advice on shadow care with OB

[sharita]

I have had "shadow care" with an OB with my last two homebirths just to get the ultrasound but then stopped.  Both times it was for insurance reasons.  Manged to lose insurance halfway through both times, once for ex hubby losing job, other for divorce and was denied medicaid so strictly midwife prenatal care from second half on both times.

This time I have medcaid and have been seeing an OB who is in the same clinic as my kid's pediatrician.  Love that place.  I didn't know I was doing homebirth again until I had to spend the night in L&D and was reminded why hospital birth was not for me unless nessesary.  So, I got intouch with my midwife, who agreed to see me again and let me have my last baby at home again.

My question is, I don't know how it is going to go down when I just show up at that office to see the pediatrician with the new baby, and my CNM sees me and wants to know what happened and why she didn't deliver my baby?

I never thought about it until today.  I like my CNM, she is very nice.  I am not the type of person who is comfortable with debates and telling her my plans ahead of time may spark one.  I mean what practicioner would say, sure go on, see me this entire pregnancy and then let someone else deliver your baby at home the last minute.  haha.  I am 32 weeks now.  My appointments are so quick and rushed but she does speak to me everytime I am in the office even if its for something else and I am not there to see her so I know she will ask.

Anyone have experience with this? 

[msmiranda]

I guess it depends on whether you want to preserve the relationship with her.  It sounds like this is your last baby so you would not need to use her again, so it's more of a personal question about whether you feel an obligation to let her know beforehand or not.  I had shadow care last time and stopped going at 34 weeks.  No one called or contacted me in any way until the baby was like 2 months old, if you can believe that, and even then it was the billing services woman.  I just told her I had had a home birth and she was like, oh, okay, well we will just bill insurance for the prenatal care then.  I was so worried about it in advance and it ended up being no big deal.  Your situation is different because you will actually have to see your CNM in person and it will likely be awkward.  But I understand not wanting to tell her beforehand if you think she will try to lecture you or talk you out of it or what have you, especially if you want her as backup in case you need to transfer care at the end of your pregnancy and you think telling her would cause her to drop you (because of liability concerns).  For that reason I would probably just deal with the awkwardness after the baby was born.