Do I need a high risk pregnancy dr? — The Bump
High-Risk Pregnancy

Do I need a high risk pregnancy dr?

I'm 44 and have consulted an RE for possibly trying IVF.  One of my concerns is that I'm on 2 drugs for depression and anxiety.  Should I consult a high risk prenancy Dr about when I should be weaned off these drugs (Pre IVF or once I get pregnant) or should I just have my therapist/RE/OB/GYN have a conference call about this topic?

 Also how do I find a high risk pregnancy OB. My insurance plan's website doesn't list any.


Re: Do I need a high risk pregnancy dr?

  • i'm not sure about whether you need a high-risk dr. but I can tell you what happened with me - i was on meds for anxiety/depression before getting pregnant, and both my ob/gyn and my therapist told me (without consulting one another) that I needed to wean off before getting pregnant/could not be on the meds while pregnant. 

    ETA: whether you need to come off your meds will certainly depend on what you take. i was taking Effexor, which I am pretty certain is universally not recommended while PG.

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  • I go to a high risk ob (asthma, FVL -blood disorder, depression, and GD). I would call a few on your insurance co list and ask. Mine isn't listed as such in the list, but he is.

    And my ob is perfectly ok with depression meds while pregnant (I take celexa, but zoloft and prozac seem to be the most common). I'm on another board and many women have taken them while pregnant. My doc showed me a info from retroactive studies and there's not risk to many antidepressants. They are listed as cat C because they don't do tests on pregnant women. The only thing you can really do is look back and those who have and see what happened. Look at it this way - is it better for mom to be depressed/suicidal/panic ridden or take a med with minimal to no risk?

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  • You may want to start with a regular OB for a pre-pregnancy consult. If you're not satisfied thats/he knows enough, move on to a peri or MFM. I would certainly look into this BEFORE getting pregnant. You may also want to talk to the RE about it in terms of whether the IF meds will have any interactions with the meds you're already on.

    Good luck!

    TTC for 3 years. Finally successful after 5 IUIs and 2 cycles of IVF. Our amazing twins were born 5 weeks early on 8/16/11. Found out April 2012 that our di/di twins are ID.

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  • I've read that generally women over 35 who become pregnant are considered higher risk.  That said, you can certainly call your insurance company and ask if you will need an OB referral to a perinatologist in order for their services to be covered. A good OB will want you to see a peri or MFM if they feel you have higher risks with your pregnancy. The peri should work with your OB to provide you the best care possible.  Hope that helps!
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  • Your RE will see you through pretty much the whole first trimester before you switch to an ob/gyn.  You can ask your RE about those meds and what he/she recommends you do BEFORE starting the IVF process.  REs also have specialized education and experience beyond what a standard ob/gyn has.  They will be very knowledgeable about what meds are safe when TTC, pregnant, and in conjuction with your IVF meds regimen.  Mine wouldn't let me take anything that wasn't safe during pregnancy while we were TTC. 

    Besides a high risk dr typically doesn't see patients until they are referred to them from a regular ob so I doubt you'd get an appointment with one to ask those questions now.  You might not need a high risk dr anyway.  My ob sees me as a high risk patient and my sister saw a regular ob though she had prediagnosed anxiety and was on meds.

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