Itty Bitty Baby Tips
Another Pregnancy... Another Preemie???

8. The final choice of doctors will be up to you (and your insurance company.) Often they will deny covering the cost of a perinatologist from the start. If this happens and you really want a specialist, try fighting the system. Send them the final bill of your first NICU stay. Ask them if they would rather choose prevention through the use of a perinatologist or risk another NICU bill. And don’t stop with the first "no". Keep moving up the chain, until someone says yes. Remember, they merely pay the bill, you are the one living with the outcome. Sometimes an alternative is to find an OB who will send you for regularly scheduled visits with a perinatologist, which are then covered by your insurance.

10. The hospital? Insist on a doctor who will deliver at a Level 3 hospital, preferably one with NICU practices you feel comfortable with, as well as an excellent reputation. (Babies treated in the hospital where they were born do better than those who are transported. -source: The Premature Baby Book) Check out the following...their visitation policy? how involved can parents be with the baby? kangarooing? breastfeeding? what type of support is offered to parents (classes, support groups, reading resources, lactation consultant)? rooming in policy? transferring to local facilities? handling patient overflow?

11. Schedule an appointment for consultation to interview doctors BEFORE you become pregnant. This ensures you will not be pressured into choosing one doctor or being limited in selection due to practices closed to new patients. It also allows for treatment at the critical start of your pregnancy. You will want to take a copy of your medical records from your pregnancy and delivery, so they can be better informed. Be sure to check with the doctor’s office for fees and discuss the visit with your insurance first to determine coverage. (Most insurance companies won’t cover this.)

12. Be prepared. Make a search for information about your previous complications. Become as educated as possible about it, so that you can knowingly talk with your doctor and be an involved patient. Ways to find info? Search the internet. Search internet preemie and pregnancy websites. Ask other preemie parents what they have learned on the subject. Check regularly in parenting magazines, which often include small blurbs on new research. Consider searching Obstetrical and Perinatal medical journals about your complications. You can often do this for free at the library of a medical school.

13. What should I ask the doc? Before you get into specifics, first find out if person if this is the doctor for you - do you mesh personally? Do you trust their practices and training? Do they treat you respectfully, or merely as an inferior patient? Would you feel comfortable with this doctor in times of high stress? Does she explain things to you? Is she open to new research and treatments? How does she respond to your questions and concerns? Do you feel like you would be "bothering" your doctor if you called often?

Next, get out your list of questions. It is best to write down everything you want to ask, because you may not remember it all once you get started. You may wish to record the answers on your paper, especially if your husband is not there to hear them, but also so you can refer back to them as you make your final decision about doctors at home.

Discuss their possible plans of treatment. How can you decrease your chances of premature delivery? How often would you be seen? When would you need to call the doctor? What extra precautions can be taken? Are their new tests (such as fFn to detect possible premature delivery) or procedures that could benefit you during pregnancy? Does she have any resources or information she could share with you?