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

[Anonymous]

Anonymous wrote:

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!

https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

https://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/

[Anonymous]

Anonymous wrote:

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.

Op here. He started pushing for a 37 week c section right away (which I didn't say I was opposed to), and that's when I asked if Sibley is able to handle newborn breathing problems since it's a level 2. Then that's when he started saying that he hasn't delivered many insulin dependent GD patients, and that it's best I go to a different Ob.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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!

https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

https://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/

Those articles are years old, and they are not written by a doctor.

Please find a new doctor to discuss this with. You want a safe birth for yourself and your baby.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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!

https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

https://evidencebasedbirth.com/does-gestational-diabetes-always-mean-a-big-baby-and-induction/

Those articles are years old, and they are not written by a doctor.

Please find a new doctor to discuss this with. You want a safe birth for yourself and your baby.

Here's what ACOG now recommends for delivery with insulin dependent GD:
- Deliver at 39 weeks 0 days to 39 weeks 6 days
- Estimated fetal weight ? 4500: Counsel regarding risks and benefits of a scheduled cesarean section

https://www.obgproject.com/2018/03/15/cme-qs-acog-releases-updated-guidance-gestational-diabetes-2/

[Anonymous]

Anonymous wrote:

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!

I think this is the one: https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

As a PP said, ultrasound measurements, particularly weight estimates, late in pregnancy are notoriously inaccurate. I had several friends due around the same time I was. All were under the care of OBs and were sent for growth scans. All were told they were having babies over 8.5 pounds. Only one baby ended up over 8. I saw midwives and zero ultrasounds after my 20 week anatomy scan. 2 days before baby was born, midwife estimated baby to be 7 pounds 14 ounces and 21 inches long ("he's lanky!"). He was 8 pounds exactly and, yep, 21 inches.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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!

I think this is the one: https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

As a PP said, ultrasound measurements, particularly weight estimates, late in pregnancy are notoriously inaccurate. I had several friends due around the same time I was. All were under the care of OBs and were sent for growth scans. All were told they were having babies over 8.5 pounds. Only one baby ended up over 8. I saw midwives and zero ultrasounds after my 20 week anatomy scan. 2 days before baby was born, midwife estimated baby to be 7 pounds 14 ounces and 21 inches long ("he's lanky!"). He was 8 pounds exactly and, yep, 21 inches.

OP doesn't have "big baby." She has insulin-dependent gestational diabetes with a suspicion of macrosomia.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

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!

I think this is the one: https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

As a PP said, ultrasound measurements, particularly weight estimates, late in pregnancy are notoriously inaccurate. I had several friends due around the same time I was. All were under the care of OBs and were sent for growth scans. All were told they were having babies over 8.5 pounds. Only one baby ended up over 8. I saw midwives and zero ultrasounds after my 20 week anatomy scan. 2 days before baby was born, midwife estimated baby to be 7 pounds 14 ounces and 21 inches long ("he's lanky!"). He was 8 pounds exactly and, yep, 21 inches.

Did you or any of your friends have gestational diabetes controlled by insulin?

Stop it with suggesting that OP turn to non-medical sources for her care. She needs to see an OB.

[Anonymous]

How can he not have a partner OB he works with in cases like this that he's comfortable referring to?

[Anonymous]

Anonymous wrote:How can he not have a partner OB he works with in cases like this that he's comfortable referring to?

The OB referred her to her MFM, who referred her to an OB at a hospital OP doesn't want to go to.

OP, have you just asked the MFM for a different referral?

[Anonymous]

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.

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.

Shady grove is only wonderful for maternity care. I had a very preterm baby there who had wonderful care, and has done amazingly well--you would never know she was born 14 weeks early. I also had a baby who was born with blood sugar issues due to being LGA, and they were fantastic with her care as well.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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!

I think this is the one: https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

As a PP said, ultrasound measurements, particularly weight estimates, late in pregnancy are notoriously inaccurate. I had several friends due around the same time I was. All were under the care of OBs and were sent for growth scans. All were told they were having babies over 8.5 pounds. Only one baby ended up over 8. I saw midwives and zero ultrasounds after my 20 week anatomy scan. 2 days before baby was born, midwife estimated baby to be 7 pounds 14 ounces and 21 inches long ("he's lanky!"). He was 8 pounds exactly and, yep, 21 inches.

Did you or any of your friends have gestational diabetes controlled by insulin?

Stop it with suggesting that OP turn to non-medical sources for her care. She needs to see an OB.

Huh? Everyone on here has recommended seeing an OB. EBB is written by a nurse PhD and medical researcher in consultation with physicians.

Does information scare you?

[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.

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.

Shady grove is only wonderful for maternity care. I had a very preterm baby there who had wonderful care, and has done amazingly well--you would never know she was born 14 weeks early. I also had a baby who was born with blood sugar issues due to being LGA, and they were fantastic with her care as well.

OP if you live in DC there is no reason to go to shady grove, what if you start to go into labor? It could take you 90 minutes to get there. And your baby is not the kind of baby you want to have on the side of the highway. You should go to GT or GW IMO.

[Anonymous]

Go to Georgetown ER complaining of some kind of OB problem . You will be assigned a Georgetown OB.

[Anonymous]

Anonymous wrote:How can he not have a partner OB he works with in cases like this that he's comfortable referring to?

Because he’s an uncaring, unprofessional weasel - who is this doctor, OP?

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

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!

I think this is the one: https://evidencebasedbirth.com/evidence-for-induction-or-c-section-for-big-baby/

As a PP said, ultrasound measurements, particularly weight estimates, late in pregnancy are notoriously inaccurate. I had several friends due around the same time I was. All were under the care of OBs and were sent for growth scans. All were told they were having babies over 8.5 pounds. Only one baby ended up over 8. I saw midwives and zero ultrasounds after my 20 week anatomy scan. 2 days before baby was born, midwife estimated baby to be 7 pounds 14 ounces and 21 inches long ("he's lanky!"). He was 8 pounds exactly and, yep, 21 inches.

Did you or any of your friends have gestational diabetes controlled by insulin?

Stop it with suggesting that OP turn to non-medical sources for her care. She needs to see an OB.

Huh? Everyone on here has recommended seeing an OB. EBB is written by a nurse PhD and medical researcher in consultation with physicians.

Does information scare you?

Evidenced-based birth is a website written by a non-medical professional selling medical advice (that is now several years outdated).

OP needs to talk to an actual doctor.