How much should I discuss at the first appointment?

[La Rune]

The midwife I used last time flaked out on me (how I ended up with a c-section, long story) so obviously I won't be using her again. There are no others within traveling distace to be able to homebirth, and there are no birth centers within traveling distance for me to drive to.

So I'm left with OBs. I think I've found the best one possible. I've heard that as far as pushing positions whatever you want goes, she BFed her kids, etc. Plus my great ped has privileges at the same hospital, so he could see the baby instead of it being just whoever again.

That's about all I know though. Will she think I'm crazy if I go in and just lay everything on the table? I feel like I should tell her straight up that I'm not going to just go along with hospital policies, routine prenatal tests, etc. I want to just say something along the lines of "Unless you can give me good reasons backed up by research to convince me otherwise, I will only have one ultrasound, I will not be induced, I will not have an IV, I will not wear a hospital gown, the baby won't be leaving my sight, I won't sign a blanket consent form, no episiotomies or counting while I'm pushing or pretty much any of the standard things you probably do."

I feel like I need to be upfront and honest. If she's not willing to let me do the things I know I need to do (lots of birth trauma last time!), then I need to either keep looking or start planning for a UC.

But when should I be upfront and honest? The first appointment? The second? Right when she walks into the exam room?

[tinyblackdot]

Well it depends, are there other OBs you could go to if she fires you?

If not, then, no i wouldnt. Just wait and see if any of those things even come up or are necessary. And i would be ready to carefully to pick your battles appropriatly. Your best option would be to day its all for religious reasons. They cant fight that.

[msmiranda]

I do think it is important to find out early whether a care provider is likely to be compatible with your needs or not so as not to waste her time or yours, but I think going in there telling her everything you won't do is the wrong way to go about it because even if she would otherwise be willing to accommodate you, a lot of "I won't"s right up front will make her defensive and think you are unreasonable. Or, some doctors will pull the bait and switch and say sure, whatever you want, but then that doesn't end up being true in the moment. So I would go in asking open-ended questions that don't reveal your stances on various issues to see what she says. For you, it sounds like the first thing you need to establish is how supportive of VBAC she is (and also, is she a solo or part of a practice, how supportive are her partners/backups). So you could ask about her "parameters" for VBAC, what the success rate is for women seeking VBAC in her practice, etc. Some of the other things you mentioned (wearing your own clothes, separation from baby, etc.) are more to do with hospital policies than with your doc, so you can take those things up with the hospital tour guide.

I don't know where you live, but I am so sorry you are in a place with so few choices. Every woman should have access to a good MW if she wants one.

[mysticmomma]

I think coming on too strong/negative could backfire.

[Evergreen]

I think in order to get a feel for her style you need to find out as much as possible as soon as possible. You can do it nicely. I'm sure she has newly pregnant women "interview " her- after all you are essentially hiring her. Frame it more like, "What is your take on episiotomies?", "How many VBACs have you attended?", "I only want one ultrasound, are your comfortable with that?" and if she says something like, "All first time vaginal births require them", "I don't 'beleive' in VBACs," or "I require everyone to have six ultrasounds." she isn't for you.

The hospital gown thing is more a hospital not an OB thing. I wouldn't bring it up. I think hospitals just figure no one wants to get their clothes messed up so they routinely tell women to put them on. I've never heard of anyone given hassle for not donning it. Baby leaving sight, Ivs etc. are also hospital things that the OB will not have much control over. As someone who delivers there though, she should know how easy it is to refuse these things and you can ask that she help advocate for your right to do so.

[SandraS]

I asked if I was going to be able to have a completely intervention free labor and if I would be able to leave in a few hours (if all is well, of course). That covered all the bases. Once she said yes, we were good to go.