for the induction at 41 weeks, I dont know if it is law, but it is not healthy. When the placenta is mature, it begins to calcify. Meaning that it is not getting as much nutrients to the baby, making it a less healthy environment. Thats why induction is recommended above 41 weeks, or even 40. We offer it at my office at 39 weeks, and most women accept, plus it increases their chances of their physician delivering them instead of another doctor in the call group. The midwife has obligation to see you through your pregnancy and to deliver a happy healty baby. If they dont offer or try to do what is possible to get that baby out healthy, then there may be legal consequences to them. THey have to make sure they cover themselves as well as to not lose their licenses.
I guess, just make sure you keep track of your kick counts, stay hydrated, and go in to the hosp if you feel decreased fetal movement. Well wishes for a great delivery!
Many, many pregnancies go beyond 41 weeks without the complication of calcification of the placenta. Hitting 41 weeks doesn't automatically mean you will have problems with the placenta, it typically doesn't even happen until later than that, if it happens at all. The smart thing to do is actually to request antenatal testing such as NST's and BPP's to assure that things are still going well with both the baby and the placenta.
Any provider can refuse to continue care if a patient goes against what their policy is, which is a sad situation in itself. That said, any reasonable provider will accomodate requests for additional testing if a patient wishes to not be induced past their edd (within reason, of course).
As far as the second paragraph, I'm only familiar with Ohio laws, but your provider is required to give you 30 days to find a new provider. So, if you are 41 weeks and refusing induction and you go into labor at 42 weeks, that provider is still obligated to provide you care.
Very few states have "patient abandonment" laws. Maryland does not, and relies solely on case law, which essentially says doctors releasing patients from their care must use a "reasonable and customary" standard, but that is defined on a case-by-case basis. I don't know the California law at all.
I only know this because my OB released me from his care (without any discussion or stated reason for releasing me) when I was 15 or so weeks pregnant. Per the AMA guidelines (not requirements, just guidelines), they provided 30 days during which they would provide "emergency medical care only" (it was italicized, even). On the 28th day, my home health care company called them and told them that there was an emergency with my PICC line (that they had had placed) and the office never called the home health company back. It was good fun. I had a very hard time finding a new doctor to take me - and didn't find one until 6 weeks after my original notice from the OB's office.
Um. No. There is no expiration date on the placenta and automatically inducing with no medical reason is going to cause more problems than it solves. It is not evidence based care to offer an induction at 39 weeks, for no medical reason. Early inductions are the reason for a lot of the late term preemies that are taking up space in the NICUs, when had all involved been patient, those babies would have been perfectly healthy, if allowed to come in their own time.
1. Estimated due dates are called estimated for a reason. There is no stopwatch to a pregnancy. No one knows if the woman ovulated on time in the first place, not to mention that due dates tend to get moved around. What a doctor is calling 41 weeks could really only be 38. Or, in the case of your practice routinely inducing at 39 weeks, the baby's actual gestational age could be considered not even full term.
2. If there was a problem with the placenta, which is rare, there are several signs that detect this, not to mention testing available BEFORE concluding that a mother should be induced.
I guess, just make sure you keep track of your kick counts, stay hydrated, and go in to the hosp if you feel decreased fetal movement. Well wishes for a great delivery!
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Any provider can refuse to continue care if a patient goes against what their policy is, which is a sad situation in itself. That said, any reasonable provider will accomodate requests for additional testing if a patient wishes to not be induced past their edd (within reason, of course).
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As far as the second paragraph, I'm only familiar with Ohio laws, but your provider is required to give you 30 days to find a new provider. So, if you are 41 weeks and refusing induction and you go into labor at 42 weeks, that provider is still obligated to provide you care.
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I only know this because my OB released me from his care (without any discussion or stated reason for releasing me) when I was 15 or so weeks pregnant. Per the AMA guidelines (not requirements, just guidelines), they provided 30 days during which they would provide "emergency medical care only" (it was italicized, even). On the 28th day, my home health care company called them and told them that there was an emergency with my PICC line (that they had had placed) and the office never called the home health company back. It was good fun. I had a very hard time finding a new doctor to take me - and didn't find one until 6 weeks after my original notice from the OB's office.
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2. If there was a problem with the placenta, which is rare, there are several signs that detect this, not to mention testing available BEFORE concluding that a mother should be induced.
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