Ob no longer delivering me due to having GD and insulin dependent, 35 weeks - what to do?

[Anonymous]

Anonymous wrote:

Anonymous wrote:I had GD and had to take a pill (elected for this rather than insulin). Foxhall never mentioned inducing me early and I was measuring ahead 2 weeks the whole time. They were wonderful. I delivered at Sibley.

OP here. Ob officially dropped me and is sending me to find a doctor through my MFM who's recommending a doctor that delivers at Shady Grove. I really don't want to go there....was there a particular doctor you liked at Foxhall? Thanks!

If you don't want to be at Shady Grove, ask your MFM to a referral to a doctor at Georgetown. He should either help with a referral or give you a reason why you shouldn't deliver there. This should be a conversation, not an order to be followed.

[Anonymous]

Op I just want to add my voice of support to say your doctor is crazy, and I’m so sorry you are having to deal with this at this point in your pregnancy. It absolutely sounds like patient dumping and for the life of me I can’t imagine why he would be doing it at this point! Midwives can co-manage the care of Insulin dependent GD moms. Yes there are additional risk factors, but you’ve had care along with an MFM. I have to imagine that this isn’t about you and your level of risk, but something that is going on with him, his privileges or insurance or some such thing. Or he’s just a bastard.

I also would hope if you called another local practice and explained the situation they would slot you in. This isn’t that unique of a complication factor that other docs are likely to run away screaming.

Here’s hoping this gets quickly resolved and you have a straight forward, healthy birth.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Have you tried Dr Christine Colie at Georgetown? With that practice whoever is on call will deliver your baby, but there are many doctors.

Have you thought of just showing up in labor at Georgetown?

Op here. I haven't heard of her but will definitely check her out. I will pretty much go to whoever is willing to take me at this point.

Last resort is to show up in labor at Georgetown.

+1 That practice saved both of my babies and only one ended up in the NICU.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Shady Grove has a level 3 NICU. Why don't you want to deliver there? Also, you will most likely be induced prior to 40 weeks, so waiting and walking in while in labor (unless it happens naturally before 39 weeks) is unlikely.

Probably because if she originally planned to deliver at sibley she doesn't live remotely close to shady grove and doesn't want to drive for an hour in labor when there are two excellent hospitals, one with a level IV NICU near sibley in the city.

There's a reason her care was transferred by her MFM to that specific doctor, though. With an induction she'll have plenty of time to plan travel time etc.

That is just silly. Georgetown and GW have full OB and MFM teams. They are both equipped to handle OPs situation and are massively more convenient, particularly in the event of surprise early labor. The doctors she has at sibley seem pretty crappy considering the circumstances so I'm not too committed to believing they are making the best recommendations.

[Anonymous]

Anonymous wrote:I would call this doctor back, say no OB would take me at this late date and let him know that you’ve decided to have the baby at home. Preferably leave that as a message.

She's already been discharged from care due to being high risk (insulin dependent, out of control blood sugars, macrosomia) and her original OB cannot care for her anymore, it happens. She has already been referred, but doesn't want to see that OB for whatever reason. Your advice would make her seem crazy.

OP It doesn't seem like you understand you are a high risk patient, and both you and you baby can have serious outcomes during pregnancy, birth, and even after birth. You really should see who were referred to.

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would call this doctor back, say no OB would take me at this late date and let him know that you’ve decided to have the baby at home. Preferably leave that as a message.

She's already been discharged from care due to being high risk (insulin dependent, out of control blood sugars, macrosomia) and her original OB cannot care for her anymore, it happens. She has already been referred, but doesn't want to see that OB for whatever reason. Your advice would make her seem crazy.

OP It doesn't seem like you understand you are a high risk patient, and both you and you baby can have serious outcomes during pregnancy, birth, and even after birth. You really should see who were referred to.

Health outcomes are worse for people who just take the doctors word on everything. OP seems like she understands the situation fully and is trying to figure out what to do.

The sibley ob dropped her with no notice and no conversation. That is bad medicine. OP is allowed to chose another hospital that meets her needs that isn't in line with their suggestion. Georgetown is 5 minutes from sibley and more than equipped to deal with her. It makes no sense to not refer her there.

[Anonymous]

Anonymous wrote:Shady Grove has a level 3 NICU. Why don't you want to deliver there? Also, you will most likely be induced prior to 40 weeks, so waiting and walking in while in labor (unless it happens naturally before 39 weeks) is unlikely.

Op here. I had 2 relatives who had bad experiences there, not in the maternity ward but it makes me apprehensive about receiving care there.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would call this doctor back, say no OB would take me at this late date and let him know that you’ve decided to have the baby at home. Preferably leave that as a message.

She's already been discharged from care due to being high risk (insulin dependent, out of control blood sugars, macrosomia) and her original OB cannot care for her anymore, it happens. She has already been referred, but doesn't want to see that OB for whatever reason. Your advice would make her seem crazy.

OP It doesn't seem like you understand you are a high risk patient, and both you and you baby can have serious outcomes during pregnancy, birth, and even after birth. You really should see who were referred to.

Health outcomes are worse for people who just take the doctors word on everything. OP seems like she understands the situation fully and is trying to figure out what to do.

The sibley ob dropped her with no notice and no conversation. That is bad medicine. OP is allowed to chose another hospital that meets her needs that isn't in line with their suggestion. Georgetown is 5 minutes from sibley and more than equipped to deal with her. It makes no sense to not refer her there.

sure she's allowed to chose another hospital. it's the "just show up in labor" part that is reckless and stupid.

[Anonymous]

Anonymous wrote:I would call this doctor back, say no OB would take me at this late date and let him know that you’ve decided to have the baby at home. Preferably leave that as a message.

Op here. I already got rejected by two practices so far since calling this morning because they don't want to take me in this late.

[Anonymous]

Anonymous wrote:Op I just want to add my voice of support to say your doctor is crazy, and I’m so sorry you are having to deal with this at this point in your pregnancy. It absolutely sounds like patient dumping and for the life of me I can’t imagine why he would be doing it at this point! Midwives can co-manage the care of Insulin dependent GD moms. Yes there are additional risk factors, but you’ve had care along with an MFM. I have to imagine that this isn’t about you and your level of risk, but something that is going on with him, his privileges or insurance or some such thing. Or he’s just a bastard.

I also would hope if you called another local practice and explained the situation they would slot you in. This isn’t that unique of a complication factor that other docs are likely to run away screaming.

Here’s hoping this gets quickly resolved and you have a straight forward, healthy birth.

Op here. Thank you so much

[Anonymous]

Anonymous wrote:

Anonymous wrote:I would call this doctor back, say no OB would take me at this late date and let him know that you’ve decided to have the baby at home. Preferably leave that as a message.

She's already been discharged from care due to being high risk (insulin dependent, out of control blood sugars, macrosomia) and her original OB cannot care for her anymore, it happens. She has already been referred, but doesn't want to see that OB for whatever reason. Your advice would make her seem crazy.

OP It doesn't seem like you understand you are a high risk patient, and both you and you baby can have serious outcomes during pregnancy, birth, and even after birth. You really should see who were referred to.

Op here. The baby hasn't been diagnosed with macrosomia yet btw and my blood sugars are 95% under control. I am only on bedtime insulin at a low dosage and my MFM said my case isn't that serious at all. My last growth scan was 32 weeks and baby was measuring in the 99th percentile (he's also very tall btw). I will have another growth scan soon to see where he is at. I may be diagnosed with macrosomia then, but not yet.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would call this doctor back, say no OB would take me at this late date and let him know that you’ve decided to have the baby at home. Preferably leave that as a message.

She's already been discharged from care due to being high risk (insulin dependent, out of control blood sugars, macrosomia) and her original OB cannot care for her anymore, it happens. She has already been referred, but doesn't want to see that OB for whatever reason. Your advice would make her seem crazy.

OP It doesn't seem like you understand you are a high risk patient, and both you and you baby can have serious outcomes during pregnancy, birth, and even after birth. You really should see who were referred to.

Health outcomes are worse for people who just take the doctors word on everything. OP seems like she understands the situation fully and is trying to figure out what to do.

The sibley ob dropped her with no notice and no conversation. That is bad medicine. OP is allowed to chose another hospital that meets her needs that isn't in line with their suggestion. Georgetown is 5 minutes from sibley and more than equipped to deal with her. It makes no sense to not refer her there.

Op here. I didn't want to just take any doctor that will take me at this point, because I want to be a little more proactive and at least identify someone that I feel comfortable with.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would call this doctor back, say no OB would take me at this late date and let him know that you’ve decided to have the baby at home. Preferably leave that as a message.

She's already been discharged from care due to being high risk (insulin dependent, out of control blood sugars, macrosomia) and her original OB cannot care for her anymore, it happens. She has already been referred, but doesn't want to see that OB for whatever reason. Your advice would make her seem crazy.

OP It doesn't seem like you understand you are a high risk patient, and both you and you baby can have serious outcomes during pregnancy, birth, and even after birth. You really should see who were referred to.

Op here. The baby hasn't been diagnosed with macrosomia yet btw and my blood sugars are 95% under control. I am only on bedtime insulin at a low dosage and my MFM said my case isn't that serious at all. My last growth scan was 32 weeks and baby was measuring in the 99th percentile (he's also very tall btw). I will have another growth scan soon to see where he is at. I may be diagnosed with macrosomia then, but not yet.

It's not possible to diagnose macrosomia until after the baby is born, because late pregnancy prenatal measurements can be wildly inaccurate. All they can do until s/he is born is make an educated guess.

There is a great article on Evidence Based Birth about macrosomia and the shoulder dystocia risks for a baby whose mom has insulin-dependent GD.

[Anonymous]

Anonymous wrote:

Anonymous wrote:That's really weird. Maybe his insurance lapsed or recently had a traumatic delivery or something.

That his job!!!!

I was trying to say in a delicate way that maybe he had a stillborn or neonatal death recently with a high-risk mom. Doctors are human beings and sometimes a patient's death hits them hard.
I doubt that explanation though, because you could easily just do a c-section if you were really that concerned. Unless OP is refusing an elective C.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:I would call this doctor back, say no OB would take me at this late date and let him know that you’ve decided to have the baby at home. Preferably leave that as a message.

She's already been discharged from care due to being high risk (insulin dependent, out of control blood sugars, macrosomia) and her original OB cannot care for her anymore, it happens. She has already been referred, but doesn't want to see that OB for whatever reason. Your advice would make her seem crazy.

OP It doesn't seem like you understand you are a high risk patient, and both you and you baby can have serious outcomes during pregnancy, birth, and even after birth. You really should see who were referred to.

Op here. The baby hasn't been diagnosed with macrosomia yet btw and my blood sugars are 95% under control. I am only on bedtime insulin at a low dosage and my MFM said my case isn't that serious at all. My last growth scan was 32 weeks and baby was measuring in the 99th percentile (he's also very tall btw). I will have another growth scan soon to see where he is at. I may be diagnosed with macrosomia then, but not yet.

It's not possible to diagnose macrosomia until after the baby is born, because late pregnancy prenatal measurements can be wildly inaccurate. All they can do until s/he is born is make an educated guess.

There is a great article on Evidence Based Birth about macrosomia and the shoulder dystocia risks for a baby whose mom has insulin-dependent GD.

Op here. Do you mind sharing that article? Would love to read it, thanks!