Peri or OB

(28 posts)(27 voices)
  1. For those of you with non identical twins did you go to an OB or a Peri? What was your rationale?

  2. I saw only my OB (and the 6 other OBs in her group) and I think it was a mistake. They were too unconcerned, treated the whole thing too normally, even when I had 1.5 cm of cervix left at 24w. It wasn't necessarily my OB that was the problem (my personal OB was very good), it was that I had to rotate among the others in the group, and I don't think I was treated as carefully as I should have been. For example, when I had a big bleeding episode at 16w, after my u/s all the other docs were booked (my doc wasn't on that day), so I was told to meet only with the nurse practicioner, not even an OB. And THEN, she counted it as my monthly visit, and had me come back in four weeks. I should have put my foot down on that one - my fault. I was on lovenox, to boot. But my OB had said they handle twin pgs all the time (and that's true).

    I did notice a difference in care though when I happened to see the head dr of the group - she IS a high risk OB: I was sent to L&D by my personal OB at 28w because I had further cervical changes (1.5 cm dilated, 80% effaced with baby A at the 0+ station). The high risk OB happened to be the dr on call that day, and it was her decision to keep me overnight for observation. When I was at the hospital, two different peri's in addition to her were also taking care of me, and I noticed that all three of them were much more serious and seemed a lot more sure of themselves than the regular OBs. With the regular OBs and a twin pg, I sensed a little bit of insecurity that comes out as \"sure, we can handle that...\" And then there was the time that they forgot to tell me about a kidney issue that had come up on the level II u/s. Several weeks later, after another u/s, a different ob in the group called to give me the report and she was like, \"and you know about the kidney issue...\" um, NO, I didn't. It was serious enough that ds ended up having kidney surgery at 8 months old. If that second doc had forgotten to tell me, the nicu would never have known either - the chief neonatologist blew a gasket when I mentioned the kidney issue the day after delivery, when I had assumed that they had been told, that they had gotten records from the ob.

    A few years later, we moved to another state and I obviousy got a new OB. What a difference - he sent me to a peri for the lovenox. The peri's office was phenomenal. I'm sure if that had been a twin pg, the peri would have been great. Every time I called them, for any little question, even the receptionist spoke to me as though I was in a state of emergency - they took everything very seriously. There was always the utmost concern in their voices. Now, my new OB did too (it is a group of two, which is wonderful compared to 7), and my new OB is *extremely* knowledgable, but he is not afraid to pass things off to the peri, for consults at a minimum.

    Whether or not you \"need\" a peri depends on your OB, of course. I thought I was doing the right thing - it never occurred to me that I ought to look up a peri myself, and my RE said the OB would be OK (I think she was probably deferring to the OB). But now I have regrets, and I wonder, what if I was managed a little more conservatively, what if I was on complete bedrest before I started dilating, such as after that 24w appt with only 1.5 cm cervix left (I was on some vague sort of partial bedrest). If I was managed a little more conservatively, I wonder, could I have made it a few more weeks (I delivered at 33w), and thus, maybe we could have avoided the nicu (which was miserable and cost the insuranc co $100K); maybe baby B could have avoided respiratory distress syndrome, maybe he wouldn't have ended up in the hospital at a year old with rsv; maybe their asthma wouldn't be quite as bad; maybe their speech delays would not have been quite as bad; etc.

    Lots of people do fine with an OB. It's a hard decision. I'm probably one of the few people with regrets. good luck!!

  3. I'm seeing both peri and OB. I am in my 40s...don't know if that's why, but I think it's standard with twin pregnancies to see both although my OB is my \"primary\" doctor. If there were any issues (and so far there are none whatsoever) I would not be surprised at all if they had me go to the peri either exclusively or at least a lot more often.

    So far cervix is long at 4.19cm, no bleeding, no pre-e or any other issues with my health. Babies are on target for growth and no abnormalities have been detected. Both babies are at 51%, 57% so I guess we're still having a \"boringly normal\" pregnancy. I'll gladly take it.

    I didn't vote though because we are seeing both, although it would be safe to say I'm really under the care of myh OB with monthly visits to the peri.

  4. this poll needs an option for both...
    i am continuing to see my OB and she will deliver, but as of 18 weeks i also started seeing a Peri who oversees all the u/s and will consult with my OB throughout the pg. truth be told, i like the Peri better and feel reassured that i have his expertise.

  5. I went right to a peri. Although I know many twin pregnancies can be routine, many are not. My DH and I are both MD's -- he specializes in neonatology and I'm in developmental disabilities. We have both seen enough unforseen complications that we just felt better and more reassured with a physician who had tons of experience with multiples and complicated pregnancies. We worked so hard to get here, I just didn't want to take any risks.....

    Melissa 12w6d

  6. I see both. couldnt vote.

  7. I only saw the OB and felt very comfortable with that choice.
    I went into preterm labor at 31.5wks that was caught at a routine visit with my OB. I was sent to the hospital and to the care of a Peri. But I was released 2 wks later back to my OB. I went onto deliver at 36.5wks with my OB. All went great!

    g/g 11mos

  8. I saw only an OB. Where I live, the nearest peri is 3+ hrs away. Fortunately my pg was uncomplicated, so I was very comfortable with my OB/GYN who has been delivering twins for 20+ yrs. I was, however, very proactive about my care, and insisted on cervix measurements & bi weekly NSTs.

    Ryan & Colby 8.5 mos

  9. I think most women who see a peri also see an OB. I saw both because of my twin pregnancy which was extremely uneventful until I started having lots of painless contractions and uterine irritability around 26 weeks resulting in 10 weeks of level II bedrest. Everything turned out fine (c-section at 38w5d and healthy 6+lb babies), but it was very reassuring to have the peri following me during that time.

  10. I only saw a peri, partly b/c it had been found during my fert. work up that I had some blood clotting issues. I prob. could have gone to both or just an O/B but in hindsight, I'm very glad I saw a peri only. My pg became very complicated around 20 wks and I worry what would have happened if 2 drs were making the call or if I only had an ob. Luckily I was watched closely by my peri and managed to make it to 33 1/3 wks after 9.5 wks of home bedrest and 1.5 wks of hospital bedrest.


  11. For those of you with non identical twins did you go to an OB or a Peri? What was your rationale?My rationale is that there are no Peri's in my town -- the closest is 2 hours away. I would only go if absolutely necessary. My OB team can deal with general high-risk stuff, they'd only send me off if something really serious came about.

  12. I am going to an OB there is an OB High Risk nurse there that has been checking in with us at all our appts as well though.

  13. I see both.

  14. Peri. I highly recommend it if there's a peri in reasonable distance from you.

  15. I see both.

  16. I saw both. I saw the Peri (in addition to the OB) during weeks I'm back to just the OB.

  17. I see a peri... you just never know what's in store for you, so if there is one in your area, I would HIGHLY recommend seeing one. I thought I would have a picture prefect pregnancy. Although I've been on bedrest for 12 weeks. I had no idea any of this was going to happen when I initially chose my peri.

  18. I see both. I go to the OB and the peri--my OB referred me to the peri because of my age (37) and the fact that I'm having twins. They don't treat me any differently than if I was pg with a singleton but that's because I'm pretty boring but the peri is there if I have any issues.

    21w3d b/g

  19. I don't see any reason to see a peri unless you're having problems. My opinion is that you're pregnant, not an invalid. Pregnancy is healthy and normal, even with multiples. I see a peri only because one of my twins is sick, and I have to deliver at a specific hospital so she can get care at Childrens (which is connected to the one where I'll deliver) immediately after birth. The ONLY clinic affiliated with that hospital is a peri, so I had no choice. Even they have told me I don't need to see a specialist because I am perfectly healthy, but that was my only option. I don't feel like I am getting any \"better\" care there, they barely talk to me, just tell me I'm fine and to keep those babies growing. Honestly, I think a peri is only necessary in a small number of instances. fwiw I am 33w today.

  20. I saw both, but after week 21 or so, my OB no longer referred me to the Peri.

  21. I have had plenty of problems but my high-risk OB has been consistently more helpful than the peri practice that I've seen from time to time.

  22. I saw both, not because of issues with the twins, but because of my ama (39 at the time I delivered the twins) and I also developed gestational diabetes with the twins (which was controlled through diet).

  23. I've been seeing both an experienced ob AND a hi-risk ob for consult. i don't think being pg makes me an invalid, but i can read, and multiple pregnancies just have higher complications risks, statistically.

    the highly populated area i'm in refers people to peri's for ultra serious conditions only, like chronic illnesses (lupus) or previous transplants. whew.

    i arranged the hi risk consult for peace of mind, even though the hi risk doc and mkyob thought i should have no problems whatsoever with this pg. but i am a careful person, at least in this area. by seeing both i had someone checking on me every two weeks, vs. a month (at the hi risk ob's suggestion i scheduled her visits in between the regular ob's). also, the hi-risk ob had access to u/s equipment and such that my regular ob did not have - the really hi class u/s stuff. also, she was willing to do some extra things like monitor my cervix length starting at 18 weeks. my pg didn't seem to be a problem, but again i read, and was keeping on the lookout for those increased complication risks.

    boy was everyone surprised when i came in at 23 weeks for a \"routine\" cervix check at the hi risk ob, the extra cervix series i had requested, and found i was suddenly shortened... and in labor the next day. because of the extra monitoring i had arranged, we caught it early, they could throw me on meds and hospital bedrest, and instead of delivering doomed twins at 23 weeks, i'm still pregnant at 28 wks. not a guarantee, but boy so MUCH BETTER odds for the twins.

    of course many twin moms do not go into pre-term labor. but more do than with singletons. i'd advise you to do what feels right for you - if you aren't really concerned, why bother? i've just been thru too many ivf's to take any chances now, that was my mindframe. but others do fine without the extra care.

    one thing you could check - how much experience does your ob have with delivering twins? most ob's have some experience, but someone who has delivered 3 sets in 5 years has a different level skill set than someone who has delivered 40 sets in 20 years of practice. there are just different issues to look out for in a twin pg, and you probably want someone experienced in those issues to help you watch out.

    good luck!


  24. Can you tell me what Peri stands for? Very new to this. Thanks

  25. I couldn't answer because I see a Peri and an OB. I am 24 weeks and see the OB every 3 weeks and the Peri every 4 weeks for growth ultra sounds.

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