Midwifery, well-woman checks, and CF status

10 February 2010 at 10:22 am Leave a comment

A woman on a listserv I belong to was lamenting the fact that, almost at the end of her first trimester, she suddenly found out she was a CF carrier and had to have her husband tested. She posted wondering why her OB had never suggested testing her before her pregnancy, and, while this obviously doesn’t help this particular woman, I thought I’d post here about my experience with this issue.

As I’ve said before, I’ve seen a CNM for well-woman care/annual gyn. exams since I was eighteen and a first-year in college. Going to a women’s college with a strong midwifery slant to the on-campus health center, I sort of fell, luckily, into the midwifery model of care more than I consciously chose it at first. 

In my experience, it was indeed part of standard pre-conception care to test women for CF status, and I don’t even fall into a particularly high-risk group on that front. When I was 30 (childless and in a monogamous relationship), even though I said I wasn’t planning on having kids, my midwife said she’d strongly recommend doing what she called a pre-prenatal exam. I was indifferent, but figured that it couldn’t hurt. When she said she’d bill it to my insurance company under a special code so I wouldn’t even have an extra co-pay for the labwork, that decided me (seriously, I don’t think we should discount how many health decisions are made on the basis of money, even for those with health insurance).

So my midwife did baseline bloodwork, and checked my rubella status, RH status, CF status, etc. A year later my husband and I did decide that we wanted, someday, to start a family, and a year after that, I just swapped a folic acid pill in for a birth control pill one day, and off we went. It was really good knowing we had the tests behind us at that point. To me, these contrasting experiences just show, once again, some of the differences between well-woman care received from midwives vs. doctors.



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More on Gisele–the midwife speaks! Midwives in kids’ books?

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