Question switching to a midwife at 30 weeks

[Josie213]

Hi, I am 30 weeks pregnant and I have been seeing an OB.  She has been supportive in my choice not to have an epidural, but when I mentioned I wanted to be in an vertical position during delivery she said would prefer for me to be in the bed which is making me a little uncomfortable.  I don't want to have interventions forced on me or to have to argue my way through everything. Am I jumping the gun by considering switching to a midwife now or does this make sense? Has anyone else had a simlar experience?

[Juvysen]

Nope, I'd switch.  :)  You deserve a provider that is on board with what you want.

I switched from an OB to a midwife in my first pregnancy at 20 weeks, and switched from a hospital midwife to a homebirth at 30 weeks in my second pregnancy.

[CBEmomma]

I have known plenty of women who have switched providers at the end of their pregnancies. You could also try talking to your provider again and maybe show her studies that suggest that back laying isn't the best postion to give birth in.

[scottishmommy]

Honestly, you should just switch. One of my bigger regrets from my first birth was not switching to a midwife. My ob wasn't bad either, but he was totally baffled by my non medicated labor. It almost seemed like he had never seen a birth before! Good luck mama!

[Italiamom]

If I'd been attended by a provider who expected me to be on my back, I don't think I could have gotten my son out vaginally in that position.  In fact, I know I couldn't have.  I tried a bunch of positions, he was posterior, and it still took me about 2 hours to get him out.  If I'd been on my back that whole time...  No way.

Basically, another mama here for making the switch!!

[CookAMH]

Sounds like you're seeing some warning signs which could greatly impact your labor. If you are drawn to a midwife, go for it. I switched around then this pregnancy (back in Jan) to a homebirth midwife and am SO glad I did. I know of many women who have switched.

[msmiranda]

I'll play devil's advocate for a minute ... is this the only issue you have discussed with her that she didn't seem supportive of what you wanted?  Was her response a strong "I won't consider delivering a baby with a mom in any position but lithotomy" or was it more like "I don't have any experience catching a baby somewhere other than the bed"?  Did she say that you must lay flat on your back, or just that you be on the bed?  There are other positions you can do on the bed -- e.g. side-lying, which helps open the pelvis; kneeling while upright on the bed (sometimes called Captain Morgan, I think); and using the squat bar attached to the bed. 

All that said, if there are no countervailing reasons for you to stay with this OB (financial, logistical, medical, etc.), then of course it is never too late to switch providers.  And in a general way, I highly recommend midwifery care for any low-risk woman, especially first-time moms.

One other thing to consider in terms of position:  if this is your first, you may find that you actually don't want to be upright to give birth.  I actually prefer to be horizontal because the descent and pushing part is so painful and intense for me, and being horizontal slows it down a bit.  I could never have predicted this before I actually gave birth, because upright looks like such a great way to have a baby! 

[Gena 22]

Originally Posted by Italiamom 

If I'd been attended by a provider who expected me to be on my back, I don't think I could have gotten my son out vaginally in that position.  In fact, I know I couldn't have.  I tried a bunch of positions, he was posterior, and it still took me about 2 hours to get him out.  If I'd been on my back that whole time...  No way.

Basically, another mama here for making the switch!!

Exact same for me!  I switched at 30 weeks to a homebirth and am thrilled I did!

[Juvysen]

Originally Posted by msmiranda 

I'll play devil's advocate for a minute ... is this the only issue you have discussed with her that she didn't seem supportive of what you wanted?  Was her response a strong "I won't consider delivering a baby with a mom in any position but lithotomy" or was it more like "I don't have any experience catching a baby somewhere other than the bed"?  Did she say that you must lay flat on your back, or just that you be on the bed?  There are other positions you can do on the bed -- e.g. side-lying, which helps open the pelvis; kneeling while upright on the bed (sometimes called Captain Morgan, I think); and using the squat bar attached to the bed. 

All that said, if there are no countervailing reasons for you to stay with this OB (financial, logistical, medical, etc.), then of course it is never too late to switch providers.  And in a general way, I highly recommend midwifery care for any low-risk woman, especially first-time moms.

One other thing to consider in terms of position:  if this is your first, you may find that you actually don't want to be upright to give birth.  I actually prefer to be horizontal because the descent and pushing part is so painful and intense for me, and being horizontal slows it down a bit.  I could never have predicted this before I actually gave birth, because upright looks like such a great way to have a baby! 

I ended up lying down, on my back (curled up, holding my knees) for two of my births, too... one of which was at home. I still think any first time mom ought to have the option of which position to give birth in (as I did), and that just hoping it's the position you will want is not a good reason to stay with a provider who won't allow other positions. It's completely normal for the position that feels best to differ from woman to woman and with each labor (my last was born with me kneeling in the water *shrug*).

[Climbing Rose]

I switched at about 30 weeks, because of a move.

Switching that far along wasn't as bad as I thought it would be!

Getting the right answers to your questions can be everything, and if you find an awesome person, it doesn't matter that it's week 30.  =)

[Comtessa]

I was so grateful that I switched to a homebirth midwife at 30 weeks!!! 

If you are sure you want to birth in hospital, though, I would point out that one of the issues with birthing upright in a hospital is that hospital floors are really, really gross.  A lot of care providers are going to be weirded out about the idea of a mama birthing her baby that close to the germy floor.  And though there are certainly ways to get around that ("here, let's put this sheet down so you have a clean birthing surface" comes to mind as an easy solution), they're probably not going to have any experience with those kind of  creative solutions, because most women are compliant and let themselves be shepherded into a lithotomy position (quite comfy for the OB, if not terribly helpful for the mother or baby).  If it breaks their routine, they're not likely to want to do it. 

With all of that being said, my HB midwife had me pushing flat on my back on the bed with my knees pulled to my chest!  In my case, the baby was having a hard time getting under the pelvic bone, and that was the only position that seemed to work to get her out.  Just goes to show you that you never can plan birth...

[Josie213]

Thanks everyone, I think I'm going to give my OB one more chance and bring my birthplan at the next visit and explain why I would like to try different positions for birth.  If she says no then, I'll switch.

[Turquesa]

That sounds reasonable, hearing her out before dumping her altogether.  If she's inexperienced at working with different labor and birth positions, that alone would be a red flag despite her good intentions. 

Here's one more anecdote: My MWs took on a woman when she was at 38 weeks because her doctor was already telling her she'd have to do a "time's-up" induction at 40 weeks, regardless of her and her baby's medical condition.  It is absolutely not too late for you to switch. 

[298mom]

I think another thing to consider is whether the doc is on board with all your other desires.  (Since you're planning to take your birth plan to your next appt, that should work things out.)  It's much better to have a clear understanding about everything with your doc beforehand.  Trying to negotiate when you're in labor is pretty difficult!

So if he's on board with all your other requests, and birth position is the only issue, and if you want to stay with a hospital birth, then hopefully you have time to work that out with him!

In that case, it comes down to what you're more comfortable with - home or hospital.

[Jaimee]

I switched care  providers at 37 weeks and so glad I did!  Go with your gut- envision your birth and go with what feels right.