Aa
Moving/Changing physicians during high-risk pregnancy
Because I am looking for a COMPETELY unbiased opinion, I am not stating which party/relation to which party I am and this will be very 'mechanical' in nature.
Wife: Currently 11 weeks in gestation, due date Oct. 24, 1st pregnancy, Type I diabetes (last A1C = 7), Rh -, living in CA
Husband: Currently overseas (military), due to return mid-August, being transferred to IL upon return, O+
Would it be safe for the wife to relocate and change physicians at ~15-19 weeks? What would the potential negatives be? At what point in the pregnancy would air travel be restricted?
Would it be safer for the wife stay in CA until after the baby is born? At what point after the baby is born would the wife be okay to relocate with the newborn? Should she wait for her post-natal check? Or would it be okay to relocate and return for the post-natal visit? Would air travel be safe for the post-natal visit?
Husband was deployed 1 week after learning of the pregnancy (1 day after 1st doctor visit); the military will allow 2 weeks off upon return from deployment; husband will be required to attend 4 weeks training in FL for new assignment shortly after return from deployment; after training, there is a 3 week time allowance before reporting to new assignment; husband will get 10 days maternity leave.
Timeline made simple:
Day 1: Pregnancy confirmed with MD; 6wks gestation, due date of Oct. 24th given
Day 2: Husband is deployed overseas
Mid-Aug: Husband returns to CA
Early Sept: Husband enters 4 weeks training in FL
Early Oct: Husband searches for housing and relocates to IL
Late Oct: Baby is born
Following birth: Husband has 10 days leave
???: Wife and baby relocate before or after birth???
Wife: Currently 11 weeks in gestation, due date Oct. 24, 1st pregnancy, Type I diabetes (last A1C = 7), Rh -, living in CA
Husband: Currently overseas (military), due to return mid-August, being transferred to IL upon return, O+
Would it be safe for the wife to relocate and change physicians at ~15-19 weeks? What would the potential negatives be? At what point in the pregnancy would air travel be restricted?
Would it be safer for the wife stay in CA until after the baby is born? At what point after the baby is born would the wife be okay to relocate with the newborn? Should she wait for her post-natal check? Or would it be okay to relocate and return for the post-natal visit? Would air travel be safe for the post-natal visit?
Husband was deployed 1 week after learning of the pregnancy (1 day after 1st doctor visit); the military will allow 2 weeks off upon return from deployment; husband will be required to attend 4 weeks training in FL for new assignment shortly after return from deployment; after training, there is a 3 week time allowance before reporting to new assignment; husband will get 10 days maternity leave.
Timeline made simple:
Day 1: Pregnancy confirmed with MD; 6wks gestation, due date of Oct. 24th given
Day 2: Husband is deployed overseas
Mid-Aug: Husband returns to CA
Early Sept: Husband enters 4 weeks training in FL
Early Oct: Husband searches for housing and relocates to IL
Late Oct: Baby is born
Following birth: Husband has 10 days leave
???: Wife and baby relocate before or after birth???
Oops! One more thing:
What about post-natal visit? Would Mom be able to air travel at 1-2 weeks after birth or land travel? If land travel, would Mom be able to air travel for the post-natal visit?
What about post-natal visit? Would Mom be able to air travel at 1-2 weeks after birth or land travel? If land travel, would Mom be able to air travel for the post-natal visit?
Thank you so much for your input!
Wife has whole family in CA
Husband has Father, Grandparents, Aunt in IL, Mother (who is a nurse) and siblings would stay with wife while husband is overseas if move occurs before baby is born.
Referral has been made to perinatologist in CA and has been seen 2 days ago for first time due to abdominal pain/spotting (all is fine, US shows proper implantation, + heartbeat, etc.). In detail US scheduled for next week.
Some concerns raised in addition to yours are:
If baby is premie and requires NICU for any length of time beyond the 10 days allowable leave, dad will have to jump through more hoops to be able to stay with mom and baby in CA; however, wifes parents, grandmother, siblings CAN travel to IL without too much difficulty job wise.
Thank you again for your help.
Wife has whole family in CA
Husband has Father, Grandparents, Aunt in IL, Mother (who is a nurse) and siblings would stay with wife while husband is overseas if move occurs before baby is born.
Referral has been made to perinatologist in CA and has been seen 2 days ago for first time due to abdominal pain/spotting (all is fine, US shows proper implantation, + heartbeat, etc.). In detail US scheduled for next week.
Some concerns raised in addition to yours are:
If baby is premie and requires NICU for any length of time beyond the 10 days allowable leave, dad will have to jump through more hoops to be able to stay with mom and baby in CA; however, wifes parents, grandmother, siblings CAN travel to IL without too much difficulty job wise.
Thank you again for your help.
MEDICAL PROFESSIONAL
Hi!
One piece of information I am lacking is: location of supportive family!
If wife has her mother/ his mother or other close family members in California, I am inclined to relocate her after the baby is born.
It would be safe to change doctors at 15-19 weeks, and if that must be done, that is definitely when I would do it. I feel fairly certain husband is beside himself with worry, and I suspect that both parties would feel more safe and secure if they had an alternate support system of some type since he can't provide that due to military obligations.
Some things to consider:
Women with type 1 diabetes require intense monitoring of blood sugars throughout pregnancy. As the pregnancy progresses there is going to be more and more monitoring of the baby--possibly as much as 2-3 doctor visits per week. It can be very nice to have a companion at these visits, and transportation/traffic should be considered too. Women with IDDM get the best care from a perinatologist (high risk specialist). So access to a good MD should be considered. Women with type 1 IDDM often deliver early due to potential complications, and are almost never allowed to go over-due.
Babies born to moms with IDDM are often monitored in NICU for at least 24 hours after birth--so you want access to a good NICU too. New moms need lots of help (at least I did!!!) and blood sugars can be pretty erratic right after delivery. Once everybody is stable, there is no reason why mom and baby cannot re-locate as soon as 1-2 weeks post partum (both can travel then even if C/section which by the way is very likely)
I hope I haven't made you two even more nervous. I hope I have been helpful. Go where the support and medical care are the best!
Good luck and Congratulations!
Dr B
One piece of information I am lacking is: location of supportive family!
If wife has her mother/ his mother or other close family members in California, I am inclined to relocate her after the baby is born.
It would be safe to change doctors at 15-19 weeks, and if that must be done, that is definitely when I would do it. I feel fairly certain husband is beside himself with worry, and I suspect that both parties would feel more safe and secure if they had an alternate support system of some type since he can't provide that due to military obligations.
Some things to consider:
Women with type 1 diabetes require intense monitoring of blood sugars throughout pregnancy. As the pregnancy progresses there is going to be more and more monitoring of the baby--possibly as much as 2-3 doctor visits per week. It can be very nice to have a companion at these visits, and transportation/traffic should be considered too. Women with IDDM get the best care from a perinatologist (high risk specialist). So access to a good MD should be considered. Women with type 1 IDDM often deliver early due to potential complications, and are almost never allowed to go over-due.
Babies born to moms with IDDM are often monitored in NICU for at least 24 hours after birth--so you want access to a good NICU too. New moms need lots of help (at least I did!!!) and blood sugars can be pretty erratic right after delivery. Once everybody is stable, there is no reason why mom and baby cannot re-locate as soon as 1-2 weeks post partum (both can travel then even if C/section which by the way is very likely)
I hope I haven't made you two even more nervous. I hope I have been helpful. Go where the support and medical care are the best!
Good luck and Congratulations!
Dr B
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