depression = high risk?

[Maruschke]

I was talking to my GP and she doesn't want to do shared care with me, nor will she refer me specifically to the midwifery run clinic at the local hospital. She seems to believe that because I am currently medicated for depression and am having a baby from IVF that I should be managed by an obstetrician. I think that is a bit bogus. Other than being rubella antibody negative and having a few ovarian and vaginal cysts, I don't see how I am much different at all. Am I high risk merely for depression???

[Ca Plane Pour Moi]

No. Even a history of depression and a family history of PND was not enough for midwives to tell me not to worry, I wouldn't end up with PND (no, I ended up with something worse, but never mind). So frustrating - your care providers need to know about your depression, but mine wrote it off entirely and yours are blowing it out of all proportion.

Can you ask your GP if it is for the depression or another reason? And will the Ob refer you to the midwife clinic if you ask? (And do you need to see anyone at all? Just throwing my plans in there for you.)

[Maruschke]

Well, my GP doesn't want to manage me. And I don't know if it is serious enough to warrant an Ob. But... I don't think (correct me if I am wrong?) midwives know enough about depression to manage meds throughout a pregnancy. Sounds like maybe I need a new GP??? The GP said that it was both ivf and depression that makes me unsuitable for her care or for midwifery care. Sigh.

[sunshine 11]

I am blessed not to suffer from depression, but my sister does, and was monitored in her pregnancy, most particularly as the medication she took had a small risk of causing heart problems (my nephew is fine, just had a few more scans than a normal bub). BTW she didn't have an OB and had a homebirth, but lives OS, so probably that info isn't as relevant.

I think whilst it's reasonable to let a Mum who suffers from depression know they are more likely to suffer from PND, like FlyingButter says, I think there are a few more questions to be asked here as I can't see why she would stop you from going to a midwife clinic - surely they would decide if they couldn't help you. An IVF pregnancy is no different from any other as you know all too well - just the beginning is different. It might be that indeed you need to find another GP who is more confident in helping you, as it seems she doesn't feel confident to do that, which of course is the most important part. If you couldn't afford an OB - what exactly is the option for you - that would be my question too (even if you can afford it).

GL and I hope you find someone you are comfortable with

[onthefly]

What a fob off!
The IVF thing is completely irrelevant, unless there's some underlying issue that may affect pregnancy or birth.

For the meds, I don't know, but surely a GP (and yes, perhaps a different one) can handle that side of thigs while a midwife handles the pregnancy stuff (communicating between the obviously to ensure seamless care of you).

ETA - it's different, but my GP had a similar response for me. Because we went with midwifery care 2nd time, she wanted me to see the specialist to manage my thyroid stuff since I wasn't seeing a doc for the preganncy. paid $150 to see the endo who said "Your gp can handle this".

[anney]

I agree with you a new gp might be what is needed. Ivf is definitely not an indicator for needing an ob. I think the continuity you would get from a shared care gp particularly post baby would be great. The midwife clinic can still consult a doctor anyway can't they? Or refer you to one.

[Maruschke]

Yeah my GP is really old fashioned. She doesn't really believe in IVF. I wanted to mutter something under my breath when she said that. I don't know why IVF means high risk but it's a view held by quite a few GP's. I have a trusted GP at work I will talk to. Perhaps just a once off appt to an Obs at my local hospital might sort out a treatment plan for the midwives to work with???

[HotI]

high risk for what is the question. what is it that she thinks an ob will do to mitigate or monitor that risk that a midwife won't? if something comes up during the pregnancy, you can always be referred to a specialist then.

i went through the 'high risk' cinic unneccessarily with my 1st pregnancy. lots of me educating drs on my condition with no benefit to me or baby.

[Mak]

TBH I'd consider it a gift that she does not want to do shared care. Are you able to shop around and find someone else - there is no point having a care provider with such a fundamental difference of opinion in regards to your needs.
I'd be making an appt with the midwives and see if you can get some recommendations for another GP who is more in line with you. Good luck!

[Maruschke]

I'm going to the early pregnancy assessment unit today, since you don't need a referral to that, and once they have me on record I'll ask them to refer me to the midwifery program. FX going the back road works .

It really peeves me to be put on the back foot against doctors so early in the pregnancy. She (GP) is making a mountain out of a molehill (and it's not even a molehill!).

[Mak]

Hugs to you M. Remember that it is her issue and not yours.

[Maruschke]

Thanks for the advice and hugs everyone. I really love middies, they were the most helpful and actually most informed when I was pregnant and birthing DD1. I would LOVE to be in their care for this pregnancy.

[sloane]

i totally agree with you about m/w. i was 'high risk' last PG (and this one) & it was the m/w i came across (for monitoring & during labour) who made it all bearable. the doctors i 'had' to see barely saw me for more than a couple of minutes anyway!

i can't see why ivf would make you high risk - one of my friends has had 2 ivf PG and has been through a birth centre twice.

perhaps if the hospital won't put you onto the midwifery program then you could still do shared care with a more enlightened GP? i was doing shared care this time but the GP panicked and put me onto a tertiary hospital so i'm doing a follow through program with a student m/w. so far it's been fantastic & i feel somewhat pacified maybe that would be an option for you too?

good luck today

[Ashlee]

I'm booked into a midwifery led birth centre that is attached to a hospital and birthing suite. I've recently gone on AD's and now that I have I will probably be ineligible to birth at the birth centre as for them it is considered high risk, as the AD I'm on has risk of breathing/feeding issues. Every AD has risk to unborn babies so I'm not sure you would qualify for midwife only care. The IVF thing is absolute rubbish! And your GP sounds like she is putting you in the too hard basket - my GP has been nothing but supportive and if I have to birth at the regular birthing suite she will continue to do shared care with me.

Honestly I don't think it matters who manages your care and your birth, so long as you and your partner/doula will stand by how you wish to deliver, that's what really matters. Make it clear if you want to avoid intervention, no drugs, etc etc.

[nickle730]

Uh... your GP told you she 'doesn't believe in IVF'??? Definitely time for a new GP methinks. How very thoughtless, insensitive and unprofessional of her.

[Maruschke]

Uh... your GP told you she 'doesn't believe in IVF'??? Definitely time for a new GP methinks. How very thoughtless, insensitive and unprofessional of her.

I know. I should probably be more ****ed off about it, but to be honest, it is not worthy of my emotional energy. I'm just going to shuffle along to someone else.

[Ryatha]

The AD's carry a slight risk of withdrawal at birth but my two never had any effects from it. My last pregnancy was with midwife care and I had a team of mental health midwives looking after the mental health side of it.

It doesn't make you high risk, just increases the risk of pnd - so as long as they follow up post birth you are fine.

The ivf... Not sure about that one - sorry.

[Pholi]

Hi Maruschke,

I'm sorry you had such a disappointing response from your GP, but I think it sounds like a golden opportunity to find a GP who is able to be professional as well as supportive of you and bubs through this pg. You could try calling a few local GP clinics and asking receptionists if one of their GPs has a special interest in obstetrics, or even which is the DR that most of the pg women/mums of young kids choose to go to, and go and 'interview' them to find one you feel comfortable with.

If it were me, even if I found a midwife-led clinic which could look after all of my anticipated antenatal needs, I'd still want to know which GP I'd want to go and see in case something unrelated came up.

My IVF clinic has told me that having had IVF/ICSI makes no difference at all when it comes to choosing my model of antenatal care - even if it does turn out to be twins.