I brought it up the other day and got several responses, from you, about how they handled the transition from their fertility specialist back to their Obstetrician/Gynecologist.
Here are what just a few, very recent graduates of Reproductive Medicine Associates of CT had to say about their graduation (my responses are below each one in bold):
I can totally relate to this post! I would have LOVED it if Dr. Richlin was the one to deliver my baby :) One thing that made the transition to my OB easier was finding one that was understanding and compassionate about my fertility struggle, and was willing to provide extra ultrasound scans whenever I wanted for peace of mind.
I love hearing that about an Obstetrician. It's wonderful to hear that humanity trumps medical protocol.
Next step? How many babies are out there with their doctor's names or middle names? Or send their fertility doctors birthday cards every year?
For people who don't want to get attached, how grateful do we feel when we leave pregnant?
Thanks, as always, for writing. Hope it's all going tremendously well.
Well - for me - I was a high risk w/ twins and a congenital heart defect (repaired but could recur). So, my transition was a little easier probably - but I too remember feeling a little odd. BUT - also had a FABULOUS OB/GYN who knew exactly where I was coming from and would have done anything I asked.
But - in a vain attempt to try to treat my pregnancy as any other "normal" pregnancy, I tried to stay away from the docs as much as I could. Instead - I opted for a rental of a heartbeat monitor (thank you Carrie Van Steen for letting me those existed) and that got me through any times of concern. I'd find their heartbeats and listen in if I was feeling anxious and all would be good. One caution on this though - be sure you can stomach it if you can't find a heart beat immediately - the baby just may be in a position that it is hard to hear. Listen to the instructional CD that comes with the monitor to identify the different sounds you will hear etc.
Yes, sometimes we truly are high risk. Often we assume that because it's taken intervention to get pregnant that will make being pregnant a higher risk situation. Luckily that is not medically true, even if it continues to feel that way.
How smart of you to slay your own dragons about your diagnosed high risk pregnancy! I love you taking matters into your hands so that you could have instant comfort by hearing the baby's heart beats.
A wonderful suggestion, thank you for passing it on and thank you to Carrie Van Steen for suggesting it.
Thank you for writing and sharing, none of us want to feel alone with this.
I really, truly appreciated this post because I felt the same exact way when I got pregnant after 2 cycles at RMA and 9 weeks into my pregnancy I "graduated." It was extremely difficult to leave and transition to my regular OBGYN and be considered "just another pregnant woman." I actually was so upset and disappointed when I transitioned to my regular OBGYN that I decided I needed to find a new one that would be sensitive to the fact that I had a really difficult time getting pregnant, and would understand that I might need to talk or stop in for a visit more than once every 4 weeks. I think that's the best advice I could give about graduating from an RE...now I have 9 weeks left until delivery and while I still miss Dr. Hurwitz and Dr. Leondires all the time, I have the most wonderful obgyns that have taken care of me (even during my emotional/hormonal breakdowns) and never made me feel like I was just another crazy pregnant woman. I can't wait for the day to come though, that I can bring this baby boy to see the two doctors that helped make this dream come true for us.
Thanks for writing!
We are regular pregnant women. We are pregnant women who feel very protective and somewhat vulnerable about our pregnancies.
We do need doctors who can recognize that because we feel more vulnerable, that in fact, does not make us crazy. It makes us need an OB/Gyn who is sensitive to the years and procedures that we've gone through to get to them pregnant.
I believe it's not too much to expect. A sensitive OB/Gyn.
I'm so glad that you found one.
And we can't wait to see your baby!
How else have you handled graduation from your fertility practice?
What about those of us who have graduated without the pregnancy?
Are you willing to share your stories?
There’s someone reading who would truly benefit from knowing that they are not alone.
It's my day to muse. To ask more questions than I answer. To bring up things to think about. Bear with me!
Graduation. Without looking anything up online, my understanding of the definition, is finishing with one thing and moving on. Sometimes, often, it will mean going to a higher level or next level. But it doesn't always mean that.
Finishing or completing something.
I've been wondering how we graduate from infertility treatment. How we move on.
Often, very, very often, it's because we get pregnant. At our practice? We are well over the national average for pregnancies per cycle, per patient. Many fertility patients will leave their infertility practice just that way. Pregnant.
As much as none of us want to be in a fertility program to begin with, many of our patients then don't want to leave. The transition from being monitored several times a week, seeing blood levels rise appropriately, and having personal relationships with the nurses, coordinators and medical assistants back to their Obstetrician/Gynecologist can be a little tough.
Although we are in a reproductive endocrinologists (fertility specialist) program because we're having a tough time getting pregnant, this does not make us high risk pregnancy patients.
Let me rephrase.
Most of the time, with definite exceptions, once we become pregnant, we are no higher risk than any other woman who's pregnant.
We're not used to that.
We're used to things not working properly. We're used to needing at least some level of medical intervention. We're not used to seeing things progress just the way that they're supposed to, especially without medications and procedures.
We're just a normal OB/Gyn patient? Just a normal pregnant lady?
How do we graduate from infertility patient to normally pregnant woman?
How do we accept not seeing the doctor more than once a month for the first month or so and then only twice a month after that? To not see the pregnancy, hear the heartbeat, know that the bloodwork is confirming that everything is progressing normall?
How do we know everything's ok if none of those things are being done?
How do we understand everything's ok, especially if, in the past, they haven't always been? If there's a miscarriage in your past, how do we know it's not happening again and we just don't realize it?
There is that time of transition, that leap of faith. There's a time of feeling unbalanced and unsure and perhaps even frightened and anxious.
Normal, normal, normal.
How do I know?
I've been listening and talking to women who are struggling with infertility for over twenty years. In over twenty years, I've spoke to hundreds of women. Perhaps close to a thousand.
We don't want to come to our fertility specialist. And then we're pregnant and we don't want to leave.
In fact, we'd be happy, often, if our fertility specialist would deliver the baby.
Yeah, it's a hard transition. More tomorrow. Suggestions or ideas on how to make this transition easier? Please share!
The subject of today's blog is reproductive health upkeep. Ok, no kidding, right? Except, that if you are anything like me or any of my friends who were/are in treatment, you may forget about taking care of other health needs as the vigor's of treatment can be overwhelming. Here are a few things that you may want to keep in mind during fertility treatment.
Seemingly unrelated, one of the best parts of my job is that I have the opportunity to meet with the OB/Gyn's (Obstetrician/ Gynecologists) in our area. Dr. Joshua Hurwitz and I met with an OB/Gyn group that practices up in Waterbury, CT. They were welcoming, helpful and extremely informative. One of the purposes of these visits is to be able to exchange information about one another's practices so that when patients are referred to us there is an understanding about treatment and care.
When speaking with them, I was reminded of the testing that one should have done on a regular basis. If you are in treatment, you will be reminded to have, or given, a pap test, so that test is one you may not have to worry about outside the RE's (Reproductive Endocrinologists) office. Then again, in speaking to the OB's today, with new guidelines that come out from ACOG (American College of Gynecology) frequently, it can be hard to keep up with how often to have some of the testing done.
There's HPV and other sexually transmitted diseases, again, taken care of in most fertility practices. If you are not sure that this is being done, please ask.
Depending on your age and your family history, there is a mammogram to consider. Again, fascinating to listen to the OB's relating the guidelines, who's issuing them, what changes have been recently suggested, what you really do need to know. The U.S. Preventive Services Task Force just recently updated their 2002 findings to a very mixed reaction in the medical community. You can read what the American Cancer Society has to say, the reactions there weren't mixed at all. The controversy is raging as I write.
It was hard to hear that the teaching of self-testing (self breast examination) is being discouraged, according to the new guidelines. As I understood it this afternoon, it's being discouraged because it's not considered effective and can raise anxiety. . The OB's were quick to point out that from an epidemiologist's perspective, it's not effective. For the doctor treating individual patients, it can be quite effective. From a monetary point of view, it's completely cost effective. The doctors that Dr. Hurwitz and I visited this afternoon have every intention of continuing to teach self examinations.
Ok, so while I'm at it, up to date with the dentist? Ophthalmologist? Annual physical? If not, make an appointment. We need to take care of all of you, not just the parts needed to create a family. So wonderful this afternoon to hear the doctors, nurses, and other clinicians speak of the patients with such respect and regard, hear how delighted they were when Dr. Hurwitz spoke of how our practice offers services to treat the patient as a whole human being.
So take care of yourself, outside of treatment, all of you. Take a walk; see a movie; or have tea with a friend. Treat yourself with respect and kindness, the way you would a dear friend.