I would try to see someone from a different practice, ideally.
One thing that differed between the different MFM's I saw besides their opinions on lovenox was that with my MFM, I will only always see "my" MFM. With the other MFM practice, they rotate MFM's so I would never (or not typically) see the same MFM two appointments in a row. That would have made me crazy! (One of my friends had an OB practice who did that with her first pregnancy, it was a mess. One doctor would change her due date. At the next appointment a different doctor would change it back. Etc.) Did you happen to ask or find out about that?
I think it's a little unusual that the MFM will be co-managing but also will do the delivery in a normal pregnancy. If you had a typical c-section and not a classical/vertical incision on your uterus, I don't think it would be too hard to find an MFM who would be more okay with a VBAC. I do think they prefer 2 years between pregnancies after a c-section for a vbac, but in our area we have some pretty vbac-friendly mfm's, since repeated c-sections will ultimately limit how many children you can have without raising the risks of repeated sections. (With a vertical/classic incision, they never consider VBAC an option.)
The website http://www.smfm.org
is a good resource for finding MFM names in your area, at least.
Oh, and 18 months between conceptions sounds more like the norm, I thought you meant 18 months from the time you delivered Gracie until the time you can conceive again. I've heard anything from 6 months, 9 months, 12 months, between pregnancies, so that falls right in the middle with about 9 months between pregnancies. (My MFM also thought the same thing about weight loss and she was right, I actually had a healthier pregnancy at a heavier weight than I was at with my first preg.)
Angie, I really appreciate all of the advice. Thank you so much.
I reached out to another group of MFMs and received an e-mail from the head of the practice, saying that he'd meet with me after a referral. Today I had my annual exam with my OB and she asked if I didn't like the other MFM she referred me to. I told her that I actually really liked her, but that I just wanted a second opinion. I like her so much in fact, that if the other MFM recommends the same thing that she did, I will stay with her- despite the new MFM being only 5 minutes from where we live.
Anyway, my OB said that she will absolutely send the referral, but she told me some interesting things about the other practice. The other practice is a consultative practice, so they will only co-manage my next pregnancy, versus the original MFM who will be my primary. There are 3 MFMs at the new practice who will all share my care, which I don't like too much. I also don't like that it is only a clinic, so if things get crazy and I have to be hospitalized or (God forbid) have to have an emergency c, the new docs will have to send me to the hospital where my original MFM works anyway.
I know I have a lot of decisions to make, but it's starting to wear on me. At this point right now, I want to stay with the original MFM I saw. However, what if the new doc says yes to Lovenox? I told my OB today that I understand that it is not a guarantee that pre-e and HELLP will not show, but I also don't want to have something terrible happen again next time and regret not having done everything possible. Ugh!
I thought about asking the original MFM if she'd be willing to prescribe it anyway, but idk how that will go.
OH, my OB told me today that the bloodwork my MFM ordered came back mostly normal. Only hiccup was elevated protein c activity, which I cannot find much info on. She is going to contact my MFM to see if this will change her recommendations, but since it's not a deficiency, it probably won't change anything. I'll find out soon.