Dumping your OB if you really liked her...

[thursday2]

I'm not a very confrontational person. I haven't gotten DH 100% on board for a HB yet, but I think it's going to happen - if so, we'll see the OB until after the 20 wk ultrasound and then transfer care to the MW. I'm getting more and more concerned with how to dump my OB. I absolutely love her and if she made house calls I'd keep her the whole time - she's the only reason my DH isn't on board with HB yet, because he figures if we have a doc we like, why mess it up - but the hospital she delivers at isn't natural friendly, and I don't even know where she stands personally. I plan on going back to her for gyno after the baby is born, so I don't want to ruin the relationship...but the whole prospect of that conversation with her is making me nervous. Did you talk to your OB about your HB plans, just stop going to appointments, write her a nice note...?

[nikirj]

If the type of MW you have is legal in your state, your MW can dump your OB for you. It's as simple as a records release request. It happens all.the.time and your OB really shouldn't take it personally (almost none do).

[laughingfox]

If I was in your situation, I suppose I'd write her a note? Let her know that you feel very secure in her care, but are uncomfortable with how the hospital might handle things, especially during the times before and after birth that she might not be there with you, or something like that?

Personally, I never told my OB I was pregnant, just went straight to a MW. My OB knew we were TTC, but she won't know anything happened until my next annual exam post-baby.

[sunfish21]

If you like her and want to use her again, I would set up a visit to talk to her in person. You don't have to be confraontational to let her know that you really like and respect her but that you feel a HB is the best option for you. (just don't get into a debate about the merits of it!) She should respect your honesty and willingness to clue her in...

[ColwynsMommy]

I was in the same exact situation when pregnant with my third. I'd been seeing the same OBGYN for years and really liked her. She didn't attend my boys' births because of the on-call schedule, but I felt like the prenatal care I received was great (for an OB, of course) and we just got along really well. She never did anything wrong, nor did I have bad hospital experiences, so I wanted to make sure she knew it wasn't her fault.

I went for my ultrasound at 18 weeks and then saw her afterwards for a regular appointment. That's when I told her. I was so nervous I thought I was going to throw up. I just said, "I want to let you know that we've decided to go a different route than before, and we're planning to have a homebirth. I've always been totally satisified with the care you've given me, but I feel the need for something different. I really hope we can continue with well-woman visits after the baby's born." She took it really well, said that given my history of healthy pregnancies and super easy births, I was a good candidate, and good luck! I was so amazed. I went in a few weeks after the birth to see about getting some levels checked (breastfeeding issues) and even though I saw her MW, my OB came in and cuddled the baby, congratulated me, etc.

This time (fourth baby) things were a little different.. she was definitely more worried about the whole 'multip' thing, but when I explained why I didn't think that would be a serious issue, and what I was doing to lessen my risks, she took it well enough. I ended up not going for a 'last visit' because the scheduling department was such a pain after my ultrasound that I just never booked my next appointment. I feel a little bad about that, but I'm sure she was expecting it.

So, I think that if you're polite, reassuring, yet firm about your choices, it can go well. It really depends on your doctor, of course, but it doesn't *have* to be a disaster.

[laughingfox]

I forgot to mention-

Have you asked your MW how familiar she is with your OB? She may have had other patients who transferred, and might be able to let you know how your OB has reacted in the past.

[*Christa*]

I just couldn't go there & just went to a MW in my OBs office when I found out I was pregnant. I knew it would be too hard to drop her. I love my shadow care MW now & she is totally onboard with my HB.

[MegBoz]

Originally Posted by thursday2

but the hospital she delivers at isn't natural friendly, and I don't even know where she stands personally.

Just curious, then why do you love her so much? She should be a disaster when it comes to birth. If she delivers in a hospital you know isn't NCB friendly, then why would you not presume she herself is also not-NCB friendly?

If she has the attitude of the majority of American OBs, she thinks "Home deliveries are for pizza." (Printed on bumper stickers that were given out at an ACOG meeting a few years ago.) It's entirely possible she could be very hostile towards it & say she refuses to care for you if you take such a dangerous route. In which case, you probably can't go to her if you need to transfer.

If you want to leave open the option of transferring back into her care if a transfer becomes necessary, I'd either lie to her - tell her your switching to a FSBC, closer hospital, or tell her you're moving out of town (take a copy of your records yourself.) or at the very least, ask her her thoughts on HB in a totally neutral way FIRST, i.e. "A friend of mine had an HB & said it was fabulous! I think the idea sounds risky. What are your thoughts?"

Yea, it's also entirely possible she could react well & you would have no problem. But odds are not in your favor & considering you don't know her views on childbirth, this is a real risk here.

[Fly Girl]

I told my OB around 20 weeks that I was having a homebirth. He was a bit taken aback but then he agreed that I was a good candidate. He said his malpractice insurance wouldn't allow him to be my "back up" but that he was happy to see me for prenatal care until I "transfered" my care to my midwife. So I saw him until I was about 28 weeks and then never scheduled another appointment. I saw him again post pregnancy for my annual and we talked a little about my birth and things went as normal.

I felt ok telling my OB about my homebirth plans because I had already asked so many questions about his methods and had determined that he was natural birth friendly. Most OBs are so busy that they probably won't notice if you just stop making appointments.

[sweetpea_119]

Just curious...does your midwife do well-woman care? If so & you like her, why go back to the OB at all?

When I transfered care with baby #3, I just never went back & had my midwife ask for my records...no big deal. I did like my OB during my appointments, so I can relate to that in your post, but being that I just couldn't stand the hospital & medical environment that she worked within, I finally realized she wouldn't be a good fit for me no matter how sweet & wonderful she was on a personal level.

[SwanMom]

I'm also surprised by how many homebirthers regularly see OBGYNs when they're not pregnant. Just goes to show you how mainstream I am not.

[DoulaVallere]

Originally Posted by SwanMom

I'm also surprised by how many homebirthers regularly see OBGYNs when they're not pregnant. Just goes to show you how mainstream I am not.

Same here...since transferring care from an OB to a mw during my first pregnancy I've never seen the need to ever see an OB again.

For the OP, I'd just let my mw ask for the records transfer. Odds are your OB won't even know about it...the office manager will just take care of it.

[ColwynsMommy]

Originally Posted by SwanMom

I'm also surprised by how many homebirthers regularly see OBGYNs when they're not pregnant. Just goes to show you how mainstream I am not.

Midwives here can't prescribe things like birth control pills (which I've never had any side effects with). Plus, there's the whole paying out of pocket vs. complete insurance coverage thing. It's cheaper, closer, easier, etc for me to see my OBGYN for well woman care, and since there isn't anything I'd need to decline/refuse at an annual pap, it doesn't really matter.