Having OB prenatal care make you less confident?

[L J]

I've been throwing this around in my head for some time now. I am barely pregnant, again, and this time I am seeing an OB, for the first time ever in my life. I think I got very lucky with her, she is young and laid back and I don't get the vibe that she is going to push to induce or section me without a really good reason.

I was completely honestly with her about how my first two were born, without hinting that I might just not go to the hospital in labor. She made a remark that as fast and I give birth, I might just not make it this time, and she laughed. I think that's a good sign.

Anyway, what I have been wanting to talk out with some mamas who have been there, done that, is whether 9 months of very frequent prenatal care (I'm going twice a week, it'll no doubt increase as the pregnancy does) will rob me of my confidence in birth.

Even though my youngest son was stillborn, birth has never failed me. I believe in birth. I believe in my body's ability to efficiently and safely get my baby here. I am a great birther. I like to give birth. My son died before I went into labor, and I am thankful to my body that it knew to get him out before I got sick from carrying a dead baby. I had no complications from his birth, or my first, and no infection.

I really, really don't want to give birth in a hospital if I can avoid it. I enjoy birthing alone. I don't like to be touched, I don't want to be messed with at all. I don't even want my husband in the same room - I just want to squat and do my thing and be in my own head and body with no distraction.

I just wonder if all this prenatal care is going to take some of this away from me. Will I trust my body less after relying on tests and ultrasounds and a doctor to reassure me that everything is okay for 9 months?

I would love to hear from mamas who UC'd, or attempted to UC, and had prenatal care with an OB. (Midwives are not legal in my area, none within a 2 hour drive, before anyone suggests that I switch to one of those.)

I really appreciate anyone taking the time to help me talk this out.

[ursusarctos]

Well, I'm not really planning a UC at this point but I have definitely considered it extensively. Reading and thinking about it has influenced my choices with prenatal care now. I just went in at 12.5 weeks, got weighed and b/p measured, heard the heartbeat with the doppler, and I'm not going in again until the 20 week ultrasound that I decided I wanted. I feel great about this level of care and hope they are as laid back as this for my whole pregnancy. I had considered in early pregnancy going in to get an early ultrasound because I have had early losses, but I decided against it and I'm really glad I did. I feel like, instead of relying on "them" to validate my feelings and my pregnancy, I relied on myself to go through my own anxiety, instead of externalizing it, and I feel like it helped me be more centered and peaceful. I often find that when I keep something inside rather than sharing it I am able to live it more fully somehow. Not quite sure how to explain. Like if I am by myself when I am in pain I go into the pain and can tolerate it and be present with it, but if I instead complain about it to somebody I feel like the power is scattered and like I can't deal with it as well. All this is just to say that I think there can definitely be something beneficial to choosing less outside scrutiny/care, at least I feel like that for myself. It can help you to be more centered in yourself. I think it really depends on what makes you most comfortable though. I don't think OB care in itself is going to cause you to lose your confidence, as long as you keep in mind that they aren't actually doing anything to grow the baby or make your pregnancy "work" - it will happen by itself regardless of whether they weigh you and test you and validate you. I think the nature of OB care can be to get you to lean on them to make things work. But it doesn't have to be that way automatically and it sounds like your OB is really relaxed, so I wouldn't worry about it if you like going in and it's not stressing you out. You can always make fewer appointments too if it feels like too much.

[dayiscoming2006]

Why are you having appointments twice a week? That seems VERY excessive, especially early in pregnancy. I skipped prenatal care with my last pregnancy and was planning to UC but sadly I didn't have a place to do it. Anyway, I was in Romania where they just shove you off in a room to labor by yourself (sort of) you are in the room with other laboring women but it was easy enough for me to ignore them. I was unhappy that my hubby couldn't be in the room but was glad they mostly left me alone. At the end when I started involuntarily pushing on my hands and knees, it felt great. If they would have left me alone, it would have been really good. 

So, specifically to answer your question. I think it's fine to have some level of prenatal care but I'd definitely space it out more than you have been. I went to my first prenatal appointment of the pregnancy at 24 weeks. That felt early enough to me. The hospital midwife told me everything looked fine. I'm glad to have some care I think, though I'll be refusing vaginal exams from now. I allowed it for the first appointment because they did a pap and checked for STD's. I figured I didn't want them panicking that I might have an STD. (Which of course I don't.)

Anyway, I will probably do all the appointments up until the very end. But normally until you reach your third trimester, I think they see you every four weeks. And in the third trimester every other week and at the very end it might be weekly - though I don't think I would go in that often. You should be able to set it up for only as often as you want. 

[L J]

Maybe this forum wasn't a good place to pose this question. But, I suppose no where really is. There is not a large group of UC mamas who have had full term stillbirths floating around. I do know a couple, but the cause of death was something very different, where they don't necessarily feel compelled to see an OB the next go round. Losing a baby so very late in pregnancy really changes everything, and I don't think you can get that until you are there.

I'm going in as often as I am for progesterone checks - I am not on any type of progesterone supplements, but she is keeping an eye on my levels. Because of the nature of my son's death, we are also checking blood flow in my uterus regularly. Trying to avoid blood thinning injections (Heparin / Lovenox) unless they truly are necessary.

With my oldest, other than the one required visit for proof of pregnancy I didn't have any prenatal care with a professional. That was perfect for me then, as I knew everything was just fine.

With my youngest, who died, I did go in for several visits because deep down I felt like something was wrong. Unfortunately, everything always appeared just fine at first glance, and I had never had any problems in the past so there was no "reason" for deeper investigation.

Now that I am pregnant again, and I know that had I been having lots of prenatal care and u/s and such with an OB, my son could have lived. I live with that guilt every day, and it is most certainly coloring my experiene of this pregnancy and the decisions that I make over the course of it.

I am trying to find a balance with the constant high level fear that festers inside of me always and my innate trust in my body and birth.

[lizzie]

More than anything I'm coming here to see what other mamas think about this, because while I've been UPing up til now, that wasn't really what I had planned from the beginning (been planning to UC all along, but I'd planned to have fairly regular prenatal care originally). Between intense morning sickness early on and moving a month ago, I just haven't found anyone... primarily because I haven't really been looking. Things have been going so well and I've felt so good about it all lately, (had a few sketchy days earlier on) I *do* kind of wonder if starting care now won't throw off my happy vibes. But... I wonder that primarily because I know how my brain works, rather than because I think an OB or MW giving one their input would necessarily create fear or a lack of confidence for any given woman.

My first two children were born in hospitals, one with an OB, one with a CNMw, and I was crazy-confident in myself with both of them, in spite of some of the things they had to say. I was only having my babies in a hospital because UC hadn't really occurred to me! This pg has been different - after 6 years of TTC, I'm just not the same person I was 9-10 years ago, didn't start out quite as confidently, and I've been much more timid about it than I thought I would be! Which is why I'm even considering finding a source for prenatal care still. And I kinda do want an U/S... Idk. :)

[dayiscoming2006]

Laura,

I didn't mean for it to seem offensive. I just couldn't imagine going in for prenatal care twice a week if it were me. I do understand your reasons.

I don't think you should feel guilty about your son (although easier said that done I am sure) because there was no way you could have known what was going on. The type of prenatal care you would have needed to hopefully save his life would not be offered to you as there was no known reason for it. I can't imagine losing a child though. I am sure it was devastating. I only know second hand through my sister who lost her baby at 2 months old. It is very sad. 

[lizzie]

After reading your reply, LJ, it's amazing you're hear with us again! I hope you get a very different, joyful outcome with this little one!

[Lauren82]

I'm so sorry for your loss.

I am contemplating UC but still opting to see midwives for prenatal care. I follow a usual prenatal appt schedule at this time. While midwives are obviously not the same as an OB, mine are nurse midwives and I know local women that have accused them of being *too* medical minded.

That said, I have some of the same fears that you do especially since I have had all of the tests, u/s and everything they offer. There is still that little voice in my head saying "what if?"

But at the same time, I have this strong urge to birth completely alone.

At this point, the only thing I can commit myself to is waiting to see how I feel when I go into labor. I'm not going to put any limits on myself. If I feel like staying home when the time comes, then I will. If not, well, then I will be going in to the birth center. I am 2 miles from the nearest hospital in case of an urgent complication so that does help my fears a little bit.

[newsolarmomma2]

Good OB/CNM care won't rob you of your confidence, it may even give you more of it. I can tell you are worried, and I understand why, I know all you want is a healthy baby. If you get good care, you will know that both you AND your baby are in top shape for the birth. I know lots of people UP, and I support this, but in your case I think you will actually feel better if you know nothing is wrong. Knowledge is power, why refuse knowledge just because it's from a doctor?

I think UC is more than just the birth, it is the idea that you know your capacity to birth and will follow your intuition even when it leads you in a direction you don't want to go. I wanted a UC, expected to UC, planned to UC, but I just couldn't shake the feeling that something was wrong. I had good prenatal care, but everyone-both CNM and OB- said I was low risk and just fine, they didn't even think Ds was big. But, when I went into labor, I just KNEW something was off, no physical reason for it either.

I hightailed it to the hospital (LAST thing I wanted) and low and behold, DS was stuck. Turns out his head was actually bigger than the pelvic opening, rare but it happens. No amount of pushing could free him. After a 36 hour labor with 3.5 hours of pushing, a few hours of laboring down, along with being fully dilated and effaced, he was removed by CS. (which went very well much to my surprise) Turned out he also had a problem with his blood and needed weeks of NICU care.

I didn't know this while driving to the hospital, I only hoped my son and I would be safe and the experience not too terrible. This long rambling story is just to tell you that it's OK to have OB care, and its OK to follow what your body tells you even when it doesn't agree with what your mind wants!

Good luck with your new LO!

[LadyJennifer]

I'm so sorry for your loss, LJ. I can only imagine the pain, and the fear.
I think if your bi-weekly visits make you feel less fearful and more at ease about the health of your LO, they must be a good thing. :)

[ElizabethE]

Originally Posted by lizzie 

More than anything I'm coming here to see what other mamas think about this, because while I've been UPing up til now, that wasn't really what I had planned from the beginning (been planning to UC all along, but I'd planned to have fairly regular prenatal care originally). Between intense morning sickness early on and moving a month ago, I just haven't found anyone... primarily because I haven't really been looking. Things have been going so well and I've felt so good about it all lately, (had a few sketchy days earlier on) I *do* kind of wonder if starting care now won't throw off my happy vibes. But... I wonder that primarily because I know how my brain works, rather than because I think an OB or MW giving one their input would necessarily create fear or a lack of confidence for any given woman.

My first two children were born in hospitals, one with an OB, one with a CNMw, and I was crazy-confident in myself with both of them, in spite of some of the things they had to say. I was only having my babies in a hospital because UC hadn't really occurred to me! This pg has been different - after 6 years of TTC, I'm just not the same person I was 9-10 years ago, didn't start out quite as confidently, and I've been much more timid about it than I thought I would be! Which is why I'm even considering finding a source for prenatal care still. And I kinda do want an U/S... Idk. :)

Lizzie, it seems like you and I are extremely similar. My first child who is 7 now was a hospital birth that I confidently thought I could do natural. My second labor, for my son who is almost 2, I had midwives and also felt confident I could do it the "right" way, and it didn't work out. And I too question if seeing an OB at this point would be bad for the vibes. I don't think they could change my mind or shake my confidence, but I do think any negativity at this point would be seriously unwelcome and I don't want to put a damper on my mood. It's a HUGE improvement for me to actually look forward to birth again.

LJ, I understand as much as someone who hasn't been through what you have, could. If it were me personally I think I would continue to seek the care and make sure everything was fine along the way. Peace of mind while healing from something like that is priceless.

[lizzie]

Originally Posted by ElizabethE 

Lizzie, it seems like you and I are extremely similar. My first child who is 7 now was a hospital birth that I confidently thought I could do natural. My second labor, for my son who is almost 2, I had midwives and also felt confident I could do it the "right" way, and it didn't work out. And I too question if seeing an OB at this point would be bad for the vibes. I don't think they could change my mind or shake my confidence, but I do think any negativity at this point would be seriously unwelcome and I don't want to put a damper on my mood. It's a HUGE improvement for me to actually look forward to birth again.

I was thinking we are from other posts, too, actually! :) Though in fairness to the staff who attended me during both of my previous births - all hospital staff - both of my hospital births went just about as well as hospital births can go. I was very surprised at the level of support I received for my choices and birth plans both times. Nonetheless, I want *more* than that. I still felt like I was constantly compromising to avoid being labeled an idiot or irresponsible mother or whatever. We shouldn't have to answer to someone else for basic choices we as parents have a right to choose. We shouldn't have to be militantly vigilant to make sure medications or glucose are administered or even, God forbid, circumcisions performed because of mistakes, misunderstandings, or being willfully disregarded by people who believe they know what's best for your children. I'm really looking forward to our being able to relax and enjoy our baby with no pressure to have to immediately go into hyper-vigilance mode! :)

[ElizabethE]

I agree with every single thing you said 100%. :) Even the hospital bit. People did the best they could and I actually came to appreciate the hospital and the staff, mostly.

[L J]

Y'all have given me so many wonderful words, and I am so thankful for that. I will always treasure the support in this community.

My OB has actually decided that all is looking so well, she doesn't want to see me again for 3 weeks! I agree with her, too - this pregnancy is progressing just as it should at this point. I am really relieved that I am going to get a break from the appointments for a bit.

newsolarmomma2 - I love your attitude about UC being so much more than the birth. I am so glad you were able to trust in yourself so very much and head for the hospital - how terrifying it must have been for your son to be in the NICU for so long.

Elizabeth - you make a very good point about an OB adding negativity. I have gotten so lucky with mine, and she is very optimistic for me and this pregnancy, and I honestly don't get the vibe from her that her attitude will change unless something is very wrong.

I am def going to just play it by ear for now, and hope that there are no complications that seal my fate for a hospital birth. For a few months after my son died, I kept saying that the next time I got pregnant, I was going to schedule my c-section at my first prenatal appointment. That was my initial reaction to the whole thing, to never trust in my body again. Thankfully, most of that has faded away, and it seems like the stronger my symptoms become and the more times I see that little heart beating away on the screen, the more I feel that this will be a healing pregnancy and a great birth. The urge to birth totally alone seems to be something very deeply ingrained within me, and I am going to remain optimistic that I will once again get the opportunity to do that.

[frugalmum]

hi laura, I am struggling with this too.  I don't mind giving birth in a hospital but the "high risk" prenatal care is VERY stressful for me for and quite frankly, there's not a whole lot they could do for me until the baby is viable.  I am seriously considering not going in for care until I am well along...

My advice to you, and of course I can't pretend to know exactly where you are coming from, is to do what makes you feel emotionally safe, regardless of whether it might effect your confidence in birth.  I think your emotionally safety is most important right now, more important than how you might feel down the road when you are in labor.  It's ok to put yourself in the hands of medicine if you feel emotionally safe there.

[Almi]

I got regular prenatal care.  My first visit was at 15.5 weeks.  I had 8 visits total.  I was up to biweekly visits, but I delivered at 36.5 weeks, so I never made it to weekly visits.  I enjoyed my visits and ultrasounds and whatnot.  It was nice to know that everything was going perfectly.  It helped to put me completely at ease for my labor and birth, instead of make me second-guess myself and my ability.

Like you, I cannot be touched or bothered when I am in labor.  I knew that I would never tolerate a hospital birth, so UC was the choice for me.  I had a high risk pregnancy - twins.  Yeah right.  My pregnancy was as low risk as can get.  My labor and birth were great.  The only thing really unexpected was that I had an extremely short labor (less than four hours) and my smaller twin came first!

I strongly believe that because I believed in my body and birthed alone, that I avoided c-section as well as a myriad of annoying to terrible interventions for me and my babies.

[lizzie]

LJ, your strength shining through after the loss of your little man is just amazing! I'll be thinking of you and hoping for continued healing and comfort throughout this pg!

[labortrials]

Originally Posted by Almi 
Like you, I cannot be touched or bothered when I am in labor.  I knew that I would never tolerate a hospital birth, so UC was the choice for me.  I had a high risk pregnancy - twins.  Yeah right.  My pregnancy was as low risk as can get.  My labor and birth were great.  The only thing really unexpected was that I had an extremely short labor (less than four hours) and my smaller twin came first!

I strongly believe that because I believed in my body and birthed alone, that I avoided c-section as well as a myriad of annoying to terrible interventions for me and my babies.

Almi, you go girl.  Really, UC is about the only way someone can birth twins naturally.  I felt the same way as you - like there was NOTHING high risk about my twin pregnancy.  Heck, I was out mowing the lawn at 36w and probably would have gone to 40+ weeks had my Baby A not broken her water with her feet.  And I, like over 75% of women in my state birthing twins, had a c/s for double footling breech presentations. :(

Laura, I'm not a UCer but I read this forum b/c it makes me feel much more comfortable about my decision to have my 4th and final baby at home.  I have worried about the same thing - that obstetric care will only add to my fears and that I will yet again become over-reliant on the bells and whistles of medical management.  I stayed with my OB through the 20w u/s - wanted to make sure the placenta wasn't in my scar.  Now that everything looks perfect, I'm ready to move on.  It's not like he would really support my choice to HBAC after 2 c/s or my choice to do it at home.  I'm just trying to find the most graceful way to "break up" with him.

Anyone here have suggestions for breaking up with OBs while still leaving yourselves open to obstetric care if it became necessary later on?  TIA.

[ElizabethE]

Just from what you have told me, I could see how you'd want to try to keep it cool and calm. I would say to him that you've chosen to minimize your visits and that you'll call him when you've decided you're ready for another appointment. You don't even necessarily need to speak this directly to him, as a nurse/receptionist or whomever handles appointments there could probably take that. But, all things considered, I don't think you'd be shutting the door to OB care if you were to just *disappear* from this doc now, would you? I mean, if you had to in future needs, getting another OB wouldn't be much of a problem, would it? Or do you just really like this one? Or were you thinking about needing him again specifically, for this pregnancy?

[Milkymommi]

LJ~ Mama... I hear you beyond words. It sounds as though you found a great situation though! You will know when and if it starts to take a negative toll on your state of mind. You can still trust birth and yourself and have prenatal care as long as the conditions are right. It sounds like they are just right for you, right now. I, on the other hand, haven't even seen my midwife yet although she does know I'm pregnant. I had the opposite issue with my last pregnancy, over managed care.  My son was stillborn at fullterm and died before onset of labor like your sweet boy.

My midwife was on hiatus from delivering and the one that I chose to see, well, lets just say I was the product of what you are in fear of. Shoved through the medical system with more drama than I can even convey, which contributed to massively high stress levels and a mama who was unhealthy in the mind the whole time and gave way to fear, lost my trust of my body's ability to do what I know it can. I didn't experience having the understanding and support that you seem to have found in your hcp. By the end I was avoiding the office, living in a panic and totally lost control of my decision making capability. So, I understand your concern. It doesn't have to be that way though... you just need to stay on your toes and keep filling your mind with positive reassurances that you will be aware and assertive when you need to be.

It's been 2 yrs. I'm 15 weeks and feeling confident that things are what they are. I am monitoring myself and will see my very hands off but practical and experienced mw soon. I feel like I need the "back up" prenatal care from her to help me make sure that I am making sound decisions and that I'm not missing anything. Essentially, doing the same as you without the u/s or doppler checks. I am going to avoid traditional care for now... but that's an option I have that you don't other than UP. I won't take that option either. Regardless of having chosen it last time and having such a bad experience, I'm still choosing care. I trust myself more than EVER after losing my son. You should too.

Fear is the enemy here... regardless of what kind of care or lack thereof we are choosing. Fear will keep us from knowing what is best. Stay strong mama. You're amazing.