expectations of OB for di/di twins

GirPipley · December 2014

Hey there.

I'm 12w3d and had my second appointment with my OB today.I really liked the office the first visit, but I'm having hesitations now.

When I arrived, the nurse immediately started drilling me on the different genetic tests I could do. I have my NT scan on Wednesday, but I did not know I was going to be offered any of the other tests. This one was called Progenity, which tests for CF, Spinal Muscular Atrophy and Fragile X. I don't know if my insurance covers these, and I haven't done any research. I'm 29, have no family history of genetic disorders. I told the nurse I was starting to feel overwhelmed, and needed to think about this and talk to my FI, but she kept pressuring me. I finally told her I just wanted to see the Dr and I would come back if we wanted to do the test.

Then, we go into the room and the nurse pulls out a doppler and finds baby A pretty quickly, but then takes 5 minutes to find baby B, and we only heard her for maybe half a second. The nurse said "good enough for me" and left the room. Well, it wasn't good enough for me! I have been bleeding since week 6 and I wanted to have some solid reassurance that the babies were okay. In the 5 minutes it took her to find baby B, Baby A could have moved and been "baby B"

Dr comes in and I ask about getting an ultrasound to make sure they are okay with all the bleeding, and she said I don't get one until 20 weeks, and then will have one every 4 weeks. I also wont be getting a referral to MFM, b/c I'm having Di/Di twins. I was supposed to have a PAP and Breast exam today, but I ended up telling the DR I was too overwhelmed and just wanted to leave.

Is this typical for di/di twins? No MFM and no ultrasound until 20 weeks?

I do have anxiety/OCD and elected to stop taking my meds. I'm wondering how much of my reaction was from anxiety and how much was legit. Either way, it was my reaction and I need to make sure this is the right OB for me.

I'm at Capital Womens Care in the DC area, which is a top notch practice, but you do not get a "regular OB', you have to rotate, and I'm not sure that is going to work for me.

TIA, any advice would be great.

TREDgirl · December 2014

Nope, nope, nopeity nope. I would find a new OB stat. Even though it's 'only' di/di there are still a lot of things that can happen. Some of the tests that they do for singletons will not produce the same results with multiples.

MY OB did an ultrasound every.single. visit. and I started at the MFM at 14 weeks since I was having bleeding. So I was seeing one of them every other week.

And there is no way that I could have made it through the pregnancy and especially the post partum part without the meds I take for anxiety/depression.

Good luck!

GirPipley · December 2014

@Tredgirl Thank you for that. That is more of what I was expecting based on what I have read.

As for the anxiety meds, I am thinking it might be time for me to get back on them, now that I'm nearing the second trimester, I am feeling more comfortable with taking them. I am struggling to even get out of bed at this point, and making it through the day without screaming at my family, or having horrible thoughts about myself and my babies is a thing of the past. I've been talking to my therapist and psychologist, and they are ready to prescribe again when I tell them I am.

Rynleigh · December 2014

Run away, now... If you are getting the NT scan on Wednesday, you'd be having an ultrasound as part of that test.. and if you are concerned and you want an ultrasound, you get an ultrasound - even if insurance won't cover the thing, your doctor shouldn't say something as absurd as "Not until 20 weeks".... Find a different OB who is experienced with multiples, or a maternal fetal medicine clinic where you can get in with a perinatologist - if your insurance doesn't allow self referral, find an OB who will refer you to MFM.

ekreps · December 2014

Switch if you aren't getting what you feel you need. I have di di and had no bleeding but see my doc every two weeks and MFM every month. Ultrasound every visit to check heartbeat and measurements of both. Ask them to tell you what they are checking when they do anything and ask questions if you want something else checked. Trust yourself and your mama instincts. Many doctors are different and you need one that feels ok to you.

BabyKsMommy · December 2014

I didn't see an MFM just my reg OB. I did get u/s every visit. I also had monthly growth scans starting at 24 wks.

My pg was going smoothly until my water broke at 31w2d. No extra care or u/s would've predicted or prevented it so I feel the care I got was adequate.

hais_mommy · December 2014

I started with MFM at 20 weeks with my AS and then every 4 weeks for growth scans. I have been seeing the OB every 4 weeks until I got to my third trimester and now am every two weeks. I have an US with them every visit but it is literally two seconds...to check for Hb

GirPipley · December 2014

Thank you everyone! I made an appointment with a new OB, so I'm hopeful things will go better there.

vpine · December 2014

I didn't check with my insurance first on the genetic testing so I got a bill for it and had to pay OOP a few weeks later. There's no genetic issues/family history but I felt better after getting tested. They also did the Y chromosome test at 13 weeks where we found out we are having 2 girls, confirmed at 20 week anatomy ultrasound. I saw Ob once a month the first-second tri but now during 3rd tri, will be seeing him every Friday until delivery. As for ultrasounds, will be having another one at 33 weeks - called the growth ultrasound which will take 1 hr. Not sure if there's any more ultrasounds after that.

MissEm15 · December 2014

AshB62 said:
I didn't see a MFM with my di/di twins, BUT my OB practice has a lot of twin experience and treated me as a high risk pregnancy.

I was seen every 3 weeks until 20, every other week until 28, then weekly until delivery. I had an u/s at every appt. Usually it was just a quick heart rate and fluid check. Then I had my A/S at 20 weeks and growth scans every 4 weeks after that.

As far as rotating OBs... That seems pretty common. I saw all the doctors in my practice because whoever is on call will deliver when you go into labor. It was the same at the practice I went to with my DD as well as the practice my sister goes to.

I definitely think a second opinion is in order here. You should be completely comfortable with the level of care you're receiving.

All of this for me. They did the same protocol as the above. I also see most doctors bc anyone could be on call when u go into labor.

apb8-6-05 · December 2014

I'm also in the DC area and go to Capital Women's Care. They are all independent offices with the same name, so don't feel like they are all the same. I haven't seen MFM, but my doctor has let me have an ultrasound because he knows I'm a nervous wreck. They would have had me go to MFM for the anatomy scan, but I preferred that they do it in their office. Oh I hope that things get better from here for you.

Mushibamboo · December 2014

I wish I got an US every visit. Like most PP I see both a perinatal specialist and my OB, so I have an appointment every 2 weeks. Only get scans at the high risk dr. at this point (21 weeks), they just doppler at the OB. So I have a scan every 4 weeks. And actually the first time they did the doppler at the OB they picked up baby girl's heartbeat twice by accident so it isn't unheard of. I use a doppler at home too to keep from getting too anxious. Love feeling them kick

.

ljh25 · December 2014

I am also expecting di/di twins (currently 9 weeks). I talked with my OB about MFM. He let me know that all ultrasounds at our hospital are conducted at MFM and interpreted by the MFM docs. I had an ultrasound at what we thought was 8 weeks (probably more like 7w3d) and will have our next ultrasound at 16 weeks. He said we will typically have an ultrasound every month.

Evo9380 · December 2014

Just wanted to add that even if you think you're getting adequate care but you feel uncomfortable - switch anyway.

I had a terrible experience. The clinic felt rushed, etc and ended up switching. Best decision ever! Stick to your gut!

Wishing you a smooth pregnancy

cls78 · December 2014

I started with my MFM at 12 weeks for my NT scan. (I am also AMA). I started off going there for growth scans every 4 weeks and recently they had me start coming every 3 weeks since there was a small difference in weights with the babies. I have rotated between my OB and MFM my entire pregnancy and they work together on my care. My OB will deliver my babies as of right now and I feel comfortable with that. I am currently 32 weeks.

Edited to add that SMA, CF, and Fragile X is usually tested after a positive pregnancy test and should be covered. My OB does the same, but since I was tested at the RE I made sure the OB didn't run them again.

GirPipley · December 2014

Thank you ladies! I had my NT on Wednesday at the Genetics and IVF clinic in town. It was a wonderful experience, and they gave me a referral to a MFM b/f of my anxiety, and the bleeding I've been having. The DR said, if I want to see a MFM, I get to see a MFM, end of discussion.

I am feeling much more comfortable with this now, and I'm looking forward to seeing them in the next few weeks.

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