32 Week Doctors Appointment

So I had my weekly appointment today. (I'm 32 weeks now ...WOW how time has flown!!)

As many of you I am at a practice where I rotate through all the doctor's, and today I had the "mean one".

I had my ultrasound and my tech was concerned that one weighed in at 4lbs 2 ozs and the other baby weighed in at 3lb 6ozs the same as my last appointment. She said that she'll mark in my charts but next week she needs to see significant weight gain on the smaller of the two. Up until then both boys were always 1 to 2 oz's off from each other.

SO then i got to see the "mean one" doctor, she asked how I was doing and I told her about aches and the sharp pains I was feeling and felt she kind of blew it off and said "Braxton Hicks" and then moved on. She checked my cervix's and said "Oh your 1 centimeter dilated" and I asked her, what does that mean? and she said "it means your one centimeter dilated". And asked me about my birth plan. I told her I wasn't sure which way I wanted to go and said since both boys were head down she said she would make me due natural and if necessary induce.

I then asked her I read about and was told by the other doctors about a scheduled c-section date as a back up, and she said yeah and she would recommend my date to be at 40 weeks, so to give me time to give naturally. I told her the other doctors said they were recommending 36-37 weeks and she said "NO" that's not her method and she wants to do natural and that's it...even if I wasn't keen on it.

I felt totally rushed by her and more confused more then ever, she measured me and said I measured at 42 weeks and I asked her about the weigh issue and she said we'll deal with it next week. (No reassurance there!)

So I see the last "new" doctor next week (FINALLY) and then I have to choose one to be the "primary" and all others will be considered a secondary. All i know so far, she is definitely not going to make the short list!!

Am I wrong for feeling concerned about the weight issue and not understanding the whole dilating thing?

 

Heck no! Your doctor should take the time to make sure you understand what's happening with your body so you feel comfortable. Being 1 cm dilated just means your cervix opening is no longer fully closed. You need to be dilated to 10 cm to deliver.

On the baby weights, I'd be more concerned. Mine started showing a disparity early on and I ended up having my c-section bumped at 36 weeks because one baby did not gain any weight in two weeks. Mind you, I had to request to my OB to have another ultrasound to check. Glad I did. My doc originally wanted to deliver me at 39 weeks (37-38 weeks is considered full term for twins). 40, with a possible discordant weight issue, is a bit short-sighted on your doc's part. It may also mean a c-section and you should be prepared for that, just in case. I really wanted to deliver vaginally but it just wasn't in the cards.

Your doc (new or old) should be requesting/performing ultrasounds every 2 weeks at this point to check their weights. Demand it. It can be the case that your twins might be better off outside than in later on. But, at the very least, get a doctor who will not make you feel rushed. That's just not cool in my book under any circumstances.

It's still early so hopefully your other twin will catch up. Just be sure to pick the doctor who will give a damn either way. Hope this helps!

 

I would be mad as ****. I think I'm mad for you! :angry:

Under no circumstances should a doctor ever blow off your concerns or questions. I just can not stand that. And to not even consider your thoughts and feelings is crazy. It's not her body and it's not her children. End of story.

I'm sorry you had that experience today. I hope that there are other doctors there that you feel more comfortable with.

 

I am mad for you too :angry: You should be supported by your doctor and how dare she not explain dilation to you! It's just not right. I am going to be a first time mom and if my doctor did not expalin certain things I would be lost. She should definitely schedule a c section date because your babies still have plenty of time to move around. Mine still are moving! Hopefully the ultimate decision is not up to her. Good luck with your next doctor.

 

I am so sorry that you had that experience. She should have explained to you what it means to be 1 cm dilated and not contradict the other doctors in her office. I hope you never have her again!

 

QUOTE
SO then i got to see the "mean one" doctor, she asked how I was doing and I told her about aches and the sharp pains I was feeling and felt she kind of blew it off and said "Braxton Hicks" and then moved on. She checked my cervix's and said "Oh your 1 centimeter dilated" and I asked her, what does that mean? and she said "it means your one centimeter dilated". And asked me about my birth plan. I told her I wasn't sure which way I wanted to go and said since both boys were head down she said she would make me due natural and if necessary induce.


That is so rude, I can't believe your doctor said that!!! You have every right to be concerned, call the doctor's office and ask to speak to one of the other doctors, that's what I would do!!

 

I too would call and ask to speak to one of the other docs. You should not be receiving conflicting advice. And if you are, then you need let the other doctors know so that they are aware of the descrepancies within their own office.

Are you taking it easy? Although women can be dilated early and still carry to term, it seems that your doctor would be a bit concerned with dilation and contractions (have you had an NST?) at this stage in your pregnancy.

 

QUOTE(twoin2005 @ Sep 25 2007, 05:04 PM) [snapback]423181[/snapback]
I too would call and ask to speak to one of the other docs. You should not be receiving conflicting advice. And if you are, then you need let the other doctors know so that they are aware of the descrepancies within their own office.

Are you taking it easy? Although women can be dilated early and still carry to term, it seems that your doctor would be a bit concerned with dilation and contractions (have you had an NST?) at this stage in your pregnancy.


NOPE!

It was on my list to ask but I was so frazzled by the end of the appointment I forgot to ask

 

Are you wrong to feel the way you feel? No Way!!!! I spent most of my pregnancy feeling uncomfortable about my doctor. I finally at 29 weeks moved to another doctor in another practice! After the first appointment I was mad a myself for waiting so long to make a change! I think that the doctor you choose to be your main doctor is crucial. YOU need to feel good about the care you are recieving and feel that your doctor is on the same page with you!

As far as scheduling a c-section. I have to say that from experience this is something I would never do. I had an emergency c-section with my daugther and wish I could have a vaginal delivery this time around, but after research and really discussing the options with my OB I can see that a vaginal delivery is not in the cards for me. With that said, obviously you need to do what feels best for you. I would just like to put it out there that a c-section is MAJOR surgery and the recovery is not easy, doable, but if the possibility for a SAFE vaginal delivery is available to you definately consider that as a real choice. My sister-in-law has had both a vaginal and a c-section delivery and is able to make a true comparison. Her experience was that with the vaginal delivery the pain was pretty much done when she had her c-section it was several weeks before she felt as good as she did only a day or two after her vaginal delivery. Just food for thought since it sounds that you may have a choice, but do what is best for you and your family.

Good luck at your next appointment and be glad that you get to choose your primary doctor now that you have met several! This gives you the chance to have the one you feel will be the best match, and you don't have to have the one you had today!!!

Like a previous poster mentioned, call and talk to another doctor. It sounds like you had questions that did not get answered today, and there is no reason you have to wait another whole week to get answers. Call the office during regular hours (unless it is an emergency) and request that one of the doctor's that you like call you back at his/her earliest convienience. If they ask why simply say that you recently had an appointment and have questions that did not get answered at your appointment and you feel they need to be answered before your next visit. If your first choice doctor is unavailable have a second choice ready.

Good Luck!

 

You can and SHOULD let everyone in that practice know that you absolutely refuse to be treated by this woman. Not only is she uncaring with a bad bedside manner, but she's obviously more interested in what she wants and not what you want. You are the one paying her for her expertise and help and you can absolutely refuse to be under her care in any way. You have that right as a patient of anything, anyone, anywhere.

Women carrying twins 50/50 deliver at 34 weeks, so you're pretty close. Make sure they continue to monitor your babies. Right now they sound healthy, but with a weight discrepencies and no growth for 2 weeks I'd be VERY WARY of what's going on. I'd be sitting in their office demanding answers. They should be monitoring you for TTTS and/or IUGR. Have they recommended bedrest, extra fluids, etc? How are their heartbeats? Are they doing stress tests on them? Be as proactive as possible...

 

sorry her bedside manner totally stunk!!

On the one hand 1cm doesn't mean a whole lot... You can be up to 3cm for weeks and weeks and it doesn't necessarily mean anything. So the doc probably just didn't want to make a big deal out of it.

As far as c/s at 36 or 37 weeks...honestly please don't be disappointed if your other docs back away from this as you approach that time frame...lots of docs prefer waiting until at least 37-38 weeks just to really make sure the lungs are mature. Some are willing to do it around 36 weeks WITH an amnio....(ALL of my docs told me 36 or 37 weeks the whole pg and as it came down to that NONE of them wanted to schedule it then...they all wanted to wait until closer to 38 weeks.) Personally, I wasn't comfortable doing amnio...so I preferred to wait. Plus, even at 37wsk 5 days my babies were each under 6pounds...they were tiny. I really wouldn't have felt comfortable bringing home babies less than 5 pounds... so that's definitely something you want to consider in terms of looking at a goal of 37-38 weeks as a POSITIVE thing not a negative thing....

As far as you preferring a c/s...well, if the other docs want to schedule one, then just make appts with them as it gets closer to the end of your pg..then they will have no issue scheduling. But you can't expect a doctor to do something they aren't in line with philosophically or ethically. The doc you saw today clearly is in favor with letting nature take it's course....which to tell you the truth, is backed up by research quite strongly. So don't hate her too much. Lots of moms with c/s happy docs would love to have a doc like her.... albeit her bedside manner obviously could use some improvement. Anyway, I had one doc I really didn't like in my twin pg..I just made it a point to avoid him as I got closer to the end of my pg. Then I didn't have to worry about him being involved with the birth.... I was nervous if we had been able to do vaginal that he would be the one on call..but as it turned out my baby A went transverse and we couldn't do it anyway.

 

Mean doctor ...!

One cm at 32 weeks is OK (I was 2 cm at 32 weeks and still made it til my scheduled induction at 38 weeks). With my first I was 1 cm at 37 weeks and went 9 days late. Women with twin pregnancies tend to dilate earlier because of the weight. It doesn't have to be a big deal.

I would definitely talk about the weight gain and/or lack thereof next time.

And whatever way you and your doc decide to deliver, I wouldn't schedule before 38 weeks unless medically necessary. At 36 or 37 weeks they could be on the small side with all possible side effects. My hospital won't do scheduled c/s or induction (unless medically necessary) before 38 weeks without an amnio. So if your body can handle ... hang in there, it will be worth it. I also think with 2 babies head down you could have a vaginal delivery.

Again ... I would definitely discuss everything (again) with a nicer and better doctor!

Good luck!

 

Argggghhhh - that just makes me furious....I would never see that doc again. My OB's office had the same policy and the "mean one" was also EXTREMELY condescending and I made sure that the one time I did have to see her was my last. Then, I had some PTL at about 24/25 weeks and she was the on call at the hosp - I made sure that things calmed down so I wouldn't deliver with her there.

Dr's need to listen to their patients, I don't care how many babies they've delivered or not...

I'm sorry that you had to deal with that. Hang in there!

Alexis

 

:hug99: Sorry she wasn't at all helpful. I would call and ask to talk to another doctor. Explain the situation and that you were not happy with her answers, etc and that she is telling you something different. With my twin pregnancy, they told me that they wouldn't let me go beyond 39 weeks, I was scheduled at about 38 weeks and went at 37. Also, with your cervix starting to dilate, I would definitely take it easy, make sure you drink your water to help with the contractions. I started NST around 32 weeks, so they may start those soon. Good Luck and take care of yourself! Let us know if you talk to another doc.

 

Thanks everyone for their responses, it really helped!

I called the office this morning and spoke to the "head physican" of the practice and laid out my concerns.

I told him I understood natural is the preferred method for birth but I need to hear from a medical "official" the pro's vs. con's of a scheduled c-section and going natural and what would benefit my babies the best. (I even told him I came to this forum for advice, and he laughed (in a good way)) and that I need professional medical advice and a forum will only take me so far and they (the office) are the medical experts not me and I have to trust them but not answering my questions just make me want to run away. I told him I didn't appreciate the "off handed" remarks from the "mean one doctor" and I'm new at this might need my hand held for some of this stuff.

I also explained about the differnt answers I am getting and very confused about to really expect, and he changed my appointment to see him instead (which helped) and he said he would help formulate my birth plan and really laid alot of my concerns to rest.

I really appreciate everyone telling me to call the office to complain it really worked and it help me out alot too!! Thank you everyone!

 

Absolutely wrong - your doctor has a responsibility to answer your questions and to treat you with some respect and she simply did not. What a horrible bedside manner - It's good that you called and are now feeling a little bit better.

Can you include on your list doctors you don't want touching you with a 10 foot pole? If so, maybe her name should be on it.

 

QUOTE(first time mom at 34 @ Sep 26 2007, 03:03 PM) [snapback]424677[/snapback]
Thanks everyone for their responses, it really helped!

I called the office this morning and spoke to the "head physican" of the practice and laid out my concerns.

I told him I understood natural is the preferred method for birth but I need to hear from a medical "official" the pro's vs. con's of a scheduled c-section and going natural and what would benefit my babies the best. (I even told him I came to this forum for advice, and he laughed (in a good way)) and that I need professional medical advice and a forum will only take me so far and they (the office) are the medical experts not me and I have to trust them but not answering my questions just make me want to run away. I told him I didn't appreciate the "off handed" remarks from the "mean one doctor" and I'm new at this might need my hand held for some of this stuff.

I also explained about the differnt answers I am getting and very confused about to really expect, and he changed my appointment to see him instead (which helped) and he said he would help formulate my birth plan and really laid alot of my concerns to rest.

I really appreciate everyone telling me to call the office to complain it really worked and it help me out alot too!! Thank you everyone!



Good for you! I am glad that you talked with him, and it sounds like it really paid off! I hope you feel good about the outcome of your next appointment and now that you have spoken to him I am sure that he will make sure that you get your questions answered! :yahoo:

 

I am glad you called and got that straightened out. That is what I went through between 2 dr's having different opinions and driving me nuts, finally one caved but made it sound like if SHE was the one that was on staff at the hospital the day of my c/s she would cancel it and induce me instead.