how do you coordinate the peri and ob?

[hoya]

I know this is a bit of an old post, but:

In my first pregnancy, I saw a peri. from time to time right from the beginning (it started with pains I had that I thought might have indicated an ectopic pregnancy... turned out not to be, but the peri did notice that I had a septate uterus, so he wanted to follow up with me... eventually we discovered severe IUGR at week 22), but everything was coordinated through my primary OB UNTIL I was admitted to the hospital at week 28, at which point all of my care was transferred over to the Maternal Fetal Medicine team (all peri's, including the one that I had been seeing from the beginning).

For my second pregnancy, I decided not to work with my original primary OB at all, even though I like her a lot, but to work exclusively with my favorite of the peri's I had met the first time around. It was too much of a hassle in the 1st pregnancy coordinating getting test information back and forth between the doctors, not to mention scheduling so many appointments. I am SUPER HAPPY with my current arrangement, and I look forward to having this peri deliver baby #2 (she didn't deliver the 1st one, but she was by far my favorite of the peri's to work with, in terms of information sharing, priorities, bedside manner, etc.).

[lorelei]

Just wanted to add that I saw my ob every week (sometimes 2-3 times a week) and they would send me to the peri basically for back up to be sure that everyone was on the same page. I saw the peri weekly in my 1st pregnancy from about 30 weeks on and in my 2nd pregnancy I saw the peri once a week from weeks 33-36 (when I delivered)

[missgamecock]

I forgot to put that I had to have a referral from my ob for my peri. The ob's office took care of all the insurance, setting up the first appt, and faxing my records over. I didn't have to anything but show up and make the next appt. I can't go and see a peri without the referral and I think a lot of insurance companies work this way. My insurance had her listed as a specialist.

[missgamecock]

Ohhhh I was looking for this post when it first came out and darn it I lost it when I hit a key. My first pregnancy, I didn't see a high risk dr till after I was admitted and they didn't bother talking to me to tell me what was going on.

With Sara I had an ob and a peri who comanaged my care. I started seeing the peri at 26 weeks and saw her every two weeks. She would ask me how things were going, take my bp, wanted to know my readings, what did my ob think, results of bw and 24 hr urine. Then she would do a level II us, NST, doppler blood flow studies and a bpp. She and my ob talked a few times. My peri made the decision to deliver me because I looked like the most miserable pregnant woman she had ever seen. No seriously, Sara had heart decels on NST and I had very high bp and wasn't feeling right. She said it was too dangerous to go on. My ob was primary doc, but he relied on the US and studies that the peri did. My ob was the one that delivered Sara. My ob would be like I want that US from the peri.

If I get pregnant again, which I am planning to do. I'll have comanaged care again. Just will probably start earlier than I did last time.

[christinab]

For my last pregnancy I had to see both. The Ob was a pain in my neck. I felt that they were useless. All they did was take my bloodpressure and weight. They would check the babies heartbeat and when that was normal, I was done.

My peri did all the ultra sounds and he was the one that chose when I delivered. Since, I have a blood problem he had to do speacial ultra sounds to see if the baby was in any distress. But ulimately, my peri was the more important appointment for me.

[bonnie]

Hi Frances.

My peri provided all of my care for both pregnancies. As a matter of fact, my peri was the only dr that I needed to see while pregnant. When my underlying disorder started to flare, my peri controlled it. If there was any question about treatments regarding my underlying disorder, he contacted my rheumatologist directly.

I'm sorry that I'm of no help, but I wish you luck!

[julie f]

I think it really depends on the individual peri and OB but, I can give you my past experience if it's any help.

Pregnancy #1 - Never saw the peri until after I was admitted to the hospital.

Pregnancy #2 - We had several perconception consults with different peris and the one we ended up choosing was out of state. So, my care was co-managed by my local OB and my out of state peri. I saw him [peri] once pre-pregnancy and three times during the pregnancy (15, 24 & 30 weeks). About delivery, my OB made the decision and my peri supported it. We got further than we ever expected so, everyone was happy! (Had I used the local peri, my care would have been co-managed as well, only seeing him when necessary.)

Hope that helps some, let us know what your doctors say!

[frances]

i just found out that my peri who was doing ob work and delivered me and did everything last pregnancy is now only doing peri stuff. so i need to find an ob to do the ob stuff.
can anyone tell me what role the peri and ob will be playing and who is going to be the one making the decision to deliver.
if the ob is going to be doing everything - then how important is the peri. are you just going to the peri for scans maybe 2-3 times throughout the pregnancy?
i have an appointment to ask the ob how it works, but that is not for 3-4 weeks. i would appreciate the feedback.