Infertile to Pregnant | FAQs for the Fertility Clinic to OB-GYN Transition
You're pregnant, finally! And everything’s sunshine and rainbows. Right?Well, yes, with a tiny pinch of not exactly.
Us infertility patients put our focus on the getting (and staying) pregnant piece. We don’t often wander into the “now that I’m pregnant, what’s next?,” because we’re afraid of getting ahead of ourselves.
Now we’re here though. Pregnancy... what we’ve been dreaming of and working towards.
But what’s next? What can you expect when leaving your fertility practice and moving on to a new health care provider? Likely there are a lot of questions cropping up, and we’re here to answer them.
These are the specific questions we’ll be answering:
- How Long Do I Stay with My Fertility Practice After I’ve Become Pregnant?
- When Should I Make My First Appointment with My Obstetrician/Gynecologist or Midwife?
- Do I Need a High Risk Doctor?
- Is it Weird That I Don’t Want to Leave My Fertility Practice?
- How Do I Say Goodbye to My Fertility Practice?
- I Was Labeled as Having a “Geriatric Pregnancy.” What is That, and Are You Kidding Me?
- How Much of My Emotional Infertility Journey Should I Share with My Obstetrician or Midwife?
- What Differences Should I Expect to See Between My Fertility Practice and My OB?
- Will I Ever Be a “Normal" Pregnant Patient?
- Former Fertility Patients Give Advice
Fertility Clinic to OB-GYN | FAQs for Your Transition
Below are the frequently asked questions I hear in my support groups, in one-on-one conversations, and just classic transitional concerns infertility patients have as they graduate to their Obstetrician. Keep reading so you know what to expect!
How Long Do I Stay with My Fertility Practice After I’ve Become Pregnant?
Most fertility practices “release” you to your Obstetrician/Gynecologist (OB/Gyn) or Midwife between seven and ten weeks. Rarely do you leave before or much after that. Typically, your fertility practice will have checked your blood HCG levels (human chorionic gonadotropin) at least twice. (HCG is the hormone that indicates pregnancy.) At least one ultrasound is usually done at your fertility practice, checking to see if there’s a gestational sac and/or a heartbeat. (All fertility practices have different criteria and standards, so keep that in mind, if your experience is different.)
When Should I Make My First Appointment with My Obstetrician/Gynecologist or Midwife?
Obstetricians and midwives often book pretty far out, but they are also practices designed for new patients, like you, who are pregnant! Even though they are accommodating and set up for newly pregnant patients, call them and find out when they want to see you. Some Obstetricians or midwives want to see you earlier than is recommended, especially if you have undergone fertility treatment. Also, if you call earlier, you are more likely to get an appointment that suits you best. A good idea if you are comfortable with it, is to call and make an appointment when you have an ultrasound that confirms the blood tests showing that you are pregnant.
Do I Need a High Risk Doctor?
That will be a conversation between you and your obstetrician and/or your fertility doctor (board certified Reproductive Endocrinologist—REI). If you’ve spent a long time, and have had to undergo fertility treatment cycles, you may assume that you need a high-risk doctor (one type of high-risk doctor is called a maternal fetal medicine doctor). I hope that you will be pleasantly surprised to find out that you likely don’t need one! While getting pregnant might have been difficult, that was due to infertility. Being pregnant may very well be a very different experience.
If you had pregnancy losses or any bleeding (with this or other pregnancies), then yes, depending on the reason, you may be considered high risk. However, if not, then being a “normally pregnant person,” after having to try so hard to conceive, may be a bit of a strange adjustment, even if it’s a welcome one. Moving away from having something “wrong” (infertility) to having everything.
Is it Weird That I Don’t Want to Leave My Fertility Practice?
Nope. Even though you never wanted to need a fertility doctor to become pregnant, there is a high likelihood that you have grown attached to them. Fertility treatment cycles are demanding of your time—you probably saw the fertility treatment team, including front desk staff, medical assistants, nurses, embryologists, mental health professionals, and yes, of course, the doctors ...a lot. You may have seen these team members several times a week at certain points during treatment. You’ve grown attached to them and them to you. You know their first names, they know yours. It’s hard to leave, even when that was the entire point of fertility treatment. So, know that you are in good company if you are feeling strange about moving on.
Pssst…A secret question fertility doctors get asked a lot—“Can’t you deliver my baby?” Technically, yes! A board certified Reproductive Endocrinologist (REI) is also board certified in Obstetrics/Gynecology. But alas, no. REIs stick to helping people get pregnant, not delivering babies.
How Do I Say Goodbye to My Fertility Practice?
That’s very individual. And all ways of doing it are perfect, if they are good for you! Some patients leave a fertility practice and literally never look back. Some people bring or bake goodies as a thank you. Some write a card. Some send birth announcements when their baby is born. We get a lot of holiday cards with updates (which we LOVE...just sayin'). Some give gifts to special fertility treatment team members. Many just say thank you. We do hear “I love you” a lot, too. (We say “I love you” a lot also.)
I Was Labeled as Having a “Geriatric Pregnancy.” What is That, and Are You Kidding Me?
Only with reproductive health could anyone be called geriatric if they’re 35 or over! The term feels insulting, no doubt, especially when our egos have taken so many hits with infertility already. Many of us have had to manage feelings of being “damaged” or “less than” when we couldn’t get pregnant on our own. You know, the old-fashioned way!
So hearing we’re geriatric feels like adding insult to injury.
One very important thing to remember is that this is mainly a label. (Another term for this is “advanced maternal age.” Less offensive? Not too sure about that.)
Yes, there are a few things that will need to be done differently in your pregnancy because of some increased risks due to your age. Yes, there may be more monitoring than if you were under 35. After all you’ve been through to get pregnant, isn’t that OK? Maybe we just need to change the name… I’m thinking… Queen Pregnancies? Extra Special Pregnant Ladies? Any other ideas out there?
How Much of My Emotional Infertility Journey Should I Share with My Obstetrician or Midwife?
Share absolutely every detail of your medical and physical history with your OB or midwife. It’s the only and best way for them to help you care for yourself during this pregnancy. By sharing your history completely, you will have the best chance of having no complications or surprises.
Notice though, the question is about emotional history! Mental health history is also different than emotional health history and should be shared. Any medications or extra support that you needed to help support you mentally, tell your OB or midwife!
Let’s move on to the actual question. What do you need to share about your emotional history or journey? Some patients become very close with their OB or midwife or Nurse practitioners or physician assistants and end up sharing quite a lot of the ups and downs of fertility treatment.
And some patients do not. Some patients feel quite nervous going to see their OB or midwife and need to express that their concerns that everything is normal and ok. Some patients go through their pregnancies completely confident, basically unscathed by their infertility experience. Expect that you will be somewhere on that spectrum and that your experience with your new caretaker may slide around a little.
Some appointments you will be confident and relaxed about. And some you may not. Give yourself a break. Share if you want to share, and don’t share if you don’t feel comfortable.
Remember that the RMA of Connecticut Pregnancy After Infertility FB page is available to you (invitation only page, please email firstname.lastname@example.org if you are interested in joining). It’s a group of dynamic women who are at different stages of their pregnancies but still want to stay connected with women who’ve come from fertility treatment programs.
What Differences Should I Expect to See Between My Fertility Practice and my OB?
With a non high-risk pregnancy, you’ll typically see your OB/Gyn or Midwife on this type of schedule:
· Prenatal visit every 4 weeks until 28 weeks gestation
· Prenatal visit every 2-3 weeks until 36 weeks gestation
· Prenatal visit every week until delivery
It’s probably needless to say that your care will depend on your individual situation, but we’re reminding you of that anyway.
Will I Ever Be a “Normal" Pregnant Patient?
You will discover the answer likely fluctuates between yes and no. A little no, dramatically yes and everything in-between.
The most important thing is to notice how you feel and resist the urge to shame yourself for not feeling how you would like to feel or think that you should feel. Feelings are feelings and not a reason to judge yourself. You’ll enjoy your pregnancy the best you can and better if you avoid shaming yourself for not enjoying it more!
Former Fertility Patients Give Advice
No one needs or wants to reinvent the wheel. It’s a circle, serves a purpose, we all get it. Here’s some solid advice from people who’ve made the shift from fertility patient to pregnant patient.
“All my energy changed. I wouldn’t say that all my nervousness disappeared, but having new doctors made me feel like I had a new start. I saw myself as they saw me, as an average pregnant woman!” -JW
“Best advice I could give? Pick an Obstetrician that you really like, even if they are part of a large practice. You need to start this new experience, really liking and trusting someone.” -KV
“I wish I had realized that my new health care provider did know my history with infertility. My fertility practice sent them my history. I spent more time than necessary telling them things they already knew because I was so nervous!” -BK
“Use the Pregnancy After Infertility [Facebook] page, even if you didn’t use the Ladies Night in page. Hold yourself gently and (try to) remember each moment is what you wanted and worked so freaking hard to get to experience.” -SL
“Advocate for yourself.” -GS
“If you need less medical intervention bc you are tired of that and ready for your capable body to take over, then talk to your doctor about what things can be left out safely.” -AH
“The relationships that I made at my fertility practice—I still have them! I send them pictures and updates regularly. I’m excited to go back for baby 2.” -PG
Last Bits of Advice
Give yourself a break. There was a lot of focus on getting pregnant. Now the focus has shifted to being pregnant. You’ll get there, one way or another. Even those people who have a hard time enjoying or accepting their pregnancy because of previous disappointments, need to know that those feelings won’t create a bad outcome.
Find an outlet! Writing. Painting. Dancing. Pick up an old hobby.
Meditate. And while you’re doing it, talk to your fetus. You can do this out loud or in your mind’s eye. This can be very comforting and help connect you to the pregnancy that you’ve been dreaming about but maybe, we're afraid to let yourself hope would happen.
Lastly, be present with yourself, without judging. You’ll likely have moments of intense joy and ones of worry. Just do your best to let any judgement go, using the best, most efficient tools at hand.
Want to be part of our Pregnancy After Infertility support group and/or share a personal message with your RMA of CT team?
About Lisa Rosenthal
Lisa has over thirty years of experience in the fertility field. After her personal infertility journey, she felt dissatisfied with the lack of comprehensive services available to support her. She was determined to help others undergoing fertility treatment. Lisa has been with RMACT for eleven years and serves as Patient Advocate and the Strategic Content Lead.
Lisa is the teacher and founder of Fertile Yoga, a program designed to support men and women on their quest for their families through gentle movement and meditation.
Lisa’s true passion is supporting patients getting into treatment, being able to stay in treatment and staying whole and complete throughout the process. Lisa is also a Certified Grief Recovery Specialist, which is helpful in her work with fertility patients.
Her experience also includes working with RESOLVE: The National Infertility Association and The American Fertility Association (now Path2Parenthood), where she was Educational Coordinator, Conference Director and Assistant Executive Director.