Looking for an OBGYN who understands mental health & can work with my psychiatrist

[Anonymous]

I recently started with Foxhall OBGYN (and I LOVE them) but my doctor, Dr. Green, doesn't take any insurance, so it seems worryingly expensive. My husband and I are well-off but it just seems like a waste of money to go out of network for something that would otherwise be completely covered by our excellent BCBS insurance. My psychiatrist recommended Dr. Green at Foxhall specifically because she has a strong understanding of how pregnancy hormones and post-partum hormonal changes can affect mental health, and she would work with my psychiatrist to help me monitor or treat any issues that arise. I have a mental health diagnosis that makes me much higher-risk for a mental health episode during or after pregnancy. (Which I am pretty nervous about! Though I am otherwise in very good health and currently am very mentally healthy—just worried that pregnancy could trigger an episode.)

Any recommendations for an OBGYN with this type of expertise?

[Anonymous]

I don’t know, but my MFM, Dr. Pinckert, was open to discussing mental health issues and pregnancy with me.

[Anonymous]

Stay at Foxhall. I'm with Dr. Beckerman and he worked seamlessly with my psychiatrist and the MFM practice at Sibley to manage my bipolar disorder. The MFM practice is excellent for this type of thing. They actually have a staff member whose practice is (half) dedicated to medication exposure in pregnancy and she is extremely knowledgable. She actually helps you weigh risks vs. benefits instead of just telling you to stop all medication like most OBs will.

Plus, your appointments with the MFM practice should be covered by insurance, even if your appointments at Foxhall aren't.

[Anonymous]

Anonymous wrote:Stay at Foxhall. I'm with Dr. Beckerman and he worked seamlessly with my psychiatrist and the MFM practice at Sibley to manage my bipolar disorder. The MFM practice is excellent for this type of thing. They actually have a staff member whose practice is (half) dedicated to medication exposure in pregnancy and she is extremely knowledgable. She actually helps you weigh risks vs. benefits instead of just telling you to stop all medication like most OBs will.

Plus, your appointments with the MFM practice should be covered by insurance, even if your appointments at Foxhall aren't.

Thanks for this. Super helpful. My first visit to establish care with Foxhall was over $1,000 for the one visit. Insurance only reimbursed like $80 of that, which I don’t totally understand because usually my OON benefits are about 40 percent covered. I’m worried that over the course of a pregnancy it’ll be $10,000 or more… do you mind my asking what your cost of care for your pregnancy was? And thank you so much for sharing. I have bipolar 1 (have had 1 manic episode- a year ago - that required inpatient at Sibley; no depressive episodes; not currently on any medication as I was able to come off after 6 months of lithium) so it helps to know you had such a positive experience.

[Anonymous]

I’m not sure how Dr. Green handles things, but Dr. Beckerman has a flat rate for all pregnancy care and his hospital fees. It’s about $9k. When I had my son a few years ago it was around $6k and insurance reimbursed me for about $3500.

[Anonymous]

If you can afford it, stay with Dr. Green.

[Anonymous]

It's hard to say based on what you've said so far.

I see a OBGYN specialist put of pocket but it was literally a last resort. All other OBs would not touch my issues with a 10 foot pole. So it's worth the multiple thousands out of pocket to me, but that's my situation.

[Anonymous]

I have bipolar and have been hospitalized for it and have gone through some serious pre and post partum episodes. My OB, Dr. Malcolm DeSouza, took my mental health very seriously and worked with my medication regime. He is a sole practioner and very compassionate. He takes major insurance.

[Anonymous]

What’s your mental health issue? Pregnancy and postpartum will challenge any person so if you have mental health issues you need a strong postpartum support plan, too. Sleep deprivation is hell and will exacerbate many other issues from the hormones, stress, lactation, and normal baby/mom/relationship/self adjustment issues. Please make sure you have a good therapist, find a good postpartum support group, and throw lots of money at postpartum help, especially a night nurse.

[Anonymous]

Anonymous wrote:What’s your mental health issue? Pregnancy and postpartum will challenge any person so if you have mental health issues you need a strong postpartum support plan, too. Sleep deprivation is hell and will exacerbate many other issues from the hormones, stress, lactation, and normal baby/mom/relationship/self adjustment issues. Please make sure you have a good therapist, find a good postpartum support group, and throw lots of money at postpartum help, especially a night nurse.

This.

I know someone whose PPD sent them into a serious tailspin for several years. They only had one baby because of how terrifying the next 2-3 years were…and they had buckets of money and a ridiculous amount of help.

Is your partner really, really, super duper up for being the primary caregiver if things go south? Because that’s who needs to step up. I can immediately think of a handful of scenarios I know of irl where this was the case. In two instances the mom was already the breadwinner.

[Anonymous]

In your situation I felt incredibly lucky to have access to a high risk MFM practitioner and used them throughout.

They were DRAMATICALLY less alarmist about medication than conventional OB/GYNs.

[Anonymous]

Anonymous wrote:I have bipolar and have been hospitalized for it and have gone through some serious pre and post partum episodes. My OB, Dr. Malcolm DeSouza, took my mental health very seriously and worked with my medication regime. He is a sole practioner and very compassionate. He takes major insurance.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I have bipolar and have been hospitalized for it and have gone through some serious pre and post partum episodes. My OB, Dr. Malcolm DeSouza, took my mental health very seriously and worked with my medication regime. He is a sole practioner and very compassionate. He takes major insurance.

Did you not have a surrogate like other families who know there is a genetic disposition? (CF for example's

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have bipolar and have been hospitalized for it and have gone through some serious pre and post partum episodes. My OB, Dr. Malcolm DeSouza, took my mental health very seriously and worked with my medication regime. He is a sole practioner and very compassionate. He takes major insurance.

Did you not have a surrogate like other families who know there is a genetic disposition? (CF for example's

No because I don’t believe in renting other women’s wombs.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I have bipolar and have been hospitalized for it and have gone through some serious pre and post partum episodes. My OB, Dr. Malcolm DeSouza, took my mental health very seriously and worked with my medication regime. He is a sole practioner and very compassionate. He takes major insurance.

Did you not have a surrogate like other families who know there is a genetic disposition? (CF for example's

Well obviously you're a moron. Surrogates don't change the genetics of the birth Mother if that's what you are suggesting.

But, also PP, being righteous about renting wombs when you clearly shouldn't reproduce at all is funny.