Folic Acid

[Aubrey]

So this is one of the things the ER nurse was yelling at me about on the way out. When I mentioned that it could be found in food, time stopped. Her head kind of imploded. And then it started again, & she was yelling.

 

I finally looked it up tonight. I'm taking multi-vitamins right now, but not prenatal. I've never taken prenatal vitamins--I've never had a dr prescribe them. First pg, I got some otc, & they made me sicker. Dh's wife was a nurse, & she gave me some that worked better, but I don't know what they were (other than rx, not otc).

 

Anyway, different websites have different info, but it looks like they all agree about 400mcg in early pg, which is what the multis have. They also mention that the body (for some insane reason we don't understand) absorbs the man-made folic acid better than that found in food. Someone could politely & calmly say this to me, & I'd say, "Oh. OK."

 

But now that I know that generally a multi vitamin offers the amt of folic acid needed during pg...I'm wondering why she was so freaked out about it? Why prenatals in particular? I mean, I know they usually offer more, & more is maybe better, but...really? Yell at me over a difference of, say, 200mcg?

 

Is there another possible reason for her behavior? What am I missing?

[BakersDozen]

All I know is that extra folic acid was the one thing stressed by my doctor over and over again. I can't tolerate any prenatal or multivitamin but do choke down FABB tablets to ensure adequate folic acid intake (especially since I'm having "twinkies", lol). I would suspect that given the link between folic acid and spina bifida and the fact that many women do not get enough folic acid in their diets, the nurse would freak out upon thinking that you were relying solely on your food alone. I don't know what difference 200mcg would make however it might be worth it to take a folic acid supplement if the prenatals have more folic acid than your multivitamin.

[OrganicAnn]

Folic acid of course prevents Spina Bifida. About 50% people have the gene that could cause spina bifida in their babies if they are low on folic acid. I believe it is only the first few weeks that matter for Spina Bifida (also helps prior to pregnancy). You can buy just folic acid to add to multi vitamin. Also the chlorine used to purify water can contribute to incidents of spina bifida. Some areas use more chlorine in their water supply than others. There are no standards for this in the US. So some areas it is more important to take Folic Acid.

 

Don't know why she freaked out, unless she has seen someone who could have prevented a baby with spina bifida, but didn't.

Edited May 4, 2011 by OrganicAnn

[Shellydon]

Nurses see lots of babies that have been severely injured in utero by neglectful mothers. I am guessing your attitude might have seemed very nonchalant to her which can be disturbing for someone that ends up trying to save babies all day long. When you work with sick babies that are disabled or dying because mama didn't pursue prenatal care and/or didn't take care of themselves it can make you very heart sick and frustrated when you meet yet one more mom that doesn't *seem*(at least on the surface) to understand the importance of basic things like vitamins. This is just a guess, I don't know the woman of course. She could just be worn out from working in a hospital under cruddy administration. She could have had PMS. Her mother could have died last week. She could just be plain 'ol mean. :001_smile:

 

I like Rainbow Lite prenatals, they are OTC.

[Carol in Cal.]

Folic acid is helpful if taken for a few months before pregnancy and during the earliest weeks. Beyond that, it's just a good thing, but not anything more special than any other nutrient.

 

My understanding is that prenatals are mostly for the iron. I took Stuart's, and they are OTC, and very absorbable. They were great.

[Aubrey]

All I know is that extra folic acid was the one thing stressed by my doctor over and over again. I can't tolerate any prenatal or multivitamin but do choke down FABB tablets to ensure adequate folic acid intake (especially since I'm having "twinkies", lol). I would suspect that given the link between folic acid and spina bifida and the fact that many women do not get enough folic acid in their diets, the nurse would freak out upon thinking that you were relying solely on your food alone. I don't know what difference 200mcg would make however it might be worth it to take a folic acid supplement if the prenatals have more folic acid than your multivitamin.

 

This makes sense, but if it's such a big deal, I wonder why NONE of the dr's/mw's I've ever seen have *ever* rx'd anything--or even discussed prenatals.

 

And then for this one nurse to suddenly freak out...surprised me. I guess I'm suspicious since they didn't actually tell me anything other than that I am "VERY pg" & I didn't even get to see the sono. They found something awful & conspired not to tell me...:lol:

 

My mw always interprets these questions as worry; it's really not. I'm just that curious about everything.

[Lisa R.]

So this is one of the things the ER nurse was yelling at me about on the way out. When I mentioned that it could be found in food, time stopped. Her head kind of imploded. And then it started again, & she was yelling.

 

 

 

Was she really yelling? In other words, did people 50 feet away hear her yelling at you to take folic acid?

 

The reason I ask is that my kids accuse me of yelling when I'm talking seriously and firmly.

 

No offense, I've just never heard of such unprofessionalism. So sorry you were treated rudely.

[LibraryLover]

It's crazy that she would yell. What the heck did that accomplish?

Edited May 4, 2011 by LibraryLover

[katilac]

The medical community does tend to get freaked out about this one. It's unprofessional, and not helpful, to lose your cool, but humans aren't always at their smartest when they're frustrated.

 

My ob wasn't happy when I got pg without a planning visit, b/c ideally one should take the prenatals for a certain length of time before even getting pg. Folic acid deficiency is easily prevented, and can cause severe birth defects. My take on it is that these are the people who have seen these severe birth defects in action again and again, and to KNOW some of them were preventable has to be frustrating. She may have had a recent encounter with a newborn with severe birth defects.

 

The prenatals are considered higher quality (not just higher dosage), with better absorbtion rates and so forth. And they have special coatings and such, so that they are less likely to make you sick. Quality of multivitamins varies widely. I'm pretty amazed that you were never prescribed prenatals before! I've never known an ob who didn't. Texas really is a whole other country, I guess :tongue_smilie:

 

 

So this is one of the things the ER nurse was yelling at me about on the way out. When I mentioned that it could be found in food, time stopped. Her head kind of imploded. And then it started again, & she was yelling.

 

I finally looked it up tonight. I'm taking multi-vitamins right now, but not prenatal. I've never taken prenatal vitamins--I've never had a dr prescribe them. First pg, I got some otc, & they made me sicker. Dh's wife was a nurse, & she gave me some that worked better, but I don't know what they were (other than rx, not otc).

 

Anyway, different websites have different info, but it looks like they all agree about 400mcg in early pg, which is what the multis have. They also mention that the body (for some insane reason we don't understand) absorbs the man-made folic acid better than that found in food. Someone could politely & calmly say this to me, & I'd say, "Oh. OK."

 

But now that I know that generally a multi vitamin offers the amt of folic acid needed during pg...I'm wondering why she was so freaked out about it? Why prenatals in particular? I mean, I know they usually offer more, & more is maybe better, but...really? Yell at me over a difference of, say, 200mcg?

 

Is there another possible reason for her behavior? What am I missing?

[indigomama]

Prenatals always made me feel horrible. My midwives have all said as long as I eat my fruits and veggies, I was good. I usually eat spinach in my eggs for breakfast or have a spinach fruit smoothie for breakfast. Lots of folic acid in spinach.

Don't know why the nurse freaked, sorry.

[katilac]

This makes sense, but if it's such a big deal, I wonder why NONE of the dr's/mw's I've ever seen have *ever* rx'd anything--or even discussed prenatals.

 

I think lots of us are wondering that! I have never heard of an ob who didn't prescribe and stress prenatals. I heard it for years before we got pg: remember, if you decide to ttc, it's important to take those vitamins FIRST, etc. I can't imagine an ob or midwife who doesn't even mention them. That's skirting malpractice, imo.

 

I didn't do the planning visit, but I did research and take a quality OTC before going off of birth control.

[Shellydon]

I think lots of us are wondering that! I have never heard of an ob who didn't prescribe and stress prenatals. I heard it for years before we got pg: remember, if you decide to ttc, it's important to take those vitamins FIRST, etc. I can't imagine an ob or midwife who doesn't even mention them. That's skirting malpractice, imo.

 

I didn't do the planning visit, but I did research and take a quality OTC before going off of birth control.

 

 

I did a ton of reading and research as well. To the OP, after all you've said of your midwife, I personally, would be very leary of her. She quite honestly sounds a bit loosey goosey with the basics of good health care for pregnant women.

 

Please know that I use midwives as well and I've never, ever heard of one acting the way you are describing.

[8circles]

I think lots of us are wondering that! I have never heard of an ob who didn't prescribe and stress prenatals. I heard it for years before we got pg: remember, if you decide to ttc, it's important to take those vitamins FIRST, etc. I can't imagine an ob or midwife who doesn't even mention them. That's skirting malpractice, imo.

 

I didn't do the planning visit, but I did research and take a quality OTC before going off of birth control.

 

I don't know - I've always gotten very good prenatal care & none of my OBs or nurses were freakish about prenatals or Folic Acid. I've always had a hard time remembering to take vitamins & they would just say to do my best & that was it. Honestly I probably managed to remember a few times a month. One OB just suggested taking a children's vitamin when giving them to my kids if it made it easier to remember. Little did he know I couldn't remember giving them their vitamins either. :D

 

Aubrey, I have to admit that it sounds like you got very bad treatment because you have no insurance. They are probably making all kinds of negative assumptions about you & they don't believe you deserve to be treated better. That sounds harsh but it's what I've been thinking since you posted your ER experience. How they treated you is awful & I'm pretty sure at least some of it is illegal. I've never heard any other ER horror story that's even close but I do know the attitude which some of the nurses seemed to have.

 

:grouphug: You've passed the "critical" point for FA so just do your best with a multi if you can & don't worry about it. Congrats, btw. :)

[UnsinkableKristen]

I'm pretty amazed that you were never prescribed prenatals before! I've never known an ob who didn't. Texas really is a whole other country, I guess :tongue_smilie:

 

 

I've delivered my three babies (and plan to deliver this one as well) in the same town as Aubrey and I have never heard of anyone being treated like this. It is definitely not a Texas thing, not even a local thing. I am appalled for her and the lack of care and basic respect she has received.

 

Aubrey, please speak to someone in the management of that hospital/ER department. Lack of insurance does not give them the right to speak to you like you are an idiot or a child. You are an adult who is perfectly capable of understanding reason, without being yelled at. :grouphug:

[Joker]

I've had two children in two different states (CA & IA) and no dr. ever freaked about me not taking prenatal vitamins. I couldn't because I was already so sick and the pills made it worse. In fact, the only thing the two drs did agree on was that I should eat/drink nothing that was sugar free or diet. They wanted no fake sugar in my body but they had no problem with no vitamins. So, it's not unheard of that some drs don't stress the vitamins if you have a good diet and and prenatal care.

[OrganicAnn]

It might be that doctors didn't mention prenatal/folic acid if your first visit to the OB was past the critical point for developing spina bifida.

[redsquirrel]

By the time you have your 10 wk appt, the window for folic acid has either closed or pretty much closed. After that, it's just the iron and to close any gaps. I took vitamins when TTC but by 8 weeks or so, had to stop due to vomiting.

 

And I think taking two regular vitamins is pretty much a prenatal. Did you know that kid vitamins are the same as adult vitamins? The RDA is for 4 years of age and up. So, you can take a chewable and it the same as a grownup vitamin.

[Blackacre Farm]

I am pregnant right now as well and I was not prescribed a prenatal vitamin either. I take a multivitamin when I remember to. I try to eat fairly healthy and I do eat quite a bit of spinach salad. My ob practice, which is very well respected, doesn't freak out about vitamins. They actually told me that Flinstones were fine.

[melissel]

I delivered my first with an OB and my second with a midwife. Both reminded me about prenatals/folic acid, but neither ever prescribed anything or pushed on either issue. And I have never heard of an OB being annoyed that someone didn't go in for a "planning visit" before getting pregnant :confused: IMO, that's as ridiculous as getting yelled at for not taking folic acid. Now we have to have approval from an OB before we get pregnant? That's just weird.

 

Aubrey, I do happen to agree a bit with Sheldon that ER nurses probably see a lot of stupid people. I worked in a public health environment for awhile, and I worked in a nonprofit for awhile, and I met a lot of people who would make you bang your head against the nearest wall. I also agree with Kristen that you were treated badly because you were "profiled" based on your lack of insurance. Of course, none of that makes any of what happened OK, and I still say I would be making it my mission to go after that ER and the staff members who treated you so horridly.

 

ETA: Also, two regular vitamins don't equal a prenatal because there are some things that pregnant women shouldn't have so much of. So don't do that without checking amounts and RDAs specifically for moms-to-be.

Edited May 4, 2011 by melissel

[kchara]

It sounds like the nurse was on a power trip. She should've known that unless you're consistently taking folic acid before you get pregnant, by the time you find out you're expecting, the window is usually nearly closed for it to do any good. AFA prenatals, I'm horrible at taking them, too. They made me sick as a dog with my twins' pregnancy. My OB suggested taking 2 Flinstones multivitamins instead, the kid's chewable kind, so that's what I used. :grouphug: I'm sorry you got such horrible treatment.

[Aubrey]

Fwiw, I've used 2 OBs & 2 mw's over the span of having babies. Two of ours were planned ahead of time, & I saw an OB/mw first. Not one of them at any visit ever mentioned prenatal vitamins. W/ the mw's, I assumed it was because they were "natural." W/ the ob's...they were never in the room long enough for me to wonder anything.

 

Eventually, you just don't question it, kwim? But this isn't just one mw, & it's not just because I've gone after 10 weeks. And, although we've had a rough time of things for a few years now, this is our first baby w/out ins, & if we can work it out in time, we will self-pay.

 

I did probably look the part of a stupid person after waiting ten hours, though. Esp combined w/ how freaked-out hospitals make me feel. I'm one of those compliant, do-whatever-I'm-told people when it comes to that sort of thing. But, jeepers, I thought polite might be worth *something.*

 

PP, I'm not good at measuring distance, but the nurse could definitely be heard down the hall. How far? 50'? I don't know. "Extremely loud & annoyed griping" would also be a fine way to categorize it, if that's more comfortable. Either way, that wasn't really my point--I was wondering if there was anything about folic acid I wasn't finding on Google. Maybe some condition that would make it more necessary or something. I try to keep my Conspiracy Theorist Persona under my hat as much as possible, though, because that *does* make me look stupid. ;)

[melissel]

But, jeepers, I thought polite might be worth *something.*

 

I tend to think that in places like the ER, especially a very busy one, polite will only get you ground down under the millstone even faster. To people like that, it probably looks more like simple or naive, and then you get to be a whipping boy too. Sadly, had you been more aggressive/strident, you probably would have fared better. Isn't that terrible?!

[Susan C.]

First pregnancy, could not take any vitamins, I had severe morning sickness. Ds was 7 lbs. 2 oz. at birth. Four years later, I found a prenatal I could take when I was pg w/dd. She was 8 lbs. 12 oz., a HUGE baby for small me. The comment at the doctor's office after she was born was "no more prenatal vitamins for you!" So... you have a first hand account of a ob/gyn saying not to take prenatal vitamins.

[Cindyg]

I didn't take prenatal vitamins. My ob did mention it once. I told him I was confident I was getting enough nutrients through my diet. He didn't mention it again.

[Catherine]

in preventing neural tube defects: all the forms of spina bifida and anencephaly. Unrecognized folic acid deficiency has been clearly linked to these disorders, though not all cases are attributable to them. It turns out that western diets are low in this essential molecule, although most people who are deficient have to progressed to the point of developing symptoms.

 

If it's going to be useful in prevention, it needs to be taken before pregnancy and around the time of conception.

[katilac]

I think there's a big difference between an ob not stressing over vitamins, and never mentioning them at all. Even if a person is past the optimal point for taking them on her current pregnancy, it could and should be mentioned for future reference.

[WishboneDawn]

I finally looked it up tonight. I'm taking multi-vitamins right now, but not prenatal. I've never taken prenatal vitamins--I've never had a dr prescribe them. First pg, I got some otc, & they made me sicker.

 

Just a quick note. I am also, er, pregnant right now (completely inexpected but very welcome) and my doctor mentioned that the multi's do make some moms sick. She said it's generally the iron in them that gives women a hard time and if I found that I was getting sick then I should switch just to folic acid supplements until I was past the morning sickness.

[Pretty in Pink]

If you are interested in starting prenatals at this point you can pick up chewable, gummy prenatals at Target (and I'm guessing Walmart and drugstores as well). They are about ten bucks for a 45-day supply. They do not contain iron, which I believe is what tends to make those of us with weaker constitutions queasy during the first trimester or so.

[Saille]

I tend to think that in places like the ER, especially a very busy one, polite will only get you ground down under the millstone even faster. To people like that, it probably looks more like simple or naive, and then you get to be a whipping boy too. Sadly, had you been more aggressive/strident, you probably would have fared better. Isn't that terrible?!

 

I agree with this. I used to be very nervous in situations like that, and I got walked on a few times. I've come to think of it as being similar to dominance in dogs/wolves. When someone starts to be aggressive with you, the best thing to do is make intense eye contact and square your shoulders. It sends the "I'm not rolling over" signal, and the conversation usually goes better from there. Out-vocabulary-ing them doesn't hurt, either, and I know you can do that! :lol:

 

AFA pre-nates, I always used Solgar for pregnant and nursing women, from the health food store, and I drank red clover tea for the easily absorbable calcium so that the baby wouldn't take mine. They made me nauseous during the first trimester, but if I took them at bedtime, I was OK. I just had to be diligent about getting breakfast in the morning. Omega-3s are also good to take. Or you could just eat a lot of flax and avocado...

Edited May 4, 2011 by Saille

[Crimson Wife]

Aubrey, I have to admit that it sounds like you got very bad treatment because you have no insurance. They are probably making all kinds of negative assumptions about you & they don't believe you deserve to be treated better. That sounds harsh but it's what I've been thinking since you posted your ER experience. How they treated you is awful & I'm pretty sure at least some of it is illegal. I've never heard any other ER horror story that's even close but I do know the attitude which some of the nurses seemed to have.

 

:iagree:

I've been fortunate to always have had insurance coverage, but I've witnessed some *EXTREMELY* unprofessional treatment of other patients by doctors & nurses. The simple fact of being uninsured by itself shouldn't result in a patient being treated like a pariah. :glare:

[UnsinkableKristen]

I think there's a big difference between an ob not stressing over vitamins, and never mentioning them at all. Even if a person is past the optimal point for taking them on her current pregnancy, it could and should be mentioned for future reference.

 

 

:iagree: This exactly. It's irresponsible to never mention them. And FWIW, every midwife I've ever talked to/heard of has suggested them or suggested alternatives - but they are always mentioned.

[Tangerine]

I thought you might be interested in this article if you haven't seen it.

http://www.slate.com/id/2292213/

[plansrme]

Dh's wife was a nurse, & she gave me some that worked better, but I don't know what they were (other than rx, not otc).

 

Oh my, Big Love comes to the WTM board.

 

Terri

[brehon]

I was born with occult spinal bifida and mild scoliosis. Obviously, it has not impacted my life too much. I have no idea if my mom took prenatal vits during my pregnancy or not (or even if women were routinely told to back then).

 

*For me* making sure to take PVs was very important as the one big thing I worried about w/each of my babies was SB or other neural tube defect. Yes, these things probably aren't genetic; what can I say, I suffered from advanced progesterone poisoning. :tongue_smilie:

 

I can't imagine either an OB or MW not mentioning the importance of taking PVs, especially if one is seeing the provider in early pregnancy. Taking folic acid is such an easy way to prevent potentially serious birth defects.

 

Aubrey, I didn't comment in your ER visit from hell thread; although, I was appalled. I highly encourage you to call the nurse administrator for the hospital (or whoever handles these things) as, based simply on what you wrote, there seemed to be more than one EMTALA violation. [Our nurses here could probably give better info on this.] Mention this to the hospital administrator and you should see the color drain from his/her face. EMTALA violations are *very* serious and hospitals take them *very* seriously. There is no reason for anyone to be treated the way you were. Ever. Personally, I'd get my medical record from the hospital to make sure it was accurate and not, um, an exercise in creative writing by Nurse Ratchet.

 

Congratulations on your pg! I hope all goes well with you!!

[ChandlerMom]

First pregnancy, could not take any vitamins, I had severe morning sickness. Ds was 7 lbs. 2 oz. at birth. Four years later, I found a prenatal I could take when I was pg w/dd. She was 8 lbs. 12 oz., a HUGE baby for small me. The comment at the doctor's office after she was born was "no more prenatal vitamins for you!" So... you have a first hand account of a ob/gyn saying not to take prenatal vitamins.

 

But I doubt they were *serious* about not taking prenats. :D

 

Attitudes about prenatals and esp folic acid have changed over the last few years. The scientific knowledge has definitely changed over the last 5-10 years, basically more importance of maternal nutritional status has been found, and a few things are really tough to get enough of from diet, though no pill replaces a good diet. Some Drs/nmw's are slower to adapt to current guidelines, others faster. Some naturally more militant, others more laid-back. Nurses are often more hard-nosed on these things, maybe because they are less knowledgeable about the Whys that the whats? (No disrespect to nurses.) Your obviously had a burr in her saddle for *some* reason.

 

There's nothing in a prenat that requires an RX -- I've only have one try to RX it but always just used the Costco ones (I think $15 for 300, which is a full pgc) for pgc and BFing. Never had any trouble.

 

As my dh said, "Prenatal care would be a lot different if men were the ones giving birth." My laid back dh has been to every appt and marvels at what women put up with from the staff (and guys would NOT). OB and peds are the only areas I've seen Drs really treat patients like idiots, and yes I think gender plays a role (regardless of Drs gender, btw).

[Aubrey]

Oh my, Big Love comes to the WTM board.

 

Terri

 

Um, my dad. :blush:

[ocelotmom]

Is there another possible reason for her behavior? What am I missing?

 

There's NO good excuse for her behavior.

 

I mean, I can see a nurse going and losing it at a pregnant woman who was using drugs, or a blatantly abusive parent, or whatnot. Even that's not appropriate, but more understandable. Not taking a folic acid supplement is not in the same category in the least.

 

The vast majority of people will get adequate folic acid from their diet, even if they don't really get enough of their green leafies. A small percentage have problems absorbing folic acid, and these people really need supplementation, because they aren't going to get enough from their diet even if it is perfect. Because the first symptom of folic acid malabsorbtion may be a baby with a neural tube defect, it's recommended that everyone of childbearing age supplement. But most will be perfectly fine without it.

 

Also, the neural tube develops early, so folic acid supplementation is most important pre-conception and during very early pregnancy. If you're past the first trimester, folic acid is still helpful to the development of the baby, but the neural tube ship has pretty much already sailed.

 

All that said... folic acid supplements are small pills (as opposed to the prenatal horse vitamins), inexpensive, and generally better tolerated than prenatal vitamins for people with morning sickness, so it's generally pretty painless to go ahead and take them.

[Carol in Cal.]

 

 

 

All that said... folic acid supplements are small pills (as opposed to the prenatal horse vitamins), inexpensive, and generally better tolerated than prenatal vitamins for people with morning sickness, so it's generally pretty painless to go ahead and take them.

 

This is consistent with what my docs told me. They didn't even want to see me until I was 12 weeks along, but sent me a letter telling me to phone in and listen to a taped message--it was all about folic acid, and advocated taking it starting immediately. There was no mention of prenatal vitamins, but just of getting that one supplement, at least early on.

 

Later I never got a prescription for prenatals, and the OB's said I could take them if I wanted to. They were real horse pills--big and hard to swallow during the first trimester's nausea.

[wapiti]

I was wondering if there was anything about folic acid I wasn't finding on Google. Maybe some condition that would make it more necessary or something.

 

Kind of off-topic, but in case anyone is interested, there actually is such a condition, a genetic thrombophilia (increased risk of clotting) called MTHFR. However, the issue is controversial, and gets even more complicated in terms of whether there are different subtypes of this genetic variant and which patients may or may not benefit from higher doses of folic acid. Back when I was a patient of a doc who specialized in recurrent pregnancy loss, I vaguely recall her recommending 1000 mcg of folic acid, even though I have a different genetic thrombophilia; I guess that was a "can't hurt/might help" rationale.

[Aubrey]

This is consistent with what my docs told me. They didn't even want to see me until I was 12 weeks along, but sent me a letter telling me to phone in and listen to a taped message--it was all about folic acid, and advocated taking it starting immediately. There was no mention of prenatal vitamins, but just of getting that one supplement, at least early on.

 

Later I never got a prescription for prenatals, and the OB's said I could take them if I wanted to. They were real horse pills--big and hard to swallow during the first trimester's nausea.

 

Now, see, this is part of why I was in no hurry to see my mw. I *know* they can't do much before 12 weeks. They treat you like you're a panicked first-time mom if you call at 4 weeks, lol. Combined w/ healthy pgs, I just figured I'd take care of it ASAP but not *worry.*

 

So why on earth would someone freak out if I'm in the ER w/ no prenatal care at 14 weeks?? (Actually 16, once I checked my calendar at home, but 14 is what I told them & what I thought at the time.)

[Pretty in Pink]

So why on earth would someone freak out if I'm in the ER w/ no prenatal care at 14 weeks?? (Actually 16, once I checked my calendar at home, but 14 is what I told them & what I thought at the time.)

 

That didn't make any sense to me when you originally brought this up, either. IME, my providers have not seen me prior to 10 weeks. With my second child, the providers covered by our insurance were completely booked solid (military town, post-deployment babies) and I was nearly five months pregnant when I finally got in. I had the anatomy scan and found out the gender the day of my first appointment!

 

But not having been seen by 14 weeks is a far cry from not having been seen by 20+ weeks. I don't know why they were so up in arms over that. And the folic acid issue was neither here nor there by that point.

[ocelotmom]

But not having been seen by 14 weeks is a far cry from not having been seen by 20+ weeks. I don't know why they were so up in arms over that. And the folic acid issue was neither here nor there by that point.

I don't get that, either. I didn't get in until around 14 weeks with my last pregnancy, and no one so much as asked why I hadn't had an appointment sooner.