Questions for my OB??

[Nanette56]

So I have to transfer from my wonderful M/W to an O/B. A twin birth in the state of FL is an automatic OB sentence. So, I'll be serving time for the next 3.5 months with him. Here's the situation. He came highly recommended as a laissez-faire kinda guy, and encourages natural twin births. The bad news?

1) He's in a practice with 5 other docs, whom I haven't heard ANYTHING about; and

2) I need a doc who will attend me at this particular hospital, because I'm refusing Antibiotics for GBS in favor of a Hibiclens wash (because I'm now negative, but the CDC only two weeks or so ago came out with new guidelines that say if you test GBS+ at ANY time during pregnancy, you're automatically supposed to get antibiotics http://www.cdc.gov/groupbstrep/guidelines/new-differences.html) so I need MY pediatrician to attend the babies, and not the on-call pediatrician.

So I'm kinda stuck with this group. ANYWAY, obviously I have a lot of opinions on what I want my birth to be like. How much detail do I go into with him? I want to tell him we're delivering the babies vaginally, vertex or breech, and regardless of who's first or second and what position they're in, and that I'm refusing antibiotics, and that I don't want internal exams (well maybe one at the very end), and that I'm not doing the 1 hour GTT,  AND that he better not argue with me while I'm in transition about any of these choices, or talk down to me, or tell me that I'm putting my babies in danger.

I'd also like to tell him that if they're premature, or I have pre-eclampsia or GD then I will cede the reigns, but only then and not before.

But I probably shouldn't be this bossy with him right off the bat right? I don't want to scare him off. I really want to U/C, but I'm want to give him the benefit of the doubt first.

Any suggestions on how to handle the new doctor consult?

[~Adorkable~]

i think there is something to be said for also doing our best to show the same respect for doctors and their jobs as we want them to show us, and to show it in the way that means something to them.

so i would be happy that you have some time still and start off learning as much as you can and showing them that you are an informed patient that expects to take an active role in your own care.

i know I'm bad at assuming the fight before it actually happens and I'm working on that, i suggest the same for you.

deal with the issues as each comes up, will make it feel less like an attack and more like working it through together.

in some cases you might approach things by asking about the hospitals policies on various things, since he is restricted to those as well, that lets you both maybe be on the same side and put the faceless lawyers in the hot seat rather than your doc. and that way you learn some of the important things that might affect you.

i good questions i tend to ask a lot is "So where do we go from there if and when i choose to refuse that?"  in some cases i find that things that they presented as a must do or a always rule were really more of a guideline that they are usually not questioned on, and when pressed fairly they give a plan B

[WifeofAnt]

Originally Posted by ~Adorkable~ 

i think there is something to be said for also doing our best to show the same respect for doctors and their jobs as we want them to show us, and to show it in the way that means something to them.

I think I might be a little more flexible about the vaginal birth in any position thing.  If the doctor you have at the birth has never attempted twins or breech vaginally you might not be able to get what you want.  I know I sure wouldn't want to be demanding he/she do things a certain way if he/she had never done it before!!  IMO its important that OBs learn how to do it but I sure wouldn't want me and my babies to be their test dummies.

I also agree with the hospital policy thing.  Even if the doctor is knowledgeable and willing it doesn't meant they are *allowed* to practice that certain way.  They aren't going to risk losing their malpractice insurance or privileges with the hospital for one woman's special requests.

About the GBS and antibiotics... not everyone follows new rules as soon as they come out.  You might not even need to fight about the antibiotics if they haven't change how they practice yet.

I really don't like the policies about the GTT either but I don't think its uncommon for them to just assume you have uncontrolled diabetes if you refuse the test.

[mclisa]

I think I would go the the appointment informed (it sure sounds like you are) and scope out what the OB's expectations are.  If you act demanding, then they feel pushed and none of us like to be pushed around.  Maybe try to tackle just one point at a time.  This time, GBS issues.  Next time, delivery options.  Ask open ended questions.  What are the hospitals expectations for someone in labor with twins? What is your protocol for GBS.

The good news is that you do have a lot of time to address this issue so use each appointment for your questions.

[tracymom1]

Well, maybe you should get your prenatal care from this doctor and if everything goes on a healthy, straightforward path, plan on UCing.  If complications come up, use both your informed research and the doctor's experience to determine the course of action. Can you try to find a direct-entry midwife that will deliver twins at home?  Might not be legal, but might be an option nonetheless.