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Military Families
MrsMandyPandy
member
So upset with Tricare
MrsMandyPandy
member
My DH is stationed at Andrews AFB. I had a MC then end of May. When i talked to the OB then she said i could try to get pregnant after my first period which came the 20th of June. Three weeks ago i found out i was pregnant again and we were thrilled. I went and got labs done to confirm the pregnancy.And then called to make my first appointment. But was told i will need to go to a orientation first and there was only one a month so i will have to wait till August 18th and i don't even known if then i will find out how far along i am. I had pain in my lower abdominal and wasn't gas pain so i went to the ER yesterday. I was there for 5 hours with labs and a Vaginal ultra sound. And all they said was it was my uterus or my ovaries. And i still was unable to find out how far along i was. It just said "Early Pregnancy" on my D/C papers. My MC i was very early in pregnancy only about 4 weeks and didn't even know i was pregnant until i had a "period" that lasted 4 weeks and i went to the ER. Since i didnt know i was even pregnant i didnt greve very much and we felt ready to try again. But this time i am having symptoms and Morning sickness and i just want to know how far along i am so eventually i can tell my family because i want to shout it from the roof tops. As far as i can tell i am 8 weeks. I just get so disapointed when i read so many women go in at 4 weeks or even 8 weeks and i dont even know when my apointment is just the orientation. And as the orientation goes i dont even know what to exspect or if i will find out information. I called the womens clinic and the lady said i would have to go to the orientation first and that was all. Maybe its my horemones but i think if this was her baby or her daughters baby she would want to know too! Im trying not to stress. Sorry for venting but are all bases like this? If so i might wait for baby #2 when my hubby gets out of the military is 3 years...Also isnt it my right to know my own medical history? Has anyone else had to deal with this? Again sorry for venting but waiting 8 days for this stupid orientation is driving me crazy...
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Re: So upset with Tricare
The thing is, even if you were able to get an earlier appointment, you most likely will not have an u/s until around 10-12 weeks along anyway, unless there was some other reason for needing an earlier u/s. With Tricare usually the only u/s's you get, unless you need others for medical reasons, are around 12 and 20 weeks.
And it's not just Tricare that has this "policy," there are also a lot of civilians whose insurance covers the same type of u/s schedule.
I'm also not sure what you mean by "right to know my own medical history." What do you not know about your medical history?
They might not have measured to know how far along you are. Unless you actually got an OB in the ER, chances of your ER doc knowing how to properly date a pregnancy by u/s are slim. Even if you did see an OB in the ER they may have a policy to not tell how far along a patient is for whatever reasons.
I understand how frustrating it is. I had two early losses, and various other problems, before getting (and staying!) pregnant with my twins. Then I had lots of spotting and bleeding before my first appointment with them. Luckily our ER had an OB on call at all times so I was able to get a good idea of what was going on, and figure out about how far along I was when I went in at 6 weeks. Even then all I knew was, yes you're bleeding, I can't see why, there are two babies in there measuring 5w6d, I think I see heartbeats flickering but it's too early to tell, follow up with your doctor.
Your discharge papers said "early pregnancy" so that's a pretty good sign that everything is ok for right now. I don't think I ever left the ER during a pregnancy with papers that said anything other than "threatened miscarriage." Even when the babies themselves looked ok, it was still labeled that because of bleeding. If they didn't label you as a threatened miscarriage then I would bet they saw absolutely nothing other than a healthy pregnancy.
I agree with this 110%. I had two miscarriages before DD and I received extremely unprofessional care from the MTF. I refused to be seen at the MTF when I was pregnant with DD and was able to get a civilian referral and stay on Prime. That is becoming harder to do these days, though. For this pregnancy, I switched to Standard. I started with the MTF process since we are now at a different base, but it was more of the same incompetence.
Maternity is covered 100% under Standard. There are some downsides (like being locked out of Prime for a year if your sponsor is above E-4), but the most important thing is that you receive the level of care that you are entitled to and are in competent hands.
I had my OB care at Bethesda and went to the orientation at 10 weeks. It was a 2 hour long session where they give you all the nutritional information and prenatal care guideline books and they also have you listen to an STD talk and advise you to be tested as expectant mothers.
At the end you were put with an OB nurse to enter your information into the system and set you up with your first OB appt. (this appt. had to be no later than the end of your first trimester), my appt. was set for 13 weeks. When I was with the OB nurse she went over any concerns or issues I had and I was acutally sent to acute care for a consult because I was pregnant with twins and was having severe morning sickness and she felt I was dehydrated. So yes it is only an orientation and setting you up but you will meet with an OB nurse to go over things and they will give you paperwork for bloodwork as well to be done before your first appt.
I agree with the other ladies... my 1st appointment was the OB orientation at 12 weeks and all they did was discuss nutrition and what to expect during pregnancy. They also provided a book that went through when each appointment would be by week. The only reason I know how far along I am is because of the date of my last period. That date is what the doctor goes off of until the first ultrasound. Then they can change the EDD by a few weeks depending on how things are measuring.
If you feel strongly that you are getting the run around you should go to the patient advocate. Explain how you have had a MC and the need to go to the ER during this pregnancy. The patient advocate might be able to speak to the Women's Health Clinic and get you the information you are looking for.
Congratuations on your pregnancy!
Just like to add that this is wrong, an accurate dating US needs to be performed before I believe 9 weeks. At that stage all babies grow the same after this point they can still date based on avergaes but it isn't as accurate as a very early ultrasound. I had a dating ultrasound that put me at 13 weeks with my son and when he was born at 39 weeks the doc said he was probably only 37 weeks.
I saw a civilian OB and didn't get an ultrasound until like 18 weeks. And nothing exciting really happened at the first appointment anyway. We got to hear the heartbeat and she felt to make sure my uterus was in the right place.
Be patient, your orientation will be here soon enough and then you can meet with the doc and get all your questions answered!
Huge ditto to this. Go ask on the First Tri board how early they had first appointments and you'll see that very few doctors want to see pregnant patients until 10-12 weeks. Dating ultrasounds are not the norm, especially not in very early pregnancy when LMP is known. This is not a Tricare problem, this is a your expectations problem.
I'm sorry about your MC and I completely understand your worry and need to know. I went through it after my first ended in MC. But as many others said, they most likely would not do a dating US until you are about 12 weeks. With my second pregnancy, they did an ultrasound at 6 weeks but only because I had really low pregnancy hormones and a high risk condition.
Honestly I wished I'd just waited to do the US a few more weeks because then at 6 weeks she couldn't even really see much of anything and started apologizing thinking it might end in miscarriage again. I was so upset! I waited 2 weeks and got another US done and then everything looked great. But not without much suffering during those weeks of waiting.
I know it's hard to have patience, but you really need to stop stressing yourself out so much.
Goodluck.
I hated the orientation.
Go to NNMC at Bethesda. Trust me you'll be happy you did.
I had a MC before I had DS so I understand your pain. Atleast around here it is common to get your first appointment around 8 weeks. I had one at 8 weeks with DS where I got an U/S to see how far along I was and if there was a HB. I know on base (pendleton) they make you wait till you are atleast 12.
I had DS on standard and after our deductible we only paid $115 out of the over $300,000 we racked up between my labor, CS, recovery and DS being in the NICU for 2 weeks.
If you aren't happy with the care you are receving already I would switch to standard. My year of being locked out has passed I will not being going back on prime.
What exactly does Tricare have to do with any of this? This is a base policy, not Tricare. I will tell you that at EVERY base I have been to, you get an u/s first to date the pregnancy. That can be done anywhere from 8-15 weeks. You then have to go to an orientation where you have paperwork to fill out and bloodwork done. After that, you usually have your first prenatal appt. within a week or two.
You do know your medical history. Dating the pregnancy is not part of it yet.
That might be how it is in a perfect world, but even civilians wouldn't treat this pregnancy any differently. M/C are incredibly common. If doctors treated their patients differently after one m/c, they would never leave the office. Believe me. I wish that it could be different. I have had 4 m/c, but after one m/c, additional attention is not warranted unless their is an underlying diagnosed issue. Even after my four m/c, it is highly unlikely that I will receive any additional attention during my next pregnancy.
This. With a history of miscarriage you should be considered high risk and treated more urgently. Typically, you are seen between 8-10 weeks at our hospital, but we're Army so maybe it's different. Also, civilian friends of mine were seen at 8-10 weeks and then once a month after the 1st tri, monthly there after, then every 2 weeks in the first 2 months of the 3rd tri, and weekly for the last month. Each appoint after 1st tri they did an u/s. Each practice/insurance coverage is different, but for someone with a m/c you would expect more. We plan on switching to Standard when we conceive. I would suggest doing the same and research OBGYN's in your area.
There is a lot of info here.
I have had two miscarriages, have cervix issues, and had a premature baby. Because of that, I am Tricare Standard and avoid the cattle call "one size fits all" OB care that MTFs seem to operate with.
That being said, with one early miscarriage you are not considered "high risk" and wouldn't be even with a small civilian OB practice. It is common practice to date your pregnancy early on by your last menstrual period and then to adjust the date when they give you an ultrasound at 10-12 weeks at your first appt. Most MTFs do that late first trimester "date the pregnancy" ultrasound. So you will find out how far along you are - it just isn't right.this.second.
My advice is to jump through the hoops (go to OB orientation and then show up at your first appt. at 10-12 weeks) and try to relax. If you aren't bleeding heavily or cramping then you have to assume things are going okay. I know that is hard (believe me - both of my losses were "missed" so I know what it is like to worry) but it is the way the OB care works. They can't do anything for you. Early ultrasounds for dating are NOT the norm. You are in the same boat with zillions of other women who just want to fast forward their pregnancies to the second trimester
.
If you feel like you aren't getting good care - switch to Tricare Standard and shop around for an OB practice that you are comfortable with. You can also call a patient advocate. But like I said, I don't think you have been treated poorly or outside of the standard of care yet.