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I'm back, and I need help!

post #1 of 30
Thread Starter 

I know I took my ball and went home, but I'm back now with my big girl panties so I'm hoping I can watch what I type and we can all get along.  We're all super sensitive right now (I have been bawling like a maniac lately because I'm "lonely"), so I am going to try really hard to behave and to also take things with a grain of salt.  I have had the most terrible week ever, and this was my ONLY pregnancy support system - I need you guys.


Here's the deal - I'm 23w2d today, and I need a new health care provider.  I'm not specifying midwife, because I'm flexible at this point, but I'm firing my current one on Friday.  This is long, and I apologize, but I need to vent.


This is my first baby (it's a boy, by the way, but I'll update all that fun stuff in the chat thread later), and I knew I wanted a natural birth, not in a hospital, but not at home.  There are two birth centers in town, and I contacted both of them.  DH did NOT approve of the first center.  He has zero tolerance for tardiness, and they made us wait for over half an hour past our appointment just for our tour.  Then we found out it is a rotating pool of providers - we don't get to pick who sees us for prenatal care or who will attend the delivery.  When we heard that, we checked out the other center.  We liked the facility, loved the childbirth educator that gave us the tour, and I personally loved all the babies!  There are little babies all over that place all the time, and it just seemed so relaxed and comfortable.


However, that should have been my clue - things are a little TOO relaxed for my taste.  So far, they've screwed up ordering and following up on my labs, have been confused about who saw me and when, given me zero advice about my prenatal vitamins (which led to my chiropractor flipping out about me taking "bad" ones and giving me specific directions), and I've been on the receiving end of some advice I did not like, and did not follow.  I have severe allergies, but was instructed not to take anything because "it could make [my] labor last longer."


This is not what made me snap though, surprisingly enough.


I had my only planned ultrasound at exactly 20w (May 23rd) and I called the next day to ask about it.  I spoke with my midwife, who was sleep deprived from a delivery, and I told her that I wasn't worried about the results, he was just RIDICULOUSLY active and I wanted to make sure they got all the pictures they needed (the tech had to repeatedly switch what he was looking at because baby would wiggle out of the way).  She told me she was going to get some sleep and to give her about 24 hours, but then she'd call.  No call came.  I'm used to their "no news is good news" policy, though, and didn't give it too much thought.


Monday of this week (23w), I had a large amount of discharge that appeared to be mucus.  Like I said, first pregnancy, so I know that SOME is normal, but this was a lot more than "some."  I called the birth center, they transferred me to the midwife, and she tells me, "We're just juicier when we're pregnant."  puke.gifShe said if I was really that concerned, I could see their nurse on staff.  I made an appointment for that afternoon, and the nurse suspects I've got some sort of infection going on, but once again, not the kicker...


The nurse went to measure me, and asked, "Uh, how far along are you again?" "23 weeks, why?"  "You're measuring 29."  After she confirmed that I was, in fact, measuring at 29 (after measuring 19 4 weeks ago), she asked about my last ultrasound.  I told her I had never heard back, so she starts digging - no one has it, and it isn't in my file.  She called to get a copy sent over, and guess what?  Not only did baby wiggle too much for them to get a good look at his heart, his kidney measurements were really, really high and they had asked that I come back in to have a follow up. Cuss.gif Also, baby measured pretty darn big at 20w (his head was 91st percentile) and while examining me, the nurse found an extremely tender spot on my lower left side she wanted looked at.


To summarize, as of Monday afternoon, I had allergies that had gone mostly untreated for 2 months, a vaginal infection that was just me being "juicy" from pregnancy, a baby with a potential issue that should have been identified 2+ weeks prior, a 23w uterus measuring 29w (which at least explains why I thought I felt him in my ribs already), a really fat headed baby, and mystery LLQ pain.


I had my follow up ultrasound yesterday, and I had the report sent to me this morning and all appears to be well.  Baby is fine (still big headed, but stll measuring about a week ahead, not SIX weeks), there was no visible reason for my LLQ pain, his kidney measurements were WAY better, and his heart was fine (he just cannot be still - ever). I've got a lot of fluid, but not enough to explain my 6cm measurement discrepancy.   I only know all of this though because of calling the clinic for my report - no one from the birth center has contacted me regarding either ultrasound or my labs from Monday.


I'm done.  I just don't know how to start trying to find a provider this late in the game.  I know of a few awesome midwives through friends, but they only do homebirths.  HB is just not an option for me right now.


Any thoughts on good resources for finding out about decent OBs that aren't induction/c-section happy?

post #2 of 30

I have no particular advice, but I wanted to say that I'm glad you're back.  I'm sure someone has some good advice!

post #3 of 30

Welcome back!! love.gif

Originally Posted by AKChix0r View Post
Any thoughts on good resources for finding out about decent OBs that aren't induction/c-section happy?

Ask around. See if you can ask L&D nurses at your local hospital(s) who they would recommend who is middle of the road (competent, keeps on top of problems, but doesn't freak out over normal things.) If you have any sort of natural-birth-oriented groups in your area (ICAN, LLL) contact them and ask who they would recommend. Also try the Find Your Tribe subforum here. You could also try checking reviews at The Birth Survey though I'm not sure how comprehensive they are at this point.


ETA: Just a note that while I totally understand how this would drive you to see if you can find someone with whom you feel more comfortable (it sounds very stressful!), keep in mind that you might have similar (or different) issues with an OB. If you otherwise really like the birth center and midwife, you may want to consider talking with her about expectations around communication.

Edited by ~pi - 6/16/11 at 12:11am
post #4 of 30
Ok, so more information needed: birth center and homebirth are equivalent in supplies and safety. Is it just that you don't want to do it in your home? There are alternatives to home that aren't a birth center or a hospital - like a cabin rental or hotel or ??

As far as OBs - as at ICAN - the ceasarian awareness network. They know who is good and who is not. If there isn't that pool of information, ask the doulas in town. Failing that, interview a family practice doc (they don't do sections) and hospital midwives.

Good luck!

PS Congrats on the baby BOY!!!
post #5 of 30

Sorry, I don't have anything more helpful to offer, but I'm glad to see you're back.
post #6 of 30
Originally Posted by Jane View Post

ask the doulas in town. Failing that, interview a family practice doc (they don't do sections) and hospital midwives.


nod.gif  Those are great suggestions. (Though minor correction: It isn't actually true that family docs don't do sections. Most don't, but some do, especially if they practice in a rural area. Here is the relevant AAFP statement.)

post #7 of 30

welcome back Karli! congrats on your boy :)


Sounds like you need a new care provider, b/c I would not be comfortable with MWs who are missing warning signs of possible problems. IMO, that is a big part of their job- to make sure you actually ARE low-risk. That means taking risks seriously- and hopefully helping you resolve problems, rule things out, etc. BUT, I do want to caution you also that a hospital-based OB practice may be similar... in some ways at least. Long waits, incomplete charts, seeing a different provider each time so you have to go over things... and then they may be blase about medications etc where you want someone who will actually talk you about risks/benefits...


I have had hospital OBs, switched to their affiliated MWs for #1. (who were better, and more on top of things, and actually got to know me slightly, and you had a consistent prenatal care provider, but for the actual delivery, could be anyone of a big team of MWs). But the whole, "you get who is on call when you are in labor" was the case with both. Then w/ #2 I had a homebirth and co-care (well, "shadow care") from the hospital MWs (basically so my insurance would cover tests, etc). I have to say, the HBMW was way more informed and on top of things with me. She helped me ask the right questions and ask for the right tests, and she monitored my health much more closely, helped me interpret my labs and test results, etc. Plus, the continuity of care is such a nice change. Now for #3 I am in a new state, I have a pair of HBMWs who can write prescriptions and order tests, and who take medicaid (my insurance) and I am thrilled. Finally I am getting the continuity of care AND the bureaucratic stuff all together. Though I will get whichever of the two of them are on call, I will know them both well by then (they bring a trained attendant with them too, so their are two professionals at the birth).

post #8 of 30

YAYYYYY Karli is back!!!!!!  With bummer news though....


I don't have advice, except like everyone else says, to ask people in the know.  BUT I did want to tell you I just switched care providers at 25 weeks, for much less compelling reasons that you have, and no one seemed to blink an eye.  It seems late in the game to me, but for them, it seemed like things are just warming up.  Ask a lot of questions, especially the ones you don't want to ask, and see where folks come out.  You'll find someone good.  Thanks for coming back. I missed your thoughts and input. 

post #9 of 30
Thread Starter 

To clarify, I'm only saying OB because as far as I know, the remaining midwives in town are affiliated with an OB's office or the hospital.  I could be way off base and missing somewhere awesome, and that's what I HOPE comes out of this.  I just didn't know how to start looking.


My concern is that through this whole process, I seem to either come across "traditional" medicine, which scoffs at my midwife/natural path and is drug-happy, or I find the natural healing providers to be so overly cautious of medical intervention that my care suffers.  I went to a chiropractor for my allergies - I'm obviously still coughing and having problems breathing, so maybe we need to try something else?  No, Doctor at Urgent Care, Class C medications aren't "totally safe."  Ugh.


Jane, I hear over and over that birth works best if you are comfortable and relaxed.  I freak out when there are people in "my space," and would be constantly worrying about the cleanliness of the house, making a mess, etc.  I think I would be even more tense in a hotel or a rental where I would be responsible for clean-up.  I know I'm weird, but I also know my limits and I want to be as relaxed as possible.  The birth center had the comforts of home without the worry.


There is one last possibility though.  While my midwife has been kind of flakey, her apprentice has been handling most of my visits, and I LOVE her (and her baby loves my DH - she crawls all over him every time we have an appointment).  I have an appointment scheduled with them tomorrow, so I might try to take her aside and find out if my birth is one of the ones she will be handling mostly on her own.  If it is, I might just have a chat with her about the situation so far and take it from there.  She's been such a sweetheart and has really made me feel good this whole time, it's just her coworkers that have been making things difficult.


Thaks for the good resources!  If I get some free time today (probably not, with the amount of legal filings I have due), I plan to start digging!

post #10 of 30

Welcome back orngbiggrin.gif

post #11 of 30

Nothing helpful except welcome back!  

post #12 of 30

I don't think you'll be able to find an OB who delivers in a birth center.  Ask around for a friendly/ nice OB and see if you get any recommendations.  I had to switch to an OB from midwives when their practice closed.


You may just have to accept that you won't have the "perfect" scenario you're envisioning-- even if you do find a great OB you'll be starting from scratch and might run into other problems.  Sometimes the devil you know is better than the devil you don't.  If you are determined to give birth in a birth center you'll probably have to stay with the midwives.  Also, with an OB, you will not be with your dr the whole time, so a lot of decisions will be made with the nurses and whoever is on the floor at the time.  It may be difficult to find an OB willing to take you on this late in the game-- each office has their own policies.  

post #13 of 30

First of all, welcome back!



Originally Posted by AKChix0r View Post

My concern is that through this whole process, I seem to either come across "traditional" medicine, which scoffs at my midwife/natural path and is drug-happy, or I find the natural healing providers to be so overly cautious of medical intervention that my care suffers.  I went to a chiropractor for my allergies - I'm obviously still coughing and having problems breathing, so maybe we need to try something else?  No, Doctor at Urgent Care, Class C medications aren't "totally safe."  Ugh.


Regarding the bolded part above, have you come across any naturopaths in your search? My care provider is a naturopathic doctor and a licensed midwife, and so far I've been super happy with her...she is really on board with a natural, non-medicalized view of birth, is definitely non-drug-happy etc. but she does understand that some people have concerns/issues that require a little bit more of a "conventional" approach (as an example, we are doing a natural homebirth, but when she detected a fetal arrythmia at one of our appointments she didn't hesitate to send us to the high-risk clinic to get it checked out...turned out baby is fine though!). Anyway, just a thought...I don't know if her attitude is typical of naturopathic midwives, but it's probably worth checking out if you can find one. Good luck!


post #14 of 30
Pi - thanks! I forgot that some do. I live in such a big city, the OB's run the privileging committee. There are no FP's that do surgery. Or FPs under age 60, at least - only grandfathered in ones. FPs can be an excellent, excellent choice for a hospital birth.

AkChix - I getcha, you need to be comfy. V. V. important. I mean, your uterus will contract, your cervix will open, and you'll have a baby, even if your only choice is a Honda Civic at rush hour on the expressway. But it makes sense to plan something you like. With people you trust, even if you don't like them. But people you like is better.
post #15 of 30

I'm glad you're back - I missed your humour!


What a scary experience - I can totally see why you would want to switch providers.


With ds I really wanted a midwife but we were living in another country where midwives do not have hospital privileges & hb's are a grey legal area. The combination of them not being able to transfer easily to a hospital & being in a foreign country (& not wanting to get into legal hotwater) meant that a midwife was out of the question. But I did meet with them once while we were still deciding & found out that they had an OB they used for those clients that had to be risked out or who had to transfer to the hospital (the midwives cannot even enter the hospital apparently). I figured I'd give him a try (even though I was unsure of a male provider) & it worked out great. He really was fabulous & respected all my wishes during the birth. Best line from him was when I went for my 6 week pp appt & I was very worried about tearing so severely in the future (I had a 3rd degree tear) & he said "I'm an ob, but I know nothing about obstetrics. Any doctor who says he can predict the outcome of a birth is making it up." LOVED HIM!!!


Anyway, sorry for being so long winded - you could try contacting some of the hb midwives & asking who they use for hospital transfers or those clients who are risked out. Those ob's are probably more likely to be naturally minded as they work (& hopefully respect) with midwives.


The other thing I am trying hard to do again with this pregnancy is to trust my instinct. I really like my ob so far this time & am trying to not second guess those feelings 'cause most of the time those first impressions are right. I just FEEL like I can trust him.

post #16 of 30

This is an excellent suggestion. They know the docs and which ones do not just "scoff" at a natural path.

Originally Posted by lifeguard View Post
you could try contacting some of the hb midwives & asking who they use for hospital transfers or those clients who are risked out. Those ob's are probably more likely to be naturally minded as they work (& hopefully respect) with midwives.

I know people who had very respectful, empowered hospital births with OBs. It doesn't have to be awful (and it shouldn't be!!!). Have you read "Birthing from Within"? I found is very new-agey and parts of it really hard to take seriously, but if you can cut through that, there are some really good points about how to protect yourself during labor, so that you can do what you need to do (labor and birth your baby).

post #17 of 30



Originally Posted by AKChix0r View Post


My concern is that through this whole process, I seem to either come across "traditional" medicine, which scoffs at my midwife/natural path and is drug-happy, or I find the natural healing providers to be so overly cautious of medical intervention that my care suffers.

In my experience, the middle road doesn't really exist. It may be different in other places, but for what it's worth, that has been my finding in all the places I have lived. I've found this to be especially true in pregnancy. When I was pregnant with DS, I heard, "You buy the hospital ticket, you take the hospital ride," and I thought, well, maybe that's true if you aren't informed and knowledgeable, don't have research relationships to draw on, aren't able to meet with the head of L&D ahead of time to talk over your birth plan, bla bla bla ... basically, I was totally idealistic and naive.


This time I went in with a different attitude. I know that I will get different things from different care providers, and, as annoying as it is, it's up to me to make sure that everything I feel I need is covered. More work on my part, but it was worth realizing that, given that I have needs and desires that are a little outside the norm, I don't fit into any of the existing boxes and I need to build my own box.


Since you want a little of both, it might be worth considering how you might be able to get that. Can you specifically request the apprentice even if she hasn't been assigned to you? Do you have a specialist or can you get a referral to one who can help with the allergies? Etc. It's quite a bit to ask of a care provider that they deal with all the normal stuff of pregnancy and also questions that might be better answered by a specialist. Pregnancy care providers (and urgent care docs, too, for what it's worth) are, for the most part, generalists. Very knowledgeable generalists, but generalists nonetheless. (And I don't mean that in a bad way at all. Generalists have way, way more stuff to take into account at once. It takes some serious smarts to do a good job.) Admittedly, a lot of specialists get freaked out by pregnancy, and it's very common to take the view that pregnant women should stop all meds (not smart) so this is a tough situation, but I would not expect a midwife to figure out your allergy meds. That is not what midwives are trained to do, at least not in most cases. There may be exceptions of which I am unaware. She may be able and willing to tackle the question, so it's extremely reasonable to start there, but that's really a question for a specialist IMHO, so if you don't get a helpful answer from the MW, that's when you ask for a referral.


I also totally agree with Jane that a family doc can be a terrific choice if you want someone with more of a medical orientation but you're looking for less intervention. It varies by doc, of course, but family docs as a group tend to use fewer interventions compared to OBs as a group. And I always think that if the continuity of care of midwives is something that appeals to you, think of what it means to have a doctor who can look after you and your baby for your entire lives. I love the stories of family physicians who caught babies, and then, 2-3 decades later, catch those babies' babies. Imagine having a birth attendant who has known you since you were born! How amazing is that? (Depending on the system where you live, sometimes this happens with midwives, too.)


Anyway, sorry to ramble. This covers several pet topics of mine, in case that isn't totally obvious. lol.gif

post #18 of 30
Maybe you should check out the first midwifery clinic? I know that they were half-hour tardy and have rotating midwives, but that is common in any practice and actually that sounds like a pretty minimal wait compared to others. OBs are notorious for making you wait 1+ hours for you appt. I remember being steamed at having to wait so long for the OB for my first appointment. I switched to another OB and there was still a wait but not as long. That one had one other OB partner that he rotated with. Then I switched to a midwifery clinic and the wait was about the same. Most OB and/or midwifery clinics have a rotating staff so that all of them get to see you during your prenatal care. This is so that you will know the person who will be with you during labor b/c very few clinics can ensure one specific care provider will be available for your birth. My midwifery clinic with my son had 2 CNMs and an OB that rotated. The guarantee of having one specific care provider usually only comes from a homebirth midwife. That is a hard reality but it has to be that way for them to be able to attend to the shear volume of patients they have at clinics. Homebirth midwives on the other hand only take 2-3 births per month so that they can provide the personalized care and ensure availability to their patients.
post #19 of 30

Welcome back!  I'm really glad that you're back... I have been wondering what you are up to and how you've been!


I actually agree with tutucrazy... perhaps it is worth checking out the first midwifery clinic again.... Even though you did have to wait for the tour, I agree that unfortunately, that is probably a reality anywhere you go.  I don't think I have EVER gone to a doctor or dentist without having to wait, even though I get there way early... I think the quality of care you would receive is much more important (in my opinion, I'd rather have to wait and be able to spend enough time with my midwives then wait and still be rushed by my provider).  With the midwives clinic, even with rotating midwives, you are much more likely to have more time for your visits, and you'll most likely get the opportunity to get to know them better.  My understanding is that most OB practices are limited to 10-15 minutes with each patient.  Someone else here can probably share their experience with OB clinics.  With our HB midwives, our prenatals are at our own house, and last 60-90 minutes, with the majority of time we are just asking questions.  For us, we absolutely LOVE having this much time with them.  Personally, when I think about continuity of care, the time we spend with our providers matters to me a great deal- it may be something you want to think about in considering changing providers.  If you're not happy with your current providers, then by all means you should change the situation so that you and your husband are both comfortable, but I can see how one could easily get into a grass-is-greener mentality...  As tutucrazy mentioned, you are always going to have to make some kind of tradeoffs, and I can hardly imagine there exists a place where you can go and never have to wait!


That is great that you are currently clicking with the apprentice, and that she is the one spearheading your prenatal care.  Again, this is my own opinion, but personally, I would be pretty wary of taking her aside to ask her to be in charge of your birth.  Perhaps it depends on the nature of her apprenticeship and their unique relationship, but she is responsible to her preceptor, the midwife, during this portion of her training.  The way I see it, she has kind of an ethical obligation to the midwife who is teaching her, and I can see situations where it could be damaging to the realationship to essentially "go behind" the midwife's back.  Again, you should do what you are most comfortable with, but just another thing to consider... personally I would suggest talking with BOTH of them.  Definitely you can ask about what the apprentice's role will be during the birth, but it might be a good idea for everyone involved to be able to communicate openly about this.  (If you truly don't trust the midwife or don't feel comfortable around her, that is a different story, and you should definitely consider finding another care provider).  It is SO important that you feel comfortable with your providers!!!  Also, it is absolutely NOT too late in the game to change providers (and it is also not like you haven't been getting care up until this point either). 


Anyway, best of luck to you, and I'm looking forward to hearing more about your pregnancy so far.  Once again, welcome back.

post #20 of 30

Congrats on finding out that you're having a boy! And sorry you had such a bad experience with your midwife!


If it were me, I would give the first birth center another chance. I had DS at a FSBC with a rotating pool of 4 midwives and I had a great experience. I liked all of the midwives, although with some it took a little longer to click with them than the others. They did a good job of making sure that I got to know all of the midwives before I gave birth, so that I would be comfortable with whoever ended up attending the birth. Hopefully the first birth center you checked out is better than the first impression they gave you.

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