Questions about OB attitude

Hi-
I am 20 weeks with twin boys. My OB visits are every 4 weeks and I had a level 2 at 18weeks with another one in a month. It seems to me, that my ob is so nonchalant about everything. Yesterday, at my check, I asked about whether my cervix was measured at my level 2 and he said he would check my chart to see. Well, the report wasn't even in there. He said he would have to get the report, but that if something was wrong they would have told him. I also asked the peri at the level 2 about cervical length and whether they check it and he said no. I just thought they would be more thorough in checking everything, not just he health of the babies. Also, since they are both boys, the peri said he is not sure if they are identical or fraternal. Is there anyway to tell this before delivery?
I just have so many questions.
Thanks!

 

Sorry but your peri doesn't sound that great. If there is even a chance they are identical they should be monitoring you for twin to twin transfusion syndrome, just in case. I would call your peri and discuss this with them.

 

It's not to late to change docs if you are not happy. I always say trust your gut. I would call your Peri and ask if there is one placenta or two. If there are two, you will be fine being monitored every couple of weeks (2-4), but if there is only one placenta you should be monitored every other week as pp mentioned due to possibility of TTTS.

Where do you live? If you don't mind sharing.

 

I could have written this exact post myself--just got back from my OB who also didn't know my cervical length even though they took the measurement I guess it was not in the report; not concerned about it; am having two boys, they said I won't know if they are fraternal or identical until the twins are born. I have a f/u u/s in about two weeks to monitor growth but basically my MD today told me to chill out b/c he was treating my preg as low-risk 2nd preg since my first had no complications. I was thinking today that maybe that is good and I should just stop being hypervigilant and enjoy my pregnancy, but it is hard when you do your own research and reading and find that many doctors follow a much more extensive testing/measuring/scanning.

 

There are two placentas. I do know that. The problem is that there is only one practice here that has perinatologists and the equipment to do the ultrasounds. I live in Delaware and it's a very small state. This is also my 2nd pregnancy. First, was a singleton, full term, etc... The OB said that yesterday, "well you went to full term with your last." But isn't have twins make you at a higher risk?

 

QUOTE(lillysmom @ May 27 2009, 01:15 PM) [snapback]1330337[/snapback]
But isn't have twins make you at a higher risk?

No. Having twins and no other risk factor does NOT make you high risk

I think your appt schedule sounds very normal to me. It would be nice to have the US report in your folder but depending on who did your U/s (Another practice or at your local hospital) it can take a while to get it dictated, written up, mailed, received, and filed.

Honestly I think you are over reacting a bit. Glad he is going to go check the report but he is right, if there was anything concerning he would have been told.

I don't believe there is a definite way to tell ID or Frat without testing after they are born.

 

QUOTE(twoplustwo @ May 27 2009, 10:23 PM) [snapback]1330344[/snapback]
No. Having twins and no other risk factor does NOT make you high risk

I think your appt schedule sounds very normal to me. It would be nice to have the US report in your folder but depending on who did your U/s (Another practice or at your local hospital) it can take a while to get it dictated, written up, mailed, received, and filed.

Honestly I think you are over reacting a bit. Glad he is going to go check the report but he is right, if there was anything concerning he would have been told.

I don't believe there is a definite way to tell ID or Frat without testing after they are born.



I agree with this. My OB is very good when there's a problem (and I have had them -- miscarriage, fibroids, etc) but he has told me consistently from day one of this pregnancy that yes, twins are considered higher risk pregnancies generally, but that he considers me to be very low risk. If you're young and healthy and seem to be carrying well with few problems then there is no reason to worry too much about your OB not treating you with kid gloves. You should be thankful that you're not having issues and hope that he is able to continue having a more relaxed attitude as it means that you and the babies are doing well.

 

The fact that you had a good previous pregnancy and your boys have their own placentas etc puts you in the best category to be in with twins, the lower risk end of the spectrum, which is a good thing and your will probably not need to be on any strict monitoring or anything unless something does indeed come up. My boys have their own placentas etc, which helps out, but due to my history of ptl and other complications i've been monitored a lil closer but not as much as some. Each pregnancy will be on a case to case basis with any dr and in most cases if your dr doesnt seem concerned, you probably shouldnt be either since they are the ones that have seen many multiple pregnancies.

 

Thank you for all of the information. But, I have to disagree that I am overreacting. I am a concerned individual and have never been down this road before and really don't know what to expect. I have been through more than anyone can imagine just to be pregnant again. I just had a few questions, but next time will search out better ways to have them answered.

 

I personally don't think you're overreacting to be concerned about this! As previous posters pointed out, the presence of two placentas puts you in a lower risk category, but the peri neglecting to check your cervical length seems like a red flag to me, too. Since it sounds like your options for changing doctors is pretty limited, I think if I were in your position I would keep doing what you're doing: asking the right questions and pushing for answers and the level of monitoring that will reassure you throughout this pregnancy. Good luck!

QUOTE(lillysmom @ May 27 2009, 07:14 PM) [snapback]1330441[/snapback]
Thank you for all of the information. But, I have to disagree that I am overreacting. I am a concerned individual and have never been down this road before and really don't know what to expect. I have been through more than anyone can imagine just to be pregnant again. I just had a few questions, but next time will search out better ways to have them answered.

 

QUOTE(lillysmom @ May 27 2009, 07:14 PM) [snapback]1330441[/snapback]
Thank you for all of the information. But, I have to disagree that I am overreacting. I am a concerned individual and have never been down this road before and really don't know what to expect. I have been through more than anyone can imagine just to be pregnant again. I just had a few questions, but next time will search out better ways to have them answered.

I don't think you are overreacting at all. My OB considers all twin pregnancies to be 'high risk'. I first found out it was twins at 21 weeks, and was sent to the peri the next week. I had a more in depth u/s there including cervical length measurement. I think it's really wise to have a baseline at this point in case you do begin to shorten.

I also have to disagree with the 'if your doctor is not concerned, you shouldn't be' theory. Most of the time it holds true, however, there are times when you have to go with your gut. If you feel like you are not getting adequate care, by all means find someone else who will listen to your concerns, and don't ever be afraid to ask questions!

:hug:

 

I absolutely agree with Becky. Most Drs, mine included, considered having twins high risk.

I also think that you are your best advocate. So if you don't feel something is right, then go with your gut and keep pushing them. It is their job to care for you and your babies, but they are not perfect.

 

I had never heard of cervical length until after I had my twins and found this website. Never once throughout my whole pregnancy did someone tell me about my cervical length and half the stuff that many of you mention. But I had been with my OB for nearly a decade before I had my twins, so I knew that if anything was wrong, she would tell me...I had complete trust in her. My OB was very laid back, and she would never get upset unless there was a reason to be...which ended up happening about halfway through my pregnancy when my babies started measuring small.

I definitely agree with the other pp's, you are your best advocate, especially if you don't know your OB that well. You should ask lots of questions. So if you don't know your OB's or peri's personality well, talk to them and ask them what is going on and how they will handle things should an emergency come up. If you don't like their responses, switch.

 

So sorry that you are feeling this way! I know I did with my last pregnancy but that was a singleton pg. I definitly think you need to feel comfortable with your doctors. Twins here are considered high risk and that's the only reason I get to see an OB vs a family doc this time. Yes definitely advocate for yourself (I know it's hard to do, I am always shy to do it) but it's good that you asked for the info. Do what you feel is best!!!! Your gut will know!! :hug:

 

QUOTE(twoplustwo @ May 27 2009, 05:23 PM) [snapback]1330344[/snapback]
No. Having twins and no other risk factor does NOT make you high risk

I think your appt schedule sounds very normal to me. It would be nice to have the US report in your folder but depending on who did your U/s (Another practice or at your local hospital) it can take a while to get it dictated, written up, mailed, received, and filed.

Honestly I think you are over reacting a bit. Glad he is going to go check the report but he is right, if there was anything concerning he would have been told.

I don't believe there is a definite way to tell ID or Frat without testing after they are born.


I totally agree with this!