Really? OB's don't handle sickness during pregnancy?

[Aspasia]

The cold I have had for the past few weeks has developed into something that is slightly concerning for me, so I called my OB this morning and the lady I talked to (a nurse, I think) told me I needed to see my PCP or go to urgent care because their office only handles "healthy pregnancy, not sick pregnancy".

 

Is this normal? I guess I've never been sick enough in my other pregnancies to call my OB, but this was surprising to me. So if I go to urgent care and something is wrong, who handles it? Urgent care doctors aren't pregnancy specialists and apparently the OB doesn't handle sickness, so who specializes in treating a sick pregnant woman, taking her pregnancy into concern while treating the illness? I'm bugged.

[Aura]

Yeah. My OB didn't do this either.  :glare: It was incredibly frustrating since I only had him and the kids' pediatrician at the time. He referred me to someone, but I wasn't overly impressed w/ the MD. My OB was awesome. The MD, not so much. And no, he really didn't know that much about taking into account my being pregnant. But we did eventually work it out, and I got my sinus infection taken care of. That was several years ago. I doubt it's much better now.

 

If I had to do it over again, I would just go to an non-urgent clinic instead of trying to deal w/ being a new patient at a dr. office.

 

Hope you get to feeling better.  :grouphug:

[Word Nerd]

That sounds normal to me. I wouldn't have expected my OB/GYN or CNM to treat a sinus infection, though I might have called the office to check on using OTC meds to treat cold/flu symptoms. A lot of family doctors do OB/GYN care for patients as well even though they didn't specialize in that area. They may also want to keep contagious patients out of their office as much as possible for the benefit of all the other pregnant women they see.

[GSOchristie]

No, I have actually been sent to my OB from Urgent Care when my perioral dermititis flared up during pregnancy.  They were not comfortable prescribing the needed antibiotics.

[Laurie4b]

Well back in the dark ages when I was pregnant (15-21 years ago), my OB wanted to handle ALL illnesses to make sure that drugs weren't given, etc. that could negatively impact the baby, not to mention that some "minor" illnesses can have an effect on the developing fetus.

[Murphy101]

I refused. It was a pita when they gave me that line. Because what did the go say almost every time? Take to your OB bc your OB will know more about what you should do while pregnant. None of the GPs would touch me once they found out I was pregnant bc they were terrified of being sued if anything went wrong with a pregnant patient. I told my OB that and said they were my primary dr and I expected them to treat me. They didn't like it, but they usually did it.

[Lawana]

My OB handled things like sinus infections. When I had a gall bladder attack during pregnancy, it was my OB that hospitalized me and handled my care. He would have called in a general surgeon if I had needed it out. But that was 17 years ago.

[Laura Corin]

That was the norm when I was pregnant in Hong Kong.  The OB handled pregnancy issues; my GP handled everything else.

 

When I was pregnant in the UK, I had GP/midwife care, so I went to my GP for any illnesses.

 

L

[J-rap]

The one time I had an OB was when I was at a big city clinic, and the OB ONLY handled my pregnancy-related issues.  Three of my children were born after we were in our present small town, which only had general practitioners, so then my doctor handled everything.  They were true family doctors.  They handled baby and child-care visits too.

[lexi]

My midwife handled my sicknesses unless I needed something that she could not prescribe. She then worked with my PCP to help me get what I needed. But when I was sick with the flu she checked on me multiple times to monitor me and check me for dehydration. She went out of her way to be helpful anytime I was sick.

But for liability I can see why an OB won't help. I would be frustrated though!

Hope you feel better soon!

[Murphy101]

It's fairly newish policy here. Back when I had my first 3? OB handled everything BUT my OBs were also family practice drs. But over time many drs had to choose to do either family practice or OB, because the cost of insurance to cover both is insane expensive. Now, I don't know ANY fp/gp that carries maternity malpractice protection. So they don't even want to take my call until after baby is born if at all possible.

[prairiewindmomma]

My understanding is that it is an insurance coding issue. At my office, you are just billed separately outside of the global billing fee.

[Pawz4me]

Well back in the dark ages when I was pregnant (15-21 years ago), my OB wanted to handle ALL illnesses to make sure that drugs weren't given, etc. that could negatively impact the baby, not to mention that some "minor" illnesses can have an effect on the developing fetus.

 

This was my experience, too (note my kids are 15 and 18).  My OB group made it clear that I was to contact them first for any and all health issues while pregnant.  I don't recall ever needing to, so I don't know what issues they would have handled and what they would've farmed out.  But I feel fairly confident that for cold complications like bronchitis, sinus infections or something similar that an OB would have prescribed something.  The group I used was exclusively an OB/GYN practice.

[Murphy101]

My understanding is that it is an insurance coding issue. At my office, you are just billed separately outside of the global billing fee.

Well of course. That was explained to me by the OBs too. And when it affects how much you pay, often double the copay for example, many patients are going to be ticked, but it is what it is. I think in one case the OB said I had to make a separate appoint for my ear infection bc although I was already there for my scheduled OB appt, they couldn't bill the ear infection treatment at the same appoint. So they scheduled me later that afternoon.

[ashfern]

I dealt with this through two pregnancies. In both I had a head cold that developed into a cough. My OB office (mix of docs & midwives) told me to take OTC meds and if it didn't improve to see my PCP. The PCP I had 8 years ago wouldn't see me as soon as he heard I was pregnant. I had the same issue in my most recent pregnancy of a dry cough turning into something worse. Again, the OB said to use OTC meds and call PCP if it didn't improve. I got a new PCP and he was more than happy to see me & treat even though I was pregnant. I ended up with an antibiotic which cleared up in days my month long cough.

[cjzimmer1]

I've been sick multiple times when pregnant and it would never occur to me to call the OB for sick things.  I've always gone to my PCP's clinic (because sometimes she can't get me in that day) but they are all family practice doctors so perhaps they are more comfortable handling sick pregnant women since they normally handle both sick women and pregnant women ( due to prior C-section I can't use the family practice for delivery so it's easier to use OB for the whole pregnancy than to try to bring one in just for delivery).  But upon hearing/seeing I'm sick, the OB's have always made sure to have me check in with them if I'm not getting better soon so I have no doubt they would have seen me if I called them first.

[mom2myboys]

The CNM/OB office I went to became the PCP as well when I was pregnant. After my 6 week follow-up, I need to go to a regular PCP for other issues. While pregnant though, they handled everything.

[JustEm]

I have been sick a few time during pregnancy.  Only once that made me think to call a doctor.  Called my OB and he saw me that day. Prescribed the necessary medication and I was on my way. I hope that never changes because I don't have a PCP. I suppose if I ever need one I'll just go with the dr my dh and kids see.

[Bearcat]

When I was sick during pregnancy (6 years ago) my OB gave me a prescription for cold medicine. I went in for my regular check up and she noticed the coughing etc. She wrote me out a prescription and that was that. I did not go specifically for treatment of my cold and I don't know what they would have done if I had called and asked for help with my illness. I don't really have a gp. The only doctor I've seen in years is my OB/GYN.

[gingersmom]

I was sick during pregnancy and never thought to call my OB. 

 

I did see my regular doctor who called the OB to make sure what he was prescribing was okay with her.

[Whereneverever]

My ob does sick care but I also saw urgent care while sick just because it was often easier to get it.

[Rubix]

I often do a quick care type of place or my PMD.  You can see PA's at my OB's office - I saw once when I was in for a prenatal visit, and thought I had an ear infection.  However, this pregnancy I went into a Walgreens quick care place, with a sinus infection & bronchitis.  They treated me, but couldn't do anything for cough.  

 

I saw my OB the next day for a routine visit and she gave me a script for cough meds at the appointment, so even though they didn't treat the illness, they were able to give me a med that the quick care couldn't.

[trlt]

I'm pregnant now and my OB sees me for sickness/non-pregnancy related stuff.

[Aspasia]

I refused. It was a pita when they gave me that line. Because what did the go say almost every time? Take to your OB bc your OB will know more about what you should do while pregnant. None of the GPs would touch me once they found out I was pregnant bc they were terrified of being sued if anything went wrong with a pregnant patient. I told my OB that and said they were my primary dr and I expected them to treat me. They didn't like it, but they usually did it.

This is what I'm afraid of. Seems like most gp's don't want to get involved in pregnancy issues...and from what I understand, everything that happens while you're pregnant is a pregnancy issue.

[momto10blessings]

My Ob says to come in for illnesses. The only time I don't go to my OB when pregnant is after hours/weekends. He'll also call in meds for me for the flu when my kids have been tested, ear infection and UTI. It's so nice to have a dr who trusts me. I just wish I could find a GP that I liked.

 

I've had several GPs end up calling the OB on call at the hospital to ask if a medication was ok to use during pregnancy.

[happypamama]

I've always used midwives, who don't always have prescriptive authority, so when I am sick during pregnancy, I see my regular doctor.  When I was pregnant with #2, I had a strange thing where I injured a chest muscle or something, something outside of the midwife's scope, so I saw my regular doctor.  He gave me some suggestions and had me talk to my midwife about the safest option.  During my last pregnancy, my asthma flared up badly, so I saw my regular doctor (a different one), and she prescribed the safest option that brought me relief.  I would expect that an OB or midwife would refer you to a regular doctor for a lot of things, but then I would also expect that once the regular doctor made a diagnosis, he/she would contact your OB/midwife to check which was the safest option.  It seems like everyone working together should be the norm, although I'm sure it's probably actually not.

[Plateau Mama]

When I was pregnant my ob handled all my from the day I was pg till I delivered. No FP dr. would have anything to do with me. When I was pg with my oldest I got the flu while on vacation. My FIL did not want me going to the ER so he called a family friend who had been their Dr since DH was a kid. He checked me out, but wouldn't prescribe anything w/o talking to my OB at home. They've handled everything, colds, flu, sinus infections, etc.

[Aspasia]

I've had several GPs end up calling the OB on call at the hospital to ask if a medication was ok to use during pregnancy.

Exactly. This is what I'm afraid of.

[GoVanGogh]

My OB/GYN has has always had a sign up in office in her office that she doesn't treat illnesses not related to pregnancy.

1.) insurance codes/billing

2.) she doesn't want sick people bringing illnesses into her office and exposing other pregnant ladies or newborn babies.

[Kathryn]

My OB handles everything when I'm pregnant.

[Pippen]

My OB would handle routine illnesses while I was pregnant only if they were discussed during a regular office visit or could be handled by phone. I wouldn't have been able to make a sick visit for a respiratory or ear infection.

[Laurie4b]

I refused. It was a pita when they gave me that line. Because what did the go say almost every time? Take to your OB bc your OB will know more about what you should do while pregnant. None of the GPs would touch me once they found out I was pregnant bc they were terrified of being sued if anything went wrong with a pregnant patient. I told my OB that and said they were my primary dr and I expected them to treat me. They didn't like it, but they usually did it.

 

I didn't experience this, but I did experience the "It's the other doctor's job" while breastfeeding. My OB said my pediatrician should decide about drugs, etc. and their safety for the infant. The ped said the opposite. Drove me crazy.

[shawthorne44]

Most depend on the doc.  After I'd given birth, I needed a yearly wellness exam for insurance (the regular kind, not the GYN kind).  I called my OB/GYN that I love and I've been seeing for years and years for a GP referral.  She said, I can do it.  Her billing person was incredibly confused though. 

[LMA]

Most OBs can tell you which drugs to avoid when pregnant, but they may not know the dosage to give you or which med to give you. My OB gave me a prescription for what is now Mucinex and the pharmacy called me because she prescribed triple the usual dosage. Never again did I try to save time and copays with the OB/GYN.

 

Most OBs will tell you they are not internal medicine doctors or family doctors. While a GP will call an OB to confirm if a drug is safe, a GP will know how to help your non-pregnancy-related condition. It's not just OBs. Most specialists will not diagnose things for which you would see a GP.

[OH_Homeschooler]

When I had a slight fever and a cold/sinus issue with my last pregnancy, I called my OB first but they told me to go to my PCP. Not a big deal, I just wanted to check with them first. Of course I let my PCP know I was pregnant (I don't think I was showing yet) when he prescribed antibiotics. 

[VeganCupcake]

I see our family practitioner for illness while pregnant. I actually see the PA there--she's very thorough and competent, she's a nursing mom, and she's a good friend of mine. She checks two sources to see about what pregnancy category various medications are and why--that information is quite readily available, particularly if you're a medical professional, so I don't see why a family practitioner would need to call an OB to find out about safe medications.

[OH_Homeschooler]

I see our family practitioner for illness while pregnant. I actually see the PA there--she's very thorough and competent, she's a nursing mom, and she's a good friend of mine. She checks two sources to see about what pregnancy category various medications are and why--that information is quite readily available, particularly if you're a medical professional, so I don't see why a family practitioner would need to call an OB to find out about safe medications.

 

That's so true about the availability of information--my PCP actually used his phone to google the pregnancy category of the antibiotic he prescribed me right in the office. 

[kbutton]

I think this varies greatly by region and by practice. If you find yourself in a "pass the hot potato" situation, I suggest you make the original OB or GP (or whomever you saw or called first) call and/or refer you to a specific practitioner THAT THEY KNOW WILL TAKE PREGNANT WOMEN if they don't want to see you. It's not fair to the patient to have to figure out where to go if they are sick while the doctors are being a pita about it. In some cases, the patient then ends up in the ED (and often the ED physician has to call and get referrals too), and then everyone is inconvenienced, and the patient pays a lot more money for the same care. Where I live, patients end up in a follow up/refer out/"not my problem" situation a lot of the time. The doctors do it to patients and to each other! It's ridiculous. The ED practitioners often end up in the middle of it all, though some are part of the problem too.

[LizzyBee]

The cold I have had for the past few weeks has developed into something that is slightly concerning for me, so I called my OB this morning and the lady I talked to (a nurse, I think) told me I needed to see my PCP or go to urgent care because their office only handles "healthy pregnancy, not sick pregnancy".

 

Is this normal? I guess I've never been sick enough in my other pregnancies to call my OB, but this was surprising to me. So if I go to urgent care and something is wrong, who handles it? Urgent care doctors aren't pregnancy specialists and apparently the OB doesn't handle sickness, so who specializes in treating a sick pregnant woman, taking her pregnancy into concern while treating the illness? I'm bugged.

 

When I was pregnant with my third, insurance companies in my area stopped covering any prescriptions or extra costs associated with OB visits but not OB related.  I always went to my regular doctor for sickness while pregnant, but if I happened to be at the OB and needed a script for something else, it was handy and it saves costs for the insurance companies too.  But any good doctor should know what you can or can't take while pregnant.  I remember going to my allergist while pregnant with my 2nd child, and he spent a long time explaining how medications are ranked for use during pregnancy, my risk tolerance, risk vs benefit of medications, and so forth.

 

Interesting discussion, because I have never had a GP refuse to see me or even blink an eye over it when I was pregnant or nursing.  I had cellulitis when my oldest was 3 wks old and my GP was wonderful about checking which antibiotics I could take safely while nursing. That was another situation where an NP and MD in the office both spent a lot of time to make sure I got good care.

[Arcadia]

I was told to see my OB for flu when I went to the general clinic since I do not have a family practitioner.  Both my pregnancies were high risk and I do have drug allergies and asthma which complicates matters.  The OB and the general clinic were in the same building under the same medical group. They probably put in the correct billing code for insurance.  My out of pocket for OB or FP/GP/urgent care is the same $20 per visit so maybe that's why.