Behind the (Very Honest) Scenes of my 8 Week Pregnancy Appointment
*This is solely based on my experience, and my feelings towards this experience. This does not speak for the entirety of the medical space, and should not be taken as medical advice. I went to a local provider, Genesis OBGYN, which is a larger local network of OBGYNs connected to hospitals in town (making it easy for delivery planning + opportunities for your OB to be the delivery doctor.) After sharing with my audience on Instagram stories, there were mixed reviews from local Tucson women about their own experiences with Genesis. Some positive, some negative. It's important to remember this is a journey we all go on individually, and we're all in different circumstances and head spaces. My experience may not be yours, and vice versa.
When I walked in for my 8 week appointment in February 2022, I'm not sure what I was expecting. A red carpet rolled out for me? Someone to hand me flowers and say "congratulations Ada, you're pregnant!" Honestly I had no clue what I was expecting, but I can 100% tell you I was not expecting the cold demeanor I got from the nurse's assistant as well as the nurse practitioner.
When I walked in for the first appointment, I would have expected a little more excitement from the person who called my name in the waiting room. She knows I'm there for my FIRST appointment. Instead she handed me a cup and said "bathroom is to your right." I know I'm a 31 year old woman, who maybe "should" know what's going on, but this is my first time doing any of this so I expected more communication, more emotion, more handholding essentially.
I took the cup, and went to the bathroom. I assumed it was for a urine sample but it had none of that information on it. After getting through my first urine sample (one of many to come ladies!) I went to find my husband who had been told to go into Room 12. I found him in there, and we waited for the NP as we made small talk.
Once the NP came in, she introduced herself and gave us some basic information. I explained to her I had called at 5 weeks pregnant due to severe stomach pain (I really thought something was wrong related to the baby but it turns out constipation gives you some of the worst stomach pain you could ever imagine.) During that call, I spoke with Nurse Triage who answered some questions about constipation and then a few more about supplements. In that call, they said to and I quote "bring all your supplements, herbs and tinctures with you to your 8 week appointment and the NP will go through them with you one by one to let you know which are safe to take during pregnancy."
So of course, I brought my Mary Poppins bag of supplements because if you know me pre-pregnancy I was taking a lot of different things to boost my system. I'm a big believer in supplementing on top of a healthy lifestyle.
When I mentioned I had a bag of supplements I wanted to go through one by one, she looked really annoyed and said she didn't need to go through them one by one. She said she always airs on the side of caution, and mentioned the basics can be taken (probiotic, vitamin D, zinc, etc) but the least amount of supplementation is best. "Make sure to take your prenatal everyday!" She kept referencing a booklet pamphlet situation that the office had written and said "check the booklet for more information on X." This felt like a lack of service, or care. Not necessarily laziness but she did not want to get into the weeds with me which is what I personally needed.
Lack of service.
Said booklet that she continued to reference? It's basic AF. For example "to avoid constipation and hemorrhoids, drinks lots of water." No shit Sherlock. We all could have told ourselves that one.
When I asked questions specific to my workouts (CrossFit) she said "exercise is good for you and the baby so make sure to continue exercising." I was looking for more guidance from her at 8 weeks about what I should and shouldn't be doing because again first timer here, and she didn't provide the curated support I needed. The most comical thing about all of this is that literally every single item says to "consult with doctor if pregnant or breastfeeding" but realistically your doctor or care provider likely isn't going to review hundreds, even thousands of products, with you throughout pregnancy. It's unrealistic to even expect them to, but they won't do it even for the things you have questions on. The annoyed look when I even suggested going one by one with the supplements I brought was enough to make me want to Google everything.
Here's the thing about me. I don't need the general information. I knew that already going into this. I had read what to eat (shout out to Lily Nichols book on Real Food for Pregnancy). Plus I knew exercise was really important. I know drinking water helps avoid constipation and hemorrhoids. Same way I know I shouldn't drink alcohol while pregnant or go skydiving. Don't need to be a rocket scientist for all of this. I want to know can I do handstand holds, gymnastics movements, run 5 miles, etc. I wanted to know a doctor's stance on my workout regimen and I have come to realize I should have found a doctor (or NP) who does CrossFit who knows the movements and can give me a more detailed breakdown of what I needed.
No curated support.
There was also an air of her wanting to leave and get to the next patient, because they are booked solid. When I asked to come in before 8 weeks, they said there was nothing available so I know they are booked back to back and usually have multiple people booked at the same time. That also lends itself to a shitty experience, which is a problem with the medical institutions as a whole. They try to took on 500 patients week so you've got 10 booked at the same time to try to get through them, and then you're 1-2 hours behind schedule so everyone's waiting.
GET IN AND GET OUT MENTALITY.
Going into the first appointment, I had insurance which I thought was suitable for the process. However, going into this first appointment I had no clue how much the appointment would cost or why. The only cost mentioned to us was for a carrier DNA screening for $99 (which ended up being a whole situation for months to come that I had to handle) but the actual cost of my 8 week was never disclosed to me before I got there or when I was having my appointment. I was supposed to know the details before going in.
LACK OF COMMUNICATION REGARDING BILLING.
When I got a bil for almost $400 a few weeks later, for an appointment that so cold hearted it should've been free, you can imagine my shock. After calling my insurance, the agent said that the office should have told me the cost beforehand (billing should have called me) or the NP and staff should have mentioned the cost to me during the visit. Evidently a new act had gone into place this year:
The No Surprises Act, effective as of January 1, 2022, aims to provide patients with accurate information regarding their expected health care spending. In many cases, the new law prevents health care providers from charging patients for costs not reimbursed by insurance.
I can confidentially say that the No Surprises Act may be in motion, but this didn't mean anything for me or my now $400+ in bills and statements from my 8 week appointment. Come to find out a few days before I was supposed to have my 12 week appointment AND my 12 week ultrasound (2 separate appointments, 2 separate line items aka 2 separate bills) that my insurance covers no maternal routine care. It only covers emergency situations. Of course we are to blame for misreading this, as we believed I did have maternal care but I also find it fascinating that I'm 12 weeks into pregnancy and I'm just now being called by billing to let me know I don't have maternal coverage. Mind you, I had called them at the end of 4 weeks/beginning of 5 weeks to get on the books immediately. I had been an existing client already, with my information on file (and the same insurance for years.) But it's before a crucial 12 week appointment that I get the call that hey the ultrasound and your routine visit will be over $1,000 out of pocket given you have no coverage, and this isn't going towards a deductible.
I had to cancel both appointments and we didn't get any ultrasounds in the doctor's office until the 20 week one. We decided to go to a third party on my birthday, so I could make sure I heard a heartbeat and everything was ok, but I wasn't paying hundreds for it out of pocket especially if it's not going towards a deductible.
You have to awkwardly ask about pricing for everything.
Since no one is offering any pricing to you, you have to advocate for yourself or be surprised later. In addition, I realized I had to tell them which lab to use to run my blood because the default lab the office uses is not covered by my insurance. If you don't mention it, they send to their default, and then you end up with a lovely bill from that lab. If you do ask, it's still awkward because it's a change of routine for the staff and they have to "double check they can send to said lab." Nothing about the process is pleasant if I'm being frank, which clearly I am. This has turned into a big of diary entry.
4 THINGS I WASN'T PREPARED FOR DURING MY 8 WEEK APPOINTMENT:
1. Being my own advocate for every detail.
2. The cold, fast paced (get in get out) feel of the institution.
3. Lack of communication regarding billing.
4. Lack of curated information for me specifically.
What are some of your personal experiences going through pregnancy routine appointments?
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