WWYD - Providers / Appts (long, sorry!)

[rm2013]

Hi ladies, ok my appointment situation is a little complicated. Currently I do not have a prenatal care provider. I want to deliver with a midwife, but dealing with the limitations of the midwife with my first MMC in October was AWFUL. I had to go to a specialist the next day to "confirm" the MMC again. Then I had to wait A WEEK to get a D&C. Walking around for a week knowing the baby was there but gone was absolutely horrible.

When I got pregnant again the midwife said they couldn't give me any earlier appointments or additional scans, that I still had to follow the "standard" appt schedule of every 4 weeks. So instead I went to my GYN who I can't use because she retired from doing OB. As a favor she did my confirmation of pregnancy and a us. When I asked for a second us a few weeks later because I had a bad feeling she obliged and we discovered I had another MMC (this was March). Totally different experience. I had the D&C 2 days later with a doctor that she refers all her surgeries to.

Now, I'm doing the same with my GYN. Baby checked out well at 6w and I have another us scheduled for 10w. But because she's not OB, she has to refer me to a specialist for the NT scan and NIPT, which would be done together at 12w. I didn't realize that cell free DNA can be done after 9w, so now I'm wondering if I should just go to an OB so that I can get a us AND the cell free blood test at 10w. But I'm not sure.

I feel like my options are:

1. Stick with current plan of us at 10w and have to wait until 12w for NIPT and NT scan.

2. Go to high-risk OB at 10w for us and NIPT, then have NT scan at 12w. (I can go to a doctor in the same practice as the one who did my last D&C, so technically I'm already a patient)


I guess bc I'm AMA, I feel like I won't really be secure in the pregnancy until NIPT is done. So having to wait 2 more weeks for that has me like AAAARGH.

WWYD?

[yianna]

Can you ask your OB to give you a referral to have another scan done (if you feel like you need one sooner than in at 12w)?

Honestly, with my loss history I'm high maintenance in early pregnancy. I would go to the high risk OB since technically you're high risk due to AMA, and I bet they will oblige. If you want a scan sooner for reassurance, tell them that...

AND THEN you can transfer to mid-wives after your 20w scan if you'd like.

[Rama]

I would go with the high-risk OB. Both because of your AMA status and your loss history.

If you really want a midwife, I'm pretty sure you can have one as well as your MFM. I think LED did something similar, where she saw both an OB and MFM?

Basically, do whichever combination of things that will give you the most support and peace of mind. First tri is hard enough, dealing with it AL is a whole new ballgame. Use every option available at your disposal.

[flippinchica]

Sept 6, 2017 15:09:30 GMT -6 Rama said:

I would go with the high-risk OB. Both because of your AMA status and your loss history.

If you really want a midwife, I'm pretty sure you can have one as well as your MFM. I think LED did something similar, where she saw both an OB and MFM?

Basically, do whichever combination of things that will give you the most support and peace of mind. First tri is hard enough, dealing with it AL is a whole new ballgame. Use every option available at your disposal.

Basically this. IME most MFMs don't deliver and generally work in conjunction with an ob or midwife. If you can see an Mfm at 10 weeks I would do that. Otherwise would a midwife order nipt at 10 weeks (I know mine did but all providers are different.

[nevertoomanyshoes]

Can you get NIPT ordered by a PCP and done through pathology lab? That is an option here and we are a bit behind the US in terms of NIPT (bloods used to be sent to the US, cost lots and took ages)?

Having just gone through the NIPT process, I would go with what will give you the earliest/fastest results. Mine took a day longer than expected and I was a mess.

[rm2013]

Thanks ladies! So I did a lot of soul searching and decided on a provider, which is an OB/midwife group. Not the midwife only group that I had my heart set on. However, i think the group I picked is best for me. Will do my intake appt this week. nevertoomanyshoes, thanks for your comment - I will push them to just give me a lab order for the NIPT, although they said the earliest they could do was 11.5 weeks. It's crazy how every practice seems to have their own rules!

[Rama]

rm2013 I think 11ish weeks is pretty standard for NIPT testing. If they do it too soon, the test could come back with inconclusive results and then they'd probably just skip redoing it in favor of a different test (villi, amnio, 2nd tri quad). So as much as it sucks to wait, there's a good reason to do so.

[rm2013]

Rama you're right.... gotta wait . Sigh.

[Rama]

Sept 14, 2017 18:05:58 GMT -6 rm2013 said:

Rama you're right.... gotta wait . Sigh.

*hugs*  I know it's hard.  I hope the time goes by swiftly for you. <3