Infertility-Sensitive/HAES-Friendly OB-GYN?

[Anonymous]

Hi all-

In preparation for a frozen embryo transfer early next year, I'd like to find a good OB-GYN with privileges at Virginia Hospital Center or Sibley. I am plus-sized, so a doc sensitive to infertility anxiety and with health at every size leanings would be great. (And, I realize, also probably a unicorn. But I'm aiming high.)

Recommendations (or thoughts on doctors to avoid) would be appreciated!

[Anonymous]

I don’t think I would go with Sibley and would go with VHC since IVF and being overweight put you in a higher risk category. You don’t say your age but if over 35 that also means you are “high risk.” Good luck with the transfer.

[Anonymous]

OP here. Thanks for the note. If the first transfer takes (no guarantees, obviously) I would be 37 when I deliver - so definitely an older than average first time mom.

Despite being overweight, I have no other health issues - blood sugar and blood pressure are dead center of normal. But I recognize that the weight and age do push me into a higher risk category, and it makes sense to be at a hospital that can handle whatever situation might arise.

[Anonymous]

Eh, 37 year old FTM in the DC area isn't really "older than an average first time mom." Particularly for the practices that deliver at Sibley and VHC.

[Anonymous]

I am the PP and I think given those factors you would be much better off delivering at VHC. I was 34 and in perfect health for my first delivery and I got preeclampsia. Being in good health does not mean your pregnancy and delivery will be uncomplicated. That’s why as someone with greater risk status you are better off being in a hospital that can handle the greatest of catastrophes in the event something bad happens. At 37 and being overweight you are also much likelier to need a C section. Just something to be aware of going in. Good luck.

[Anonymous]

Anonymous wrote:Eh, 37 year old FTM in the DC area isn't really "older than an average first time mom." Particularly for the practices that deliver at Sibley and VHC.

Biologically we are all primed to deliver our babies as teenagers. Birth control unnaturally halts that natural biological process. Infertility treatments now allow many women to become pregnant who likely would not have been able to get pregnant trying the natural way. All this to say, it’s unrealistic to then expect a natural, physiologic process that has been delayed 20 years and created by artificial means to unfold naturally without incident. It’s not to say it won’t but this idea that, sure, you’re totally going to have that east natural vaginal birth, is just not how it works out for a lot of us and it’s worth Knowing that going in ahead of time to manage expectations.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Eh, 37 year old FTM in the DC area isn't really "older than an average first time mom." Particularly for the practices that deliver at Sibley and VHC.

Biologically we are all primed to deliver our babies as teenagers. Birth control unnaturally halts that natural biological process. Infertility treatments now allow many women to become pregnant who likely would not have been able to get pregnant trying the natural way. All this to say, it’s unrealistic to then expect a natural, physiologic process that has been delayed 20 years and created by artificial means to unfold naturally without incident. It’s not to say it won’t but this idea that, sure, you’re totally going to have that east natural vaginal birth, is just not how it works out for a lot of us and it’s worth Knowing that going in ahead of time to manage expectations.

But PP is right. In this area, AMA FTM isn't unusual.

[Anonymous]

Anonymous wrote:

Anonymous wrote:Eh, 37 year old FTM in the DC area isn't really "older than an average first time mom." Particularly for the practices that deliver at Sibley and VHC.

Biologically we are all primed to deliver our babies as teenagers. Birth control unnaturally halts that natural biological process. Infertility treatments now allow many women to become pregnant who likely would not have been able to get pregnant trying the natural way. All this to say, it’s unrealistic to then expect a natural, physiologic process that has been delayed 20 years and created by artificial means to unfold naturally without incident. It’s not to say it won’t but this idea that, sure, you’re totally going to have that east natural vaginal birth, is just not how it works out for a lot of us and it’s worth Knowing that going in ahead of time to manage expectations.

biologically we are primed to deliver babies as teenagers AND as middle aged women. please stop the nonsense, especially since OP can't change her age even if she wanted to.

also, IVF does not necessarily create babies that would not come naturally. IVF cannot help with age quality. it helps blocked tubes and speeds up the process allowing additional children to be born (i.e. women can try sooner for the next child).

[Anonymous]

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.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Eh, 37 year old FTM in the DC area isn't really "older than an average first time mom." Particularly for the practices that deliver at Sibley and VHC.

Biologically we are all primed to deliver our babies as teenagers. Birth control unnaturally halts that natural biological process. Infertility treatments now allow many women to become pregnant who likely would not have been able to get pregnant trying the natural way. All this to say, it’s unrealistic to then expect a natural, physiologic process that has been delayed 20 years and created by artificial means to unfold naturally without incident. It’s not to say it won’t but this idea that, sure, you’re totally going to have that east natural vaginal birth, is just not how it works out for a lot of us and it’s worth Knowing that going in ahead of time to manage expectations.

But PP is right. In this area, AMA FTM isn't unusual.

Thank you. That's all I was saying. No one is going to give OP the side eye for being 36 or 37 and pregnant with her first.

Heck, most of the practices that deliver at Sibley would be more likely give you side eye for being 24 and pregnant!

[Anonymous]

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.

[Anonymous]

OP here. In our case, IVF was necessary due to male factor issues...not anything wrong with my reproductive system. But I'm aware that that good health pre-pregnancy does not mean that I'll have an uncomplicated delivery - particularly given advanced maternal age and a higher BMI.

All of that being said....still looking for a great OB-GYN!

[Anonymous]

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.

every woman of every age who going into brith expecting it to be easy and blissful is a fool. women die every day while giving birth even in the USA.

[Anonymous]

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.

The plural of anecdote is not "data." But if we're throwing around anecdotes, I delivered my first, an IVF baby, at 36. I had an easy delivery even with an induction! Only pushed 20 minutes.

OP, I had a great experience with the OBs at Healthcare for Women whose offices are at VHC.

[Anonymous]

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.