Dr. Marjorie Greenfield
Specializing in pregnancy and birth.
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 Ask Dr. Greenfield
Midwives and High Risk Pregnancy | | | QUESTION | | | Dear Dr. Greenfield,
My first child was born in October 1999 after a very uncomplicated pregnancy. Since then I had a six-week miscarriage in October 2000 and delivered a 10 oz. baby boy in September 2001 at 20 weeks. We are expecting again and I'm six weeks along. I really want to have a midwife and my husband is really hesitant. Is there reason to believe a midwife wouldn't be capable of taking on this pregnancy? Should I go to an obstetrician with more knowledge in high-risk situations?— Melissacrevits in Charing Cross, ON, Canada | | | ANSWER |
February 28, 2002 | | | Dear Melissacrevits,
This is definitely not a pregnancy for midwifery care, not because of the early miscarriage (which wouldn't make you "high risk"), but because of your 20 week loss. You are at risk of having another preterm birth and need close medical observation including treatment for incompetent cervix or preterm labor, if either of these is an issue for you. My recommendation is to pick an obstetrician who works with midwives in his practice. Then you could see the doctor now, who can follow you closely until you are late into your third trimester. If things are going well, you could plan ahead to transfer your care to the midwife, so that she could take care of you during birth, which is what you want.
Because of your history, you should see a doctor as soon as possible, so that he can assess if you need a cervical cerclage, or any other preventive measures, and plan out the course of your prenatal care. I hope that this answers your questions. Take care--and good luck with this pregnancy!— by Marjorie Greenfield, M.D. |
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