Switching from a midwife to an OB?

[bri276]

If your chances of preterm birth were 30-50%, would you still be comfortable seeing a midwife?

I go to a group of midwife and OBs. I've been seeing the midwives just like I did when I had DD. But recently, ultrasounds have shown a shortened cervix (2.3 cm) and after some research on this condition after a LEEP, I believe my chances of PTB are about 30%. I have another ultrasound on Monday. If there is funneling of the cervix, those chances are probably closer to 50%.

I love my midwife, and was hoping for a birth center birth, but at the same time, I kind of feel like they're not taking the risk seriously. Also, if I do end up in PTL I don't want just some random OB who I've never met, yk? But if I did make it to 35 weeks or so, I could switch back to the midwives then.

I don't know.

[sanguine_speed]

[wombatclay]

I agree that trust is the bottom line. If you feel like you're not connecting with your current provider, then switch if you find someone else you feel more comfortable with. I realize this is easier to say than to do... I switched providers three times with my third pregnancy. I started with a homebirth midwife and ended up with a hospital ob/midwife team that I LOVED. It was a lot of soul searching and second guessing but in retrospect it was the perfect birth team and exactly what I wanted (and needed) to have a confident birth experience (my second vbac).

[annettemarie]

That risk would be more than I personally would be comfortable with for a midwife/birth center. But I agree that the underlying trust issues are even more important and something you need to listen to. I also agree about second opinions. There's no law that says it has to be all or nothing, and that you can't seek a second opinion. Best of luck!

[luv-my-boys]

Originally Posted by bri276

If your chances of preterm birth were 30-50%, would you still be comfortable seeing a midwife?

.

as my only provider, no. Considering your indications there is a real concern that you *might* go early and I too wouldnt want some unknown OB walking in at the height of my anxiety and stress, kwim?

You mentioned that your office is a OB/Midwife office. I would *think* that they would refer you to a OB innner-office or maybe you can ask to see the OB to discuss the results of the U/S. Its possible that you might be able to continue under the care of the OB and midwife with the midwife doing all the basic prenatal checks and occassionally meeting withe the OB to check on your progress but also get you familar with them in case the OB is needed.

[nia82]

Can your mw have you evaluated by an obgyn? I had a practice of ob/midwife. My cervix shortened from 4 to 3cm from 22 to 26 weeks, at 26 weeks I started contractions. Obgyn didn't give me any Terbutaline till 30 weeks or so. My mom had cerclages with all of us which were taken out at 36 weeks. I had Terbutaline til 35 weeks, then he refused it to me. My water then broke at 36+5 and I had DS 18 hours later.
I fully intend to go with midwives in the next pregnancy, fully aware I will have the issues again, but just will have them refer me to their back-up obgyn for PTL assessment and meds. The obgyn felt it was safe once I passed 35 weeks, while my MD sister felt it is necessary to take Terb/ritodrine til 38 weeks.

[mediumcrunch]

I'd go with an OB until 35 weeks and then switch back to the midwives.
I'm currently doing something similar. The local CNM's declined to do my care because I was too high risk BUT if things were going well and my OB wasn't on-call they'd catch. Here I am, almost 33 weeks, things are going GREAT and I see the midwives for my first real appt with them next week. I'll alternate between them and my OB from now on. My OB is a "male-midwife" and I'll be happy with either the midwives or him catching.