Need help with responding disapproving doctor.

[libbylovely]

So, here is my odd situation:

My husband and I were living in Santa Fe and found a great midwife. We plan to have the birth in Santa Fe with her.
But we have since moved to Florida for a job opportunity and are staying for 6 months. So we are going to a doctor that helped my mom give birth to me while we are here.

This is the issue:

The first visit was pretty affirming of our choice to originally go with a midwife. I was amongst many other women in this office. I was shuffled from bathroom to weight/blood pressure/information station to another waiting room. And I mean there are multiple stations of the same kind so we can all be shuffled faster.

When we met the doctor, who is a very nice, compitant man, it all seemed to be going fine enough. We informed him of our situation and that we were planning on a homebirth. However, as we were leaving the office we encountered the doctor at the elevators.

After some brief small talk, he says, "So, how far are you guys from the hospital? Is the midwife a nurse midwife? You know, I feel obligated to tell you that homebirths really aren't recommended." to which we were interrupted by the elevator opening with a large crowd inside. And he says that he hates to leave me with that thought but we'd talk about it next time.

I feel a little vulnerable. My husband and I feel very strongly about our decision to have the birth at home and we feel good that we are making a very safe decision.

Please help me. I'd like to be armed with some good information as to why our homebirth really IS a good, safe decision.

I feel like I have more information/reasons as to why I really don't want a birth in the hospital. I'm very suspicious of hospital's agendas and I don't know that they'd be appropriate advocates for the kind of birth I want.

This encounter with his office and his feelings on homebirth really are enough to send me searching for a midwife here in Jacksonville. But I want to represent my opinions and my decisions VERY WELL. I don't want to leave with him thinking that people who choose homebirth are totally irresponsible people!!

Thanks for your contributions!

[cileag]

I think coming with the latest study from Canada (which addresses many of the previous studies weaknesses) is always a good start. I also think that you can say politely, "I know we don't agree on this, and I appreciate your concern, but I'd rather just not discuss it and continue our care as previously discussed."

[Belle]

Why do you need to justify yourself to someone who has already let his opinion known? And not to mention he violated your HIPPA rights by discussing this with you in the hallway in front of other people.

You've already made your decision. Just find a mw you like and don't go back to the assembly line for prenatal care.

My OB for my first pregnancy was very nice and well meaning too. That didn't change the fact that I was just another woman on the conveyor belt. He also sugguested induction to fit my birth around his vacation. I passed. I'm glad he was out of town when dd1 was born. Dd2 was born at home.

[tammyswanson]

Trying to get a mainstream doc to go along with home birth is a toughie. They aren't taught about home birth in school, so they have no idea.

We UC'd our first, and I am so glad we did. I brought up the topic of homebirth with the nurse at my prenatal appt, and then she started in with scare tactics. I figured why even discuss it, since most docs aren't really open minded about it. It's one thing to have medical problems where you have to go to a hospital to birth, and it's another to have a 'low risk' (whatever that means!) pregnancy.

Best thing to do, go with your gut instincts.

[Peace+Hope]

libbylovely, are you planning to do concurrent care, that is, to keep going to see him, if you get a midwife?

even if you aren't, i understand that you may feel some pressure to communicate w/ him, since he delivered you - that's cool! that said, i feel like it's time for OBs to wake up and do their own research, instead of burdening their alternative patients with that. maybe there's a way you could suggest he prepare some current research on HB for your next appt. (if you're having it)? of course coming w/ your own just in case

this organization is interesting - they actually lobby for CPMs in north carolina where i live and have chapters in other states... maybe florida? if i had an OB i was trying to talk to, i'd recommend they contact a group like this.

[MsBlack]

I agree--he needs to do his own research, this is not something you have to attend to for him. If he brings it up again, I'd just say, "maybe you are not aware that there are now some large studies demonstrating that the safety of a planned, attended homebirth is comparable to hospital birth. You might want to look into these. In any event, I appreciate your concern, but we have done our research and very comfortable with our choice".

If he doesn't bring it up again, then leave it lie, don't worry at all! He was out of line to speak up without being more informed--and TOTALLY out of line to bring this up in a public place.

[emnic77]

Agree with all of the above. He's an OB. You're not likely to change his mind.
"Thanks for your concern, our decision is not up for discussion" is about all you need to say.

[Bmorefarmgirl]

it is your decision, not the doctor's.

my stepdad is an ob/gyn and he is pretty freaked out that we chose a homebirth. he wanted to talk to me about his position. i just let him talk. i was actually interested in his point of view, so i let him tell me what he thought. after he was done talking, i thanked him for taking the time to tell us his opinion. i said that we were not making this decision lightly, and that we really appreciated hearing what we had to say. and that was it.

as far as being suspicious of hospitals' agendas, that argument is going to go nowhere with a doctor. if he doesn't take a statement like that personally, then he will just say that he does not have an agenda and that he knows there are very good doctors and nurses working in the hospital whose only agenda is healthy mothers and babies. i just do not think you will get too far with your arguments.

i would tell him that you have thought it through, done lots of research, and feel very comfortable with your decision. if he engages in a conversation with you, then you could tell him some of the research findings, but i doubt you are going to change his opinion or even convince him that it is a good idea for you. a doctor will always tell you that it is safer to have an operating room right down the hall.

[smpayne]

Originally Posted by libbylovely

So, here is my odd situation:
When we met the doctor, who is a very nice, compitant man, it all seemed to be going fine enough. We informed him of our situation and that we were planning on a homebirth. However, as we were leaving the office we encountered the doctor at the elevators.

After some brief small talk, he says, "So, how far are you guys from the hospital? Is the midwife a nurse midwife? You know, I feel obligated to tell you that homebirths really aren't recommended." to which we were interrupted by the elevator opening with a large crowd inside. And he says that he hates to leave me with that thought but we'd talk about it next time.

I'm new here so I haven't had to deal with this situation, but here is my take based on what you said.
1. His question about your distance from a hospital is a legitimate question for any care provider, because things can and do go wrong sometimes.

2. He said homebirths aren't "recommended", it didn't sound like he was inferring you are irresponsible or completely out of your mind. Doctors do have certain legal obligations of disclosure. Remember doctors are trained to expect the worst situation every time.

To me it sounded like he was voicing true concern and needed verification for himself that you had completely thought this through and done the research to support your decision. I would go to your next appointment prepared with as much information as you can. If he becomes hostile, find someone new. If he just says that he doesn't really like the idea and continues to treat you with respect and good care, go ahead and stay.

[langdonslady]

I would say you have cause to see some red flags, and FL isn't very homebirth friendly, and definitely very unfriendly to vbacs... not the most progressive state.

At least that is what I have gleaned from ICAN's (international cesarean awareness network) surveys of different states. Even if you haven't had a section and could care less about vbac, they are still a fantastic resource for studies on homebirth safety and word-of-mouth referrals to the best care providers (and ones people regretted seeing) in a given area. they also have a heck of a lot of info about how to homebirth in areas where is may be harder to find support, so I hope you check it out.

And this site is great for info too!
Good luck in finding either a truly supportive provider, or else a homebirth after all!

vbacfacts.com is another good resource.

[ACsMom]

I'm with Ms.Black and others. You've made your decision, you're comfortable with it - he's the one who's uncomfortable (and uninformed, I might add - homebirth is safer than hospital birth). You don't have to take any responsibility whatsoever for his discomfort. That's on him.

Having said that, do you NEED to see him during this six month period? Maybe you could see him just a couple of times, rather than every month, if it makes you feel better to get your bp checked or urine analyzed (although you could do both those things yourself - you can get test kits for your pee that'll tell you more than the doctor's office would!) If you monitored yourself from home, you could talk with your midwife regularly on the phone and she could help you decide how to proceed if anything arises that concerns you. Just a thought.

[mwherbs]

I think he is telling you the "party line " straight from ACOG now and it may be purely for potential liability reasons- unless you find a very radical doc or one that is an old doc you probably are not going to find OPEN approval from an OB as far as home birth goes.
We use to have an old doc back up who would tell us that he would do anything we wanted but we and our clients if we transferred had to play our part and refuse what ever was standard of care because he had gotten into enough trouble fighting the head of OB and the hospital administrators -- but if clients refused in front of nurses and others then he would just have to do the best he could with what we would allow- kept him out of trouble-
and this doc may be like our old doc or somewhere inbetween- hard to say how many visits do you have to have with him?

[threadbey]

I agree with msblack and mwherbs. Just stay calm and if you feel you need to justify anything, site the recent studies. I'd leave anything emotional out of it (Inc hospital "agendas") even though to be honest I think most of us have at least partly emotional reasons for choosing homebirth.

I had a sort of similar experience thus time and was mildly annoyed but the doc was really quite respectful and I felt he was was just covering himself liability- wise and maybe also asuaging his conscience. I decided to just smile and nod. It's not like he thought he'd change our minds since we'd already had one homebirth. And we have to keep a decent relationship with him for the next few years, so it was just easier to pretty much not respond.

Our pediatrician is also not keen on homebirth, but I figure it's a moot point now that dd is here, so that doesn't bother me much at all.

[Comtessa]

Originally Posted by mwherbs

I think he is telling you the "party line " straight from ACOG now and it may be purely for potential liability reasons- unless you find a very radical doc or one that is an old doc you probably are not going to find OPEN approval from an OB as far as home birth goes.

This.

My OB said to us at our first meeting: "Okay, what I'm about to tell you is the official ACOG party line and I have to say it. After I say it, you can make whatever decision you want, and I will do my best to support you." He even called his MW friend a few times to ask her for her perspective on my situation. Yeah, my OB was wonderful. A few months ago I wouldn't have believed I'd be saying so, but in hindsight - I was really lucky.

[Belle]

Originally Posted by Comtessa

This.

My OB said to us at our first meeting: "Okay, what I'm about to tell you is the official ACOG party line and I have to say it. After I say it, you can make whatever decision you want, and I will do my best to support you." He even called his MW friend a few times to ask her for her perspective on my situation. Yeah, my OB was wonderful. A few months ago I wouldn't have believed I'd be saying so, but in hindsight - I was really lucky.

What a great OB!