I'm a teacher here and I'll be using some of these examples in my classes in the future.
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Nov 5, 2015 07:50
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KingColliwog posted:I want to give each and everyone of you a big hug. I'm just imagining someone planning a home birth and then having to get a emergency C-Section be out of a surprise extra 6K or something like "woops" too bad you needed that not to die. I'm a teacher here and I'll be using some of these examples in my classes in the future. I might be wrong, but it sounds like they paid the money and then got most of it paid back to them eventually. Like you've already noticed, healthcare financing in the U.S. is really weird. So what you see on the bill is not necessarily what you have to pay. If you're uninsured and/or poor, hospitals usually have a financial department that will work with you and often waive at least some (or even most) of your bill. If you are insured, you'll often get a bill with those insane prices on it but it will be much lower once insurance pays its share or negotiates the price down. I think sometimes insurance companies like to send that stuff to you just as a tactic to make you feel like you saved a lot of money, like "Look here's how much you would have paid if we hadn't talked the price down and paid our share!  " Insurance companies send out so many meaningless bills and statements that I feel like the environment would be saved forever if they alone just stopped mailing poo poo.
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Nov 5, 2015 11:18
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We're in a privileged position where the public health system will generally cover all costs for basic antenatal care in Australia, but I'm extra lucky in that owing to being an employee at the imaging center I get scanned for free. Most people pay some out of pocket amount unless they're destitute and/or on some kind of pension (i.e. disability/single parent/veteran/etc). I think for most ultrasounds there's a general out of pocket cost of ~AU$150-250, depending on the type of scan. Things like biopsies and steroid injections attract a higher fee because they take up precious expensive doctor time, not just my crappy sonographer time. So far this pregnancy has cost us maybe a few hundred bucks in maternity clothes and newborn cloth nappies/diapers, and prenatal supplements like multivitamins. And constipation drugs. Lots and lots of constipation drugs.I still can't feel kid move either, so it all feels more or less surreal--just getting progressively more unfit and obese!
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Nov 5, 2015 13:16
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I never had to pay a cent for ultrasounds! I think all standard prenatal ones are free.
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Nov 5, 2015 13:46
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Kimmalah posted:I might be wrong, but it sounds like they paid the money and then got most of it paid back to them eventually. I get that they will receive some money back toward paying for those care, still 1k still sounds crazy, especially since she took the "cheap" path, the actual delivery isn't included and that any problem she might have will raise the prices by a lot. I'm sure some people pay a lot more than that too Just as a counter example, my GF pregnancy cost us 0$. This included 3 ultrasound, about 12 hospital visit the doc, delivery with epidural, 2 night hospital stay, 2 at home post natal nurse visits and 2 blood tests. I'm probably forgetting some KingColliwog fucked around with this message at 18:30 on Nov 5, 2015 |
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Nov 5, 2015 18:24
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The only things I have paid a cent for so far are the NIPT and prenatal vitamins. I've had ultrasounds at 7, 20 and 24 weeks, about to have another at 28 and apparently have to have more at 32 and 36 weeks and have paid 0. My US place was going to charge for the 12 week scan but I decided against it (not because of the money). I've more than made up for it buying clothes. This kid is going to have more clothes than she can ever wear.
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Nov 5, 2015 22:16
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Another privileged Australian here. I was on Austudy when I had my now almost 2 year old, and I think the only thing I paid for through the pregnancy was iron supplements, pregnancy vitamins and we paid for some antenatal classes, which were discounted because I was on Austudy. Also we got the baby bonus which was nice and paid for a lot of the baby stuff we needed. We're planning to have another baby sometime early next year, but that time around I'll have private health insurance, won't be on government benefit and no baby bonus. From talking to friends who had babies outside the public health system I'm probably going to be 3-5K out of pocket for insurance excesses etc. I still feel like I'm extremely lucky to live in a place where that is the cost of having a baby. The idea of it costing like ten grand and up just blows my mind 
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Nov 6, 2015 00:28
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Hey folks, I just found out I'm pregnant after 2 months of trying with my hubby. Its our first. Yay! But now I gotta get on this baby train and figure out to plan the rest (oh god what did i sign up for?) I have a few questions: How did you select your OB-GYN? Did you interview a few before you went with one? Did you choose based on their affiliation to the hospital nearest/preferred to you? Or just where their offices were? Word of mouth from friends/family? I live in Seattle and there's a prominent hospital/medical provider that has 2 hospitals that do deliveries in my area. The one closest to me is marketed as the more "community" "boutique" hospital (implying more service since its smaller) while the other's the big, all-bells-and-whistles with a neo-natal unit etc. for high-risk births. Since I don't even have an OB-GYN, I wouldn't even know which hospital would I pick, etc. Does that play a role? Thanks for listening to my babbling. 
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Nov 6, 2015 08:16
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Being in the US you should see if one (ob or hospital) is a preferred provider for your insurance. My obgyn practice is the only one covered at the best rate so that's why I chose them. I really my ob so it worked out.
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Nov 6, 2015 08:58
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I think all of those are valid options for choosing your OB. I'm the first of my friends to have a baby so I found my doctor online based on my insurance and some reviews. I actually went for a preconception workup and liked her, so I decided to return when I got pregnant. It turns out that she's part of a group of 6 doctors (I've been rotating through all of them since I don't know who will be on call when time comes) and they deliver at a high quality research hospital. The only downside is that the hospital is at least a half hour drive from where we live (maybe double that during rush hour). You can also do a tour at each of the hospitals you're considering and then choose a doctor affiliated with the hospital you want to deliver at.
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Nov 6, 2015 15:52
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