Should I switch to an MFM

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Should I switch to an MFM

Postby brigidmary » Tue Jul 16, 2013 12:20 am

Hi, guys! It's been a while, but this site is near and dear to my heart, as you all supported me through two pregnancies, both of which ended in preeclampsia, and the second actually ended in HELLP too.

I just found out I'm pregnant with my third baby. It's definitely a suprise (a happy one!), but I'm a little worried. I'll be 36 at the time of delivery. I've had two preemies due to preeclampia. I've had two C-sections, and this will very likely be a third one. I'm way too heavy, though I've been trying to eat as "clean" as possible since finding out I'm pregnant, and I'm taking prenatal vitamins. I have an appointment scheduled 7/31 with my OB office.

Here's my question: my OB practice is very large, and you don't see the same doctor each time. Even if you make an appointment with one physician, they could randomly reassign you to another. While they were very supportive of me with both deliveries, there have been some instances of doctors not knowing what was going on and sending me home with high blood pressures, for me to go into the office the next day and have the next doctor send me to L&D. And so on. I don't want to abandon the practice because it's nice that they have several offices and do ultrasounds and bloodwork on site, but at the same time, given the situation and the previous complications, I'm wondering if it's time to switch. Do you guys have any thoughts?
Brigid Kemmerer
Mother of two boys, ages 6 (born 33wks due to pre-E) and 2 (born 36wks due to pre-E).
Wife, mother, YA author, and admin manager. Independently supporting the coffee industry since 2007. :-)
http://www.brigidkemmerer.com
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Re: Should I switch to an MFM

Postby mom29 » Tue Jul 16, 2013 04:19 pm

I went to the same OB/GYN for 18+ years. When he was not careful handling my PIH and sent me home with bp in the 160+/100+ range after two deliveries (had to be readmitted for postpartum pre-e) I knew it was time to see another doctor.

My concern in your situation would be your history of pre-e and HELLP putting you at a higher risk for getting it again. Your concern about the different providers not knowing what the other ones are concerned about is valid. You could explain what happened previously and see if they will let you see just two of the doctors.

The MFM I had was absolutely wonderful and I felt so much better seeing someone who exclusively handled high risk pregnancies. I saw him for two pregnancies so I knew what to expect from him. I can't say enough good things about seeing a MFM when you have a high risk situation.
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Re: Should I switch to an MFM

Postby alexis » Fri Jul 19, 2013 05:18 pm

The answer is going to be a little local. In different cities, MFM have different criteria for who they will take on for sole care vs. consult care. In my area, only the very highest risk patients are under MFM sole care; MFM mainly works on a consult basis. But in other cities, there are MFMs who will do sole care for women with any higher risk pregnancy.

You may definitely want to consult with MFM, but in many cases the MFM works with the OB, not as a replacement. Some practices are also integrated--using both MFM and regular OB for coordinated care of high risk pregnancy.

You could consult with MFM and ask under what conditions they consider a switch to MFM management rather than consultation.
Chronic hypertension
Aliza - 01/05/2007 - Severe preeclampsia, emergency CS 37 weeks
Isaac - 09/26/2011 - controlled on 150mg Toprol, NO PE, 39 weeks!
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