Pregnancy, even for the healthiest of women, can come with a long list of challenges and potential complications. And since no two women, or two pregnancies, are the same, even the most "universal" of pregnancy situations can be experienced differently. That includes a pregnant woman's relationship with her OB-GYN. So what happens when you're suddenly removed from a doctor's patient list? It turns out, there are more than a few reasons OB-GYN's reject pregnant patients that every soon-to-be mom should be made aware of.
The National Center for Biotechnology Information published a study via Journal of Women's Health in 2013, which reported that the demand for women's health services will rise by up to 6 percent over the next two and a half years. Eighty-one percent will be made up by women of reproductive ages (18-44) seeing doctors in the OB-GYN sectors. It's also been determined that, currently, the supply for essential women's health services hasn't met the demand, particularly in states with higher populations.
The aforementioned information, mixed with current policy changes now putting all women at risk, means that not only is it harder for any woman to find and secure appropriate gynecological care, but for pregnant women to obtain proper prenatal care, too. In other words, just because you're pregnant doesn't mean you'll always, without a doubt, have access to your OB-GYN of choice. Plus, doctors have their own reasons for rejecting their pregnant patients, which can include the following:
Whether you've decided to switch OB-GYNs late into your pregnancy for a variety of reasons, or you're late into getting prenatal care, a doctor can refuse to treat you because of how far along you are. Without a complete knowledge of your full medical history, or how your pregnancy has been progressing, the doctor could find themselves in a potentially liable position. A recent article in Women's Health chronicled one woman's experience, when she discovered she was pregnant at 29 weeks and, as a result, was unable to secure a doctor.
Dr. Lauren Streicher, associate professor of clinical obstetrics and gynecology at Northwestern University Feinberg School of Medicine, tells Women's Health it isn't likely only because late-stage pregnancy may come with a laundry list of risks and complications (and could become a liability), but also because the practice could be full, or they fear you've been going between different practices to avoid financial responsibility, medical advice, or any other number of reasons.
Insurance woes can hit anyone and any time. And not all doctors accept all forms of insurance, including medicaid and medicare. The Center for Disease Control and Prevention (CDC) states that 700 women die every year from pregnancy-related complications. With bad or no insurance, coupled with inability to pay for health care services rendered, prenatal care becomes difficult, albeit sometimes impossible, if individuals can't afford to seek the treatment they need.
Sometimes an OB-GYN can refuse to treat pregnant patients because of his or her personal beliefs. While The Code of Medical Ethics has a lengthy history and definition — and the declaration definitively states that all doctors should care for their patience with "competence and compassion and without prejudice," according to report from NBC News — there are still going to be doctors who choose not to treat specific patients based on their own religious or moral code, potentially hindering patient care.
A doctor could reject you due to circumstances surrounding conception, your sexual orientation, and even your weight.
Some mothers-to-be have a birth plan — it's great to be prepared — but every now and then, a pregnant woman might not agree with her doctor's recommendations for how pregnancy, birth, and postpartum treatment should go. That might lead to a termination of the relationship. The American Congress of Obstetricians and Gynecologists says ethical dilemmas may cause conflict and, as a result, interdisciplinary is necessary. If the doctor believes something to be in yours and your baby's best interest — particularly if a life is at stake — and you vehemently disagree, this could warrant a transferral to another doctor.
Health care is, well, a complicated system. Your weight, how far along you are, and any pre-existing conditions you may have can complicate the type of care you receive, especially when you're pregnant. And an OB-GYN may reject a pregnant patient if he or she decides there's too much risk involved. Johns Hopkins Medicine reported that a rejection may not necessarily be only because you're labeled high risk, but because your doctor thinks you'd be better cared for by a specialist. Pre-existing medical conditions and genetic risks may require more than your standard OB-GYN can handle. A 2011 poll conducted by South Florida's Sun Sentinel found that doctors refused prenatal treatment to pregnant patients, citing they lack "adequate equipment" to care for their patients, while other doctors rejected patients because they were "high risk."
Though it's not what you want to hear, it happens. Doctors — especially OB-GYNs who are well-known in their field — can only take on so many patients in order to give them the best care possible. If they're already treating pregnant women with due dates near yours, the doctor will probably tell you they're unable to take on any new patients.
OB-GYN-hopping is what happens when a patient runs from physician bills, medical advice, or simply avoids staying with one doctor for a significant amount of time for any reason. You could be rejected by an OB-GYN if he or she has seen this type of behavior in the past.
Whether it's an insurance issue, a full patient list, or simply a difference of opinion, the important part of your prenatal care is finding an OB-GYN you can trust to help you guide you through your pregnancy. It's not always easy, but the right one is out there.
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