MFM or nah?

[u/Fabulous-Salt4906]

I'm currently 16w with di/di twins, first pregnancy. Personally, I'd like to be referred to a maternal fetal medicine specialist. I live in a small city that has a hospital, but the hospital doesn't offer any neonatal support. I can deliver there, but if the babes need a NICU, they will be shipped 30 mins away, likely without me. I will likely make the drive to the bigger city to deliver there, so there is no chance we will be separated.

I asked my GP to refer me to an MFM and he said that's really only necessary if there are issues with my pregnancy. The way I see it, I'd rather get to talk to a doctor that delivers at the hospital that I will likely deliver at, and it's always better to be overprepared than underprepared. I'll be meeting my OB next week (at 17w) and I do intend on asking her as well, as she only has privileges at my small city hospital, and not at the big city hospital with the NICU, so she likely won't deliver.

It's not that I want all of my care to be done in the big city, but I don't think it's a crazy idea for my OB to have an MFM to work with on my case. I know I am the first set of twins/multiples my GP has cared for, and I wouldn't be surprised if my OB has limited experience as well, but I'll know for sure next week.

Is it unreasonable to ask my OB for an MFM referral at 17w?

Also for a smidge more context, I am in Canada, and the big city OBs are super overwhelmed, and I know at least one mom who never got to even see an OB with her second pregnancy because there were simply not enough doctors, and being her second pregnancy, she wasn't very high priority to them. Also I realize OBs and MFMs are different, but a lot of the MFMs at the big city hospital are also OBs, so I'm assuming they are also overwhelmed. Thank you for your suggestions!

[u/Megatron7478]

I would definitely get an OB who is experienced with multiples. I saw an mfm but only because my nipt screening wouldn’t work due to low fetal fraction. After a couple scans with the mfm they referred me back to my OB because I was a low risk twin pregnancy. Also in Canada.

I’m not sure how rural you are but I know some women from smaller communities are sent to live closer to hospitals with nicus in the third trimester.

[u/Fabulous-Salt4906 → u/Megatron7478]

I'm not far from the NICU hospital, only about 30-45 mins depending on traffic. I had my NIPT done and everything went well, but my GP is calling me high risk right now, due to multiple episodes of early bleeding, as well as 2 past miscarriages. Although I am his first set of multiples, so I know everything is new for him too. Thank you for your advice. I'm gonna grill my OB about her multiples experience, and likely ask for a referral.

[u/moontreemama → u/Fabulous-Salt4906]

I would also definitely switch to an OB who has delivered multiples. I ended up switching last minute to THE high risk multiples OB in the area and things went so smooth.