interviewed dr sort of ok but...

[mamaflutter]

So I interviewed an ob she seems ok there are some things I like about her but others I'm just not cool with. She had some training in austrailia with an aborigonal tribe so I know she has some experiance with natural birth. She also dose not do episiotomies she said she can count the few she's done on one hand. I like that. But when I asked her about her / the practices / the hosp. Csec rate she had no idea she says its on par with the national avg. And the practice may be higher because they deal with a lot of high risk and multi. Than I asked her if she worked on the progress on the hour phliosophy and she said no I do however follow the labor curve. I didn't know exactly what that met so I looked it up and feel like I've been lied to! Also there are 8 docs in the practice and despite her having a great additude about vbac who knows how her colleags will feel exspecially the surgical specialist. I don't know what to do here. My options are limited what to do what to do?
Candi 26 mom 2 mj 9 juje 3 and one still cookin

[kltroy]

It does sound like this is not an ideal VBAC doctor, especially given that you don't have a guarantee that you'll even have her for your labor. I would do a few things:
1. Contact local ICAN group, or even the nearest non-local ICAN group and ask for referrals
2. See whether there are any midwives available in your area who can attend VBAC. Try posting in your Tribal area about this
3. See whether there is a family practice doctor that will attend VBAC instead of an OB/GYN. FP doctors tend to be less interventive and they are not surgeons, so they are generally less quick to cut.
4. In the mean time (while you're exploring other options) ask this person some more questions. In particular I would ask her:
- Under what circumstances would she induce labor? How does she do this for VBAC candidates?
- Under what circumstances would she augment labor? How?
- When, if at all, would she want to schedule a repeat cesarean versus inducing/augmenting?
- How many of her patients receive pitocin?
- What is her basic philosophy of birth? (natural process versus medical condition) what level of intervention is generally "necessary"?
- Do the other 7 members of her practice share this philosophy?
- If you go into labor at night/weekend, what happens?
- Who will be there with you in the hospital? Does she mostly manage over the phone and run in at the last minute to catch the baby?
- How "late" is she comfortable letting your pregnancy go?
- What is her responsibility to you as a doctor as far as medical decision making goes? (I would want to hear that her responsibility is to give you the best evidence facts so that you can make an educated decision, having good information aobut risks, benefits, and alternatives. I would NOT want to hear that she is going to look at your situation and decide what is best for you.)

This can be accomplished via a phone conversation or in person. I would get these answers while you explore alternate options, as they will help you decide how aggressively you need to pursue other options.

[mamaflutter]

Hey thought I'd get back to ya I did do some of the things you suggested. I did call ican and she had some homebirth midwifes she could recomend but my dh is not down for a homebirth due to baby in nicu with dd. She did tell me Louisville is not the best place to have a baby naturally she suggested Jeffersonville In but because my dh works at walmart I have state insurance and they don't take it. I am concidering a fp doc but 1st I gotta find one that takes my crap insurance.
I did ask her about induction and she dose not enduce vbac because of incresed risk of rupture.she did tell me they are in house dr so whoever is delivering my baby will be in the hospotal.but again who knows who that will be. She said that she would let me labor as I "wanted" with cont monitering! So that's not how I want! I also asked her about decels in labor as you know I can read and have done this befor and she said to me , and this really made me mad, we can sit here and discus what is concidered normal and abnormal all day but I have the medical degree and ill decide what is normal or if we should just do the section. I know this is gona be a big problem for me cux I swear I will pull out my blackberry and do reserch right ther in labor and all that I know all bs dose not fly with me! Sorry got a bit ranty there. But I just don't know if this is right and this is my last one I really want to have a good experiance. I wanted a waterbirth but I have concluded that is just not ib the cards for me unless I have a homebirth. Ugh! I just don't know what to do! I have an apt with the ob nurse at the practice mon then with the doc on wends I'm not thrilled about drivin 30 mils each way 2 times thia week but I can allways change docs right?

[kltroy]

Ahh Louisville - my sister just moved there and if she decides to have another she plans to head to IN like you mentioned. That stinks. One possibility would be to get a homebirth MW to act as your official doula/unofficial midwife. In that capacity you would be able to
- labor as long as possible at home, complete with MW care
- know when it was time to head to the hospital so that you could basically walk in the door and have the baby
- if your MW thought you needed to go earlier b/c of some medical concerns, she could accompany you in the role of a doula - be there for your labor support and also to help you and your husband make good medical decisions. (My mom is a CNM and she acted as my doula for my VBAC - her advice was very very helpful, and only given when requested).

Don't know if your ins. would cover a doula or not, but you might be able to come to some arrangement with a homebirth midwife or even just with an experienced doula.