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.

[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.

[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".

[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.

[onthefly]

To reiterate the IVF thing - it's arse-covering, that's all. IF you have some underlying issue that necessitated IVF AND would affect pregnancy/birth, then ok, but NOT just because you used IVF to conceive. I planned for a homebirth with DD regardless of having conceived with IVF. No issue.

She doesn't believe in IVF.... so does she believe that you're pregnant....?

[Maruschke]

To reiterate the IVF thing - it's arse-covering, that's all. IF you have some underlying issue that necessitated IVF AND would affect pregnancy/birth, then ok, but NOT just because you used IVF to conceive. I planned for a homebirth with DD regardless of having conceived with IVF. No issue.

She doesn't believe in IVF.... so does she believe that you're pregnant....?

We have no infertility conditions which should prevent a natural birth and healthy pregnancy. I agree she is covering her sphincter. I called the hospital today and they are happy to accept me into their midwife lead program after the booking in appointment. I just need to find a GP to refer me .

[onthefly]

yay! Hope you find a great new gp in the process

[kristi14]

Ooops, i just saw this was an old thread, good to hear you got the care you were wanting

[SeppyM]

Hi ladies, not sure if this thread is still going, but came across it and thought I'd put in from personal experience. I developed antenatal depression when I was 4 months pregnant, at first I started counseling to try and help, but i ended up needing to be medication to help. I definitely felt much better once the tablets started working and enjoyed the rest of my pregnancy. I was going through the public system under midwife care. My midwife told me when I asked her, that I was actually at a lower risk of developing PND because I was already on medication. Well sure enough 5 weeks post partum I was diagnosed with PND. My midwife, GP, and MCHN were all aware of my history and no one thought to ask me about how I was doing. I think they all handballed the issue to the other caregiver. I've now changed gp's and MCHN and my medication has been changed and I'm much improved an able to enjoy motherhood. I'm not meaning to scare you or anything, but this was my experience and I dont think going through an OB as compared to midwife wouldve made a difference, i just think i needed to be more self aware and assertive with my health professionals. So if youd prefer midwife care then go for it! Sometimes you are your best carer!. Goodluck with the rest of ur pregnancy! I hope this helps a little

[Maruschke]

Oh I see this thread is active again... just to complete the thread, I was admitted under the midwifery lead care program . No Ob for me .

[onthefly]

yay!
poo poo to that gp