This is weird, right? (pregnancy related)

[Deleted]

I had an appointment with my OB today to go over family history, etc., get another u/s, and have my annual. Two things struck me as odd:

a) I'm only 8w and my doctor is already telling me I should get a c-section (for reason non other than I already had one and this baby will probably be big because DS was big...)

b) I need to see a high-risk doctor because I get migraines and I need a pain management plan. Um, isn't that what my neuro (who I've already discussed pregnancy + migraines with) is for?

(Eta: This is not the OB I usually see. There are three in the practice, and I usually request one of the other doctors, but got stuck with him today,)

[gastro]

If I had a c-section with my first then there would definitely be a discussion about possible c-section with subsequent pregnancies.

I suppose if I was on pain medication to treat migraines during a pregnancy I would want to make sure everything was safe for baby and wouldn't mind being encouraged to see a high-risk OB. Because a neuro doc might not know as much as a high-risk OB about certain drug effects on a fetus.

[lexus]

Jul 16, 2015 19:31:21 GMT -5 gastro said:

If I had a c-section with my first then there would definitely be a discussion about possible c-section with subsequent pregnancies.

I suppose if I was on pain medication to treat migraines during a pregnancy I would want to make sure everything was safe for baby and wouldn't mind being encouraged to see a high-risk OB. Because a neuro doc might not know as much as a high-risk OB about certain drug effects on a fetus.

I agree about the pain management. Makes sense that you would see both.

Also, with DS the dr talked about a RCS from the beginning. It was my understanding that my desire to have a VBAC would only be an option if DS or I didn't get too big. There are many factors to determine if You are eligible for a VBAC. Ask some follow up questions.

[Deleted]

Yeah, sorry of you got a bad vibe from this OB or felt pressured, but neither discussion seems out of the range or normal.
It doesn't mean a vbac is out, but it's not a bad idea to start a dialogue.
And do they know you have a neuro? Either way, a high risk OB will know more about how things interact in pregnancy.

[nicolewi]

I think the C-section assumption is odd, but the pain thing I can see. My OB was very open to trying a VBAC, but my C-section was only because the baby was breech. Without knowing all the history, maybe there are things that tip the scale towards repeat C. Definitely worth a discussion, obviously. I did opt for the repeat C-section for several reasons, but I liked that it wasn't assumed from the start.

[penguingrrl]

Unless the doctor was specifically trying to get the history of your prior c section to assess your chances of a successful VBAC that sounds off to me. I feel like a pro VBAC doc wouldn't be talking c section to you this early. I had a c with my first and VBACs with my second and third (all with different practices due to our moves). The only time a C was mentioned was after 2.5 hours of pushing with my third (was given the choice of C or forceps) then when I needed to deliver my third and hadn't progressed at all. Otherwise the doctors treated me as a patient giving a standard vaginal birth. I would be concerned that this doctor isn't VBAC friendly.

As far as the migraine comments, I would guess that as long as your neuro is in touch with your OB regarding treatment and meds I can't see a reason that would automatically qualify you as a high risk patient unless the neuro feels you are (which it sounds like s/he doesn't).

I'm sorry you got a bad vibe from the doctor. Being pregnant is stressful and you need to feel like your entire team is on board!

[lala]

I think a conversation about a vbac vs. repeat section are normal at some point in the pregnancy, but at the initial 8 week appt. it sounds odd to be pushing you toward a section. That would signal to me that this OB wasn't pro vbac, which wouldn't fly with me.

I don't know much about the latter issue but I don't see why your OB & neuro couldn't communicate together and with you; referring to another specialist if needed. I don't see why this would this would require a high risk OB now.

[quesyrah]

One of the first questions I asked my OB is if she does VBACs. I know a lot of OBs/hospitals still don't allow them so I wouldn't be surprised if an OB mentioned it right away. It would make me change OBs though unless you're fine with a RCS.

The pain management doesn't shock me. I have an autoimmune disease and consulted with both my specialist, OB and a peri during my 2nd pregnancy (I was diagnosed after DS was born).

It sounds to me like you just don't mesh with this OB. That's totally fine and I would ask the office manager to make sure you don't see him. I did that with my practice and they totally understood and I never had to see the OB I didn't like

[usm]

A lot of Drs in my area don't do VBACs if I pressed the issue they would refer me out but otherwise they would treat it as if you were planning anothe CS. That convo doesn't strike me as odd.

The pain management MFM doesn't strike me as odd either. It was explained to me that the OB knows "mom things" and doesn't know much as far as baby. They refer out of any question comes up. The neuro is your dr and while she is watching out for everything the MFM will know the effects on the baby. It will probably be benefit you because specialist are usually more comfortable allowing things vs those treating something they don't deal with everyday. Like some depression meds are considered a no-no while pregnant, some MfMs will allow them at smaller doses and well monitored if it is found the work best for the mom. Mom and baby are safe, Drs are comfortable and have covered their ass.