OBGYNDoc
Minneapolis, MN
Female, 36
I am a practicing Obstetrician and Gynecologist, providing care for women in all stages of life. Approximately half of my practice consists of pregnancy-related care, including routine prenatal care, high risk obstetrics, and delivering babies at all hours of the day. The other half consists of gynecologic care, which ranges from routine annual check-ups to contraception and menopause. I perform many surgeries, including laparoscopies and hysterectomies.
Typically, when a clinic is closing, the physicians will make arrangements to transfer their patients to another local clinic. Be sure to ask your clinic if they have made these arrangements, and where you should be scheduling your future appointments. If not, then you should be sure to make an appointment with your current clinic for the last possible date they are open. It may be difficult to find a clinic that will accept you as a new patient this late in the pregnancy. Be sure to request a copy of your entire medical chart from your current clinic, and keep a copy of that in your purse. Call your hospital labor and delivery department and ask to speak to the charge nurse. Ask if there is a doctor available for patients who do not have an assigned clinic to take care of them. Typically, all hospitals have a call system in which physicians will take on the care of patients who present to the hopsital but do not have their own physicians. The hospital cannot turn you away if you are in labor or have a pregnancy-related issue. They will find an appropriate physican to take care of you and your baby. Of course, all of this will be made easier if you have a copy of your medical records. If you have had complications in the pregnancy or have medical problems, you should work hard to call around and find another physician in your area who would be willing to accept you as a new patient.
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If the Mirena IUD is placed properly, it should not shift positions with intercourse. No method of contraception is 100% effective, but the Mirena is reported to be >99% effective. If you do conceive with the Mirena in place, it could be harmful to the pregnancy. You should immediately consult with your doctor in that unlikely situation.
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You will need to discuss this with your physician. This forum is intended to answer questions about the profession of OBGYN, not to answer specific medical questions.
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In our practice, as in most practices, patients may choose who they see throughout their pregnancy for outpatient care. However, when they are in the hospital for delivery, we have one doctor assigned to take call. The reality of this profession is that in order to maintain a healthy personal life, we simply can't be available 24/7. Instead, we've opted to maintain a call schedule in which one physician is available for deliveries and emergencies at all times. Without such a system, it would be impossible for Ob/Gyns to maintain any sort of healthy lifestyle. The consequence of this is that patients don't get to choose who will deliver their baby. Almost all patients are understanding of this and are willing to get to know all of the physicians throughout their pregnancy so they are not meeting us for the first time on the big day.
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I actually don't agree. Sperm preservation may become more common, as it is a non-invasive simple process. However egg retrieval is more complicated. The donating patient would have to start fertility medications to stimulate production of eggs (normally women only produce one egg per cycle, but with a retrieval, they want to stimulate production of multiple eggs). In addition, the retrieval of eggs is invasive, uncomfortable, and requires anesthesia. Most women would not want to undergo this procedure without a medical necessity. In addition, eggs are less tolerant of the freezing process than sperm, and do not the survive the process as easily. However we are fortunate to have this technology at our disposal for the times when it is truly indicated, and hopefully these procedures will become less cost-prohibitive over time.
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This is a very important question, not lame at all. I would start by asking friends and family who may live in your area. Post a question on your Facebook wall or ask your coworkers. Personal experiences with people you know are probably the best way to choose your provider. I don't put much trust in the online sites that allow patients to rate their doctors anonymously. I find that mostly people with negative experiences tend to post reviews, which makes the ratings really skewed. If you have a family practice doctor or internist, you could ask him or her for recommendations. Finally, you could use your insurance provider website for suggestions.
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Due dates are established based on last menstrual period, if known accurately and periods are regular, or based on the earliest ultrasound performed. If your due date is pushed back a month, it does not mean your pregnancy will be prolonged. It means that your original dating was incorrect. Most likely your ultrasound showed that the fetus measured a month smaller than anticipated, thus you likely conceived a month later than you had originally thought. The growth of a fetus in early pregnancy is a very accurate way of dating a pregnancy.
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