Peri/MFM vs. OB/GYN only?

Laura Emerick · July 2009

I've read many moms of multiples saying that in hindsight they are glad they went to (or wish they had gone to) a perinatologist/MFM. Usually because they picked up on something going wrong far sooner than their regular OB/GYN would have.

Is it necessary to see a peri/MFM simply because you're pregnant with twins? What do you ladies think? I've been seeing my regulary OB/GYN who delivered my DD. He has made no mention of this type of specialist. I only found out about it through Dr. Luke's book and this board.

Also, I'm in good health. No complications thus far. Separate placentas and separate sacs. No complications at all with previous pg either. Normal vag. delivery. I appreciate your input!

Temp6313048411121614 · July 2009

That's exactly my situation. I'm not seeing a MFM/Peri.

kelliwill · July 2009

MrsLee04:
LauraS1977:

Is it necessary to see a peri/MFM simply because you're pregnant with twins?

Yes.

I say Yes as well. I switched OB's at 13 weeks after we found out it was twins and luckily saw a peri for my NT scan who then said, I'll see you again in 4 weeks and then every two after that. We have identical twins, seperate sacs but same placenta so higher risk. Had he not said that and my new OB didn't refer I would have asked for a referral until I got one. This was confusing to me at first too and I herad about it here and Dr. Luke's book, but I do think it's important. My previous OB stated that they don't refer to a peri unless there are problems and I just didn't agree with that, but hey, they also thought my babies had two placentas, so clearly they were wrong and the Peri was right and I feel more comfortable being monitored by my Peri and my OB.

MandieSueM · July 2009

I only saw my OB with my triplets, I never even heard of an MFM, or a Peri until I started chatting on message boards. If your OB was concerned, they would send you to a specialist. I am of the personal belief that they aren't always necessary.

RobynK · July 2009

I started with triplets so I went straight to an MFM -- when we learned we were expecting twins instead she gave me the choice to stay with her or go back to my OB. I stayed with her and had wonderful care. I had a really good pg up until the very end when I developed PIH and eventually pre-e. I'm so glad I was with my MFM.

ancjph · July 2009

I saw both. My Ob was my regular dr and the peri did scans. They did talk and came to descions on my care together. So I was extremley happy with the care I recieved from both.

mushmouseKD · July 2009

I'm a twin, and 2 of my sisters had twins- I've never heard of a Peri/MFM. They both used the same OB thru their pg.

MrsARC1105 · July 2009

I vote yes unless your OB has a ton of experience with multiples AND high risk pregnancy. My pregnancy was pretty easy until they found the vasa previa. It was then that I started seeing a MFM in addition to my OB. My OB was very proactive and sent me for all the u/s, tests, etc but I could imagine that at another practice that may not be the case.

omalley · July 2009

I only saw my OB (she has twins and her partner has twins) I always felt comfortable with her.

I also never heard of a Peri or MFM (<---- I still don't know what that stands for) until I went on message boards.

Congrats on having a good, healthy pregnancy!

mrscalkins · July 2009

I was at a high risk practice already when I thought it was one because I have bp issues. The doctors I saw were never referred to as a Peri or MFM's, yet the practice handled fertility treatments and high risk pregnancies. I had no reason to doubt the level of care I was getting.

gymrat · July 2009

I started out w/ triplets and only saw a peri/MFM and I'm glad that I did. My MFM was able to detect my funneling cervix at 24 1/2 wks and quickly admitted me to hospital bedrest and administered my babies steroid shots.

I don't know if I would have had the same standard of care with my OB. My MFM really was the first person in a long line of people who saved my babies lives.

kimarino13 · July 2009

My RE said I need to go straight to the Peri, and not bother with an OBGYN, because the twins are identical. Solidifying the "requirement" is the fact that in the past year, I have gone through 2 IVF cycles, 2 FET cycles, 3 chemical pregnancies and I only have one kidney (donated the other to my dad a few years ago).

kelliwill · July 2009

mushmouseKD:
I'm a twin, and 2 of my sisters had twins- I've never heard of a Peri/MFM. They both used the same OB thru their pg.

But you yourself do not have twins? When did your sisters deliver their twins?

HisLobster · July 2009

I only saw an obgyn. If you're worried, ask for a referral or just make sure to ask lots of questions. I did have a level II ultrasound because of having twins but that was the only thing that was different. I had a complication-free pregnancy too.

macchiatto · July 2009

I only saw an MFM once, at around 26w, but that's because he was part of the practice I was at and I was rotating through all the OBs. Other than that I saw regular OBs. I also had di-di twins, no complications, and everything was fine. The MFM didn't pick up on anything the others didn't, and he didn't really do anything different except a ... I forget the name now, but the test that tells whether you're likely to go into labor in the next 2 weeks. He starts doing that test 2 weeks earlier with MoMs than the other docs do.

macchiatto · July 2009

I should add, I was at a high-risk practice to begin with, too. Not because I had any issues to begin with; it was just one several friends had recommended to me. If I hadn't been, I probably would have looked for an MFM or at least an OB practice that has LOTS of experience w/multiples.

meldoo2002 · July 2009

I only saw an OB, but she was very experienced with multiples. A peri read all of my ultrasounds and came in to talk to me about what he saw after each ultrasound.

jacobandcrystal · July 2009

I can say that after we saw our peri, we felt SO much more at ease! He gave us more in-depth information and was very obviously much more experienced with multiples than our OB practice. (And our OB practice even has several doctors with different specialties, and told me they could handle a twin pregnancy just fine.)

IMO, there is absolutely no comparison between our OB and peri. We scheduled our 20 week u/s with the peri because he does them himself, but we'll mostly have checkups with our regular OB. I just feel better knowing that we have our peri available to us : )

Ms.Scarlet · July 2009

ancjph:
I saw both. My Ob was my regular dr and the peri did scans. They did talk and came to descions on my care together. So I was extremley happy with the care I recieved from both.

This is our situation so far, and it's been great for us.

MrsBee10 · July 2009

We get extra and more in depth monitoring from the peri. I have had no complications, all my tests have come back perfect, but had we not been seeing him, they would not have detected fluid building up around Baby A's heart.

If your OB is willing to give you the extra monitoring you need, you may be fine staying there only. Many women on the board only had an OB. My OB however has never treated me any different than someone pregnant with a singleton and I was not okay with that.

atc282 · July 2009

I didn't realize some had both or even just went to an OB until I started reading posts on this board. When I conceived through IVF, my RE said that I needed to go to a peri/MFM when I relocated to London. I only saw a peri in London (I ended up seeing a midwife in between monthly peri visits though to hear baby's heartbeats, get BP taken, etc. for my own peace of mind). Now that I am home in the US, I was told at my peri's that I didn't need an additional OB--my peri will deliver my twins.

Holanchi · July 2009

omalley:

I also never heard of a Peri or MFM (<---- I still don't know what that stands for) until I went on message boards.

MFM = Maternal Fetal Medicine doctor

I go to an office with both regular OBGYN and MFM doctors. They've only scheduled me with the MFM drs from the beginning.

susanb · July 2009

I'm a firm believer that it's always necessary with multiples. Why? Because no matter how many years an OB or even high risk OB has been practicing - they didn't get the extra time in school or extra residency required to be an MFM. It's like going to your family doctor vs. a cardiologist when you have heart problems - which is more qualified?

The MFM can pick up issues much more quickly because they are looking for them. They will see you more often and have the equipment and the plan in place to deal with what comes up. I can't tell you how many women have told me (on this board, others and in real life) that an MFM saved their pregnancy after an OB blew them off. I personally know a woman in real life that was pg with triplets. Her regular OB told her that she did not need to go to an MFM, talked her out of it. She went in and complained at about 20 weeks that she was having cramping, things didn't feel right. He did a manual cervix check (not bright), it was closed and sent her home. If he had actually done a vaginal u/s which they did at L&D that night he'd have seen she was funneling and had virtually no cervix left. When she got to L&D that night because she knew something was wrong (her contractions got stronger after that manual cervix check - which can happen - it's known to provoke labor) she was very much in labor and dialating. It was too late for them to save her pregnancy and all her babies were born and died. If he'd known what was going on she could have had a chance to save the pregnancy. They could have given her drugs to stop it, done a cerclage.. something - but now she is having a hard time getting over the fact that she listened to her OB in the first place. I'm not sure she ever will.

I'd seriously ask for a referral. My OB automatically kicks all multiples to an MFM - and they all deliver here.

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