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HR OB/Need opinions please. :) (A little long.. sorry!)

niknak1208niknak1208 member
in Pregnant after 35
Hi Ladies. So I have a bit of a dilema and I need some opinions pretty please. :)  I am technically high risk because I lost our sweet baby Brooke at 20 weeks back in September of 2011.  My water broke at work for reasons unknown to date.  We *think* that it was because my cervix opened slightly and my bag of water slipped through but we do not know that for fact.  I got pregnant shortly after with my 2 yr old DD, Olivia.  I treated at the high risk MFM clinic at the big hospital where I used to work. I was seen oh about every other week until week 16-17 and then I started with 17 OHP (progesterone) injections which are supposed to keep your cervix from opening.  Those are weekly injections for 10 weeks.. week 17-37 and most insurances only cover them do be administered in the clinic (which is the only way my insurance covers it).  

So here's the deal.  I live 40 minutes away from that hospital and now I work at the hospital close to my home so i also work 40 minutes away from that hospital.  I started my treatment there because I work in HR here and I don't know anyone on the clinical side at all.. all of my docs are through the other hospital.  So I've had 2 appt's so far.  We talked about transferring my care to this hospital so I wasn't missing so much work time and driving so far to appt's.. especially given the injections are every single week.  So they scheduled three appt's yesterday.. 12/29, 01/05, and 01/12,  They said if I could find a doctor here.. I could cancel them but they wanted to get them started. I absolutely HAVE to start injections no later than 12/29. 

here's my issue.. if I stay there.. I KNOW my director is goign to make me file intermittent FMLA and i"m probably going to burn through a week or two of my FMLA time which means a shorter leave with my newborn baby.  Issue two..  I cannot seem to find someone at the hosp. where I work. Apparently, we don't have any high risk docs here!  They refer them all out to this other hosp where I'm currently treating.  

I never actually had any known issues with my DD but we were doing all of the precautionary things because we have no idea why my water broke so since it worked with her.. our theory is that it will work this time and we're doing the same protocol. 

First question- would you be comfortable treating with someone who is NOT a high risk doc if you had my history? 
Second question- would you just take the risk on a shorter maternity leave and stay with the docs you're with?  

I have no idea what to do! I haven't actually called any OB's yet but I did confirm today that we defintiely have NO high risk clinic here at this hospital where I curently work and live.  
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Re: HR OB/Need opinions please. :) (A little long.. sorry!)

  • NeonNoonNeonNoon member
    I would probably stick with the doctors I've worked with before and risk shorter maternity leave.  Good luck, it's not an easy decision.
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  • niknak1208niknak1208 member
    The other issue is that my coverage at both hospitals is 100% for ME.. but once the baby is born the coverage for the baby is only 70% at the hospital I'm currently treating with.  So I'm also going to get a rather large coinsurance bill. 
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  • niknak1208niknak1208 member
    "@"hikerlady  That's kind of what I'm hoping to do because the injections are just RN visits and they're usually only 20 minute visits.  I won't have to have my normal prenatal care weekly so I'm hoping that I can find someone here who would be willing to administer injections but I'm not sure if a physician would feel comfortable taking on injections without you actually being a patient that they monitor. Ugh. Why does it have to be so complicated! 

    honestly what I'm hoping is that my hubby gets the promotion he's hoping to get and that I won't have to worry about it because if that happens I won't have to go back to work! But that's all unknown at this point! 

    I'm also a little peeved that they would make me call in intermittent time anyways because I'm salaried so I won't have to use any PTO for these appointments and there are tons of others in our dept. who just make up time by taking their laptops home or skipping lunches etc. 
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  • woodberrieswoodberries member
    Best of luck. Th at IS frustrating. Does it make you feel better that I had to drive 2 hours to get to the dr once I started going twice or more a month? lol. We lived in the mountains and he came out to ski once a month and saw OB patients. 

    I hope you can get those shots close. Ask around... a lot. You could ask the high risk OB if he could consult with a local OB on what to look for with you. Can you have the local OB do most of the prenatal and then deliver with the high risk one in the other hospital? 

    My main advice is to be persistent in asking around to find out your options. 
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  • Samuelismomma Samuelismomma member
    Most insurances I know will pay for nurse to come to your house. That way less appointments at current doctors but less work missed. I would call my insurance and ask.
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  • niknak1208niknak1208 member
    Thanks Ladies.  I'm going to try to do some calling around this week.

    Can't have an RN come to my house. Insurance only covers the injection to be administered in the actual doctor's office.  

    I am just frustrated in general. Obviously, it's much more convenient to have treatment here but I also don't want to take any chances with myself or my baby. :( 
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  • stacydjordanstacydjordan member
    Ask your high risk doctor if they will allow you to administer the shots yourself. That is is you are comfortable doing it .
    I'm in the same position and my high risk dr is going to let me do it.
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  • BigbonededBigboneded member
    Or can you go to a PCP or Family Medicine office? If its 100% covered and just for the injections.... I would guess someone would be willing to get paid for that and consult with your regular doc as to why...
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  • niknak1208niknak1208 member
    My doctor would let me do the injections.. insurance won't cover the injections unless they are administered in a physician's office so that's not an option.  

    I did find a doctor here close to home that stocks my injection and will see me so I"m pretty excited about that!!  I see the midwife for the first time on 12/19 for paperwork, history, and hearttones.  I see him on 12/23 for physical exam and u/s.  My first injection is scheduled 12/29 at the other hospital.. I may need to keep that appointment if this new doc can't get me in by then because I'm 17 weeks 5 days on 12/29 and it has to start in the 17th week.  

    The new doc is literally 3 minutes from my office. It's super super convenient.  That part I will really like because it takes me a good hour to get from here all the way to the other hospital and park in a structure and drive in downtown traffic etc.  
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  • woodberrieswoodberries member
    I'm glad you were able to make it a little better for yourself!
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  • af2004rnaf2004rn member
    You could keep the prenatal care at the doctor you currently see. When it's time for delivery you could go to the hospital that covers your care 100%. If your doctor doesn't have privileges at that hospital, they usually just use an on-call doctor. Maybe not your first choice, but I throw that out as an option. That facility can't refuse you.
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