MFMs - see by need or routine?

[danielsmom]

I'm seeing the same OB I saw with my son's pregnancy. At the first sign of trouble (growth restriction around 20 weeks), he referred me to an MFM who I saw in conjunction with my OB until my son was born. I had pretty good care and monitoring. I had ultrasounds performed by my OB at every visit, starting at 4 weeks.

Before we got pregnant this time, I spoke with my OB again who laid out a plan that mirrored exactly what my last MFM recommended. We were more than prepared to work with an MFM again, but at my 21 week appt the other day he didn't see the need to get them involved yet if things were going perfectly, which they are thankfully. I think I'm comfortable with that. Should I not be? I think some of you see an MFM just because of history.

[flori]

I do not have any experience with baby after pre-e and HELLP (yet!), but I think I am going to be so neurotic that I will want to be seen by both the entire pregnancy, starting as soon as they'll allow it.

I will be seeing a completely new team (we moved states) next time around. If we weren't, I would have been adamant about seeing both anyway because my OB was so lackadaisical and I've developed somewhat of a distrust for OBs. It wasn't until I finally saw an MFM at 18 weeks that he changed my status from "normal pregnancy supervision" to "high-risk pregnancy supervision". My OB knew I had chronic high bp, but never adjusted that. He also kept me on HCTZ and lisinopril until 13 weeks, despite the negative consequences. He never made the extra effort to reach out to an MFM for advice on what medication I should be on. Now, do I think it played any part in what happened? Probably not. But I will feel at ease with an "expert" looking after me.

That being said, congratulations on your big baby and I hope you never reach the point that you need an MFM.

[lennoxlm1]

I think it has allot to do with the "mothers instinct" if you feel comfortable with your doctor and you trust the choices they are making then I would keep it that way, why add one more thing to the pot. I think it's awesome that an OB is taking such good care of your and baby girl
I see my MFM get ultrasound and then my OB, I have been doing that since 10 weeks, (I guess with my sons pregnancy I was on the verge of coding... I wish my OB would have noticed that in his charts.) I have a really hard time trust OB's anymore he kind of ruined it for me, I wouldn't even see an OB for my daughters pregnancy.

[kerisue]

My OB flat out told me she wouldn't see me in a subsequent pregnancy and told me I'd have to see an MFM from the get go. Honestly I don't know how much that will change any of my care, though I do expect the MFM to be at least a little more up to date on PE research than the OB.

[cmccaffrey]

i'm not sure... I think there should be an element of playing it by ear, but also, there are things that an MFM will see that an OB would not normally see. Sometimes its better to have that second eye/opinion. I saw an OB and an MFM. I think I saw the MFM around 20 times where I saw my OB every 3 weeks at first and then once a week at the end. I had a pretty much normal pregnancy this time around, but I do not regret having that much attention from my doctors. I think you should at least be seeing an MFM once a month, that way he may be able to detect things a little quicker than a regular OB. buuut you did say that your OB provides top notch care, so I would factor that in as well. I guess it all boils down to your comfort level and how proactive you think your doctor might be in the future...

lol sorry if that wasn't very helpful.

[danielsmom]

No Christa - that is helpful. I'm one that usually thinks it's better to have too much than not enough... you know, within reason. It might be good to involve a second pair of eyes, especially as I approach the time that I had trouble the last time around. If there's anything sooner that comes up questionable, I'd be asking for that MFM appointment. But with past history, my OB isn't hesitant to refer me anyway.

I also take into account that the practice isn't a one man show. He's one of 3 OBs in the office and they help each other. Also, his physician's assistant specialized in Radiologic Technology-Sonography.

So I guess I feel comfortable right now, but it's a big wait and see game for the next coming weeks.

[angieb]

I saw both from the beginning. Mfm at 6 wks (started lovenox), OB at 8 weeks, MFM again at 10 weeks, etc. (plus growth ultrasounds every 4 weeks in there too.) Starting around 23ish weeks, I started seeing my MFM every other week, plus my OB just monthly, and then around 28 weeks, I started seeing my OB every other week and my MFM weekly, plus 2x weekly NST's. It was A LOT of appointments but he didn't do very well on the NST's and I had notching on a bloodflow study so they kept a very close eye on me and really were pleasantly surprised I didn't get sick. (Also I had gestational diabetes in there so that's probably also partly why all of the extra appointments towards the end.)