Infertility-Sensitive/HAES-Friendly OB-GYN?

[Anonymous]

This should go on the infertility forum.

[Anonymous]

OP here. I have a reproductive endocrinologist, along with six embryos in the freezer. I don't need infertility advice. Been there. Done that.

My question relates to finding an OB-GYN for pregnancy post-embryo transfer. I want to set up a pre-conception appointment with a doctor ahead of time so that I have an established doctor/patient relationship somewhere by the time it is necessary.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes but the first delivery age matters. It causes the most anatomic damage typically with subsequent pregnancies having less impact. Also the risk of complications like preeclampsia and genetic abnormalities other conditions goes up the older we are. I’m AMA and was nearly AMA with my first, it’s just worth knowing going in that your birth might not be the blissful experience they teach you about in birth class. Literally no one I know who had their first in their mid thirties had an “easy” birth.

I must be some sort of freak of nature. Birth was way easier than pregnancy for me, and I was 36. 6 hours start to finish, 2nd degree tear, delivered vaginally with no epidural or augmentation. Blissful? No. Easy? Yeah, easier than a lot of people I know, including those much younger than me.

I only know of 3 women in my circle of good friends who had that in their first birth. The rest of us had:

IUGR
Preeclampsia
Forceps
C section for breech
Emergency c section for failure to progress/fetal distress
Emergency section for prolonged second stage
Vacuum
Emergency c section for CPD/macrosomia
3rd degree tear
Preterm delivery and NICU admission

I am of the camp that we need to start being more honest with women about what to expect. But right now the way we treat pregnant women is like children who can’t handle the truth. I’d much rather someone have told me ahead of time the truth. I think it’s common especially for women doing IVF to want a natural birth experience after the invasiveness and medicalization of IVF and I get that feeling but it’s not fair to lie. The OP has a number of considerations that put her at higher risk and she deserves to know that. Full stop. She should not fee bad about that, it’s just the reality and any OB will tell her that.

What makes you think that OP, who has been through IVF, needs educating? You're projecting your own anxieties and hijacking a simple post asking for an OB recommendation from a woman who I'm gonna bet knows more about this stuff than your average AMA pregnant lady.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes but the first delivery age matters. It causes the most anatomic damage typically with subsequent pregnancies having less impact. Also the risk of complications like preeclampsia and genetic abnormalities other conditions goes up the older we are. I’m AMA and was nearly AMA with my first, it’s just worth knowing going in that your birth might not be the blissful experience they teach you about in birth class. Literally no one I know who had their first in their mid thirties had an “easy” birth.

I must be some sort of freak of nature. Birth was way easier than pregnancy for me, and I was 36. 6 hours start to finish, 2nd degree tear, delivered vaginally with no epidural or augmentation. Blissful? No. Easy? Yeah, easier than a lot of people I know, including those much younger than me.

I only know of 3 women in my circle of good friends who had that in their first birth. The rest of us had:

IUGR
Preeclampsia
Forceps
C section for breech
Emergency c section for failure to progress/fetal distress
Emergency section for prolonged second stage
Vacuum
Emergency c section for CPD/macrosomia
3rd degree tear
Preterm delivery and NICU admission

I am of the camp that we need to start being more honest with women about what to expect. But right now the way we treat pregnant women is like children who can’t handle the truth. I’d much rather someone have told me ahead of time the truth. I think it’s common especially for women doing IVF to want a natural birth experience after the invasiveness and medicalization of IVF and I get that feeling but it’s not fair to lie. The OP has a number of considerations that put her at higher risk and she deserves to know that. Full stop. She should not fee bad about that, it’s just the reality and any OB will tell her that.

What makes you think that OP, who has been through IVF, needs educating? You're projecting your own anxieties and hijacking a simple post asking for an OB recommendation from a woman who I'm gonna bet knows more about this stuff than your average AMA pregnant lady.

Agreed.
-IVF veteran

OP, I'm not familiar with practitioners in your area (I'm way out in the suburbs), but my advice, as a woman who went through IVF to conceive and delivered at 37, is to consider either a small OBGYN practice or a hospital-based group of CNMs (not sure of the availability of that at Sibley, but I thought VHC had practicing midwives). I had tremendous amounts of anxiety related to being pregnant via IVF, and it hit me unexpectedly. I think I was so aware of all the things that could go wrong, I couldn't focus on all the things that were going right. I started out in a very large practice, and I felt like I was basically just a number to them. From my experience (limited anecdata, I know), the smaller OB practices and groups of CNMs are better able to take the time to answer questions, allay fears, etc.
For what its worth, I had a relatively easy pregnancy (even after IVF and being AMA) resulting in an uncomplicated labor and delivery. I was induced due to PROM, but delivered vaginally with very minimal tearing and (physically, at least) had an absurdly easy recovery. I agree that people should understand the potential risk in pregnancy and childbirth, but not everything is all doom and gloom.

[Anonymous]

Hi OP, I am nearly 42, got pregnant through IVF, normal BMI so can't really advise you on HAES-friendliness of my OB, but I go to Capital Women's Care. They deliver at Sibley and I see patients of all shapes and ages in the waiting room. It's a little bit of a mill (many doctors, no guarantee to have a given doctor deliver your baby). Maybe you can call the reception, explain your concerns and ask them to recommend an OB. Good luck!

[Anonymous]

I am with the GW midwives which is working out extremely well for me but may not be right for your situation, OP. I like them because they don’t fuss about weight (my BMI was 25.5 pre-pregnancy and the only time weight gain concerns came up was when I brought them up and the midwife I was talking to said “people police women’s weight WAY too much already; unless I see something indicative of a serious health problem, I’m not going to talk about it”) and they support unmedicated birth but in a hospital setting so there is a doctor on call if anything does go wrong. Also my primary midwife is very understanding of my specific situation and sensitive things I worry about which is great.

That being said, they are very militant about unmedicated birth and breastfeeding so you will not get a supportive environment about inductions, elective cesarians, pain meds, or formula feeding even though there is no good reason not to have these options if you want them. Also they only take low to moderate risk pregnancies so you would have to double check with them how they would rate your risk factors. If you develop additional risk later in the pregnancy they will manage your case with the GW OBs (this is happening to me) which I really appreciate.

GW is also not your preferred hospital and the accessibility for appointments is definitely important; just wanted to give you my impressions. I think a PP mentioned one of your hospitals had midwives on staff which might be a good fit for you? Or not if you feel more comfortable with an OB.

Good luck and I hope your first transfer takes!

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes but the first delivery age matters. It causes the most anatomic damage typically with subsequent pregnancies having less impact. Also the risk of complications like preeclampsia and genetic abnormalities other conditions goes up the older we are. I’m AMA and was nearly AMA with my first, it’s just worth knowing going in that your birth might not be the blissful experience they teach you about in birth class. Literally no one I know who had their first in their mid thirties had an “easy” birth.

I must be some sort of freak of nature. Birth was way easier than pregnancy for me, and I was 36. 6 hours start to finish, 2nd degree tear, delivered vaginally with no epidural or augmentation. Blissful? No. Easy? Yeah, easier than a lot of people I know, including those much younger than me.

I only know of 3 women in my circle of good friends who had that in their first birth. The rest of us had:

IUGR
Preeclampsia
Forceps
C section for breech
Emergency c section for failure to progress/fetal distress
Emergency section for prolonged second stage
Vacuum
Emergency c section for CPD/macrosomia
3rd degree tear
Preterm delivery and NICU admission

I am of the camp that we need to start being more honest with women about what to expect. But right now the way we treat pregnant women is like children who can’t handle the truth. I’d much rather someone have told me ahead of time the truth. I think it’s common especially for women doing IVF to want a natural birth experience after the invasiveness and medicalization of IVF and I get that feeling but it’s not fair to lie. The OP has a number of considerations that put her at higher risk and she deserves to know that. Full stop. She should not fee bad about that, it’s just the reality and any OB will tell her that.

No one is treating women like children. No one is withholding information from women, it's not locked up in a cabinet they can't access. If women choose not to educate themselves that's on them. It's in fact pretty sexist and insulting to assume that women can't take the initiative to learn what they need to learn. I'm not an idiot and don't need anyone spoon feeding me information about what MY body is going to go through. I went to the library and read up. No reason why others can't do the same.

[Anonymous]

The GW midwives wouldn't take me because I did IVF (maybe because over 40 too).

I'd recommend Dr. Bridges. He's a solo practitioner. It can be emotionally-difficult "graduating" from the RE to a normal OB, so I found having just one doctor managing my care to be reassuring. Also, he partners with the Sibley MFMs for the big ultrasounds and tests, so you'll have access to them too if anything becomes more complicated.

[Anonymous]

Anonymous wrote:OP here. I have a reproductive endocrinologist, along with six embryos in the freezer. I don't need infertility advice. Been there. Done that.

My question relates to finding an OB-GYN for pregnancy post-embryo transfer. I want to set up a pre-conception appointment with a doctor ahead of time so that I have an established doctor/patient relationship somewhere by the time it is necessary.

You are putting the cart WAY before the horse. I think you should get treatment for your anxiety first.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes but the first delivery age matters. It causes the most anatomic damage typically with subsequent pregnancies having less impact. Also the risk of complications like preeclampsia and genetic abnormalities other conditions goes up the older we are. I’m AMA and was nearly AMA with my first, it’s just worth knowing going in that your birth might not be the blissful experience they teach you about in birth class. Literally no one I know who had their first in their mid thirties had an “easy” birth.

I must be some sort of freak of nature. Birth was way easier than pregnancy for me, and I was 36. 6 hours start to finish, 2nd degree tear, delivered vaginally with no epidural or augmentation. Blissful? No. Easy? Yeah, easier than a lot of people I know, including those much younger than me.

I only know of 3 women in my circle of good friends who had that in their first birth. The rest of us had:

IUGR
Preeclampsia
Forceps
C section for breech
Emergency c section for failure to progress/fetal distress
Emergency section for prolonged second stage
Vacuum
Emergency c section for CPD/macrosomia
3rd degree tear
Preterm delivery and NICU admission

I am of the camp that we need to start being more honest with women about what to expect. But right now the way we treat pregnant women is like children who can’t handle the truth. I’d much rather someone have told me ahead of time the truth. I think it’s common especially for women doing IVF to want a natural birth experience after the invasiveness and medicalization of IVF and I get that feeling but it’s not fair to lie. The OP has a number of considerations that put her at higher risk and she deserves to know that. Full stop. She should not fee bad about that, it’s just the reality and any OB will tell her that.

No one is treating women like children. No one is withholding information from women, it's not locked up in a cabinet they can't access. If women choose not to educate themselves that's on them. It's in fact pretty sexist and insulting to assume that women can't take the initiative to learn what they need to learn. I'm not an idiot and don't need anyone spoon feeding me information about what MY body is going to go through. I went to the library and read up. No reason why others can't do the same.

Oh please, most mainstream birth books totally gloss over complications. I promise if your tore your anal sphincter or lost your uterus or got a severe prolapse or any other number of awful delivery complications or outcomes you would not be saying you were prepare for it because you read Expecting Better.

[Anonymous]

Anonymous wrote:

Anonymous wrote:OP here. I have a reproductive endocrinologist, along with six embryos in the freezer. I don't need infertility advice. Been there. Done that.

My question relates to finding an OB-GYN for pregnancy post-embryo transfer. I want to set up a pre-conception appointment with a doctor ahead of time so that I have an established doctor/patient relationship somewhere by the time it is necessary.

You are putting the cart WAY before the horse. I think you should get treatment for your anxiety first.

Don’t you have a regular OB for annual exams?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes but the first delivery age matters. It causes the most anatomic damage typically with subsequent pregnancies having less impact. Also the risk of complications like preeclampsia and genetic abnormalities other conditions goes up the older we are. I’m AMA and was nearly AMA with my first, it’s just worth knowing going in that your birth might not be the blissful experience they teach you about in birth class. Literally no one I know who had their first in their mid thirties had an “easy” birth.

I must be some sort of freak of nature. Birth was way easier than pregnancy for me, and I was 36. 6 hours start to finish, 2nd degree tear, delivered vaginally with no epidural or augmentation. Blissful? No. Easy? Yeah, easier than a lot of people I know, including those much younger than me.

I only know of 3 women in my circle of good friends who had that in their first birth. The rest of us had:

IUGR
Preeclampsia
Forceps
C section for breech
Emergency c section for failure to progress/fetal distress
Emergency section for prolonged second stage
Vacuum
Emergency c section for CPD/macrosomia
3rd degree tear
Preterm delivery and NICU admission

I am of the camp that we need to start being more honest with women about what to expect. But right now the way we treat pregnant women is like children who can’t handle the truth. I’d much rather someone have told me ahead of time the truth. I think it’s common especially for women doing IVF to want a natural birth experience after the invasiveness and medicalization of IVF and I get that feeling but it’s not fair to lie. The OP has a number of considerations that put her at higher risk and she deserves to know that. Full stop. She should not fee bad about that, it’s just the reality and any OB will tell her that.

No one is treating women like children. No one is withholding information from women, it's not locked up in a cabinet they can't access. If women choose not to educate themselves that's on them. It's in fact pretty sexist and insulting to assume that women can't take the initiative to learn what they need to learn. I'm not an idiot and don't need anyone spoon feeding me information about what MY body is going to go through. I went to the library and read up. No reason why others can't do the same.

Oh please, most mainstream birth books totally gloss over complications. I promise if your tore your anal sphincter or lost your uterus or got a severe prolapse or any other number of awful delivery complications or outcomes you would not be saying you were prepare for it because you read Expecting Better.

Speak for yourself. I was prepared for all of those possibilities because I read about them beforehand. Not my fault you stuck your head in the sand. Take some personal accountability for God's sake.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:OP here. I have a reproductive endocrinologist, along with six embryos in the freezer. I don't need infertility advice. Been there. Done that.

My question relates to finding an OB-GYN for pregnancy post-embryo transfer. I want to set up a pre-conception appointment with a doctor ahead of time so that I have an established doctor/patient relationship somewhere by the time it is necessary.

You are putting the cart WAY before the horse. I think you should get treatment for your anxiety first.

Don’t you have a regular OB for annual exams?

I have a regular gynecologist. And I am currently pregnant after many rounds of IVF. My OB is at a different practice because my gynecologist is not an OB. I did not get in touch with an OB until after I was pregnant. You will get monitoring from your RE until 8 weeks if the transfer is successful. Your infertility journey is not over until you transfer and get some ultrasounds in. I would focus on that first.

[Anonymous]

OP here. I have a primary care doc that does my annual exams, Pap smears, etc. If I had a regular OB-GYN, I wouldn’t have posted this question.

As for getting treatment for my anxiety? 1. I have, thanks. 2. Good luck finding someone who’s been through infertility treatments who isn’t anxious. 3. It can take MONTHS to get a new patient appointment with an OB. I don’t think that it’s too early to start doing research. 4. If you don’t have any actual helpful advice, you can take your condescension elsewhere.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Yes but the first delivery age matters. It causes the most anatomic damage typically with subsequent pregnancies having less impact. Also the risk of complications like preeclampsia and genetic abnormalities other conditions goes up the older we are. I’m AMA and was nearly AMA with my first, it’s just worth knowing going in that your birth might not be the blissful experience they teach you about in birth class. Literally no one I know who had their first in their mid thirties had an “easy” birth.

I must be some sort of freak of nature. Birth was way easier than pregnancy for me, and I was 36. 6 hours start to finish, 2nd degree tear, delivered vaginally with no epidural or augmentation. Blissful? No. Easy? Yeah, easier than a lot of people I know, including those much younger than me.

I only know of 3 women in my circle of good friends who had that in their first birth. The rest of us had:

IUGR
Preeclampsia
Forceps
C section for breech
Emergency c section for failure to progress/fetal distress
Emergency section for prolonged second stage
Vacuum
Emergency c section for CPD/macrosomia
3rd degree tear
Preterm delivery and NICU admission

I am of the camp that we need to start being more honest with women about what to expect. But right now the way we treat pregnant women is like children who can’t handle the truth. I’d much rather someone have told me ahead of time the truth. I think it’s common especially for women doing IVF to want a natural birth experience after the invasiveness and medicalization of IVF and I get that feeling but it’s not fair to lie. The OP has a number of considerations that put her at higher risk and she deserves to know that. Full stop. She should not fee bad about that, it’s just the reality and any OB will tell her that.

No one is treating women like children. No one is withholding information from women, it's not locked up in a cabinet they can't access. If women choose not to educate themselves that's on them. It's in fact pretty sexist and insulting to assume that women can't take the initiative to learn what they need to learn. I'm not an idiot and don't need anyone spoon feeding me information about what MY body is going to go through. I went to the library and read up. No reason why others can't do the same.

Oh please, most mainstream birth books totally gloss over complications. I promise if your tore your anal sphincter or lost your uterus or got a severe prolapse or any other number of awful delivery complications or outcomes you would not be saying you were prepare for it because you read Expecting Better.

Speak for yourself. I was prepared for all of those possibilities because I read about them beforehand. Not my fault you stuck your head in the sand. Take some personal accountability for God's sake.

And I bet you were just fine and had no serious complications.