High risk OB or Perinatologist?

Lindsay - posted on 08/18/2009 ( 9 moms have responded )




My daughter was born at 27 weeks from what are debatable reasons (different doctors have different opinions). I am now pregnant with my second and not sure if I should just see my high risk OB or also see a perinatologist. All the moms I know who had a full-term baby after their preemie saw a peri and even NICU nurses said that the repeat families they see in the NICU were moms who didn't see a peri. Due to insurance I would really have to fight to see a peri and even then might not win. Anyone have experience or suggestions to share?


London - posted on 08/31/2009




I had a peri with our second son. Even with all their care and diligence, he was premature and I had a TIA due to blood clot in my brain.
My recommendation would be that you do fight to see the peri if you can. Make a request for approval from your insurance company and point out that preventative care will be far less costly, and that there is greater liability should your request be denied and something does go wrong. If your current OB is supportive of sending you to the peri, ask for the referral from him/her. Oftentimes they are under pressure to keep those referrals (and costs) down. Don't be deterred if your OB won't. You have the right to seek appropriate care regardless. Good luck! and do please keep us posted.

Christina - posted on 08/19/2009




What does your OB recommend? Do you trust that your OB will be more aware of your history this time around? I saw both my OB and a high risk during my last preagnancy and they both worked hand and hand.

Liz - posted on 08/18/2009




Guess I don't know the difference? Where I live the choice is regular ob/gyn doc or peri. I have heard of a doc I saw before being certified as high risk now but I don't know what that means. How much special training do they have? Peri's are the experts. I was referred to my peri after my water broke at 25wks and he took care of me the 8wks I was in the hospital on bedrest. I am too high risk, I would never go back to a regular ob doc, plus I love my peri, he is fabulous! Didn't know it made a difference with the insurance either. What, they don't think it is medically necessary to see the peri?? Won't it save them money if you see peri and don't have a preemie?? don't know what your debatable complications were, but I vote for the peri!


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Happy - posted on 06/03/2012




As a woman whose pregnancies are always high risk, I was unaware that the term perinatologists even existed any more. I have always seen a high risk OB also termed a Maternal-Fetal medicine specialist. From my understanding ACOG did away with the title of perinatologist. Have I been living under a rock or something?LOL

Cindy - posted on 06/03/2012




I am having triplets, and I see both my obgyn and perinatologist. The perinatalogist is very detailed, checks the babies, and sees me weekly. He is the baby expert. I think it makes a difference so if you have to put up a fight, then it really seems worth it. Best of luck!

Iysha - posted on 08/31/2009




Your OB should be fine. They have your medical records already and know what to look for as far as issues/complications better with your second pregnancy than with your first one. My aunt is a doctor and I asked her the same thing. The advice I'm giving you is the same that she gave me when I came to her with my concerns. A good doctor will let you know if he/she has concerns and thinks you should see a different doctor or even 2 doctors to be sure your baby and you are safe.

Lindsay - posted on 08/31/2009




Hi girls, thanks for your input. My insurance is really fighting my being able to see a peri. They are fighting me on a lot of issues (not paying for my current progesterone therapy, because they feel it is not needed & not covering the only local hospital with a NICU). So for now I am just seeing my OB. We have agame plan set for now, but still unsure about a lot of things. He was not the OB I saw when pregnant with my daughter (I lived in another state), but he was the one who delivered her (we were out of state visiting family when she was born). So he admits that there are a lot of unknown variables, but he feels he can be successful at at least giving this baby a little more time, if not a full nine months. I am going to keep fighting with our insurance company and hopefully will start winning some of these battles for this little baby!

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After my son was born at 24 weeks I ws told by my OB that if I wanted to become pregnant again that I should see him for regular appointments and a Peri as well and that they would confer with eachother about my care. If you can work it out where you can see a peri, I probably would.

Laurie - posted on 08/29/2009




With my second one I used my regular OB but it was clear that if things were to go in the direction of my first that I would be transferred to an associate of theirs who practiced at the larger hospital with the NICU. But with all the precautions and constant medical care I made it to 36 weeks with second which was four weeks more my first one didn't get. My regular OB had me set up on bed rest with at home uterine monitoring done 2x a day and once a month progesterone shots and meds for premature contractions. So I would suggest you discuss it with your regular OB and see if they are comfortable or what they would suggest.

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