This is my first post to this group and it is long-my apologies! I really need your feedback and advice on seeing a maternal fetal medical specialist or a regular OB. Here is the dilemma:

I am recently pregnant with my 3rd. With my previous pregnancies I saw a MFM doctor who handled my BS and OB. She was fabulous and I had great pregnancies-no other complications. After our 2nd we moved from a big city to a small town. The closest MFM doctor (and Endocrinologist) is 90 minutes away. I am really struggling with the decision on who to see for my OB care during this pregnancy. We are 13 hours away from family and I would feel really guilty asking any of our friends here to watch our other two (who are 4.5 and 2.5) for 4 hours so I could see the MFM doctor. My husband's job precludes him from watching our other 2 so I could make the drive as well. However, I am really worried about my care if I don't see a MFM doctor since it is all I've known. I currently only see my primary care doctor and a CDE for my diabetes (Type 1) and they are both pretty worthless. Again, this is due to the 90 minute drive to see an Endocrinolgist. With summer around the corner I could take my boys with me to every appointment (my husband could not come along-he is the head of a company and could never take that much time off). But, I would feel super guilty about it-I mean, what fun is a 3 hour car trip every 4, then 2, then every week?

What would you do? Has anyone only seen a regular OB for care during pregnancies? If you did, did you also have an Endocrinolgist as well? For all other moms-what decision would you make? Please be as honest as you can. I know you all are the only ones who understand all the added complexities, guilty, and worries of being diabetic and pregnant. I really appreciate any and all feedback!

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For my 1st I saw a high risk ob and my endo. For the 2nd I saw a normal/ non high risk ob and my normal endo. I would think that by your 3rd pregnancy that you're pretty familiar with what happens to your bgs and what you need to do to control them (check and correct your bgs all the time! I think as long as you are comfortable doing this on your own you'll be fine with whatever doctors you choose). I think its important to make sure that you are comfortable with where (what hospital) you will deliver (do they have a good reputation, they will be ok/ not be to annoying monitoring you during delivery and will check the baby's bg after delivery, etc).
Good luck and congratulations!

For my pregnancy, I saw a regular OB who was in a practice with a MFM just in case... I'm sure that if you saw a regular OB who at least was comfortable and knowledgeable about when it would be needed to refer you to a MFM, that would be definitely doable and understandable. Also, I'm sure you could work something out with your Endo so that you have a call every other three weeks (well, that was how often I had to see my endo)... that way you have cut down your trips, but still get the expert opinion in case you've missed a trend in your sugars or have any concerns... I can't even imagine having to accomplish everything with two little ones and all that travel, so I would say, do whatever you can to lighten the load while not increasing the guilt! Good luck!

Currently pregnant with my second, and both I saw/see my OB and my endo. I also get ultrasounds with a perinatologist (probably very similar, professionally, as your MFM) since he has better equipment and knows how to better watch for signs of problems in the baby than my OB.

If I were in your situation, I would see an OB (preferably one with experience handling high-risk pregnancies) and I would find an endo/MFM willing to work with me regarding scheduling. Perhaps toward the end, you can fax your records in every week but only actually go there every two or three?




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