-- Re: How do you coordinate peri and OB? (preg ment)

[Guest guest]

My experience was that my OB had to refer me for each visit, even if

the peri scheduled me for follow-up. The follow-up U/S were every 3

weeks until the very end. Of course, when the PTL acted up, or

there were any other concerns re. the health of the baby, they would

send me over.

I never did end up paying much out of pocket. I had co-pays for

the OB appts, but not for the peri. My conflict area was with my

OB; I was forced to get a second opinion re. bed rest, even though

the peri said it might be necessary on top of recommending they

repeat a cerclage at 18 weeks -- high drama. I had the incredible

shrinking cervix . . .

So, thanks to the second opinion doc I was placed on bed rest and

thank g-d, since I started major PTL at 28 weeks -- ended up in L & D

a number of times, and was given tocolytics. Even with all this

history, I still had to go through my OB for everything. It was

worth it, we got to 37 weeks.

I think this coordination game is a fact of life when the high risk

docs will not deliver an OB patient. However, my experience was

that it is almost impossible to get an OB to take a high risk case

in mid-pregnancy. I tried to get a new OB when I was 18-19 weeks

and I just gave up. I do think that the financial issue is a

significant one. If you do require special care, the last thing you

want on your mind is money.

BTW, I live in the DC area, do you mind giving me the name of the

peri you mentioned -- I am thinking about ttc again and am

collecting names. Trying to find good people in network. Thanks so

much.

Best advice I can offer is, fight like crazy to get the attention

when you think you need it. NO ONE knows our bodies or our

pregnancies better than we do.

Big hug, and hang in there with the bed rest.

t

SU (partially resected 11/04)

DS 8/1/03 (after 6 mos. bed rest, cerclage X2, tocolytics)

>

> Hi there,

> My regular OB resisted referring to a perinatologist for first 18

> wks of my pregnancy (UD, pregnant for the second time in the

> opposite uterus) despite my history of preterm delivery at 33 wks

> with my DS. They kept saying that they would do everything that a

> high-risk would do, even though they have never had a UD patient

> with a pregnancy in the opposite side. Then, I started have

Braxton

> Hicks up to 15 times/day at 18 wks, so one of his partners who I

saw

> said I should get a consult. Well, this perinatologist in DC seems

> to know a lot about MA's (he is the chief of the maternal and

fetal

> medicine fellowship program in fact).

>

> His recommendations and knowledge base are, expectedly, much more

> conservative and extensive (ex. TV U/S every week for cervical

> length versus one abdominal U/S every 4-6 wks). My question is

this:

>

> How have the members out there coordinated care with a

> perinatologist and their regular OB? Transfer of care, coordinate

> and if so, how often, and how does insurance work if you see

> multiple practices?

>

> I am not particularly attached to my OB practice, since we just

> moved here a few months ago. Also, the perinatologist is at a

> hospital that is fully covered by my insurance, compared to the

> other OB, where it will end up costing us $$$ should I need long

> term hospital care, or NICU.

>

> Thank you for your feedback!!!

>

> , UD bicollis

> DS 9-19-03

> preg #2 20wk 0d