Possibly switching from OB to MW - questions.

[isign]

I've been going to a wonderful OB for 3 years. He is the 4th OB/gyn I went to in search of a reason for our IF. He has delivered both my babies, respecting my every wish, and encouraging me to make these non-mainstream (for this area) decisions. He encouraged me to BF through my 2nd pregnancy, at the same time his partner discouraged it. His office is 30 min away, not a big issue.

We have midwives just down the street from our house. I have heard mixed reviews by some of my crunchy mama friends, but over all have been encouraged to check them out.

The hospital that I delivered at both times took wonderful care of us, but I did have some issues, such as being separated from the babies for several hours after the birth. The hospital where the midwives are,call their L/D the Family Birth Center and seem to have things set up with natural birth in mind.

I know my Dr so well, and am really unsure about switching. We do have a hospital concern though. We took DS to the ER (ped's office sent us, our Dr was out of own) for spitting up blood, once. Turned out I had passed blood to him while nursing (had a small crack), and he was fine. We didn't know that, and the ER sent him 1 1/2 hours away via ambulance to a major hospital, in the end for no reason. We never saw a ped. DH is very concerned about using this hospital again.

Questions - I am going to make an appt with the midwives to have my IUD removed, and plan on talking to them about my future pregnancy. What kinds of things should I want/expect from a midwife that differs from the OBs? The midwives deliver in a hospital, and refer to several OBs in case there is a 'deviation from normal pregnancy' (taken from their website). Should the problem with the ER be a deciding factor? While I had a good birth with #2, it was not what I wanted by any means, and has left me searching for a new place to give birth. I wish I could take my Dr, but sadly he does not go to that hospital. Is there anything specific I should be asking?

[JamieCatheryn]

Midwives, in theory, vary from ob's in that they treat pregnancy and birth physiologically instead of pathologically: they treat in as normal, work to help support it as a normal healthy process and prevent problems (talking to you about healthy diet, preparation for birth, asking in general how you're feeling, even asking about your emotions and thoughts about everything). OB's watch out for medical problems carefully through extra testing and will treat a potential developing problem with all they've got. OB's stick to preemptive routines more often rather than waiting to see if a problem happens to develop.

I'd start with the mixed reviews you heard, what specifically was negative? You'd want to see if these midwives really stick to a midwifery model of care, and see if they listen to their clients and respect their wishes completely. Obviously it's not a given just because they're midwives.

[isign]

I have not head a lot of negative about their back up Drs, that they are not really open to a more hands off approach. One girl said she was 'talked into' a c-section because of a large baby on the u/s, and is now being told there is no way she could have a VBAC. I'm thinking that if they are like that, why would they be in partnership with the MW. I honestly don't remember a lot of the negative, just remember getting mixed reviews. My LLL leader, went to them, and then ended up leaving them at the very last. Still she recommends them.

I did not have the birth I really wanted with #2. I was not allowed out of bed, not even to use the bathroom. I had pit, had to have constant monitoring. I opted for an epi, had 2,both of which failed, and just felt like everything was against me. In the end I had to deliver on my back, even though I was pushing on my side and it was working. I don't want that again.

[SunnyB1978]

My experience with a midwifery practice was based on all of my prenatal care and birth or my first child. The whole experience was a philosophy of "this is a normal process." The midwives took time to talk to me EVERY time I went in for an appointment. Each appointment was 30min to an hour, depending on how many questions I had and what I wanted to discuss. They nurtured the whole person and the whole experience. She was present during the entire labor and made sure that I was protected from having to deal with hospital staff or having to make medical decisions. She knew my wishes because she knew me and she did everything to assist me in having the birth I wanted.

My experience with OBs include attending several appointments with my sister when she was pregnant and attending the birth. Also, I am now pregnant and have seen my own OB twice. My impression so far is, "I am just your doctor, not your best friend." My OB and my sister's OB were really nice, but never particularly chatty. If you don't have your questions written down in advance so you can spit them out quickly, you'll miss your shot. I have already recieved paperwork on the lengthy lists of tests and services they offer (everything from genetic counseling to 4-D ultrasounds), and a packet on all of the potential things that can go wrong with my baby and what I can do about it (which is call my doctor.) The midwife at this point had given me a reading list including several really positive books on fetal development and having a peaceful, fulfilling birth. The doc so far has given me a list of the "rules" for labor, such as no more than 2 visitors in the room with you. It is just a radically different thing. My sister's OB was even more focused on what can go wrong. She recieved a schedule of appointments at her first appointment, and under each sheduled appointment was the list of bad things they were going to test for. It set the mood for a very fearful pregnancy as she dreaded each appointment and what horrible thing she might learn. When the birth came, the doc fulfilled her 1/3 c-section rate by telling my sis the baby had a heart problem and then wheeling her into surgery 2 weeks early to birth a baby that had no heart problems. Afterward, she told my sis that it was a good thing they c-sectioned her because she couldn't have birthed that baby anyway since he was 8 lbs and that was "too big" for her. Eight pounds is too big?

So, anyway, all in all, I'm switching to a midwife as soon as I can find one. I'm in a new area now and can't go to my old midwife. I really prefer things to be positive until they need to get negative. If something is wrong, the midwife will catch it during medical screenings and we can take appropriate action. But I don't want my whole pregnancy to be overshadowed by all of the things that could go wrong. Most of the time, nothing is wrong, and I have to trust in that and find a health care professional that also trusts in that.

[isign]

See that's what I want. While my OB isn't so serious and pretty much let me do as I requested, and supported me, and even recommended some great things - Bradley classes - his partner is not like that. I only saw him once - was extremely dizzy to the point where I couldn't take care of DS, and when he requested that I stay in the hospital overnight. I was concerned because I was still nursing. He asked me when i was going to get my baby off my tits. I dealt with him on the phone several times, always praying my OB would be the one to be on call.

The L&D nurses, one of them a friend from church, were wonderful but with DD, I was not allowed out of bed while on pit because my water was broken and they did not want the cord to prolapse, and going to the bathroom was not ok, a bed pan was needed (that was horrible!!). Since it was over night, they said the Dr was not close enough incase that happened. I thought it was silly, since I walked into the hospital and the Dr never mentioned that. I didn't want to make 'enemies' of my care givers, so I complied. I immediately second guessed my decision to not hire a doula. I know this is long, I guess I'm still trying to work it all out in my mind.

[MegBoz]

Originally Posted by isign

He asked me when i was going to get my baby off my tits.

No way!!!! Really? He used the word "tits"? Wow!!

First off, NO, I would NOT weigh your ER experience into your decision. I know it's hard to do, but IMX, you can't judge the L&D of a hospital by other departments. For example, Johns Hopkins is world renowned for many things & a top hospital in the nation, according to US News & World Report. But you do NOT want to be a healthy pg woman there! (They require continuous EFM & "nothing by mouth" even for low-risk mamas )

Also, GBMC has a great ENT practice. I had my tonsils out there. But that is another place you don't want to birth a baby (44% CS rate - highest in the state!)

So, IMX, it's just not really related.

Secondly, if you consider switching, I'd ask a LOT of questions. Here's my personal list

It sounds like neither of your options are perfect, but I guess nothing is perfect anyway, right? So I'd just ask a lot of Qs, try to pick the best option & then work hard from there to ensure my best birth. Ya know - maybe hire a doula, make sure your DP is educated on your wants & needs, have your birth-plan signed off on by all the OBs or MWs who may attend your birth & maybe even the nurse manager, do most of your laboring at home, etc. etc.

I'd also recommend practicing "civil disobedience" --> Politely disobeying your care-providers. In some cases, you can simply play 'don't ask don't tell' (like eating while they're out of the room.) Or getting up onto hands & knees & if they ask you to down on your back, saying, "Is the baby in distress?" if not just a simple, "I'm much more comfortable here, thank you very much." & have your doula and/or DP back you up!

[isign]

Yeah, he really used that word. DH and I were just in shock. I only had to deal with him if he was on call - like that weekend when my OB was out of town, or if I called after hours.

With the bathroom thing, I was hooked to the monitors (20 min out of every hour was required, and on my birth plan, and signed by my OB) and asked to be unhooked to go to the bathroom. I was told then, by a nurse who did take stay in my room all night, and was in the nursery the next 2 nights available for help, that I could not get out of bed. DH wasn't there so I didn't exactly have support. As much as I know I could have unhooked the monitors from around me, I'm not a go against what I'm told type of person.

Ok that was long, I'm still trying to work through that birth, clearly. I just want something better, but I'm almost feeling disloyal. Does that make sense?

[caned & able]

Originally Posted by MegBoz

He used the word "tits"? Wow!!

The word is teat, and it is the right word for that part of the body, but he is obviously the wrong doctor.

Physicians who talk that way know nothing about breastfeeding and really do not care.

[Incubator]

Originally Posted by isign

Yeah, he really used that word.

Wow. just wow. What are the chances you'll get stuck with this OB for the birth? Obviously it's a personal choice, but I'd run if there was any chance of that man catching my baby (or worse).
I don't see any harm in checking out the midwives, it's not like you can't switch back. Could you contact some of the women who employed them and get more information?
It is evident, no matter who you choose, that you may need to practice being more assertive to truly get the kind of birth you want. If you're worried about your ability to stand up for yourself (I'm the same way, I talk a mean talk but during birth I'm a damn sheep sometimes) then I'd definitely get a doula if you can, or bring along a VERY supportive friend and spend lots of time with her talking out what you need from her during the birth. Make sure that she DOES NOT leave you alone. I shudder to think what may have happened to me if I had not had a doula with my first child. I just think it's important for every woman to stand up for her rights, her wishes and not be afraid to question the people you have hired to do a job for YOU.

[MegBoz]

Originally Posted by caned & able

The word is teat, and it is the right word for that part of the body

The word "teat" is pronounced totally differently from "Tits" - so if he said "tits" Then he wasn't using the old-fashioned, anatomically correct word "teats" - they are 2 different words.

isign,

Yes, I think that makes sense. I know what you're saying. You feel disloyal to whom? Your OB? DON"T! If he were loyal to YOU - he wouldn't subject you to that awful other doc. If there's a 50% chance you'll get the doc you love, but a 50% chance you'll get an awful doc - I think it's worth exploring other options.

Definitely go take the tour of the hospital as well. Hopefully it's a nurse who gives the tour (was for me, but I don't know if that's a standard) & you can ask things like how often do women get out of bed during labor - again, I'd want to know not just would you allow me to get out of bed but is that normal. I'd want to know what they're used to in order to gauge if I'm likely to have to fight because my requests are outside their comfort-zone & usual habits.

I also second incubator's advice to try to get more assertive.

[JamieCatheryn]

Originally Posted by MegBoz

It sounds like neither of your options are perfect, but I guess nothing is perfect anyway, right?

I beg to disagree, sometimes you can find what is perfect for you. Until I gave birth to my second I thought it was all about compromise and making the best available choice, then I had a midwife attend me at home who was 100% respectful of what I wanted. And for some women, routine at the hospital is perfect for their comfort level too.

I guess what I'm saying is step outside the box and define exactly what you want, look at ALL the choices not just one particular MW practice and one particular OB, and see what may get you there.

[DisplacedYooper]

Originally Posted by MegBoz

The word "teat" is pronounced totally differently from "Tits"

This is not true everywhere, but even so, seriously! What was he thinking!?!

[isign]

Thanks y'all for all the replies. I don't live in a big area, so I don't have a lot of choices. These are the only midwives. I've been to most of the OB/GYNs in the area while we were trying to get an IF dx. My OB was the only one who wanted to work to find out what the problem was rather than just try to get me pg. I have seen 4 other practices, and his is the only one in the area that delivers his own patients. Even though I had to deal with the other guy b/c mine was out of town, he gives out his personal number with instructions to call when his patients are in labor. Anyways, still, it's not really what I'm wanting. As much as I like him and the hospital, I've had 2 term healthy pregnancies and don't want all the interventions. yeah, I'm working on that assertive thing too, it's long over due

I called today and will see the midwives next wed. They don't do home births - only the hospital. We don't have a birthing center near here, but reading the hospital's website makes me think it's closer to a center vs a hospital. They are LDRP rooms, vs LDR where I have delivered. They have ipod docking stations, dvd players, and even a fridge in all the rooms. Much different from what I'm used to - just a TV, just a toilet, no shower. I know they don't allow tub births, but not sure about laboring in the tub, which I'd like to try.

Oh and yeah, the OB said Tits, and was not supportive of bfing while pg, let alone tandem.