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This pregnancy has been the most difficult of all my pregnancies. While the second and third pregnancies ended in miscarriages early on, thus minimizing the emotional and physical stress, the prenatal blood tests I took around week 10 came back positive for Trisomy 18 (T18), also called Edwards Syndrome. On a Friday morning while I was at work, the OBGYN called, and from the moment she said “Hello”, I knew it was serious. Most of the telephone conversation is a blur, but I can remember her saying “low survival rate post birth, if the baby even makes it to birth.” During my lunch break and that night, I Googled everything I could about T18. While it is the second most common chromosome abnormality behind Down syndrome, it is much more serious and extremely fatal.
Related Posts: I Was Pregnant Without Insurance
The weekend was filled with sadness, but not despair, as I had prepared myself all along for the possibility of another miscarriage. I was 36, had already been through two miscarriages, and did not have the same level of fertility as I had with conceiving my daughter. A week and a half later, I was seeing a genetics counselor and a few specialists in Rochester, NY, about three hours away.
The genetics counselor asked us questions about our family history to get a better idea of about the probability that the baby actually had T18. Based on our relatively healthy lifestyles and the fact that there was very little chance that my hubby and I were related (I’m Korean and my husband is the standard white male of European descent), there was a 55% chance that the baby had T18. The specialists did a high resolution ultrasound and a chorionic villus sampling (CVS). Since I knew that a CVS involved a needle in my uterus to the placenta, I asked about any numbing drugs. The doctor said while she can give me lidocaine, the typical burning sensation from lidocaine is actually worse than the needle for the CVS, so I opted out of the lidocaine. It was more uncomfortable than painful. Just take controlled breathes and remain calm.
A few days later, the genetics counselor called with the FISH results, which is a fancy medical word for preliminary results. Of the 200 cells taken from the placenta, 190 of them confirmed the blood tests, but 10 were normal. Because there were some normal cells, she suggested doing an amnio as soon as I was 15 weeks pregnant. Two weeks later, we were back in Rochester for another meeting with the genetics counselor and specialists for another ultrasound and amnio. An amnio is similar to a CVS, but it takes cells from the amniotic fluid rather than the placenta. The genetics counselor was a bit more optimistic this time, since there was a ray of hope with the 10 healthy cells.
Three days later, the genetics counselor called with the best news I had heard in a long time. The FISH results of the amnio were back and the baby was healthy. And while the full results of the amnio would take another week or so, they would be very surprised if the full results showed anything to the contrary.
A week and a half later, she called again to say the full results were normal. The reason the prenatal blood tests and CVS were so different is because the cells on the placenta have a different composition than the cells from the baby, which makes the placenta cells not representative of the baby’s cells. While the baby is healthy, my situation is uncommon, having gone through the prenatal blood test, a CVS, and an amnio. I am proof that prenatal blood testing and CVS’ are not definitive. We went back to Rochester once more after the amnio for a 19 week anatomical ultrasound, which showed an active and healthy baby.
Now at 22 weeks, my belly gets bigger and more inconvenient every week. Two months ago I was coming to grips with the possibility of a pregnancy termination, but my gut told me to remain patient and have hope that everything would be fine.
At the beginning of 2015, my hubby and I decided to take the risk of going without insurance for the entire year. Since we were both young (enough), healthy (relatively), and our daughter was covered by Child Health Plus, we said screw you to Obamacare. Of course, we had to mess that plan up by getting pregnant. In early fall, we were pregnant and uninsured, which is actually a fairly common scenario. So common, in fact, that a quick search on Google yielded 56.6 million results.
The most common program for uninsured, pregnant women was Medicaid. When I first got Child Health Plus for our daughter, I was told that my income was too high for any Medicaid assistance, which was no surprise to me. But it was just low enough to qualify for Child Health Plus. When I was researching affordable health care as a pregnant, uninsured woman, I found out that the Medicaid income limits were higher for pregnant women.
But of course, I was still above the income limits. (Apparently, the lesson here is if you want health insurance in America, you have to be poor.)
After reading online forums about mommies and babies, I called my Ob-Gyn’s office and asked for their advice. Their billing department suggested I contact the hospital I had my daughter at, because they had a specific clinic that catered to the uninsured, which had an Ob-Gyn office. At first I was a little hesitant, but when they said that my specific Ob-Gyn doctor, whom I loved, worked there a few mornings a week, I was sold.
When I spoke to the financial department at my hospital, it turns out they have a financial assistance program for the uninsured.
After sending in some paperwork and a few paystubs, I was able to get 50% of any medical bill that went through their financial system, which included the Ob-Gyn clinic. The 50% off would even apply after I got insurance through the healthcare exchange in January 2016, which was four months away.
Being the numbers driven person that I am, I asked what the typical prenatal appointments and procedures cost, and started crunching numbers. Drawing back on the prenatal appointments when I was pregnant with my daughter, the first prenatal visit includes an ultrasound ($400), papsmear ($591), and initial bloodwork ($850). Of course, there was also the doctor ($470), and the specialist to analyze the ultrasound and tell the doctor what it showed ($170). The ultrasound specialist is a separate charge from the hospital system, thus not included under the “charity discount”, the nice name the hospital financial department gave my 50% discount on the bill. So, the total for the first prenatal visit should come to $1325.50 (50% of $400+$591+$850+$470, plus the $170 for the radiologist, without any discount), assuming a low risk pregnancy and no complications.
The next two prenatal visits, about 12 weeks and 16 weeks, are $116 each, plus the doctor to listen for the heart beat and ask how I’m feeling, $470 each, making each one $586.00. Taking off the 50% makes each one $293.00.
That brings us to the 20 week mark, halfway through the pregnancy, when it’s time to check for the gender and more blood tests. Since that would have been January 2016, when I would have been able to pick up insurance through the healthcare exchange, I didn’t bother calculating the costs. But the financial department did tell me that a C-section without any complications is around $11,500, which includes the hospital stay and doctor, but not the anesthesia.
The estimated cost for the first three prenatal visits totals $1911.50 ($1325.50 + $293.00 + $293.00).
Compare that to the estimated cost of carrying health insurance for the entire year. When I checked the health care exchange at the end of 2014, the lowest premium was around $350 a month, making the annual cost $4200.00.
Based on those numbers, it was definitely worth the risk of not getting insurance. As long as you don’t have any complications, or end up in the emergency room like I did. I ended up miscarrying, which is not a story for the faint of heart. I had an ambulance ride to the ER, and an overnight stay at the hospital so that I could get a blood transfusion. Good thing I had the 50% charity discount.
My name is Emilie. I am 34 years old, I have a 3 year old daughter, and last month, I miscarried at six weeks pregnant.
At the first prenatal ultrasound in October, the radiologist informed us that the baby was measuring at 6 weeks, and without a heartbeat. The second ultrasound nine days later confirmed the first ultrasound. The next day, the doctor presented me with my options: A) wait for the natural miscarriage, which would most likely happen within the next two weeks, B) take a prescription to induce a medicinal miscarriage, or C) get a D & C, a surgical miscarriage. I opted for the natural miscarriage, because I didn’t have insurance (under the Affordable Care Act, birth is a qualifying event, yet the 10 months leading up to the birth are not; WTF?) and I didn’t want anything around my uterus (I delivered my daughter via emergency C-section). So I scheduled the next appointment with the doctor for two weeks later, with the agreement that if the miscarriage didn’t happen by then, I would get a D & C.
One week later, I called the OBGYN’s office to inquire about the prescription. Since I still hadn’t started bleeding yet, I asked if I could still get the prescription. The nurse said they could give me the prescription at the appointment next week. Two days later, everything happened.
Warning: TMI alert!
I started bleeding at the supermarket while picking up lunch (thankfully, I already made the bank deposit for work). It was so heavy that I was soaking my pad in minutes. When I urgently called the OBGYN, the nurse said to immediately call 911. Luckily, the supermarket manager had already called for the ambulance. I had just enough time to call my husband’s office and told the front desk to page him. Now, imagine yourself being pushed out of the supermarket bathroom on a gurney, with linens wrapped around you from the waist down, with your soiled clothes in a plastic bag, completely conscious and alert. Needless to say, I won’t be stepping into that supermarket for a long time.
The EMTs monitored my vitals and gave me an IV during the ride to the hospital. They asked me questions, but most of the ride is a blur. I just remember passing blood and who knows what under the linens all the way to the hospital. Once I was checked into the hospital, and still bleeding,I remember feeling cold, thirsty and restless everytime I passed anything. I just could not lie still, even though I didn’t want to move. When I met the ER doctor (unfortunately, not Dr. John Carter from ER) and his nurses, I told them what my OBGYN had said. And let me tell you, I could feel the sense of relief wash over the entire room. The doctor would not have to tell me the bad news that I was miscarrying.
Soon after, the on call doctor from my OBGYN’s office arrived and introduced herself. She told me that I had to get a D & C, and possibly a blood transfusion. I would be put to sleep for the surgery, which would last about a half an hour. Within 15 minutes, I was transferred from the ER to the hallway outside the outpatient operating room. I remember the anesthesiologist telling me he was administering the happy, sleepy potion, and telling everyone around me “I can feel the drugs!”. The next thing I remember is waking up in the recovery room, repeatedly asking the nurse for the time, and the whereabouts of my husband. God bless her for not shushing me.
By now, about five hours had past since I totally messed up the supermarket bathroom. I did get a blood transfusion during the night at the hospital. I also got a catheter because I couldn’t potty due to the surgery. The OBGYN returned in the morning to check on me. Since I don’t remember anything between getting the sleepy potion and waking up in recovery, I asked her to tell me what happened. Basically, I had a lot of clotting in my uterus, which is why I hadn’t started to bleed. Then the previous day, my body started to flush out everything, but it wasn’t handling it very well. I lost a lot of blood, which resulted in the blood transfusion to replenish some of the lost blood. Two hours later, I went home.
I feel it is important to mention that at no point in time was I in any pain. And what doesn’t kill you makes you stronger. I am very grateful for what I have now: my family, my health, and my home.