Did you tell your OB that you were going to UC? - Page 2

[sunshinemoma]

Originally Posted by Adaline'sMama 

Well, I cant really lie to her about anything. She was my OB last time too, so she knows exactly how my labor went. She also knows that I am super into natural childbirth, and that I was a PIA for the hospital to deal with. Basically, they had to break every single protocol for me to birth there. And she made sure that it was set up to work that way. She made sure that no one ever asked me if I wanted an epi and that all of the nurses had reviewed my birth plan before I came into the hospital. I just think that regardless of how awesome she is, an OB is an OB , right? They've gone to school and learned about exactly why every woman should give birth in a hospital. So, I just cant imagine any OB being like , "Oh, cool you are having a UC. youll be fine." I guess Im really just afraid that if she knows that Im planning a UC she will stress me out about every little problem that might come up. And I DO trust her, so I think if she flat out told me "Hey, you really shouldnt do this because of xyz high risk factor," it would affect my decision for sure.


Also, Im trying not to be in the habit of lying to my hcp's, but it seems like its just harder and harder to tell the truth the more I try and take control of our own health.

That is soo cool that she did that...I wonder if it was difficult for her to get everyone on shift during your labour to let you be...?  At any rate, I think that's very rare and very LUCKY for you to have had that experience!  

And for the rest of the bolded I COMPLETELY agree.  And I do NOT believe that pointing this out is vilifying OB's.  I truly think OB's see things differently than most midwives who are trained and experienced in dealing with low risk natural pregnancy/labour/births.  They have different viewpoints.  And even if OB's KNOW that xyz is extremely rare...they might have seen it first hand which makes is so much more tangible in their mind's regardless of how low your risk is they want to avoid it at all costs-even if the procedures used to prevent 'xyz' can actually cause 'hij' which could be also be bad..maybe not so immediately or obviously, or maybe it is just less likely to cause liability issues for them.  I'm sure that many times they have great intentions but just act based on all the awful things they have heard/seen in their training/field of work.  Which lots of times doesn't factor in exactly the amount of risk being traded- as in in order to reduce a very nil chance of something extremely bad they do something that gives extreme risk of something bad(but not fatal) occuring.  Does that even make sense?  I am being so vague SORRY.

As for my personal opinion on this topic:  I am seeing an OB next month, I will not be telling her of my plans to UC.  Mind you I'm seeing her one time to get information about the condition of my cervix (was told it may/may not have been torn during last birth where DR. gave two episiotomies that extended all the way to the cervix)  Anyways, I want to know.   Not that it makes a huge difference, but it could affect things.  I have gone to a midwifery clinic and at this point I have no desire to tell them that I plan to UC.  I DO consider myself a very honest person...for some reason I don't look at them any differently than the acquaintance at church who knows I'm expecting and most likely assumes I'm having a hospital birth.  I'm I dishonest for not making certain they know my plans?  I don't think so.  So I wont be offering that info.  I can always decide to tell later.  BUT, (because once it's told you can't take it back) if at any time during my care I feel any inclination to tell one or all of the midwives I'm receiving care from I will pause and discuss it with DH as well just ponder the idea and the possible outcomes long and hard before telling them.  

This labour is going to affect me and my baby and my family more than it will ever affect any healthcare provider.  It's my responsibility to do all I can to bring the best outcome for me and my family.  At this point, I don't think telling any healthcare provider about the possibility of UCing is part of that :)  

Good luck with what you decide :)

[sunshinemoma]

Oh and, You don't need to lie to get hypothetical information.  

I'm new to this midwifery practice and could probably say ""what happen's if you don't get to my home before the baby? because I have a history of very fast labours.."  without them second guessing me -but, I haven't really had that fast of labours..

Rather I will honestly ask "what happen's if you don't get to my home before the baby?  Even tho my past labours have been long.  My older sister had similar and even longer labours and then went on to have a very precipitous labour with her third.  At any rate, what is your recommendations if my baby were to come before you?"  

Anyone could use that dialogue honestly by altering it to say "what happen's if you don't get to my home before the baby?  Even tho my past labours have been long.  My older sister had similar and even longer labours and then went on to have a very precipitous labour with her third.  At any rate, what is your recommendations if my baby were to come before you?"  or edit it according to what your back up plan is..hospital/midwife then hospital etc...

Hope that helps!

[Adaline'sMama]

Originally Posted by Astrogirl 

I'm sorry, I really don't get this:

So you:

1) Trust her

2) Think she is awesome

3) Already have experience with her advocating heavily on your behalf in a hospital environment.

I'm not understanding your reasoning for not being honest with her.  Given the relationship you have built with this woman, and how she has gone to bat for you in the past, why would you all of a sudden NOT trust her if she risked you out?

Me personally, if UC was something I was into (I gave birth in an (european) environment where an OB was present, but 'hands off' - she was nearby while I caught the baby myself, etc etc - you dont need to know my story), AT LEAST  I would simply tell her something vague that showed my intentions, i.e.:  'if all goes well, maybe I will be able to have the baby quickly at home and not need to call you.....'.     Perhaps, if shes the type of OB (as mine was) who is open minded (and it seems she is), there is additional help/advice/supplies/resources she could help you with.  I don't know why you would want to sabotage that possibility just because she HAPPENS to have some letters behind her name that automatically vilify her. 

It seems from your last post that your gut reaction is to trust her and not to lie to her - I would go with that, because you know her and you know yourself better than anyone here. Despite what some people would have you believe, there are OBs in this world that are inherently good care providers and will go above and beyond the call of duty to help women achieve the birth they want.  My second birth is proof of that.   Yours has already proven that she has the guts and the knowledge to break protocol.  Good luck :)

Well, I didnt really ask you to get it, did I? I asked if you have told your OB that you were planning a UC. You made it clear that you arent into UC, so Im not sure why you thought you would get my POV.

I trust the woman to attend my hospital birth. I did not say that I trust her about every single thing in the world.

As far as a doctor having letters behind their name meaning that Im vilifying them, no. But those letters come with certain legal boundaries. An OB is not likely to give you supplies or advice on how to have a UC the best way.

Regardless of any of your opinions, Ill let you know that I take them with a grain of salt because of your snarkyness. Telling me that "I dont need to know your story" and assuming that I dont want help or advice is just rude. I asked a question, to people on a forum that is intended for people who have had or are planning a UC, or are at least "into it". If I had all the answers about why I feel the way I do about not trusting my OB with this information, then I wouldnt have posted the question. Dont take me for an idiot who hasnt thought this through for oh, I dont know, about the last 14 months.

I told her last time that I was thinking of having a midwife with my next baby and she didnt think it was a great idea because midwifery is illegal here and the midwife could not be held responsible if she made poor decisions that resulted in my baby being born with defects or stillborn.

[Adaline'sMama]

Originally Posted by sunshinemoma 

;At any rate, what is your recommendations if my baby were to come before you?"  or edit it according to what your back up plan is..hospital/midwife then hospital etc...

Hope that helps!

I'd like to find something like this to say, but I feel that the response is likely to be, "If you come to the hospital as soon as you go into labor, that is very unlikely to happen." or "Call an ambulance if you feel that you cant make it to the hospital."

[Banana731]

Originally Posted by Adaline'sMama 

I told her last time that I was thinking of having a midwife with my next baby and she didnt think it was a great idea because midwifery is illegal here and the midwife could not be held responsible if she made poor decisions that resulted in my baby being born with defects or stillborn.
 

that does make it harder to feel out her opinion.

Originally Posted by Adaline'sMama 





I'd like to find something like this to say, but I feel that the response is likely to be, "If you come to the hospital as soon as you go into labor, that is very unlikely to happen." or "Call an ambulance if you feel that you cant make it to the hospital."
 

maybe you could say something like, " i was really uncomforatble at the hospital. i'm going to stay home as long as I possibly can. what happens if the baby comes while we are still at home?"
 

[NANandAUBIE]

Originally Posted by MittensKittens 

Yes, disclosing too much information could lead to not having OB care at all, and even facing issues with social services. It is possible to receive OB care and have a UC, and never lie about anything - calling in after the birth would be just fine. Isn't it true that, unlike homebirth midwives whom we pay out of pocket, OBs will not suffer financially if you don't give birth with them in attendance?

Actually, from what I understand, having worked in the medical field and having friends that work in a OB/GYN office, it is billed at the end of the pregnancy, in other words, they dont get paid until after the person gives birth for the prenatal care they received. Its called global billing or something. Seems insane to me but thats what I was told. Maybe it was not correct, but from what I understood, they bill globally at the end for the entire pregnancy and the services given during it.

I would be honest with her. You seem to have a good relationship with her and I would tell her you want to be seen to be screened during your pregnancy but want a low key birth at home. If things get crazy, you'll call her. I just feel like being dishonest is burning a bridge. To me, she has gone out of her way to make your previous birth a success so why not give her the benefit of the doubt?

[NANandAUBIE]

Im just playing devils advocate here for a moment. So if she bills globally at the end of your pregnancy like I understand most do, she will get paid for your prenatal care. She will lose out on the birth though and that is the biggest money maker for her. Does that make sense? So consider from an OB's standpoint, its a business and if she is going to make more money from another patient who is going to receive all of their prenatal care from her and deliver with her, she is more apt to take them on because it simply makes more financial sense for her. So will she get paid for your prenatal care, yes. Will she make more money off another patient, probably.

Just wanted to clarify my point.

Im totally just wondering what is your reason why you want to see an OB anyway, if your planning a UC? Like, do you want the standard prenatal appts or just a few and an U/S for positioning? Have you thought of alternatives like seeing a HB midwife and asking her about the possibility of having her stay nearby while you birth at home but away enough that you feel unwatched? Im just not sure seeing an OB is going to be the right choice for you. (totally not attacking you, just curious and trying to help).

[Adaline'sMama]

Originally Posted by NANandAUBIE 

Im just playing devils advocate here for a moment. So if she bills globally at the end of your pregnancy like I understand most do, she will get paid for your prenatal care. She will lose out on the birth though and that is the biggest money maker for her. Does that make sense? So consider from an OB's standpoint, its a business and if she is going to make more money from another patient who is going to receive all of their prenatal care from her and deliver with her, she is more apt to take them on because it simply makes more financial sense for her. So will she get paid for your prenatal care, yes. Will she make more money off another patient, probably.

Just wanted to clarify my point.

Im totally just wondering what is your reason why you want to see an OB anyway, if your planning a UC? Like, do you want the standard prenatal appts or just a few and an U/S for positioning? Have you thought of alternatives like seeing a HB midwife and asking her about the possibility of having her stay nearby while you birth at home but away enough that you feel unwatched? Im just not sure seeing an OB is going to be the right choice for you. (totally not attacking you, just curious and trying to help).

Using homebirth midwives is not really an option for me. I live over an hour away from them, and I have a friend who lives near me who used them and they came about 12 minutes before the baby was born. I would have to pay them out of pocket, and risk them not coming until the last minute. I want to see an OB because I want to make sure that everything is moving in the right direction for me to give birth at home, alone. If I was using a midwife for prenatal care, I wouldnt need an OB, but as it stands seeing an OB is completely free, and a midwife is not. My OB has a CNM in her office, and I have use them before, so Im comfortable with them. I may not go to all of the appointments, but I probably will go more than a couple of times. As this is my first UC and my first homebirth, I do want prenatal care the entire time. My last baby turned breech on me at 35 weeks last time and I had no idea. If I hadnt seen my OB there is no way I would have known. Maybe this time I will be more aware of things like that, but I see no harm in seeing an OB since Im not going to pay a penny for it, they allow children at the visits, and its really close to my house.

[labortrials]

Banana has some good suggestions!

Really, my concern in your case is that she really does sound like a great OB, and depending on how far along you are (or aren't), you may desire or need her services further along in the pregnancy.  But if you tell her your plans to birth at home, she may drop you.  A lot of it has to do with how your local OBs generally practice.  Do any of them offer back-up services?  Does she??  I happen to know that in my community, NONE of the OBs will back up the homebirth midwives, and I'm certain they all think UC is nuckin' futs!!  It may even violate their own malpractice insurance to offer their professional services to someone who will birth outside of the hospital without them.

I don't enjoy having a somewhat superficial relationship with an OB, but I have to put myself and my baby FIRST.  That means NOT disclosing my plans to birth at home.

Everyone's situation is different, so a global "don't lie to a medical professional" would be really poor advice for mamas in many communities across the U.S.

[ElizabethE]

Originally Posted by Ldavis24 

mittenkittens you should know that ElizabethE is the spokeswoman for all things UC (sarcasm here)...to disagree with her is to invite a long drawn out argument where you will never win because you are not ElizabethE.

OP...I personally would casually mention home birth as a feeler and see how she feels. If you love your OB so much though that might play a factor in your final decision if you plan on having more children in the same area and want to use her again for another baby....If you do not tell her and UC and then try to get her care again, she probably would be a little less receptive to even seeing you as a patient again.

Oh, so I am hated because I win arguments?   Thank you for today's positive affirmation! That feels gooood. High five!

Haters gonna hate! But, Mittens and I got no beef. You wanna be startin' something?

Oh yeah, and [obligatory response to OP so it looks like I'm still on topic and not just here to pick fights] = lawl

And yes OP, do not do anything to upset the OB. Remember to remain completely at her mercy, like a good girl. It is her life, after all. [Of course, sarcasm, Holly.]

[Ldavis24]

Originally Posted by ElizabethE 

Oh, so I am hated because I win arguments?   Thank you for today's positive affirmation! That feels gooood. High five!

Haters gonna hate! But, Mittens and I got no beef. You wanna be startin' something?

Oh yeah, and [obligatory response to OP so it looks like I'm still on topic and not just here to pick fights] = lawl

And yes OP, do not do anything to upset the OB. Remember to remain completely at her mercy, like a good girl. It is her life, after all. [Of course, sarcasm, Holly.]

or generally not trying to upset people in LIFE is nicer than being a walking confrontation...

yawn...you bore me EE.

I don't recall being civil/honest to a point with a care provider means we are completely at their mercy but then again I am not trying to hawk a book based on the point that all OBs/MWs have ulterior motives besides helping mamas birth babies and keeping everyone healthy in the process...So once again yawn...you're shtick is tired.
 

[ElizabethE]

Originally Posted by Ldavis24 

or generally not trying to upset people in LIFE is nicer than being a walking confrontation...

yawn...you bore me EE.

I don't recall being civil/honest to a point with a care provider means we are completely at their mercy but then again I am not trying to hawk a book based on the point that all OBs/MWs have ulterior motives besides helping mamas birth babies and keeping everyone healthy in the process...So once again yawn...you're shtick is tired.
 

If I bored you, you wouldn't keep coming back to engage me. What's boring is that you continue trying to pick at ME, as if that scores points somehow. Like in your last attack, I wonder if you even noticed that the way you addressed Mittens was even incorrect, as she and I were not even disagreeing with one another? It was just you jumping at any cheap shot you can take. You're not even stopping to comprehend the meaning behind anybody's posts before barking at them.

Back to the subject though... being totally honest with your care provider CAN put you completely at their mercy, in certain situations. Or didn't you know that? All it takes is a concerned professional to make it their duty to step in and suddenly a woman's body and rights are no longer her own anymore. Even if it didn't go to that extreme, there are many obstacles that can be thrown in OP's path whether intentionally or not, and it is those that she and all of us here who care about her are hoping she can avoid.

I don't know what this "hawking a book" business is, and if you had the fairness of character (and the reading comprehension) to look at mine before judging it, you would have to admit that it is not about all OBs and MWs having ulterior motives. You're just being unfair again and taking more cheap shots, which is particularly vicious considering the book in question is dealing with my own personal struggles and feelings of being traumatized. Way to be sensitive, "LDavis". Or are we only sensitive to moms on the other side of the spectrum, who abhor UC?

Now, I think I'll stop answering to you, so you can go ahead and keep saying whatever you like to me, but from now on in this thread I will restrict my comments to the others who are actually serious about UC, which is why I come here in the first place. :(
 

[Adaline'sMama]

Stop it. Both of you. Lets act like adults. Since moderation isnt happening, we need to try to remember to moderate ourselves and not fight over the people that we think the other people are because of some post or another that they made that we disagreed with.
Ldavis24 , you are one of my favorite people on this board
EE has given me some really great advice since Ive been on my quest to learn all I can to prepare to UC.
I ♥ you both. Can we get along now?

I do think its likely that if I tell my OB that I will be at her "mercy." Last night DH and I talked about it for a long time and we came to the decision that we will not tell my OB at all. I feel that regardless of whether or not she is trustworthy and reliable, I wont be able to trust her interpretation of what is going on with my body unless I know that she is not holding a biased opinion and attempting to sway me towards a hospital birth. Basically, its not about whether or not she is capable of being honest with me and supporting me, its about how I will read her comments and actions. I know that this issue is all about how I will perceive her actions and responses, not what she is actually going to do. Because of that, we both agreed that I will be less stressed out if I do not tell her.



typo edit

[ElizabethE]

Holly, sorry your thread got derailed.

[labortrials]

Originally Posted by Adaline'sMama 

I do think its likely that if I tell my OB that I will be at her "mercy." Last night DH and I talked about it for a long time and we came to the decision that we will not tell my OB at all. I feel that regardless of whether or not she is trustworthy and reliable, I wont be able to trust her interpretation of what is going on with my body unless I know that she is not holding a biased opinion and attempting to sway me towards a hospital birth. Basically, its not about whether or not she is capable of being honest with me and supporting me, its about how I will read her comments and actions. I know that this issue is all about how I will perceive her actions and responses, not what she is actually going to do. Because of that, we both agreed that I will be less stressed out if I do not tell her.
 

Glad you've made a decision that feels right to you.  You can certainly 'feel her out' over the next few months.  Ya know?!  Enjoy your pregnancy!!
 

[sapphire_chan]

How about "OB, if I make it to the hospital for this next birth, what are you going to do to keep them from freaking out about me?"

Don't most OBs bill insurance with a standard pregnancy package that doesn't distinguish between numbers of prenatal visits and time spent at the birth? If that were the case, it wouldn't really affect your OB in the slightest for you to stay home instead.

[SrkStrickland]

Well, here in my area I don't really have the option of having an ob like that. My entire state is super mw unfriendly, vbac unfriendly, and all things "natural" unfriendly. It's horrible. If I so much as mentioned home birth to any of the ob's I've been too they would and have had a heart attack. I am still searching for an ob that I am comfortable obtaining prenatal care from because they're all so close minded. So, in other words, you are super lucky. Only you know your ob best and how she might handle information like that. If you so choose, I agree with the others on casually and gradually mentioning ideas to see what her take is. But in my situation, there is no way I could even mention it, I would be kicked out of the practice. Good luck to you! Hope it goes well :)

[calldeville]

Hello, Holly. I appreciate your concern and thought that you're putting into this question. My two cents: you need to be honest with your OB. Only then can she truly provide the care and guidance that you need and deserve. You say yourself that she is good and compassionate and you two have a history and so far you've worked well together.

This is a bad analogy, but when a doctor asks during a regular checkup, "How often do you drink?" And someone says "A glass of wine each night." If it's really half a bottle of Jack each night, then a doctor needs to know that. Don't worry about judgments, just be honest with the hopes of getting and providing the best care possible for your child.

Even if she tries to talk you out of it or worry you, really that just makes you think that much more ahead and plan ahead and investigate possibilities. 

UC is not illegal in Kentucky so all she can do is warn you or inform or advise.

[NANandAUBIE]

hmmmm, I would say, go to your appts, keep your options and mind open and if you feel the time is right, tell her. If not keep it to yourself and play it by ear. I totally get seeing someone who is free because of insurance. I totally get that. Not flaming you at all just was curious what exactly you were looking for. I hope you have the birth you feel empowered to have mama. Good luck!
 

Originally Posted by Adaline'sMama 

Originally Posted by NANandAUBIE 

Im just playing devils advocate here for a moment. So if she bills globally at the end of your pregnancy like I understand most do, she will get paid for your prenatal care. She will lose out on the birth though and that is the biggest money maker for her. Does that make sense? So consider from an OB's standpoint, its a business and if she is going to make more money from another patient who is going to receive all of their prenatal care from her and deliver with her, she is more apt to take them on because it simply makes more financial sense for her. So will she get paid for your prenatal care, yes. Will she make more money off another patient, probably.

Just wanted to clarify my point.

Im totally just wondering what is your reason why you want to see an OB anyway, if your planning a UC? Like, do you want the standard prenatal appts or just a few and an U/S for positioning? Have you thought of alternatives like seeing a HB midwife and asking her about the possibility of having her stay nearby while you birth at home but away enough that you feel unwatched? Im just not sure seeing an OB is going to be the right choice for you. (totally not attacking you, just curious and trying to help).

Using homebirth midwives is not really an option for me. I live over an hour away from them, and I have a friend who lives near me who used them and they came about 12 minutes before the baby was born. I would have to pay them out of pocket, and risk them not coming until the last minute. I want to see an OB because I want to make sure that everything is moving in the right direction for me to give birth at home, alone. If I was using a midwife for prenatal care, I wouldnt need an OB, but as it stands seeing an OB is completely free, and a midwife is not. My OB has a CNM in her office, and I have use them before, so Im comfortable with them. I may not go to all of the appointments, but I probably will go more than a couple of times. As this is my first UC and my first homebirth, I do want prenatal care the entire time. My last baby turned breech on me at 35 weeks last time and I had no idea. If I hadnt seen my OB there is no way I would have known. Maybe this time I will be more aware of things like that, but I see no harm in seeing an OB since Im not going to pay a penny for it, they allow children at the visits, and its really close to my house.

[NANandAUBIE]

Yes, exactly, but they bill after the birth for all the services. I believe paperwork may be submitted the entire pregnancy but global payment is not until after the birth. So you can imagine why it might p*ss them off if you dont birth with them. They do not get paid for a birth they do not perform however. That would be fraud. So they see you, planning to deliver your baby and get paid the big bucks and then get only to bill for prenatal visits 40 weeks after beginning them.

It makes no sense. I think alot of them would care less if the billing were different. It would be like going to a hairdresser once a month for a cut but getting your color/perm somewhere else. Your hairdresser would be pretty p.o.ed. Totally not likening your prenatal health to a hair cut, just an analogy...

Originally Posted by sapphire_chan 

How about "OB, if I make it to the hospital for this next birth, what are you going to do to keep them from freaking out about me?"

Don't most OBs bill insurance with a standard pregnancy package that doesn't distinguish between numbers of prenatal visits and time spent at the birth? If that were the case, it wouldn't really affect your OB in the slightest for you to stay home instead.