High Risk Ob vs Regular OB w/ Consult

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High Risk Ob vs Regular OB w/ Consult

Postby heather41 » Thu May 05, 2011 1:01 pm

I'm 41 and 9 weeks pregnant with twins. Just graduated from the fertility clinic, and the nurse there told me not to worry about a high risk OB. On the other hand my primary care was very concerned. They recommended that I go to the high risk group that is part of the hospital with the best NICU around. It's a teaching hospital with a level 4 NICU, Albany Med.

This would be a no-brainer, except that they are an hour away. My other option seems to be to stick with the OB-Gyn group (office 15-20 min away, hospital 30 min away) that I saw before I started trying to get pregnant, and they would also consult with a specialist. They use a high risk specialist that has four offices, including one in Poughkeepsie, which is also an hour away from me in the other direction.

I think the best case scenario with my regular OB in terms of NICU and high risk care is that the consultant would assist with my delivery at Vassar Brothers in Poughkeepsie, where there is a level 3 NICU, but my OB normally delivers at a Birthing Center with no NICU. They have a system to send the babies to the NICU in Poughkeepsie, but I still find it scary.

I have appts with a midwife at my regular OB-Gyn at 10 weeks and with their consultant at 12 weeks. Called Albany Med today and they said they couldn't see me until 12 weeks, but they wanted to get me in sooner, because I'm 41 and pregnant with twins. Funny thing is they want a referral from my regular OB to get me in sooner, and when I called and talked to a nurse there it was a strange conversation since I haven't even seen them yet. That's when I really started freaking out!

Any advice? I've almost convinced myself to suck it up and go with an OB an hour away. My fertility clinic was also an hour away, and I managed that. Just the whole labor and delivery and having to drive that far, is scary too.
Me, Heather 41, DH 38, DSS 8
TTC Two years, 2 REs, 5 IUIs, 3IVFs,
11/21/11 Our twin boys were born

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Postby bethann » Thu May 05, 2011 6:10 pm

First- congrats!!!! In my personal opinion I would suck it up and do the hour drive. MFM's or high risk obs specialize in multiple high risk pregnancies. Not that your regular OB isnt good but it would be like seeing a regular ob for fertility problems instead of your RE. They can handle it but probably not very well!! And the drive to the hospital when you deliver probably won't be a big deal b/c most likely with your age and that you are carrying twins- you will probably be induced or already in the hospital before you deliver anyway. Also, you will get alot more attention, ultrasounds and specialized care with your high risk doc....or at least I did. Go with your gut and do what is best for you and those little ones!!!! :)
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Postby GreekMythFreak » Fri May 06, 2011 3:51 am

Congrats and welcome!!!! I agree with Bethann, I would go to the go to the high risk doc. It's all about what's best for you and the babies while you're carrying them and a specialist with twins is the best :)
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Postby Robynsegg2 » Fri May 06, 2011 4:12 am

Congratulations Heather! My friend is 40 and 23 weeks pregnant with twins (after having used donor eggs) and she has yet to see a high risk doc. She is and still is a complete worry wort when it comes to this pregnancy so she was quite concerned that they weren't sending her to a high risk doctor. However, she has had a wonderful pregnancy to date and really has had no reason for one....however, with that being said, you know yourself and even if you do see a high risk doc and they say that there is no reason to be there, then at least you have done your part!

I would do the hour drive (I did my entire pregnancy just to see my regular OB) but thats just me. :wink:
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Postby heather41 » Fri May 06, 2011 8:23 am

Thank you ladies for the feedback. I had almost convinced myself to switch to the high risk practice just by writing this post. Last night I talked to my husband about it and we're agreed that it's the right thing to do. He assured me that he knows the way to Albany Medical Center and he'll get me there in time, when I'm in labor. :)

Right now I'm stuck in red tape as Albany Med has asked me to get a request for a consult from my regular OB and they are not cooperating. A big part of it is that they lost the records from my RE, and I have the RE resending them now. I guess it's one of those he said/she said things, but I believe the RE's office when they say they have a fax confirmation from when they sent them last week.

My regular OB is not being helpful at all, between not having my records and not having the first appt with me until next week - their idea to wait so long to see me - it's hard for them to be very helpful. But also they're pretty negative about it for obvious reasons, including the fact that they use a different practice for their high risk ob patients.

Currently waiting for the records to be resent, before I try again at asking my regular OB for help. I could just call the high risk practice again and take an appt at the end of May, but they said they wanted to see me sooner. To see me sooner they need a request for a consult, which is where I am stuck asking my regular OB for help.

I'm honestly very impressed that the high risk OB wants to see me sooner than a few weeks from now. I just don't know if I'm going to be able to get this request for a consult. I'm so frustrated, I sent an email to my primary care provider asking for advice on how to cut through this red tape.
Me, Heather 41, DH 38, DSS 8
TTC Two years, 2 REs, 5 IUIs, 3IVFs,
11/21/11 Our twin boys were born

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Postby GreekMythFreak » Fri May 06, 2011 9:33 pm

That's VERY frustrating! Keep on them, I hate it when Doc's offices won't cooperate! grrr
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Postby heather41 » Sat May 07, 2011 6:39 am

Thanks for your support.

I heard back from my primary care provider. She says she'll help me. So at least I'm not alone in this.
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Me, Heather 41, DH 38, DSS 8
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11/21/11 Our twin boys were born

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Postby catwomanbaby » Thu May 12, 2011 8:42 pm

Can you just get the referral directly from your RE? It seems silly to require it from an OB you have never actually seen. It does seem frustrating to have so much red tape.
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Postby heather41 » Fri May 13, 2011 10:45 pm

I'm making some progress at cutting through the red tape. My regular ob sent a request for consult to the MFM. But they didn't send any records with it.

I had my first appt with the regular ob today, which helps. The RE didn't do any of the standard testing just HCG and progesterone. And the MFM wants all that stuff done before I get to see him. So Monday I'll put in a request to send the records and hopefully get an appt soon after.

Even then the MFM won't be my primary ob unless I successfully jump through more hoops. But I have an appt for June 1 with a regular OB in his practice, which seems a lot better to me than having my regular OB an hour's drive away.

The appt today was fine, but I wasn't impressed either. Will keep you posted.
Me, Heather 41, DH 38, DSS 8
TTC Two years, 2 REs, 5 IUIs, 3IVFs,
11/21/11 Our twin boys were born

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Postby heather41 » Thu May 19, 2011 2:41 pm

I finally got an appointment with a high risk OB! It only took two weeks. I'm so excited!

In fact, I have a marathon day of appointments with the new practice on June 1, which will be 13 weeks for me. I start with a nurse visit for prenatal testing, then I meet my new regular OB who is in the same practice as the high risk doc, followed by genetic counseling and a first trimester scan. Finally after lunch I get to see the high risk OB.

Unless I am an especially difficult case, the plan is for the high risk OB to consult, rather than be my primary doctor, but at least the two OBs will be in the same practice and they both deliver at the hospital with the best NICU around.

Going to hate the driving back and forth, but having decided to deliver the babies up there, I know I'm doing the right thing.
Me, Heather 41, DH 38, DSS 8
TTC Two years, 2 REs, 5 IUIs, 3IVFs,
11/21/11 Our twin boys were born

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Postby GreekMythFreak » Thu May 19, 2011 11:14 pm

YAY! That's SO awesome! Glad you're in and feeling good about it! Sounds like you have a busy first day with them ;) KUP!
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