Tell me about MFM vs. OB

zazu13 · October 2013

My RE initially said to find an OB so I did and had my first appointment with him last week at 11w. Then at my "graduation" appointment this week the RE suggested I also consult with an MFM. Do most people continue to see both the entire pregnancy? Which one delivers the baby? I am happy to be monitored more closely and frequently given the difficult road it was to get here, but I'm not sure what to expect. Can I dump my OB and go exlusively with the MFM? DH wasn't impressed with the OB and thinks we are dumping him for the high risk doc, but based on what I read it sounds like most people see both?

Enlighten me

PinkinProvence · October 2013

I only see an MFM. She delivers so there is no need for me to have an OB. If you have an MFM who does not deliver, then you will also need an OB.

I would look at nearby hospitals with high-level NICUs and call the doctors in the maternal fetal medicine department. My RE also has a sheet with recommendations.

My preference was just to have one doctor manage my care, but there are many here that consult with the MFM but regularly see their OBs.

Good luck!

matthew24 · October 2013

Yes, in my case I see both. My ob filled out the referral for the mfm and I see them regularly. My MFM monitors me as well and conducted my NT scan and will my a/s scan in a couple of weeks. The MFM in my case does not deliver but is located in the hospital I am delivering in so the ob and mfm work in conjunction. Imo it is important to see both as both have different areas of expertise and knowledge.

AngieV84 · October 2013

I see both. I see the ob every four weeks right now for the regular pregnancy check ups, but I've been to mfm more often lately due to my short cervix, but also for the nt scan and a/s. So basically, the mfm is there for me for the more detailed, high risk issues, and ob for the regular check ups, bloodwork etc..

As to who actually delivers? I'm not exactly sure, and I was just thinking about this today. Guess that's something I need to ask, and I'd be interested in other peoples input.

PurpleIris30 · October 2013

Hi Zazu -- I also see both an OB and a MFM and they coordinate our care, although in our case the nearest MFM is located in a different town, so we see our OB for our weekly appointments and then travel to the MFM every 2-3 weeks for monitoring ultrasounds. Since you have di-di twins, then you probably wouldn't need as many ultrasounds, assuming you remain complication free. If our MFM were closer, then I'd probably opt to just see him, but that's mainly because we have had so many appointments with him anyway (and I really like him).

If the twins are born before 35 weeks, we will travel to the MFM to deliver (closest NICU), but if they are born close to term for twins, then our OB will likely deliver. If the need for a NICU is at all in question, then I'll push to travel to our MFM for delivery.

BabyCottom · October 2013

See both! When I graduated our RE suggested our OB which I love. But he is so caring and he set us up with MFM. I get double the ultrasounds and double the pictures. I also don't have to go long stretches without seeing my babies. It's peace of mind when you are worried the worst will happen after the long struggle to get to where I was. You also have two doctors who communicate with each other. My OB has never acted like he knows everything about twins. I feel this way someone who specializes in twins will have a different/better perspective. Also this past Friday I saw my OB who felt everything was fine and said he'd check me weekly from 35 weeks on and probably let me go to 38 weeks. I saw my MFM on Monday and one twin had flipped to breeched and the size of him was concerning so because of the increased still birth they are inducing me Saturday. (Mind you they were both head down Friday, lol). Though, they are not born yet, I am grateful for the extra monitoring. Sorry so long. I just wanted you to see why I went with keeping both.

caden · October 2013

I saw both. I love my OB but I would have loved more to see a MFM exclusively. However, my MFM office does not see twin patients exclusively except under certain circumstances, which did not apply to me.

Stephanie2167 · October 2013

I see both as well. My girls are di/di. I see my OB for regular appointments and my MFM monthly for growth checks and cervix checks. My MFM will make the decision on when to deliver but my OB will do the delivering. I love the extra monitoring. It really relieves my anxiety. I have two amazing docs.

xladybassx · October 2013

I see both. My OB takes care of monitoring my symptoms, testing my glucose/urine/etc, tracks my weight and nutrition, and answers all my stupid first time mom questions. The MFM exclusively monitors my babies. If I make it to term I will deliver with my OB, otherwise I will deliver with the MFM because they have a top rated NICU.

KaloramaKB · October 2013

I only see a MFM. After graduating from my RE, I originally went to the OB that I had seen for years and handled a previous miscarriage but was concerned that she had limited experience with twins. She said if it made me more comfortable she could consult with a MFM but I thought it was easiest to just switch my care to the MFM my RE recommended. I also wanted to deliver at a hospital with the highest level NICU in the area and my OB didn't have privileges there. It was a little awkward to "break up" with my OB but I kept thinking that I would never forgive myself if I didn't do everything I could give my babies the best chance. However, I may also be a little bit more neurotic than most.

zazu13 · October 2013

@KaloramaKB

I'm a little neurotic as well, and I think DH is even more so.

Thanks for all the advice and comments. I have an appointment with MFM in a week and my OB again the week after. I guess we'll see what they say and go from there. I'd prefer to deliver where the OB is at (literally 2 miles from home) in case the babies have to stay a little longer, but the MFM was highly recommended although a little further away (~30 min). If they came early enough I think I'd end up having to go to the MFM's hospital due to the NICU level avaiable, but hoping they will last until we are safe to deliver close to home.

vegetablegardens · October 2013

My MFM is in the same hospital as my OB. It's nice, because I'll be seeing both once a month and they line up so that I see one of them every two weeks. They're in cahoots, so my care is coordinated, and the OB looks to the MFM for the high risk associated questions. The OB is the one who will be delivering. My setup seems really similar to xladybassx above!

hjoy_06 · October 2013

I only saw my OB. She had a lot of experience delivering twins so I wasn't worried about that. I did see an MFM once for the anatomy scan at 19 weeks. Everything looked great so he released me to strictly see my OB and she would send me back to him if she saw problems...which, thankfully, she didn't! My OB did growth scans and tests and cervical checks at every appointment so I definitely felt like I was being monitored closely. If she didn't do that I think I would have requested to see the MFM. My boys were born at 36w1d weighing 6.1 lbs and 6.4 lbs and completely healthy so it worked out great for us!

CaliCarly77 · October 2013

I go to both. Mine are di/di with no complications, so I see my OB every 2 weeks to check on heartbeats, and my health. I see my MFM every 5 weeks to check on growth and positioning, cervix, etc. After 30 weeks MFM will be every 2 weeks as well, plus 2 NST a week at the hospital.

As far as I can tell, the MFMs in my practice do not deliver. My OB, who I don't love, will deliver but nbd, it is a C-Section and he's apparently very good at them. I love our MFM!!!

zazu13 · October 2013

Just an update .. thanks for all your replies. We met with our new doc at the MFM office at the larger hospital. She was great and she said she delivers and would be happy to see us exclusively or in conjunction with an OB. She did mention that if we delivered any earlier than 35 weeks we would end up at her hospital anyway due to the NICU capabilities at the hospital our OB was at. Given that we felt she was so much more personable and thorough and there is a chance of delivering where she is at anyway we decided to switch our care to her. She will see us every 4 weeks until about 30 weeks then more frequently after that.

Next appointment is at 18 weeks for the anatomy scan and glucose test. Hopefully we can confirm genders. The tech at yesterdays ultrasound was pretty confident we had one girl and a "maybe" a second, but she couldn't really get a good look. My gut says one of each so I'm really curious if her maybe is correct or not.

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