Tuesday, July 14, 2009

Preconception Planning

So today D and I went for a "preconception planning" appointment with an OB/GYN. I visited this doctor in a pinch two years ago (he's right downstairs from my primary care physician), and as I was thinking about this whole project, I remembered how good natured and gentle he was. I was a little nervous about asking D to go with me--he sounded so scared when I called him to tell him about the appointment! He's a good egg, though: agreed to go to the appointment and was good natured and supportive the whole time. The big surprise was how nervous *I* was. It was like: oh my god, we're actually thinking about doing this!

Initially, I didn't remember the doctor's name, so I just googled "OB/GYN" and my PCP's address and voila! When I found his name, I also found that he had a website: http://www.drovitsh.com/biography.php After I got my hopes up about how great it would be to have this doctor provide my prenatal care, I was certain that he wouldn't be in my insurance network. I called my insurance company and the rep put me on hold while he searched to see if Dr. Ovitsch was in my network of providers, and my head began to spin. I thought about how hard it is to find a doctor you like, and had my first experience of feeling tied to a decision and tensing up realizing that I need to let stuff go or I'll drive myself crazy. My elation was palpable when they told me he was" in network" and there would be no problem. After a huge sigh of relief, I took a moment to remind myself how lucky I am to have health insurance. When I called and was easily able to get an appointment within two weeks, I reminded myself how incredibly lucky I am that the one doctor I went to and liked is so easily accessible and in my insurance network.

I made the appointment because we both had some questions that were making us nervous--I asked about how difficult he thought it might be for us to conceive at this age (I'm 41) and about whether he anticipated any problems because I am overweight. Neither thing seemed to concern him too much, he said he had plenty of patients who are my age or older and had no trouble conceiving or having an uncomplicated pregnancy. And as for my weight, he asked if I was active (I am) and told us that I should keep that up throughout the pregnancy. He started to suggest a nutritionist, but then D and I explained how healthy we eat (see my other blog: http://mysticgypsypickles.blogspot.com) and he seemed impressed. He said that I could gain between 15-30 pounds during pregnancy, but that I should realize that I shouldn't worry about nutrients getting to the baby if I eat healthy. In other words, I don't have to "eat for two" as they say! The most reassuring thing he said was that I wasn't carrying enough extra weight for him to be concerned; and that breastfeeding might help with losing the extra weight I will gain if I become pregnant.

Of course he asked if I was taking folic acid, and I told him about my multivitamin which has 100% folic acid. He said that was fine. He suggested that I might want to buy a home ovulation meter or something, but I think I can read my body pretty well. Plus, it's not like we're only going to have sex when I'm ovulating for god's sake! He told me to go get a panel of blood tests on the third day of my next menstrual cycle to test for estrogen levels and some other things that will tell him how easily I might be able to conceive. He also suggested trying for three cycles (fun!) and if there's no luck, I should come back and he can talk with me about hormones and some other tricks to boost the chances of conception. I'm not sure about all that--I've always thought that if it doesn't happen, it's not meant to be...don't fool around with nature. But I'll cross that bridge when I get to it.

All in all, it was a good appointment. I think we both left feeling a little bit more comfortable with this decision. I didn't raise one big question that I had: whether he would be supportive of us planning a home birth. That's another bridge we'll cross when we get to it--and another blog post altogether!

Uh oh, though--in keeping with the title of the blog, this visit cost me a $5 copay. The first expense of the project. I gotta start a spreadsheet.

1 comment:

  1. did you see that article in the NYTimes - "for firstborns, second hand fits the bill" it was the styles section on 7/8 -- I think your blog is really timely!

    and I'm glad you found a great obgyn. But I'm not sure about his response to the home birth question. Suspenseful!