Would an OB fire you for this?

[WantsALittle1]

Over the last month and a half, I've had to call the OB answering service after hours on 5-6 occasions... A couple times for fever and throat pain/tonsillitis. Another call when the antibiotics for the tonsillitis did not work. I had to call her last night at 3:30 am when I woke up with leg pain and severe stabbing pain in my C-section incision area. This was after a day spent in the hospital on monitors and terbulatline because I was having contractions and the stabbing pain. I had to call her again tonight because I was in L&D again today because the incision pain didn't respond to the terb injection, and the treatment regiment she gave me at discharge didn't work. She gave me something to stop contractions again, and told me to take Tylenol and Flexeril and a warm bath for the stabbing pain. None of that worked, and I still feel like I'm getting stabbed in the incision with a giant jagged knife.

She mentioned last night's 3:30 am call when I talked to her tonight, and now I'm petrified that she's so annoyed with me that she'll dismiss me and I won't have an OB to deliver my baby! She brought up the 3:30 am call when I said I'd prefer not to take Norco for the pain, because last night I called her in pain at 3:30 am and I'm sure she was implying that she doesn't want another phone call.

 

[Birdling]

I'm sure she doesn't! No one likes being woken in the night

I'm sure if they are all genuine emergencies, she wont really mind though.

There always used to be posters up in our doctors surgeries that talked about calling the doctor at night - they said 'Be nice, think twice - can't it wait till morning?'

I suppose it is hard in the middle of the night, when everything seems worse, to decide if it can wait or not. Just consider carefully before calling and only call if it really can't wait. I shouldn't think she'd fire you though, just be a bit annoyed in private

Hope your issues all resolve soon

 

[kat2504]

I can understand phoning about the pain in the incision but I can't understand why you would phone an obstetrician about a sore throat, fever, or tonsilitis. Those are matters for a general practitioner surely? And unless you have a high fever, none of those are middle of the night emergencies. I understand being more anxious about your health when pregnant, I am the same, but you have to be really sick before you call a doctor in the middle of the night. If it is an emergency it would be better to just attend the hospital, there will be an obstetrician on duty there during the night.

 

[AC1987]

I personally wouldn't call my midwife/ob over anything other then pregnancy related, and the only time I'd call in the night is if I think I'm in labour, I think if I thought something else was that serious in the night I'd go to emerg..

 

[WantsALittle1]

So a little background…

kat: With the sore throat, I could not swallow and was afraid I had caught Hand, Foot, and Mouth disease from my daughter, which increases the risk of stillbirth and other complications. I was in horrible pain and it could not wait.

I had been told by my last OB to call him for everything, and I mean everything, because an OB becomes your Primary Care Physician during pregnancy, and the first thing any other doctor is going to ask when treating me is what my OB says. Granted, I do NOT think that my current OB feels the same I was also told by that same OB to call him before going to the hospital, as one call from him can get me whisked through triage much faster than if I just 'wait in line' like a person walking in off the street. That is why I have called her before each time I ended up going to the hospital.

I guess my problem was transferring over practices from my last OB to this OB, and I should have started with a clean slate when I met her and should have seen what her policy is. The other thing is that I fear going to a GP and having him give me some med that is actually not good for pregnant women. I trust my OB because she treats ONLY pregnant women, so if anyone knows a good, safe medication, it's her. I would much rather she prescribe me something (I ended up needing three antibiotics for the tonsillitis) than a GP.

The stuff over the last few days I feel is valid reason to call her, as the stabbing pain gets unbearably severe and, though they've stopped contractions two times now, that pain has not subsided at all despite the contractions stopping. I do feel that is a legitimate reason to call her--the pain is directly where my incision is, and to me that's terrifying!

Thank you all for responding. I think I'll write her a sorry note

 

[Eternal]

It's slap cheek that's an issue in pregnancy that causes still births and birth defects, hand foot and mouth doesn't cause defects and there is little evidence to suggest it would cause miscarriage ( there is very limited evidence either way) and that only applies in 1st trimester.

I personally wouldn't call my on at 330, but things are different there so it's hard to say what I'd do. I do with the "can it wait until morning thing" and if it can't I call labour and delivery for advice.

It's hard to say what I'd do because it's different there, but I wouldn't see my on for general illness, only pregnancy related, like I had pancreatitis in my last pregnancy and was fairly poorly and obviously it was a worry as you can die form it, but it wasn't a on issue, it was a general surgeon issue, so that's who I saw. My OB wasn't interested in the slightest, yes it make my pregnancy much more risky (I'd had surgery at 17 weeks and it was twins) hut it wasn't something that he had any control over.

Sorry you have been so I'll, my last pregnancy was like that and it sucked!

Big

 

[WantsALittle1]

Eternal: Thank you for the hugs! Just wanted to share that coxsackievirus (the typical virus behind HFM disease) can cause myocarditis, and is the second leading viral cause of stillbirth behind parvovirus. I was shocked to learn this, and a bit miffed that when my OB found out I had HFM that she didn't tell me about the possible risks to my baby. Our Maternal Fetal Medicine department said they didn't tell me anything because I am already getting weekly NSTs/BPPs and that's all they'd do for a woman who had caught a coxsackievirus anyway :/

There are quite a few links on the dangers of coxsackievirus during pregnancy. It really scared me, as it is SUCH a common disease, especially for moms with toddlers!

https://www.patient.co.uk/doctor/Coxsackie-Virus-Infection.htm

"- Maternal Coxsackievirus B infection has been associated to an increase in fetal cardiac abnormalities.
- Coxsackieviruses A and B can cross the placenta and cause stillbirth by villous necrosis and a variety of other means."

 

[2have4kids]

I think if you're worried about being fired as a patient you should listen to your gut instinct rather than rationalize your actions. I'm sure I'd have done the same in your situation, I'd have called her too! But listen now to what she's telling you and maybe ask what she considers a valid call/not and who else is appropriate to lean on considering the health issues you're dealing with. Try using the ob on call at an Emerg clinic rather than your delivery doctor.

On the other hand if a full service OB is what you require and you only want to deal with one person, maybe she's a bad 'fit' for you. If you've called her repeatedly late night for various reasons and she's given you feedback to make you think twice about doing so, maybe a different doctor is what you need. Can you search for another OB? I'm positive all of your reasons are legitimate for calling at 3:30 - no one should argue this with you.

To her what's going to be the most important concern is if she has capacity to handle a high risk/high maintenance patient in her practice. If she decides that ongoing late night calls are compromising her ability to manage her practice and other patients, you will need to have plan B ready. In the mean time, if you wish to keep her, I'd listen to what she's told you and try to lean on other resources with your varying concerns - share the love. I hope things get a little more smooth sailing, it sounds like you've had some stormy weather lately!

 

[Amalee]

I doubt she would dismiss you for that - I'm sure all women have varying levels of problems and questions during pregnancy, and she's probably cared for women in the past who needed more than you! Having said that, I would apologize for the late night call like you're planning to, and ask her what sort of situations merit an immediate call, what can wait until the morning, and what you can ask the hospital about if you're worried and it's the middle of the night (since they all generally have a 24 line you can call).

 

[Babyfor2]

I wouldn't worry! It's not like you called her at 3:30 in the morning because you ate lunch meat or something lol. You were in pain and she should do something about it. I highly highly doubt she would drop you. After all no one likes being woken up but when it's for a good reason it should always be okay. If it's not then she needs to get in a different field asap because this won't be the last time someone does that to her

 

[WantsALittle1]

Thank you everybody. I have decided that I just won't call her anymore, period. I'll just go straight to L&D if I think something is amiss. The 3:30 call is because I woke up in excruciating pain and was about to go to the ER but wanted to talk to her first.

I ended up breathing through the pain and going to L&D the next day.

 

[Brieanna]

I am glad that you got it all sorted out but I would probably get another doctor. I am from the us (Texas too!) and my ob/gyn said to call with any problem any time. The problems you mentioned seem very normal to call for. I NEVER go see a gp when I am pregnant and my ob has never had a problem with any of my concerns.

In the US we personally pay our doctors (a lot! I am paying 2,000$ out of pocket for mine just for normal visits!) and so I think it is a bit different than in other countries. Also, I know that if I had a problem and went to the ER and then to the gp then I would be getting 2 more bills for thousands of dollars just to hear them say to talk to your normal obgyn!

Obviously don't call for silly things (I don't think you were at all) but they got into this profession knowing that late nights would happen a LOT more than with most professions. She was probably as annoyed as anyone would be for getting woken up, but if she actually makes a big deal out of it later or anything then you should find someone else. I think you should call her as much as you need to from now on and don't feel bad. Since you are so far along and you might not want to change, then just never use her again.

Also, I went into labor when my doctor was on vacation and it wasn't a horrible experience to have someone else deliver. I honestly didn't even care as long as she came out, lol. The nurses and other staff do a lot of the work (at least in my case) anyways so if your actual doctor is mean or something you either won't notice or someone else will be there.

Hope you feel better.

 

[WantsALittle1]

Brieanna: Thank you so much. I, too, come from a culture of "call about anything, anytime" from my last OB. I caught a monster cold at the beginning of this pregnancy and had a 101 fever. I called my OB at the time and immediately apologized for bugging him with something so trivial. He told me to call him for ANYTHING, as little as a sniffle, because the first thing a GP is going to ask if I call them instead is "What does your OB say?" I think he also got mad at other doctors treating his pregnant patients in ways his disagreed with (i.e meds that he didn't consider safe or effective for pregnant women) and he would have to do damage control afterward to fix their mistakes. He just got tired of too many chefs in the kitchen, and told me it's better to call him first, no matter what it's about. At very least, he said, he could call ahead to the hospital to get me seen faster by pulling the pregnancy card and using his weight as an established on-call doctor for the hospital. He was great. I miss him. He misdiagnosed this as a chemical pregnancy, but I still miss him so much. He was very supportive and caring.

Anyway, was expecting my current OB to be the same, but she's different. I like her as a person, and she is responsive, but she has told me that she's a "well visit" doctor and doesn't even have a thermometer in her office. I had been getting fevers of 102 at home and wanted her to verify (I was using a kind of unreliable ear thermometer). I was shocked to learn that… Don't pregnant women get fevers from things like UTIs or amnionitis? Wouldn't it be useful to have a thermometer to check into those things!?!?

I really was shocked. So yeah, current OB definitely doesn't subscribe to the same philosophy as my last OB...

 

[Leesy]

Can you change back to your old OB? My OB was like your first one, he was great and always said to call about anything, i actually had a very breezy pregnancy so there was no need for late night calls but he made it clear to just call if i felt the need.

 

[WantsALittle1]

Leesy: I wish. He is in California and we moved to Texas in July, when I was at 12 weeks or so. I was in his care for the first trimester, at least!

 

[claudinator]

Look it's such a stressful time, and in pregnancy your right air on the side of caution.
Or you could end out like me putting things off going into prem labor and getting the flu.
Your doing what's right for you and you and baby are number one.

 

[TXJen]

I call my OB for everything as well, because she told me to. If it's something that needs drugs to be prescribed, they're the safest bet since they know for sure what is pregnancy safe and what is not. But I also have a very close relationship with my OB so I might be in the minority.

I haven't had to call her at 3:30 am yet, but I have called quite late at times when I genuinely felt like it could be an emergency but needed guidance. Once because I was bleeding and had a flight to catch the next morning for example, so I needed to know if I should go to the ER (my worry was if it was a miscarriage would it be safe to fly - turns out they would advise against it).

If I had stabbing pains I probably would have gone straight to the ER, but I can also understand why someone wouldn't want to. We pay astronomical ER fees in the US - I've had bills come back at $10,000 before insurance costs - so I don't blame anyone for not wanting to go in and wanting to get an opinion first. If I didn't have really great coverage, I would probably think twice about it. That doesn't even begin to describe the amount of time it takes to see someone - last time I came in with no wait and it took 4 hours to get a diagnosis of nothing wrong.

So this is a long post but no, I don't think your OB would fire you. If you really do think something could potentially be an emergency, I don't think it's wrong.

By the way, I am a doctor's daughter as well so I grew up with patients calling my dad at all hours, all the time. It's not abnormal.

 

[JAJuly2013]

I wouldn't worry! It's not like you called her at 3:30 in the morning because you ate lunch meat or something lol. You were in pain and she should do something about it. I highly highly doubt she would drop you. After all no one likes being woken up but when it's for a good reason it should always be okay. If it's not then she needs to get in a different field asap because this won't be the last time someone does that to her

I agree with this. When you are in the OB field, being called in the middle of the night comes with the territory. If she doesn't like that, she needs to make her standard practice known for late night/Emergency phone calls.
I would definetly contact her to get clarification on that and find out who would be a better choice for you.

If you had to have contractions stopped the day or two before and still had pain/concerns, you would think she would be a little more understanding. Pregnancy is exciting and scary at the same time. We just want the best for our babies. Midwifes also want what is best, but they are not invested the way we are. It's not their child. Do what you feel is right for your body and for your little one.

 

[WantsALittle1]

Saw my OB today and asked her if she was mad about the 3:30 am call and she said "Oh my gosh, no. That's NOTHING…"

Then we chit chatted about Christmas. I am so relieved that she's not mad!

Unfortunately last night was a bad BH contraction night (6 in a 20-minute period), had to stop them twice with warm bath and walking around, and lots of stabbing pain today. So she unfortunately may be getting more calls from me in the near future if this stuff doesn't die down and I get a flare up of real contractions like last week. The real contractions were brought on by the BH. My uterus is pretty unhappy and really seems to be trying to kick this little guy out! I have to take Procardia to stop the BH until Sunday, at which point she'll let it go and let me go into labor if that's what my body is trying to do!

 

[amjon]

I can understand phoning about the pain in the incision but I can't understand why you would phone an obstetrician about a sore throat, fever, or tonsilitis. Those are matters for a general practitioner surely? And unless you have a high fever, none of those are middle of the night emergencies. I understand being more anxious about your health when pregnant, I am the same, but you have to be really sick before you call a doctor in the middle of the night. If it is an emergency it would be better to just attend the hospital, there will be an obstetrician on duty there during the night.

Not in the US, the OB does everything during your pregnancy. A GP will NOT see you pregnant. I wouldn't call in the middle of the night for that though unless I had a super high fever though.