My OB said not to get the TDAP shot...

kat8805

For the record, we are talking about the TDaP vaccine, a 3-way vaccine for Tetanus, Diphtheria, and Pertussis. The DTaP, while the same three are covered, tends to also include other diseases like HepB and is a larger combination it would appear. TDaP was not brought up during my last pregnancy, and I was concerned more so about the tetanus portion than anything since I was having an ECS, but I trusted my Dr and luckily there were no issues to warrant it.

I was asked this pregnancy, but many guidelines and practiced have changed since I delivered last time, so that's no surprise. I had mine last Thursday and do still have a warm, red lump on my arm. I was told the tetanus portion of the vaccine is the one that usually provokes a reaction, and I did remember a small creation from my normal Tetanus/Diphtheria vaccine I got about 18 months ago at my physical. I did ask, since I'm fairly certain that vaccine was also a TDaP, but here is essentially what I was told by Dr, straight from the CDC's site: On October 24, 2012, the ACIP voted to recommend that health-care personnel should administer a dose of Tdap during each pregnancy irrespective of the patient's prior history of receiving Tdap. Optimal timing for Tdap administration is at 27 through 36 weeks gestation.

Coming from the horse breeding world, I do not find that an odd practice. It's typically recommended to vaccinate a mare 4 weeks before her due date, for all diseases, since most vaccines cannot be administered to her foal for months afterwards. It's been the understanding that the mother's vaccinations and immunity will pass to the baby during pregnancy, and again through the antibody rich colostrum available before milk comes in.

On the pump front, I'd demand the prescription be written. You aren't requesting anything medicinal or harmful to your LO, and most insurance companies and suppliers won't allow the pump order to be processed until 30days out from your EDD, which doesn't leave much time should they decide to hee haw around like most insurance situations tend to do. Even if you do not end up using it at all, for whatever reason, I would recommend having it on hand just in case. And especially if you only have two options to go with, I see no benefit to waiting until after LO arrives.

If you feel uncomfortable with the advice your OB is giving, and already know he won't be the one delivering you at your preferred hospital, I would suggest making the shift now to someone else.

Edit for dumbphone autocorrections.

BKD1386

I got my Tdap done at my 30 week appt... it was strongly recommended.  The nurse said they've already had 3 pertussis babies this year.  I'd rather not risk it.... just need to get hubby in to get his sometime before baby gets here.

IBackBevo

OP - If I were you, I would try to get an OB with privileges at the hospital you are going to deliver at. A couple of times in my pregnancy with ds, I had to be seen by the on call doctor at a hospital and would not recommend it. ..The worst time being what led to my c-section.

pistolpackinmomma

I still can't get over not knowing the dr that will be all up in my vag delivering a child. My dr is the only one in his practice too. Because of that I have had to deal with delays from time to time but he also does all of his patients' deliveries unless he is OOT. Both times I have told him no vacations when I have my kid.

spacepotatoes

pistolpackinmomma said:

I still can't get over not knowing the dr that will be all up in my vag delivering a child. My dr is the only one in his practice too. Because of that I have had to deal with delays from time to time but he also does all of his patients' deliveries unless he is OOT. Both times I have told him no vacations when I have my kid.

Mine is one of 9 in his clinic so my odds of getting him for delivery aren't good. On the plus side, they operate their clinic as a team and are all based at the same hospital so there is a decent amount of consistency there.

pistolpackinmomma

spacepotatoes said:

pistolpackinmomma said:

I still can't get over not knowing the dr that will be all up in my vag delivering a child. My dr is the only one in his practice too. Because of that I have had to deal with delays from time to time but he also does all of his patients' deliveries unless he is OOT. Both times I have told him no vacations when I have my kid.

Mine is one of 9 in his clinic so my odds of getting him for delivery aren't good. On the plus side, they operate their clinic as a team and are all based at the same hospital so there is a decent amount of consistency there.

The practice here that has multiple drs (I think there are 5 plus a midwife) rotate seeing patients when they are pregnant but you have a "main" dr that you see any other time. But that way you've at least met the dr who delivers.

MrsT2008

pistolpackinmomma said:

The practice here that has multiple drs (I think there are 5 plus a midwife) rotate seeing patients when they are pregnant but you have a "main" dr that you see any other time. But that way you've at least met the dr who delivers.

My practice is the same way.  They make sure you meet all 5 at least once during your pregnancy.  Last time, of course, I ended up delivering wiith the one OB I only met one time (and at like 16 weeks!) but she ended up being "my" OB because of that (I didn't go to the practice prior to my last pregnancy).

whitneymarie003

It is standard at my OB's practice to get the TDAP around 30 weeks. That's when I had mine done. You can refuse to get it but it's highly recommended. They prefer to do it during pregnancy as opposed to waiting until after delivery.

stephierd81

I was given my tdap about a month ago. And urged for DH and anyone who would be holding the baby or around baby a lot to have it.

Miles2Go

What's TDaP?

mrsbtobe20122

Sounds like he just isn't up to date in current CDC recommendations...which would personally bother me due to medicine being ever changing and constant need for innovation/improvement in practice.

Why would you see someone who doesn't have privileges at your delivering hospital? Usually if the physician doesn't have privileges, there is a reason for it....

pandadair

Kimbus22 said:

I'd be looking for a new doctor since yours appears to ignore current recommendations and is giving you vague answers and basically blowing off your questions.

Yes, you CAN get the shot after delivery.  That's better than not getting it.  But the purpose of getting it in the 3rd trimester is because then some of that immunity passes to the baby and gives them some protection until they're old enough for their own vaccine.  Why anyone would advice against that is beyond me.

I'm also giving a serious side eye to PP who said her OB doesn't push it because pregnant women get stressed about having a red, swollen arm for a few days.  WTF?  If you're too stressed to have a sore spot on your arm for a couple of days to protect your kid, you're not in any way ready to be a parent.

I don't BF so I'm useless with pump information.

Well, I think she meant they'd had a number of patients with more severe reactions than they'd expected that caught them off guard and freaked them out, not that a red, swollen arm was stressing them out. Either way, I did find it a bit odd. But she has good reviews and I've always felt comfortable with her, which is why I felt so WTF about it. Blargh.

ETA: Besides, I'm not exactly in the mood to find a new OB at 34 weeks pregnant over it. I will just have to bring it up again at my appt next Tues and go to CVS and get one myself, if necessary.

ho11yday

If you want your tdap, go to the pharmacy and get it.

NorthernGal248

The CDC website states that babies may not take the vaccine as well if their moms had gotten the vaccine. I am not a doctor in any way, shape or form - but maybe this is why your doctor isn't insisting on it?

Lild09

spacepotatoes said:

Soupy84 said:

MrsT2008 said:

Maybe op is in canada? Isn't it common for them to not see OB until near the end?

It could be a provincial practice thing? I have seen my OB since confirming my pregnancy and I am in Alberta. I only know what typically happens in AB & the NWT based on experience.

In Ontario, it's around 30 weeks, about when the biweekly appointments would start. That's assuming everything is proceeding normally. I've heard of some people getting in earlier than that, though, so it could be a regional thing here.


No I don't think it's a provincial thing...I think it's just who your regular doc is and how you got referred. I've been with my midwife since week 10 and I had seen the OB for the first time at week 9 and would have continues appointments with him if I decided to go that route. I'm in Ontario.

When I asked my midwife about TDAP a while ago when it was discussed here she states that there are no recommendations in Canada to get it done during pregnancy. There's clearly a reason why it isn't recommended here so I just let it go. I had all my titres checked prenatally and was told what I wasn't showing immune to and that I'd get any of those shots post baby (mind you the one I was low on is rubella which you can't receive during pregnancy anyways).

spacepotatoes

@Lild09 The midwives in my city do start taking over care at the end of 1st tri/start of 2nd tri. But it is pretty standard not to switch to an OB until the 3rd tri. The other people I was referring to in my previous post are people who do not live in my city and are also seeing OBs, not midwives. That's why I suggested maybe it was a regional thing in Ontario.

spacepotatoes

Lild09
No I don't think it's a provincial thing...I think it's just who your regular doc is and how you got referred. I've been with my midwife since week 10 and I had seen the OB for the first time at week 9 and would have continues appointments with him if I decided to go that route. I'm in Ontario. When I asked my midwife about TDAP a while ago when it was discussed here she states that there are no recommendations in Canada to get it done during pregnancy. There's clearly a reason why it isn't recommended here so I just let it go. I had all my titres checked prenatally and was told what I wasn't showing immune to and that I'd get any of those shots post baby (mind you the one I was low on is rubella which you can't receive during pregnancy anyways).

Regarding the bolded, CDC recommendations are not exclusive to the US. Our own associations for Gynecologists and Pediatrics may not have made official recs but the CDC guidelines do count for something here too.

CVislo

My OB hasn't even mentioned it... But that may be because the Japanese do things differently. For example, I didn't have a one hour glucose test. The nurse asked me when I last ate and/or drank anything and then she's calculated it somehow. However, it was required for me to get the TDAP, among other vaccines, before I moved to Japan, so I got it a few weeks before we found out I was pregnant.

oscarwao

Thank you for all the responses ladies! It is helpful to hear everyone's advice.

Lild09

spacepotatoes said:

Lild09
No I don't think it's a provincial thing...I think it's just who your regular doc is and how you got referred. I've been with my midwife since week 10 and I had seen the OB for the first time at week 9 and would have continues appointments with him if I decided to go that route. I'm in Ontario.

When I asked my midwife about TDAP a while ago when it was discussed here she states that there are no recommendations in Canada to get it done during pregnancy. There's clearly a reason why it isn't recommended here so I just let it go. I had all my titres checked prenatally and was told what I wasn't showing immune to and that I'd get any of those shots post baby (mind you the one I was low on is rubella which you can't receive during pregnancy anyways).

Regarding the bolded, CDC recommendations are not exclusive to the US. Our own associations for Gynecologists and Pediatrics may not have made official recs but the CDC guidelines do count for something here too.
</blockquote

However they are not a governing body in Canada therefore those recommendations are not something that must or even should be followed by our health care practinioners...it's not like the CDC is the WHO. Here we have our own governing bodies like the public health agency of Canada.

ashleightricia

That's odd, my midwife brought it up at my 28 week appointment and told me it was recommended to get during pregnancy now.

Sdufort1216

I got mine at 31 weeks the nurse said they give them from 28-36 weeks. I just said ok because they seemed to make it sound important but I never really looked into it probably a bad move on my part but I trusted them