sooooo confused....please help!! (long)

We had an OB appointment today, which went fine. But I mentioned to my doctor that our peri wants to start seeing us weekly. Up until now I've been seeing both my OB and Peri bi-weekly (alternating weeks). Well, my OB asked if we just wanted to switch my care over to the peri since I don't need to see them both weekly. My peri, however, is almost 2 hours away, but we kind of wanted the option of possible delivery here...if that was necessary. We stated that we'd rather deliver with my peri at the hospital up there (they have an NICU) and our doctor said that was fine if it was really what we wanted. He said he wouldn't recommend it though because of the long drive.

We were thinking if I went into labor I would go to our local hospital here, get checked out to see if things were stable and then be transported to the other hospital. Well, my OB said if I was past 35 to 36 weeks and in actual labor they wouldn't risk sending me to the other hospital. If I was in actual pre-term labor and could be stabilized they would try to send me up there, but if things were happening too fast, they would deliver me here and bring a special team down from the other hospital for the babies. Then the babies would be transported.

So basically, if we have a scheduled delivery it would probably work to deliver at the farther hospital, but who's to know if I would make it to that scheduled date, especially since it sounds like nothing would be scheduled until 38 weeks. I need to ask my OB some more questions, but I'm not sure exactly what. Maybe we could try to have bi-weekly NSTs, BPPs, and doppler studies up at the peri's and have NSTs here in between. But I don't know if my OB would do the dopplers and BPPs. And are they necessary if the NSTs are fine? We know in an emergency situation we would go to our local hospital right away. How safe is it to drive 2 hours in labor up to the other place (if not pre-term)? I'm afraid my water would break and the babies could go into distress or something.

Sorry this is so long...Any advice would be greatly appreciated! And, no, we can't just move up to the other place. That would solve everything!

 

Oh Melissa, another curve ball! I am jealous that you already have a daughter and are used to this level of decision making. The only advice I can suggest is that my OB just assigned weekly NSTs to me and said they were predictive of fetal health for the next 7 days, just like negative FFNs are predictive of avoiding labor for 14 days. If I understood correctly and your OB/peri agree, it seems like you might want to keep having weekly NSTs. Good luck and keep us posted!

 

I haven't started NSTs yet...next week at 30.5 weeks. My peri just made it sound like they do the NSTs, BPPs, and Dopplers...and take everything into consideration. But maybe these things don't need to be done every time an NST is done?

What other questions can I ask my OB to help us in our decision??

 

Do your OB and Peri communicate with each other well? If they do, I would try to avoid the 2 hr drive every week, that's going to be hard on you anyway. It seems it would be best if you could continue to see one each week as long as the NSTs look "normal" and things look fine when you see your Peri. I can definitely understand your desire for the best care, but 4hr car trips every week will only get harder.

Personally I would not drive 2hours if I were in labor. Too much can happen in 2 hours!

I hope things fall in to place and that it all works out smoothly!

 

I consulted with another doctor and it looks like we might have bi-weekly appointments, starting at 31 weeks. We'll see both doctors weekly (3-4 days apart), as long as our OB agrees with this. I guess I may have to be a little pushy. I know it's going to be hard to be on the road quite a bit, but it's worth it to us.

Thanks for your help, ladies. We still don't know what exactly will happen at delivery time, but at least (hopefully) we'll be able to keep seeing both docs.

 

I was told the same thing when I was pregnant with the twins. If I was truely in labor then I would have the babies and they would be sent to the bigger hospital.. because ours didnt have a NICU.. but it turned out I was in the hospital and not all that stable so they just transported me to the bigger hospital and I had them there... under and Dr I had never seen before.

 

Gah, I am dealing with this too. I am just not as far along to be forced to make a decision yet. My peri is one city over and my OB doesn't have privledges at that hospital. Even if we make it to 34-35 weeks or longer, my babies still have a 50/50 chance per child of NICU time. I really don't want to deliver one place and have them transported somewhere else. I am going to talk to my OB about this at my next appointment. I may end up switching. I really hate to do that, because I think my OB is great. But I want my babies with me

I will watch how each of you deal with this in your way. Perhaps it will help me along as well.

 

I don't want to give you the wrong advice but I think that if things are going well it would be your ob that would deliver them anyway. When I asked my peri who would be delivering my babies he told me my ob would, he only gets called in if there is something wrong which usually they know ahead of time. I just spent the last 4 days in L&D for PTL and I think a lot of it had to do with spending too much time in the car. Even on a ton of meds for contractions I still got them as soon as dh pulled out of the hospital. I would try to avoid those car ride if you are comfortable with your ob's level of experience with twins, and just make sure that the peri and ob are on the same page. I wish your peri wasn't so far away!! You'll make the right decision, just try and do what your gut tells you to.

 

Wow! A 2 hour drive? And here I am stressing over a 45 min-1 hour drive to our hospital. I am fortunate though that we have a hospital 10 minutes away with a NICU.
I don't think I would chance the 2 hour drive to the hospital unless it was early labor, but like a PP said so much can happen in 2 hours.
I have to do 2 NSTs a week and see my MFM doc. I can do one of the NSTs locally and then do the other NST at the hospital across from the MFM when I go for that appt.
I am on bedrest and DH has to take me to every appt so it helps to combine and just make it twice a week for us.
So will your Peri deliver your twins if you go to the hospital that is farther away?