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.
Re: CaliforniavtnurseJanuary 30 2010, 15:46:06 UTC
I agree! My midwives' typical plan of care for women that go past their edd is they start doing twice-weekly NST's and BPP's, which to me is an acceptable non-invasive way to monitor the health of baby and mom. They don't even start talking induction, unless it's requested, before 42 weeks. (This is at UCSD Medical Center in San Diego)
In all likelihood, the parents misunderstood the directions given by the midwife stating that she would have to turn over care to an OB, which is likely. Unfortunately, there are also care providers who mis-state (to be polite) the law, in an attempt to influence the actions of the parents (usually with good intentions, sometimes not). You can decline any medical procedure that you do not want. There *have* been cases where a woman's right to make these decisions has been taken away, but they are VERY rare, generally require more than "overdue," and are not supported once the cases are appealed (with one or two EXTREMELY rare exceptions).
With the leg pain, are you dealing with singular spots of pain? Is there redness, swelling or bruising, at any of these spots? Pregnant women are more susceptible to clots, which should be something you are on the lookout for (although don't flip out over it, just an suggestion *grin*).
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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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The midwives at my birth center in CA would attend a birth from 37 to 42 weeks. After 42 weeks they are required to transfer your care to a doctor.
There is no law forcing medical procedures on you.
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With the leg pain, are you dealing with singular spots of pain? Is there redness, swelling or bruising, at any of these spots? Pregnant women are more susceptible to clots, which should be something you are on the lookout for (although don't flip out over it, just an suggestion *grin*).
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