Did you get OB care too?

[babycatcher12]

So I am planning a HBA3C in August. I have found a midwife willing to attend my birth, but am wondering about those who chose or chose not to get congruent OB care.
The OB I would see is an hour away (not at the hospital where I would transfer if it becomes necessary). The reason I won't see one here is quite frankly I don't like any of them.
My midwife doesn't require me to get congruent care with an OB. The only real reason that we're considering it is because I would like the anatomy scan at 20 weeks. We have a family member who had a baby with a diaphragmatic hernia, and while they aren't genetic, it's hard not to be skiddish. Other than the sono at 20 weeks, there's really not a reason for me to want to seek OB care in addition to my midwife.
My midwife is a CPM and doesn't have a sono machine, and doesn't have someone to refer you out to for an anatomy scan.

I'm curious for those who have BTDT...

Did you seek congruent care with an OB? and why or why not?

If you did...how did you and when did you terminate your relationship with the OB?

Thanks!

[mamatogirls]

With my 3rd pregnancy I was planning an HBA2C with a CPM. I went to an OB from 8 weeks to 20 weeks pregnant only b/c I wanted a 20 weeks ultrasound. I never discussed my real plans with them and never went back after the ultrasound. With my current pregnancy I am 14 weeks and planning an HBA3C. I was contemplating how I was going to get my ultrasound this time and had decided around 17 or 18 weeks I was going to call an OB up and tell them I need an appt b/c I just realized I was pregnant but now sure how far along and just get an ultrasound set up that way. Although my situation has changed, and I just found a D.O. to do my homebirth, she can order my ultrasound. I talked to another lady that was planning an HBA3C and she was the one who suggested to just call and tell them you just realized and then just not go back once the ultrasound was done, that's what she did.

[Sk8ermaiden]

I plan to use an OB for shadow care, and just do an "Oops, the baby came too fast." It's dishonest, and I don't like it, but I feel that the medical establishment here has left me no choice.

My reason is because of how absolutely terribly I was treated during my transfer. DH and I are on board for another homebirth, but only if there is an Ob chart on file in case of transfer. Sad it has to be that way.

[broodymama]

I've had two appointments with my family practitioner this pregnancy, I have some medication issues that we needed to work out for the duration of the pregnancy. He did measure my fundal height and check for the heartbeat with the doppler, and also put in a referral for a 20 week ultrasound in case I decide to have one. I usually don't, but it's convenient to have the referral in the system (military healthcare) in case a medical reason to have one comes up. Today was my 2nd and last appointment with him, he called me in enough refills on my meds to last me through the pregnancy, put in the ultrasound referral and wished me a happy pregnancy. I was upfront from the beginning about seeing my homebirth midwife for maternity care, but I know that option may not work with every doctor. That's what I've done for my last 2 pregnancies as well.

Good luck!

[mumofboyz]

Originally Posted by Sk8ermaiden

I plan to use an OB for shadow care, and just do an "Oops, the baby came too fast." It's dishonest, and I don't like it, but I feel that the medical establishment here has left me no choice.

this.

I had planned to just use an OB and have a regular ol' hospital birth with no interventions (like my previous birth), only to find that it just wasn't in their mind-set to allow that to happen. Long story short, I felt that I had no other option.

[emnic77]

Nope. For me, the whole point of having a midwife (aside from the obvious giving birth at home) was to avoid the crapfest that, for me, is seeing an OB. The whole 5 minute appointment while pushing you (and in some cases requiring you) to test for everything under the sun is precisely what I didn't want this time around.

[kathan12904]

I agree with the pp about avoiding OB care. I didn't get it with my first vbac and won't be seeing one for this pregnancy either. We pregnant ladies are very vulnerable and emotional and most doctors' offices will manage to say or do at least one thing to undermind you while you're there, and those things can reverberate with you for a suprisingly long time. If everything your mw is checking for is normal, there isn't any reason to think you need a peek in there. Trust your body to build a healthy baby and you'll be better prepared for your birth.

[Fly Girl]

I did concurrent care with an OB my first pregnancy. I did it for 2 reasons. 1. To ease my husbands mind (he wasn't totally onboard with my homebirth) and 2. We had an HMO and all my labs, ultrasound, and bloodwork was covered. We were already paying so much out-of-pocket for our homebirth so it was nice to have those things covered. I told my OB around 20 weeks that I was having a homebirth (he was ok with it) and continued seeing him until 28 weeks.

This pregnancy I am only seeing my midwife. I have a new PPO insurance which covers all my labs anyway. Plus with DD, I just don't have time to wait around my OB's office for an hour for a 5 minute appointment. And DH is totally onboard this time around

[babycatcher12]

Thanks for your responses!
Doing the "oops it just came too fast" would be an option except for I'm sure that the OB would be pressuring to schedule a c/s by 39 weeks. I would really like to just not go back after 20 weeks or so.

Can an OB turn you in for neglect or whatever for just not coming back? (I know pediatricians can do this if care has been established after birth and the parents don't follow up)

My other thought was to just tell them I was moving after my 20 week appointment since I wouldn't be going back to see him again anyway since my mw will do all my other care postpartum etc.

Thanks again for your responses.

--Erin

[Comtessa]

Originally Posted by Fly Girl

I did concurrent care with an OB my first pregnancy. I did it for 2 reasons. 1. To ease my husbands mind (he wasn't totally onboard with my homebirth) and 2. We had an HMO and all my labs, ultrasound, and bloodwork was covered. We were already paying so much out-of-pocket for our homebirth so it was nice to have those things covered. I told my OB around 20 weeks that I was having a homebirth (he was ok with it) and continued seeing him until 28 weeks.

Exactly this. Everything Fly Girl says is the same for me, except I stayed with the OB through my entire pregnancy. I'm glad I did, in hindsight, because I ended up with a transfer and the OB actually came in to the hospital on his day off to attend my birth. Having an OB chart and OB-"ordered" birth plan on file with the hospital made an enormous difference, IMO, in the way we were treated during our transfer (i.e., very well). If the OB isn't with the hospital where you would transfer, though, it wouldn't help in this circumstance. We skipped the 20 week scan, so that wasn't an issue for us.

[sweetpea_119]

Last time around was my first homebirth (HBA2C) & I started out seeing my OB because I didn't switch to a midwife until nearly 20 weeks when I started to have too many panic attacks about going back to the hospital. This time around I never went to see an OB since the midwife covers all that needs to be done in prenatal appointments.

I terminated my OB simply by not showing up. Did they care? Nope! If you've got a midwife, then you are getting adequate care & don't owe anyone, even an sOB, an explanation. You don't even need to tell them it's an "oops"...go to your midwife for your postnatal checkups & don't worry about the medical people. I was so horrified at the thought of going back to see a doctor after my first two, c/s, babies that I never did schedule follow-ups for me...did they care? Nope.

I think we place too much importance on gaining our doctor's good graces really...

I don't worry about having an OB ready for a transfer because, honestly, if it's an emergency, I'm only going in for a c/s & at that point do I care who's operating? Not so much...

[TanyaS]

Originally Posted by babycatcher12

Can an OB turn you in for neglect or whatever for just not coming back? (I know pediatricians can do this if care has been established after birth and the parents don't follow up)

When you are ready to terminate, just call the office manager and tell them you have found another care provider. Patients do not typically take their records with them and the new CP will ask to have them faxed over. They will most likely not even notice that this never happened.

I did shadow care for my HBAC. The stress of the double appointments with two kids was so high that I stopped going to the OB after 40 weeks. My blood pressure was always high at the OB and never at the midwife. The nurse would comment on it and I was like "Ya think??? I waited over an hour with two kids in your waiting room."

Anyway, my OB office was so large they didn't even notice I stopped coming. My baby was born at 43 weeks and the office manager called 4 days later to find out what happened to me.

[Sk8ermaiden]

Originally Posted by sweetpea_119

I think we place too much importance on gaining our doctor's good graces really...

I don't worry about having an OB ready for a transfer because, honestly, if it's an emergency, I'm only going in for a c/s & at that point do I care who's operating? Not so much...

I agree a little bit and don't agree a lot. There are precious few VBAC doctors in this city, and there is a lot of discussion at my ICAN group about wasting their time and lying to them. You don't want to be the one that sours them on VBACs, you know? At least I don't. They are doing a precious thing, giving women an opportunity to have control over their own births when 99% of the OBs here will not. The VBAC doctors here get beaten down by the system - hospitals, other OBs and their insurances, and tend to stop doing VBACs eventually - even if they believe strongly in them.

It's not my fault the system is so totally broken, and not my job to bend to it, but if there is an OB who is honestly willing to give a mom an real shot at a VBAC, I am still going to show him/her as much respect as I can.

And it's a fallacy that all transfers end in cesarean. 90% of transfers are non-emergency (and almost all transferees at one point said they'd never transfer in a non-emergency.) There are lots of things that a responsible midwife will transfer for that a hospital can still allow a vaginal birth for - very high blood pressure is one. I transferred and did need a cesarean, for a deep transverse baby still stuck after 9 hours of pushing. It was not an emergency, and I got to know very well how horrible a transfer can be with a terrible OB.

As for this
I'm only going in for a c/s & at that point do I care who's operating? Not so much...
I guess I've been in ICAN long enough to know that that who's operating can be a really big deal. The hospital stole my healthy baby and held her hostage and called CPS on us as well as treating us like garbage. The OB verbally assaulted us and our (legal) midwives. I have heard dozens of similar (or worse) stories. One women lost her baby and it was 100% because she was a transfer and the hospital refused to listen to her or her midwife.

So I guess I put a lot of stock in having a relationship with a doctor the next time around. I respect everyone's choice either way (especially one who knows she'll be affected by an OB's scare tactics), but I think a lot of women go into a potential transfer situation with a lot of naivety, and wish they'd known before what they know after. Having a bad OB can be really, really bad. I didn't get to see my healthy baby for 20 hours or have her home for 5 days. My motto for the next birth is "never again." Who knows what will happen with the birth, but I do know I will do everything I can to make sure we are treated like human beings with rights.

[Xiaohua]

Originally Posted by Sk8ermaiden

I plan to use an OB for shadow care, and just do an "Oops, the baby came too fast." It's dishonest, and I don't like it, but I feel that the medical establishment here has left me no choice.

My reason is because of how absolutely terribly I was treated during my transfer. DH and I are on board for another homebirth, but only if there is an Ob chart on file in case of transfer. Sad it has to be that way.

I am doing shadow care for the same reason - in case I need to transfer. But the "Oops, baby came to fast." might not work for me. This would be the third "Oops" baby. It works great the first time, or maybe the second, but I think by this time they have me figured out. Sigh.

Serena

[meesh933]

Originally Posted by Sk8ermaiden

I plan to use an OB for shadow care, and just do an "Oops, the baby came too fast." It's dishonest, and I don't like it, but I feel that the medical establishment here has left me no choice.

I am seeing an OB for all of my prenatal appointments, and plan on birthing at home with a MW. My insurance covers the OB 100%, and we couldn't afford the MW's full fee, so we came to this arrangement for purely financial reasons. My OB doesn't know this is my plan, and I don't plan on ever contacting her after I go into labor. I will probably just go to my family doc for my post-partum check-up. I don't like being dishonest, but I don't want to end up being dropped from her care with just a few weeks left. Like you, my OB is far enough away that I would not be transferring to her or her hospital, more than likely, so it's not like she would even be there for back-up.

I agree with PP that you could just see the OB until you get the scan, and then stop showing up. They likely won't notice, and if they do, just tell them you changed care providers.

[mumofboyz]

Originally Posted by babycatcher12

Thanks for your responses!
Doing the "oops it just came too fast" would be an option except for I'm sure that the OB would be pressuring to schedule a c/s by 39 weeks. I would really like to just not go back after 20 weeks or so.--Erin

uhhhh... that was my case precisely. At 34 weeks I was informed by my OB that they would induce me at 39 weeks because they could and in their opinion, it just wasn't worth it to them to wait. The only reason they could provide was that I was of 'advanced maternal age'. They used statistics to justify the decision they made and did not wish to discuss it with me. I was healthy. My baby was healthy. Both my other babies were 'late'. But none of that mattered. I was no longer an individual. I was a statistic. It made me angry.

Two weeks later, at my 36 week appointment (by this time I had secured a MW), I had a very frank and heated discussion with the OB. By this time I had spoken with the high risk specialist, whose recommendations on which the OB was basing their medical opinion on. The OB pulled several cards: the 'your insurance won't pay if something goes wrong because you ignored medical advice' card to the infamous 'you'll have a dead baby on your hands' card. That was the last straw. I walked out and never saw that OB again.

I did continue to see the OB's partner and had an honest discussion with him about his partner's bedside manner and how angry I was, etc. I could see that he clearly wanted me to have the birth experience that I wanted, but his hands were tied by his boss. I realized that when push-came-to-shove, they would cut me if they could. I don't think he blamed me that I continued to come in for check-ups and limited monitoring and I don't think he blamed me for missing the next appointment with an "Oops... the baby came". In fact, I think he was expecting it.

In a way, I am thankful for that awful OB. I'm not sure I would have ever explored the option of MW and HB and am so very grateful that I did. I wish I had had a better experience with the OB's office but ... meh, it is what it is.

[sweetpea_119]

Originally Posted by Sk8ermaiden

I guess I've been in ICAN long enough to know that that who's operating can be a really big deal. The hospital stole my healthy baby and held her hostage and called CPS on us as well as treating us like garbage. The OB verbally assaulted us and our (legal) midwives. I have heard dozens of similar (or worse) stories. One women lost her baby and it was 100% because she was a transfer and the hospital refused to listen to her or her midwife.

So I guess I put a lot of stock in having a relationship with a doctor the next time around. I respect everyone's choice either way (especially one who knows she'll be affected by an OB's scare tactics), but I think a lot of women go into a potential transfer situation with a lot of naivety, and wish they'd known before what they know after. Having a bad OB can be really, really bad. I didn't get to see my healthy baby for 20 hours or have her home for 5 days. My motto for the next birth is "never again." Who knows what will happen with the birth, but I do know I will do everything I can to make sure we are treated like human beings with rights.

Well, the situation here is that no matter which doctor I would be seeing, I'd just get whoever happened to be at the hospital on duty at that moment. There are 20-30 OBs & you get who you get. Hence it doesn't matter if I have a relationship with any one particular OB & I can tell you that the anxiety that I feel about all of them after what happened with c/s #2 that I really would have had to exhaust *literally* every option here at home before I ever crossed their threshold.

[Sk8ermaiden]

Oh, I know you get whoever's on, but the reason I was treated so badly was because I had no OB. My midwife's detailed, meticulous chart was worth nothing. People I know who have transferred (to unknown doctors, but with shadow care) have been treated much more civilly.

Obviously there is no right answer for everyone, but if I had known then what I know now, I would absolutely have had shadow care before - even not being a VBAC. So I try give other moms (not you, but the OP) enough info to make a truly informed decision. I wish someone had done that for me.

And I do know women who exhausted every possibility at home but went on to have vaginal births after a transfer. There are situations in which it does happen, and it's not as uncommon as some people think. But I hope that you (and for that matter, me!) never set foot in a L&D ward again!

[JennTheMomma]

We used an OB for shadow care, up until 22 weeks. I didn't discuss my homebirth plans with him, and probably won't. I wanted to, but didn't know how to bring it about. I might call him later and tell him about it so atleast he knows. If I do need to transfer it will be to this Hospital he works at, and I most likely will get him.

[Courtney&Ry]

I haven't received shadow care, but mostly because my midwife practice is able to refer me to a doctor/hospital network covered by my insurance for any tests I want done, including ultrasound. My midwives actually like having the anatomy ultrasound completed, if Mommy wants, too, just because they like knowing baby has everything in place and such. But, they don't make a huge deal when they encounter Mama's who don't want ultrasound done. My practice just gives me the test form completed with their information and the number for the department to call and schedule the test/ultrasound.