Should I tell my Dr. or not? (long)

[shenanegans]

So, this is the situation. Since the start of this pregnancy, and much before I have wanted to have a home birth but the way the system works here(Qc, Canada) is you have to put your name on the waiting lists at the birthcenters THE MINUTE you find out you are pregnant for any chance of getting in, once you get a spot you get a midwife and you can choose to either give birth at home or at the birth center. This process can take anywhere up to your 30th week in pregnancy to find out so you have to have a Dr. cover your care in the mean time. I have I have been with my family Dr. who is a young and reasonable guy. I am planning on having a vbac and he is supportive but I still don't feel comfortable to give birth in a hospital after what happened with my son's birth in Japan (water started leaking, no real labor followed, 5 days later I entered the hospital for a million interventions I didn't want which caused me to get an infection which led to a c-section) I know this could have been avoided if I had been with a midwife and they would have taken more percautions to avoid introducing bacteria to the vagina and not make me scared by talking about csections every 5 minutes!etc. ANYWAY, back to now... a few weeks ago I started to get nervous about all the waiting and not knowing if I would get into the birthcenters or not so I called them all again and found out that since I am due in July, most of the midwives go on vacation and don't hire replacements so they just take less patients. Basically, an already slim chance of getting in became impossible because I am due in July. great. Also if you get a spot in the birthcenter, the birth is covered by our health care and it is all regulated, BUT as I have explained they have very few places and a huge demand. So I wasn't willing to give up even though I was very discouraged, I started to call some doulas and a local alternative birth organization who contacted a lay midwife on my behalf. The midwife called me back and I have already had 2 meetings with them so we will have a homebirth with them in July. Basically because the government only regulates midwives who are employed through the few birthcenters and there are obviously not enough, these private midwifes have to work underground, technically illegally even though she has oodles of training and experience. The province only recognizes training that is from this province and my midwife was trained in the States. So, I have my regular monthly appointments scheduled with my Dr. but I am also seeing my midwife now. I have already cancelled next months Dr. appointment, I told him I was going on a trip. I don't want to double up on appointments, its a waste of time, I just want to see the midwife but I would like to keep a relationship with my Dr. in the case that I do have to transfer to the hospital during the birth. So should I tell my Dr. that I am planning on having a home birth and I don't need to continue with him but I would like to have him as my back-up. There is a risk he could get angry and do I don't know what exactly,rant about the risks of vbac (which he hasn't done at all so far)or maybe refuse to see me again or he could be very reasonable about it. sorry this is so long but I could definitely use some advice. Thanks!

[roadfamily6now]

do not tell your OB. Continue with 2 care providers on an As-Needed basis

[summerforever1977]

Originally Posted by roadfamily6now

do not tell your OB. Continue with 2 care providers on an As-Needed basis

You cannot inform your doctor you are preparing for an illegal homebirth; it compromises him and will most likely result in him having to report it to the proper authorities in the worst case scenario and firing you in the best case scenario.

[mollikins]

I agree that telling your doctor you're planning an 'illegal' home birth (I guess technically only the midwife's practice is illegal, you are allowed to do what you want) puts him in a hard spot.

However, could you tell a white lie and tell him that you've been accepted by the gov't MWs and will be birthing at home? i don't know how much contact they have between OBs and MWs so I don't know if that would work or not - but that way at least he would know you're planning a HB with a midwife, and that you would like to keep him on as your backup in case you require hospitalization for anything. That at least gives him the info he needs without compromising his ethical need to report an unlicensed midwife.

[Tummy]

Agree with others, however, would it not just make sense to keep on with the OB apt? Yes, it is a waste of time as far as doubling up on apt, BUT!!!, you are CYA.

[shruley]

I agree with the not telling him plan. That is what I had to do (here in the States.) And when the HB midwife dropped me, I was glad I never told. I agree it's a pain, coming from someone who did double appointments the whole pregnancy AND paid for a full homebirth AND the hospital birth! but may be worth it in the end.

[cathicog]

I would NOT say a word to the OB, none of his business where you birth, and I would do all I could to protect the mw...enjoy your hb...having babies shouldn't be this hard!
Shruly, how did your birth go? I hope all was well....

[cathicog]

Originally Posted by mollikins

=
However, could you tell a white lie and tell him that you've been accepted by the gov't MWs and will be birthing at home? i don't know how much contact they have between OBs and MWs so I don't know if that would work or not - but that way at least he would know you're planning a HB with a midwife, and that you would like to keep him on as your backup in case you require hospitalization for anything.

Most docs even in the States will drop you like a hot potato if they find out you are having a hb... mostly cuz of competition, and fear of lawsuits if the mw makes a mistake, and insurance/hospital protocol I guess...I wouldn't say a word to the OB...

[shenanegans]

Originally Posted by Tummy

Agree with others, however, would it not just make sense to keep on with the OB apt? Yes, it is a waste of time as far as doubling up on apt, BUT!!!, you are CYA.

What is CYA? Thanks for all the replies ladies. I am leaning towards not telling him but trying to cancel as many appts as possible.

[jecombs]

CYA = cover your a$$

[shenanegans]

Originally Posted by cathicog

Most docs even in the States will drop you like a hot potato if they find out you are having a hb... mostly cuz of competition, and fear of lawsuits if the mw makes a mistake, and insurance/hospital protocol I guess...I wouldn't say a word to the OB...

lucklily this isn't an issue because we do have birth centers run by midwives which are regulated by the gov't and covered by our national health insurance so I am sure Dr's are used to people going there for birth or homebirth.

[Meg08]

I would definitely stay on with the family Dr., until/unless you do get into the birthing centre with a RM. This way, any tests or procedures that may be required/desired will be covered (the Dr. can req them). CYA, as someone else said. I'd tell the midwife about the doctor, but not the doctor about the midwife - she needs protection too. There's still lots of time to think of an 'excuse' for the homebirth, after the fact!

[shruley]

My birth actually went well, I had a successful hospital VBAC with minimal interventions. My OB was awesome I couldn't be more in love with her! My homebirth midwife risked me out because "I was at high-risk for *maybe* developing preeclampsia DURING the birth." When she took my BP it was high, but when I was at the OB office, it wasn't. (It was creeping up at the end, but OB had no concerns and it was under 140/90.) My homebirth midwife acted as my doula at the hospital and did postpatrums, thus I paid her the whole fee, as well as the hospital bill. DH said he doesn't care where we birth next time, but can we please only pay 1 bill???