8 week ob appt. today

i had an 8 1/2-week appt. today with my ob/gyn, and the practice was very casual about twin pregnancies (i'm coming from an infertility clinic and am pregnant with IVF twins). for example, they did not refer me to a perinatologist (is this common?).

she gave me my 40-week due date, and when i asked about pre-term delivery for twins, i.e., 37 weeks, she said "sometimes twins are born early, sometimes not." SOMETIMES? what?!!

does this seem lax to anyone else, or am i being parnoid?? did anyone NOT see a perinatologist during their twin pregnancy?

thanks,
times two

 

I've yet to see a peri and I'm 23 weeks. Until reading this board I didn't realize that most people did. I never asked about them being born early, but my OB did tell me that as long as I make it to 36 weeks we will be fine. This was his response to me not liking the fact that the hospital I'm delivering at doesn't have a NICU.(I expect no problems, but I want all available resources open to my babies if needed) He said if we have any problems then he'll send me to someone else. Sorry if this wasn't helpful, just thought I'd give my experience with it.

 

My OB was very lax with my twin pregnancy. I did a has a few extra ultrasounds. She also missed my very OBVIOUS pre-eclampsia symptoms which resulted in an early delivery at 31 weeks.....if you feel better with a peri - GO to a peri! If you need a referral, just ask for one. Don't worry about offending your doctor. It's your babies that you are taking care of!

 

I never saw a peri. twins are not that rare these days, so I think a lot of ob's are fully capable of the job. I never had any complications so I never worried about it. As for going full term--my ob said 38 weeks was the max they would let a twin pregnancy go. I've heard of others say 39....but never really heard 40 weeks. Most babies are done cooking by then anyways so I wouldn't worry about it until it gets closer (i know...easier said than done as a preg. mom of twins!). Good luck and congratulations!

Reyna

 

My OB was very lax, and it concerned me. BUT, a peri did all the ultrasounds, so I felt like there were 2 doctors looking out for me/the babies. In the end, my doctor was great, and his lack of concern was appropriate given I had a fairly uneventful full-term pregnancy. I'd ask about who will be doing your ultrasounds and if it's not a peri, maybe ask for a referral.

 

When I initially found out it was twins (at 7 weeks) my Dr. was pretty relaxed also, but I think it's because she delivers a lot of twins. She didn't give me any specifics on a due date until my last appt at 22 weeks when she said she wouldn't let me go past Thanksgiving; at my initial appt when finding out it was twins they just gave me my 40 week due date.

I did get referred to a perinatologist, but not until it was time to schedule my anatomy scan (at 18 weeks)...now I see my peri every two weeks and my OB every four weeks.

 

I agree with Ellen's advice. Many moms here do not see a peri, unless it is warranted. And some are lucky to have peri just for u/s's. That would be a great route to if possible, and might give you the extra level of security you would like.

 

My OB was also way too relaxed about my twin pregnacy. (He was awful all around, and I should have switched right away but I didn't. Thankfully he did not do the delivery and the OB that did, was awesome !!!! ) Anyway, my original OB did tell me right away that I would get referral for peri at 20 weeks. I saw my peri once a month for the rest of my pregnancy. My peri was also not impressed by twins, I think they see other patients with truly uncommon situtations and so twins are just "another case." You should, however, not let the doctor's attitude take away form your excitement and ask ALL the questions you want.

 

I was very lucky because my ob is an identical twin herself so she took very good care of me. I didn't find out it was twins till I was 18 weeks. I kind of waited a long time to go to my first ob appointment. After this she scheduled me for ultrasounds with a peri every 4-6 weeks. I never had any real problems but she just wanted to keep any eye on everything since it was twins
good luck

 

We found out we were having twins just shy of 20 weeks at what was supposed to be my first/only ultrasound. I had an OB appt. an hour later and the hospital had called her to tell her we were having twins and send over some of the ultrasound data. She was doom and gloom about how "high risk" all twin pregnancies are and told me I had to stop working at 28 weeks. She seemed very uptight about twin pregnancies. I was scheduled for all my other ultrasounds at a peri clinic and the peri did come in to meet me the first time I was there and told me he would be monitoring my pregnancy through the ultrasounds and would schedule an appt with me if needed. I never had an appt with him but continued to go to the regular OB practice. I was sick and ended up seeing another OB in the practice and he was much more casual about twin pregnancies. DH and I both liked him better and switched. The first OB was younger and probably had less experience with twin pregnancies while the one we switched to delivered twins all the time and was very comfortable. Maybe your OB is just comfortable with twin pregnancies and doesn't want to cause you undue worry.

 

I went to the peri at 11 weeks only because they did the genetic counseling and the first tri screening. I started to see them regularly at 18 weeks. I'm 38, so part of my high risk is 'advanced maternal age'. Also, my main OB has 2 year old twins, so she knows what I'm going through, and tends to be conservative.

 

My doc was very relaxed about my twin pregnancy, he was planning on me going to 40 weeks and I have to tell you, this was great! I had a great pregnancy and was never stressed about anything, when there ever was anything to be concerned about we talked and he was always calm, it was great! I went to 38w6d...

Now, you are IVF and I dont know how different that is, so maybe someone who had it can give you better info than I have..

 

I'd say my OB has been somewhere in the middle so far. She did explain the risks of twin pregnancy, as far as which problems are more likely, but also said that many women have no problems. She gave me an idea of when we'd do a C if necessary (37 weeks unless probs sooner). I was referred to the perinatologist for the nuchal scan (12 weeks) and was pleased to learn that I'd see them again at 18 weeks for the anatomy scan, then every 4 weeks or more if needed. Definitely ask questions and if you don't feel comfortable get another opinion

 

I haven't seen a peri my whole pregnancy (I'm almost 32 weeks), and I don't have plans to . My OB/GYN is VERY uninvasive, which I like. I've only had 2 ultrasounds so far, the fewer the better, in my opinion. She never does vaginal exams, except the time that I was feeling contractions. She has talked about the extra risks with twin pregnancies, but I'm lucky because I haven't had any problems. She'll even let me go past my 40-week due date! I know I might feel differently later, but I like this because I do NOT want to be induced, nor do I want a C-section. (Although I will do what is best for the babies ) It just depends on your level of comfort. If you want the extra monitoring and care of a peri, do it. If not, don't worry, it's not necessary for a healthy pregnancy. Your nutrition and listening to you body has a higher effect on your babies.

 

QUOTE(twingirlz @ Aug 10 2007, 03:04 PM) [snapback]364282[/snapback]
I haven't seen a peri my whole pregnancy (I'm almost 32 weeks), and I don't have plans to . My OB/GYN is VERY uninvasive, which I like. I've only had 2 ultrasounds so far, the fewer the better, in my opinion. She never does vaginal exams, except the time that I was feeling contractions. She has talked about the extra risks with twin pregnancies, but I'm lucky because I haven't had any problems. She'll even let me go past my 40-week due date! I know I might feel differently later, but I like this because I do NOT want to be induced, nor do I want a C-section. (Although I will do what is best for the babies ) It just depends on your level of comfort. If you want the extra monitoring and care of a peri, do it. If not, don't worry, it's not necessary for a healthy pregnancy. Your nutrition and listening to you body has a higher effect on your babies.


This was my post...under the wrong username.

--Reagan

 

My OB was very nonchalant and very uninformative. When I found out, I was 10 weeks and had an u/s just to establish the hb, when the nurse saw 2 babies. I didn't even see the dr after that. They just sent me on my way and scheduled my 4 week appt. I've had to ask all the questions, sometimes, still not getting the answers. I finally asked my ob to refer me to a peri after reading that most of the women saw one.

 

My OB practice is taking it all in stride. I too am pregnant as the result of fertility treatments, and was a little freaked about "high risk" especially after all we went through to get pregnant!

But the doc told me "Aimee, you're having twins, you're doing great, your body is doing exactly what it needs to do. If you start having complications, we'll bring in specialists at that time, but for right now, just remember that your body is doing all the right things. Just because it didn't cooperate while you were trying to conceive does not mean that it won't cooperate now."

And I've been following his lead and doing great ever since.

Congrats on your pregnancy!

 

Congrats! I think you will be fine....I delivered with a family practice physician...not even an ob/gyn. I am sure if you have probs that warrant a peri, they will send you! Have fun! Twins are great!

 

I never saw a peri and i am almost done...

 

I did see a peri and my regular OB right from the beginning. I was only high risk due to twins. My OB actually was glad I was seeing the peri. It made me more comfortable with the fact that the peri did that all the time. I felt confident about my regular OB, but it was nice getting a growth u/s every visit with the peri.

You can see a peri as well as your regular OB. My insurance just considered it a specialist visit instead of OB, so it was a slightly higher co-pay. If you feel better seeing both then do that.

 

I see a peri and not an OB. Was personal choice really, since my last pregnancy I had to see both a peri and OB, every week I had an appt with one or the other, got to be crazy. My peri came highly recommended and he will be the one doing the delivery of my twins. Love not having to go to so many appts, especially with my 11 month old.

 

timestwo, I had IVF as well, and my first OB appointment was so low-key I was sort of "wha? that's it?". They referred me to a peri because of my 'advanced maternal age' - I'm 38 - and I'm also overweight, which can add risk as well. At one of my first appointments I was chatting with the nurse about visits, and how I was surprised by how low-key everything is, and she said that a lot of fertility patients feel neglected at first because we're used to lots of attention and care when seeing the RE, and then when we get pregnant, we're not 'special' anymore, we're just 'normal pregnant woman'. Which is great, right? But it is a shock. Hang in there, and if you'd feel more comfortable seeing a peri, I'd make an appointment and go, it certainly can't hurt!

 

QUOTE(dunkles @ Aug 11 2007, 05:17 PM) [snapback]365291[/snapback]
At one of my first appointments I was chatting with the nurse about visits, and how I was surprised by how low-key everything is, and she said that a lot of fertility patients feel neglected at first because we're used to lots of attention and care when seeing the RE, and then when we get pregnant, we're not 'special' anymore, we're just 'normal pregnant woman'.


i also had ivf. my ob (who has 2 year old twins and actually had ivf from the same RE as me) said to me at my first visit "i'm going to see you more often because you'll like the peace of mind after being at the fertility clinic with u/s every week." she was right. at first, i needed to see those babies to believe it was true and everything was okay.

 

QUOTE(tgbmomofthree @ Aug 11 2007, 02:24 PM) [snapback]365297[/snapback]
she was right. at first, i needed to see those babies to believe it was true and everything was okay.


That's why I love my rental doppler! I use that every 3 or 4 days just to make sure I can hear nice, strong heartbeats.

 

I see a peri and my OB (ob primarily) because I am high risk- even without twins. Both practices are in the hospital so it's all readily available to me. I get consults with the peri every time something comes up -high b/p..etc

I think it's pretty common to see just an OB as long as YOU feel comfortable and the OB has multiple pregnancy experience.

 

I started with my OB's office. I'd seen her for a long while, she had babies via IVF herself, and she'd seen me through much of my IF struggle. But when I became PG I had to see the entire group, and she was never available for an appointment. Everytime I went in they had to ask me why I was there, and I was put off that they weren't reviewing my chart. I also got the old "we deliver lots of twins" and "a twin pregnancy isn't considered high risk". I just really felt uncomfortable, call it mommy's intuition. I switched myself to a peri group out of a large university hospital with the highest NICU level in the state.

Let's just say my mommy's intuition was right on. I really needed that peri group and hospital starting at 16 weeks. My other OB group wouldn't have caught my issue and I'd have lost my pregnancy.

 

My doc was pretty easy going about everything but that didn't mean I got substandard care (it's her normal demeanor). I was not referred to a peri but then my OB does have high-risk certifications and a good deal of experience. I had a relatively low-risk twin pregnancy -- no complications, two placentas, etc. I was given a 40-week due date and when I asked she gave me stats on prematurity without scaring the bejeepers out of me. In the absense of problems, she was upbeat and positive with me and that was exactly what I wanted. I did have increased monitoring and loads of ultrasounds. We made it to 39 weeks when we induced due to my rising BP.

 

I'm also having twins as a result of IVF. I had only seen my regular OB a handful of times before going to the RE, so we didn't have a really close relationship. I decided to go to a peri for my OB care throughout this pregnancy (my insurance didn't care either way). My DH is a neonatologist and I specialize in children with developmental disabilites, so we definitely have seen our share of complications with prematurity, etc. Even though everything has gone very smoothly so far, we just felt better with a provider who has LOTS of experience with multiples, premature labor, and other complications. I do feel like I'm probably the easiest patient they have in the practice, but oh well.....

 

I felt and feel that my OB is a little casual about twin pregnancy too! I am now battling it out with them to get moved to another doctor at 26 weeks. My advice is change now! Look for a doctor with experience in twin delivery. Ask your hospital for a referral.

 

I too am pregnant with twins after IVF. Like pp said, listen to your mommy intuition. I went to my OB which I liked just fine. She said she delivered a bunch of twins and wouldn't treat me any different than a singleton pregnancy. For me personally, I didn't like that. I called around and found that my area only had 2 peri's and you needed a referral. I went to the one that answered the phone and seemed warm and fuzzy just from a phone call. They are a teaching doctor office and deliver at a teaching hospital. Then when I found out Dr. Quintero practiced their, I just felt better. He is the leading doctor in the USA for TTTS. I have fraternal twins but still just knowing the staff and doctors were knowlegable made me feel more comfortable.

I am glad I did, I go for regular appointments and checkups alot even though I don't have any complications and it makes me feel like I am being treated like a twin mommy to be and not a singleton pregnancy.

You just have to do what you feel most comfortable with.

 

I had my IVF twins in January - carried them to 38 weeks, scheduled c-section, perfectly healthy. I suggest you go buy Dr. Barbara Luke's book on multiple pregnancies if you haven't already. She gives GREAT advice on how to take care of yourself and explains why it is better to see a perinatologist.

Like a bunch of other ladies, I had my regular OB, who was great, but got monthly, then at the end, weekly ultrasounds and non-stress tests at a peri's office. Fabulous for peace of mind. My OB is great, I had a totally uncomplicated pregnancy and she did the c-section, but I was nervous and she felt better about sending me to a peri "just in case." I also delivered at a level III NICU hospital. Our attitude after IVF was, why take any chances? It would not have been easy to get pregnant again, so we were not interested in taking any risks. I think any GOOD OB would not be laid back about *any* multiple pregnancy, especially one that was the result of IVF.

Although twins are common these days, you are at risk for complications that other pregnant women are not. Your twins are precious. It is worth finding the extra level of care so that YOU know everything possible is being done to ensure their safe arrival.

 

QUOTE(debid @ Aug 12 2007, 08:58 PM) [snapback]365624[/snapback]
My doc was pretty easy going about everything but that didn't mean I got substandard care (it's her normal demeanor). I was not referred to a peri but then my OB does have high-risk certifications and a good deal of experience. I had a relatively low-risk twin pregnancy -- no complications, two placentas, etc. I was given a 40-week due date and when I asked she gave me stats on prematurity without scaring the bejeepers out of me. In the absense of problems, she was upbeat and positive with me and that was exactly what I wanted. I did have increased monitoring and loads of ultrasounds. We made it to 39 weeks when we induced due to my rising BP.



I felt the same way! Didn't see a peri, office is low-key in general, but on top of everything. I felt very comfortable with it...and that's key. YOU have to be comfortable with the attitude/environment in the office. We 'only' made it to 36 weeks, but that's because I developed a blood clot in my leg that got worse even after I was admitted to the hospital.