Certain pregnancies carry greater risk than others. If you are expecting multiple babies, it is important to have your pregnancy carefully monitored by a qualified individual who can identify and manage any potential complications.
Besides your OB, an MFM doctor may be recommended to help manage your care.
What is a MFM doctor? An MFM is a maternal-fetal medicine specialist who works with high-risk pregnancies. You will likely see your regular OB and an MFM doctor when you are carrying twins. The MFM appointments will provide more guidance about how to handle your pregnancy.
It can be scary to be referred to an MFM when pregnant, but you don’t need to panic. MFM doctors know how to help high-risk pregnancies go as smoothly as possible.
You can be sent to an MFM for a variety of reasons. MFMs are trained to assist in any pregnancy that is high risk or that is complicated to manage.
What’s the Difference Between OB/GYN and MFM?
An MFM has three extra years of training. These years specifically focus on high-risk pregnancies. While your OB can handle routine checkups and exams, your MFM will offer more detailed ultrasounds.
An MFM will also work with your OB to make sure they both agree on your care plan going forward. However, your OB will still likely be the one delivering your twins when it’s time for the birth.
Why Do You Get Referred to Maternal Fetal Medicine?
You can be referred to an MFM for a variety of reasons, and some women will need one from the start of the pregnancy while others may not be referred to an MFM until problems develop in the pregnancy later down the line.
Some reasons you may be referred to an MFM include:
- A pregnancy with multiples.
- Past high-risk pregnancies.
- Abnormal findings on an ultrasound.
- You had certain health conditions prior to pregnancy.
- You develop certain health conditions while pregnant.
Maternal Fetal Medicine Ultrasound
An ultrasound with a maternal-fetal medicine specialist takes longer and is more detailed than other ultrasounds.
An MFM is looking for very specific things at each ultrasound, and their ultrasound technicians know how to perform these thorough ultrasounds.
If you have twins, your MFM ultrasounds will check the growth of your twins, their positions, and how they are sharing nutrients. If your twins aren’t in the right position for the doctor to see everything they need to, your exam may take longer.
High-Risk Pregnancy Symptoms
What determines a high-risk pregnancy isn’t always based on symptoms you develop after you’re pregnant. Pregnancies with multiples are usually considered high risk from the start.
If you have a history of miscarriages, stillbirths, or preterm labor, you may also be considered high risk.
Symptoms can develop during your pregnancy that throw you into the high-risk category. These include bleeding, abnormal ultrasounds, or a change in your babies’ movements.
Fever, severe headaches, and chest pains are also signs that your pregnancy may be high risk.
High-Risk Pregnancy Complications
Doctors monitor high-risk pregnancies to try to ensure there are as few issues as possible. However, there can be complications when a pregnancy is high risk, and they can’t all always be avoided.
Some common complications with high-risk pregnancies include:
- Birth defects.
- Low birth weight.
- Time spent in the neonatal intensive care unit (NICU).
Management of High-Risk Pregnancy
Your OB and MFM will work together to figure out the best way to manage your high-risk pregnancy. More frequent appointments will be required, and you will likely have more ultrasounds and measurement checks than with a low-risk pregnancy.
High-risk pregnancies will sometimes require bed rest, early delivery, or a C-section. You may also be asked to monitor your blood pressure or blood sugar at home.
If you are taking medications to manage conditions you had before you became pregnant, you will need to have your doctors closely monitor that process to ensure your medication doses are right for you during pregnancy.
Do MFM Doctors Deliver Babies?
While MFM doctors can assist with births, they usually don’t. They work with OBs to help monitor the pregnancy and recommend testing that needs to take place.
They won’t assist in the delivery room unless there is a specific reason that they need to be there.
Maternal Fetal Medicine Consultation – What To Expect
When you go to your MFM consultation, you will need to be prepared to answer questions about your family history, medical history, and past and current pregnancies.
This information will help your MFM decide how often you need to be seen and what scans will be needed at future appointments.
The consultation is also a time for you to ask questions you need answered, so come with a list.
Do You Need an MFM for Twins?
Every twin pregnancy is unique, and not all will require an MFM. However, if your twins are monochorionic/monoamniotic or monochorionic/diamniotic, then you will need to be seen by an MFM.
These pregnancies are higher risk because your babies are sharing either a chorionic sac or a chorionic sac and an amniotic sac. Both of these put your babies at risk for issues that need to be monitored closely.
Is Monthly Ultrasound Bad for the Baby?
While most pregnancies only require one or two ultrasounds, a twin pregnancy will require more. Your OB and MFM will often perform ultrasounds to check on the growth of the babies and make sure there aren’t any complications.
Ultrasounds have not been shown to harm babies, though extensive research involving when they are done frequently has not been performed.
Does Insurance Cover Prenatal Vitamins?
Your insurance may cover prenatal vitamins. Your doctor may have to write a prescription for them to be fully covered, and they should be willing to do this.
Not every pregnancy will require an MFM, but twin pregnancies often do. Be prepared for more frequent appointments when you are carrying multiples.
Kristy is the mother of four, including identical twins. With a background in education and research, she is constantly learning more about parenting and raising multiples. When she has spare time, she enjoys hiking into the woods with a great book to take a break.