I LOVE my MW, but hate her OB, what to do?

[BirthNut]

I've been seeing a wonderful CNM at our local hospital, I love her dearly, she has pretty much let me dictate all my care & she is super supportive of me wanting a VBA2C. The OB she works under was also just as supportive & nice until I saw her for the 2nd time at 20 weeks. Then she told me she would no longer support my decision to VBAC & that if I didn't agree with her "plan" that I should find another Dr, well the only reason she gave me for this change in tune was that my last baby was over 10lbs, well, he was also a month late. My midwife understands this & so far this baby is measuring right on track, I've had a lot less weight gain myself this time, no other problems, etc... She thinks that this baby will weigh in closer to what my first child did at just over 8lbs. My MW totally disagrees with the OB however she has told me there is not much she can do since she works under her & conditions of her job, etc... which I understand comes with the territory of being in a group practice at a hospital. After the very disappointing appt at 20 weeks with the OB I did not go back & tried to find another Dr or homebirth midwife, but haven't had any luck. We either can't afford them or they don't take Medicaid. We have seriously thought of having a UC however even with me being very knowledgable having been a childbirth educator & doula almost 11 years plus midwifery student I know that I may not be in my "right mind" during labor & my husband is unwilling to learn what I feel he would need to know to be prepared for a UC. Anyhow I have an appt to see the midwife this coming Tuesday, I'll be 33 weeks now. I'm sure next appt will be with the OB though, any suggestions on how to deal with this? I am an ICAN Chapter Leader, know all my rights etc.. and have presented them to the OB with much resistence (she really doesn't seem to care what the facts are or what my rights are) but I have no choice but to use this group & even if we did UC, in the event of an emergency this would be the hospital we'd have to go to.

[lyterae]

Why do you have to see the OB, can you request to only see the midwife? My first pregnancy I had a CNM who was under an OB and I didn't meet the OB until my c-section

[BirthNut]

I have requested to only see her, to no avail, I guess it is their policy to see the OB at certain intervals, I saw her at 12 & 20 weeks, and don't know what other weeks I'm supposed to see her, but I'd certainly like not to.

[heathenmom]

Not exactly the same situation, but I loved my midwife (as much as I could love a mw who agreed I was a candidate for hb but wouldn't attend me there) and hated the ob she worked with (the feeling was very mutual). When it came down to the wire, my mw wasn't on call the weekend I went into labor, and I was terrified to go to the hospital since they'd already decided that I'd be a c/s delivery. So we stayed home and uc'd.

Hugs to you ... I hope you're able to find a solution that works for you.

[lyterae]

Originally Posted by BirthNut

I have requested to only see her, to no avail, I guess it is their policy to see the OB at certain intervals, I saw her at 12 & 20 weeks, and don't know what other weeks I'm supposed to see her, but I'd certainly like not to.

I'm sorry, I don't have any grand suggestions. I hope you're able to find something that works though. Stress about careproviders during pregnancy is something we all could do without

[changingseasons]

Originally Posted by BirthNut

My MW totally disagrees with the OB however she has told me there is not much she can do since she works under her & conditions of her job, etc... which I understand comes with the territory of being in a group practice at a hospital.

This is the important part of what you wrote. At least you know this upfront... I found out the hard way. My labor was slow (also a 10lb-er), and once I hit that invisible time limit, my care was essentially handed over to the ob (who I had never even met!) and I ended up with a c-section for ftp. If anything during your labor goes outside of that ob's set of "rules", then your midwife has NO authority in your labor anymore. And if the ob has already told you that they won't allow VBAC, then as much as your midwife would like you to have one, you're not going to have one in that hospital.

I hate to be such a downer, but I think it's important to be aware of this stuff before you get to your labor and are disappointed. For a VBAC, it's especially important to have a provider that really believes in you- not someone telling you that they won't "allow" you to VBAC.

[MovingMomma]

BirthNut, I know you said you don't have a choice about going to this group, but my answer to your question is find someone else. The OB will direct your care during labor and delivery, whether you want her to or not, whether she's actually there or not. Your MW is warning you when she tells you "there is not much she can do since she works under her & conditions of her job, etc." If you can, find someone supportive to direct your care.

[klemomma]

Can you just wait until you go into labor and then go to the hospital ready to push? I know it isn't a great solution or anything, but if your baby is crowning, it will be really hard for the OB to force you into a section.

If you know the care provider isn't supportive (which I agree is much better to know ahead of time!) and you aren't comfortable / prepared to do a UC, then I think your best bet is to try to work within the system you are stuck in and use what you do know to produce the outcome you want, or at least try.

Good luck to you mama! Big hugs :-)

[smeep]

Just throwing out another idea, assuming you really can't find anyone else... Technically you can refuse to consent to anything. Perhaps the mw would be more willing to accept your refusal than the OB? If you feel comfortable enough with her, perhaps you could ask some questions along the lines of, "Well, if I were to refuse a cesarean, that's my rights as a patient, and you can't legally do anything about it. And if I'm refusing to consent, the OB can't make me do it either, so why bother telling him/her if I'm within my rights? If I show up in labour and refuse an emergency cesarean, you'd just have to attend my vaginal birth, right?" Basically, see if you can hint around and see if she can support you under the guise of "crazy lady refused, there's nothing I can do! I told her I didn't support it, but she didn't listen, so I had to make sure this baby was as safe as possible!" .....am I making any sense? Pg brain, haha. You could even just play the "rescheduling" game and show up in labour, that way she can say she kept scheduling you...ya know, just play along. And if it's OB instead of mw on call when you go into labour, you can either UC, go in pushing or just be prepared to fight...but at least this way you might have a chance at a good birth with the mw.