PREGNANCY-BIRTH Messages for January, 2001: Re: 1 son, 1 missed m/c, and unsure what to expect from doc's? (long)

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Re: 1 son, 1 missed m/c, and unsure what to expect from doc's? (long)

From: William McIntosh, MD (anonymous@obgyn.net)
Tue, 30 Jan 2001 19:32:50 -0600 (CST)

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In reply to: TAMARA: "1 son, 1 missed m/c, and unsure what to expect from doc's? (long)"

At Tue, 30 Jan 2001, TAMARA wrote: >
>I am in a somewhat unique situation. My husband is active duty
>military. We have been married for 7 years and during this time I have
>always felt that I have gotten excellent medical care. However, In late
>Sep 2000 I had a missed miscarriage (diagnosed at 12 weeks; baby died at
>9 weeks). It was followed by a d&c. Prior to that, in April 1999, I
>delivered a perfectly healthy baby boy after a picture perfect
>pregnancy. It has been four months since the m/c and my husband and I
>are now actively trying to conceive again. After reading many of the
>posts on this site, there are serveral things that make me curious about
>the quality of care I have been receiving. First, the military clinic
>will not see anyone who is pregnant until they are 10 weeks. Secondly,
>to my knowledge, my hcg levels and progesterone levels were never
>checked with either pregnancy (this especially concerns me with the
>second one). Now, there is a good chance I could be pregnant again,
>though it is still too early to tell. Is it wise not be seen by a
>doctor until you are ten weeks pregnant? I am so nervous about a repeat
>m/c and should there be a problem (especially something as simple as a
>hormone problem) wouldn't earlier care be helpful? Is it reasonable to
>request that hcg and progesterone levels be checked regularly,
>especially with a previous m/c? I guess in short what I want to know
>is... What is reasonable to expect from my doctors when it comes to
>future pregnancies. I am sorry this is so long, but any insight would
>be extremely helpful.

You are describing a bare bones approach to prenatal care that has little to no impact on the eventual outcome. The cost of that is that you won't find out what is going on as early as you would in my office. Normally, that is not a serious concern, but in your case, you will have to endure considerably more anxiety because of your history.

By the way, I speak as my alter ego, MAJ WD McIntosh, USAR, MC. My wife has an alter ego too, MAJ Lisa McIntosh, USAFR, MC (yes, we were a mixed service couple). We have spent a lot of time taking care of military patients between the two of us. The system is designed to provide only that care which is absolutely essential and nothing more. A miscarriage is predetermined at conception the vast majority of the time. There is nothing that can be done to change that outcome. The only variable is how soon you find out. My private practice patients expect to find out as soon as technology will permit. Military system patients will not find out so soon typically.

--
William D. McIntosh, MD, FACOG

This is for educational purposes only, and is neither designed nor intended to replace consultation with and examination by a licensed medical professional.

Please, no private e-mails.  I will not be able to answer them.

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