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When you should dispute your OB bills

Chaunie Brusie is writer, speaker, and labor and delivery nurse. Her first book, Tiny Blue Lines, a guide to young motherhood, was released in May 2014. She writes about life as a young mom of three.

What you need to know

When I received the bill for my first prenatal visit, I was livid. Not two or three, but four completely unauthorized and unnecessary charges.

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It may sound kind of silly, but at the time of my first pregnancy, I was young — only 21 and still in college — so I was extremely conscious of each and every penny that I was spending.

While I was fortunate to have good maternity coverage throughout my pregnancy, I still carefully looked over each and every bill and charge from my midwife's office. In nursing school at the time, I was well aware of all of the unnecessary spending that went on in the medical world.

I was charged for what?

So when I saw a charge for almost $400 that wasn't covered by my insurance, my jaw dropped out of my head. And when I saw what it was for? I could hardly believe it.

Without even talking to me about it, without asking my consent, without gathering a health history of any kind, my nurse-midwife had tested me for every STD under the sun. I was furious. First of all, there was the implication that simply because I was a young mother, I must be riddled with STDs. Secondly, there was the fact that she had never once mentioned the tests to me, nor the fact that they may not be covered by insurance.

You had better believe I marched right into her office, informed her that I had only one sexual partner (my husband), I had not consented to these tests, and I would not be paying for them, thank you very much.

Needless to say, the charges were dropped.

Unnecessary charges

As I went on to graduate from nursing school and practice as a labor and delivery nurse, I was often struck by the myriad of completely unnecessary charges that went on simply to ease a mother's mind or make a doctor look like he or she had "done everything" in preventive measures.

Like the time a couple came in for some testing recommended by their midwife. They didn't have insurance and were paying cash only for the procedures, a rare practice for our small-town labor and delivery unit. When the couple asked careful questions of the doctor about the necessity of the testing she recommended, they were met with hostility and guilted with the ever-popular, "You wouldn't want anything to happen to your baby, would you?"

Of course, the parents weren't trying to be irresponsible. But unlike endless insurance payments, the couple had to make decisions based on practicality for testing during their pregnancy — and it's a right that as parents, we all have.

Take charge of your health care

The fact of the matter is, there is no magic formula for how a doctor, midwife or hospital charges you for your pregnancy-related expenses. Much of it is automated and standardized charges for the "typical" things of pregnancy and birth.

For example, if you are a mother who eschews the eye ointment for your baby after he or she is born (the eye ointment is given to prevent complications, like blindness, from STDs passed to baby through the birth canal), odds are you will still be charged for it, simply because it's part of the standard labor and delivery charges. It's a small thing, of course, but those small charges can add up and over the course of hundreds and hundreds of women? Crazy medical spending.

It's important for parents to understand that they are ultimately responsible for their health care experience. They retain full rights to refuse or accept any and all testing in the hospital environment and they do, contrary to popular belief, have the right to know how much that testing costs. That being said, however, it's not easy to find out those charges, because that's not the way our medical system is set up — so if you are prepared to tackle the charges, be prepared for a few challenges along the way.

At the very least, however, request an itemized bill from your hospital stay, just in case. It's pretty easy for a nurse to check off the "epidural" column mistakenly, for instance, or you may have been charged for full fetal monitoring, even though you delivered your baby seconds after you arrived.

Bottom line?

You are in charge of your health care, so you deserve to know what you're paying for.

More on labor and delivery

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When you and your doctor don't agree
How to speed up labor

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