feeling frustrated with care providers

[tutucrazy]

I'm posting this here b/c the more I think about what happened today the more I really want to UC....

As of this month I was so happy to have the "right" care providers for my birth. I'm having a HBAC and I have been so diligent about setting my birth scene with the right characters and the right setting that will give me the outcome I want. I happily ordered my Aquaborn pool, I'm reading good birth books, I ordered my raspberry tea, I'm staying very active, eating well, ordered a birth meditation cd, belly casting kits, etc. In short I'm doing everything possible to stay positive and create a setting in which I can finally have the birth I want and deserve. I have a midwife and an OB for my care providers and this made me happy b/c I know i won't have to transfer care in the unlikely event of a hospital transfer in a country that isn't my own (I live abroad). Today I had a dual appointment with my care providers in which I was ambushed with a barrage of concerns about my marriage and personal problems. From the very start, when DH and I were asked, my husband and I were open and honest about several marriage issues we have been dealing with. Now I greatly regret our honesty b/c my care providers seem to be clinging to these issues as problems that will probably cause some inevitable conflict with my labor. I now feel like my care providers don't have faith in my ability to birth based on issues outside my control at this moment. I understand the concept of the relationship impacting birth, however, I don't feel our relationship is at such a point that I would feel inhibited during birth due to my husband's presence. But my care providers took it a step further to point out that I have been sick 2 times during the pregnancy, like it was a sign of being emotionally unfit. First when I returned from my international family trip and had to care for my sick toddler since my husband was out of town and then again when I had to care for my sick son after my husband left town again. Both times I picked something up from my toddler who is in preschool!!! Long story short, I'm otherwise healthy, active, have a VERY positive outlook on birth and my capacity to birth. Sure my husband and I don't have a perfect marriage but who does? Today I brought the birth meditation cd to show them at my appointment and my OB actually said, "I feel like you are just focused on the material things like birth pools and cds". Here I am trying to show them that I'm being diligent and trying to do the work I need to do to be ready and now it is being held against me. I'm very frustrated and feel like I'm under attack instead of being supported. I don't want unnecessary medical intervention and I certainly don't want unnecessary emotion intervention. I get the whole spirituality aspect of birth but I feel like this birth belongs to ME, not my DH. When I dream of birth I always dream of being alone. I'm actually a loner by nature. Anyway, I don't know if this makes much sense but I want this birth and have been working toward this birth since my son was cut from my body. The past 3.5 years have been a ton of WORK and now I feel like I'm not being understood. I don't want to tackle marital issues at 24 weeks pregnant. My husband and i have a good, tranquil friendship despite some lack of intimacy and I feel like right now I need to focus on my body and my baby. I see zero point in stirring up bad feelings at a time when I want to remain positive and stress-free. These are the only 2 options for homebirth care providers and I'm in a foreign country with a 95% c/s rate (read: not having a hospital birth). Up to today I always had great respect for midwives but now I'm starting to feel like intervention is intervention, period. I feel like I want to birth this baby on my own.

[sunshinemoma]

oh gee... This type of "concern" would make me feel so yucky!  I hope you can feel peaceful about your birth choice, caregivers and marriage    good luck!

[DirtyHippyMama]

wow, that is awful!  if anything, that type of emotional interference can have a far more negative effect on the birth than your marital issues do!  i totally understand your desire to UC instead!  i think i would be leaning the same way in your situation.

[tutucrazy]

Originally Posted by DirtyHippyMama 

wow, that is awful!  if anything, that type of emotional interference can have a far more negative effect on the birth than your marital issues do!  i totally understand your desire to UC instead!  i think i would be leaning the same way in your situation.

Thank you for responding. I'm basically wondering exactly what you pointed out. The pressure of being under a microscope and having all my interactions and statements examined and interpreted by two people (who aren't psychologists) isn't something I want to be thinking about during labor and even during the pregnancy. Obviously I had hoped to have an assisted birth this time around b/c I'm VBACing but UC has been something that is on my mind since the birth of my son. I think my recurring dreams of being alone and doing this alone are a good indication of my subconscious feeling that this is something I want to do alone. I figure I could just plan to do it alone and then if I feel like calling them in the moment I always have that option. My husband is totally okay with UC too so it isn't like I would not have his support.

[IwannaBanRN]

I think I would have felt the need to walk right out on them. It's an outright insult to you how they are acting about your plans. Are you planning a homebirth and told them that you were planning this? They may be trying to scare you into a hospital birth. "oh you're too sick to deliver at home, we need you here." There is an unbelievable amount of politics in the medical practice and sometimes it's only about getting money and avoiding lawsuits. This is what pushed me to UC. I lost respect for care providers. The icing on the cake is most likely having a quiet and peaceful birth at home with the man I love and with my children present.

I personally would not have told them anything about your marriage. They are to care for your pregnancy. THAT is their business, after all, they are not your marriage therapist.

[DirtyHippyMama]

yeah, it seems kind of perplexing to me that they would want to know about the state of your marriage at all...but then i remember that Ina May talks a lot about that in her books, how marital discord can end up slowing labor, etc., until the mama comes out and gets it off her chest, then things miraculously progress quickly...i'm not sure how i really feel about that theory.  i mean, i'm sure it has its place, but i definitely don't believe it's one size fits all.  a couple can have serious relationship-threatening romantic issues and still be bonded strongly enough (if more in a deep friendship sense) to make it through a birth perfectly well.  [i speak from personal experience ]

[tutucrazy]

@IwannaBanRN They are actually only homebirth care providers. The OB only usually does hospital birth if there is a transfer and her transfer rates are pretty low 3-4%. The midwife is also only a homebirth care provider with a slightly higher transfer rate because she is licensed from the US and doesn't have any legal license in Brazil. I think she is more cautious b/c she doesn't want to get in trouble if things go wrong. That is actually the reason I decided to work with both of them b/c the OB is not as good with English but has a much better record/experience and the midwife is a person I've known for awhile who speaks English perfectly and I feel I can communicate better with her. We are in Brazil so humanized birth providers are very hard to come by and in general this country has a VERY obstetrical view of birth. The OB had 2 HBACs and claims to be reborn a midwife, she actually congratulated me on being the first client to refuse an u/s. I'm steamed at everything that happened so I'm thinking of meeting with the midwife and laying out everything that was said that I found bothersome. I've been planning to have a gentle birth for 5 years. After my first birth, I've learned a lot and done everything to prepare my mind and body for this moment. I hate that as this pregnancy progresses they are trying to chip away at me and intimidate me.

@DirtyHIppyMama Their influence about the marriage being in a good place comes directly from Ina May, only I think they took it to the other extreme. They don't seem to understand that I can have a marriage lacking in intimacy but still have a good friendship and partnership with my husband. Perhaps it is a cultural difference? I'm really not sure but my husband and I are actually quite good partners and friends. We've just had some intimacy issues b/c he has put on a LOT of weight and I find it harder to be sexual with him. Not a huge deal for my birth, I doubt I'm going to be even thinking about that during my labor!!! And we have always been honest about this issue so it isn't exactly something I'll be needing to get off my chest during labor.

I'm going to go ahead and plan a UC and if in the moment something changes and I want them I will call on them but honestly I don't think I will. I've been waiting for this for so long and worked so hard for this!!!

[claddaghmom]

So, if we go along with their thinking and the emotional impact of marital issues does interfere with your birth, then you are transferring. Not exactly the end of the world (for THEM). 

My point is, they didn't present their concerns in a way that affirmed you and put faith in birth. And if you transfer, then you transfer. So what was the point? I would remain wary of why anyone would feel the need to treat me like that when either way it did not clearly benefit them or disadvantage them. I would wonder about their own emotional stability and how they would treat me during birth.

[tutucrazy]

Originally Posted by claddaghmom 

So, if we go along with their thinking and the emotional impact of marital issues does interfere with your birth, then you are transferring. Not exactly the end of the world (for THEM). 

My point is, they didn't present their concerns in a way that affirmed you and put faith in birth. And if you transfer, then you transfer. So what was the point? I would remain wary of why anyone would feel the need to treat me like that when either way it did not clearly benefit them or disadvantage them. I would wonder about their own emotional stability and how they would treat me during birth.

Very good point!!! They did mention that if I couldn't fully lift the "curtain" then they wouldn't be comfortable being my care providers. Maybe they are just plain nosy???? In my opinion if you do your job right then a client should be willing and forthcoming enough to tell you the things you need to know in their own time and as the relationship builds.

[newsolarmomma2]

Wow, I cannot believe you have to deal with this. Sounds pretty inappropriate to me. I'm sorry it has happened! If it was me, I would tell them if they mention it again, they should know that's the last talk we would be having. If they can keep their minds on your birth, instead of your marriage, then fine, of not, I would drop them. If your situation isn't bothering you, thats all that matters. I think its pretty bad that they aren't being supportive right when you need it most.

You seem pretty positive and prepared, Im sure it will go great no matter what.

[IwannaBanRN]

Originally Posted by tutucrazy 

@IwannaBanRN They are actually only homebirth care providers. The OB only usually does hospital birth if there is a transfer and her transfer rates are pretty low 3-4%. The midwife is also only a homebirth care provider with a slightly higher transfer rate because she is licensed from the US and doesn't have any legal license in Brazil. I think she is more cautious b/c she doesn't want to get in trouble if things go wrong. That is actually the reason I decided to work with both of them b/c the OB is not as good with English but has a much better record/experience and the midwife is a person I've known for awhile who speaks English perfectly and I feel I can communicate better with her. We are in Brazil so humanized birth providers are very hard to come by and in general this country has a VERY obstetrical view of birth. The OB had 2 HBACs and claims to be reborn a midwife, she actually congratulated me on being the first client to refuse an u/s. I'm steamed at everything that happened so I'm thinking of meeting with the midwife and laying out everything that was said that I found bothersome. I've been planning to have a gentle birth for 5 years. After my first birth, I've learned a lot and done everything to prepare my mind and body for this moment. I hate that as this pregnancy progresses they are trying to chip away at me and intimidate me.
 

That sounds weird that they'd kinda tear apart your home situation if they weren't trying to get you to do something you didn't want to do(hospital birth). How do they expect you to be at ease if you don't even feel comfortable with them being your providers right now?
 

[tutucrazy]

So here is the letter that I wrote them today. Let me know what you think. I still plan to UC but want to keep a good relationship in case feel the need to call on them for some reason and to complete my prenatal care. I think this letter should put an end to this non-sense:

Dear C and P,

After careful evaluation of our last prenatal appointment, it has come to my attention that there are some issues concerning my care that I wish to discuss with you both. Unfortunately, I’m leaving town so I felt perhaps a letter would be the best way in which to share these concerns.

I would like to start by saying that I fully appreciate the time and dedication you ladies demonstrate with regards to my care. I am very pleased with having the opportunity to work with such amazing, talented women for the birth of my next child. This letter is written with great respect and love. Please don’t misunderstand the intentions of this letter, I feel very blessed to be able to have you both as my care providers, however, there are certain things that have been said to me that I find bothersome and I want to address these concerns.

I want to start by pointing out that from the start of my care I have been 100% honest about my family history and marriage status. I completely understand the need for this form of transparency with regards to the type of care I am seeking for my pregnancy. This is why when M and I were first asked about our marriage we saw absolutely no reason to hide our struggles. From the very start we have made it clear that, while we have many good, positive attributes, our marriage has and continues to have a lack of intimacy. Like any marriage we have our strengths and weaknesses. I understand why this particular weakness concerns both of you and I understand the negative impact marital struggles can have on a birthing woman. I too love Ina May’s philosophies. However, this is where I feel our understanding of this particular philosophy diverges. It seems to me that you ladies are under the impression that in order for me to have a successful happy birth, I must find some type of resolution to the issues in my marriage. I am not in agreement with this. While it would be divine to resolve the issues of a 6 year relationship in 9 short months, that is both unrealistic and undesirable in my opinion. No one knows and understands a marriage like the people who are in it and, while I appreciate suggestions as to how to resolve my marital issues, I find they are both unhelpful and unnecessary at this time. Much of Ina May’s philosophy revolves around women letting go of their fears and concerns in order to free oneself and birth easily. Nothing in this philosophy hints that a woman who is not entirely free from marital conflict will be unable to birth easily, rather, the intention is to allow a woman to freely express her fears so that she can feel safe to let go and give birth. As I already pointed out before, I have been open and honest about my marital struggles and have shown no sign of wanting to hide that information from you. Further, I think you both have misunderstood another aspect of this philosophy. Most women develop a relationship with their care provider over the course of a pregnancy. We have a different scenario since I was already good friends with P, which means that I am initially more willing than a typical new client to share the details of my personal conflicts. Many times a woman’s fears and struggles come out during labor itself because by that point a care provider has developed and bonded enough with a woman for her to allow these most personal details to emerge. We had a head start thanks to my relationship with P, however, that doesn’t mean that all the little details must be exposed and reviewed from the start. I am not in agreement that you ladies must know every detail of my history at the very beginning in order to feel comfortable enough to provide adequate care during my pregnancy. I feel that your own insecurities about not having all the mysteries of my past exposed are causing you to rush the natural evolvement of a provider-client relationship. This is is of great detriment in my experience with counseling relationships and I see that it is also harming the progress of our client-provider relationship. I personally don’t wish to be pressured into exposing every single detail of my life in order to assuage my care provider’s doubts or fears about being able to properly care for me throughout my pregnancy. It is my hope that my care-provider can feel secure in knowing that I’ve been upfront about the major issues and my history from the initial intake questions and that, as our relationship grows and develops, I will also be upfront about any specific details that could have an impact my pregnancy and birth. In short, I think it is naive to assume that if a provider doesn’t have it all figured out from the start that she should feel fearful about committing to caring for a woman during her pregnancy. When a woman demonstrates the type of honesty that I have demonstrated, I should hope that her care provider can be confident in knowing that with the evolution of the pregnancy and of the client-provider relationship, also will be the exposure of any details or issues that could have an impact on the labor process.

If you’re still with me at this point I would now like to discuss the specific things that have been said or done that truly bother me:

First, I don’t wish to feel like every single action or statement is under the microscope of psychoanalysis. I totally understand that sometimes statements and actions can point to a larger problem but not everything in life has a deeper meaning. When M had to remove himself from the prenatal class to attend to our son it was not a sign that he didn’t wish to be with me or that he didn’t wish to participate in a dancing activity with me. It was not a symptom of our marital conflicts. M was not happy about having to leave but when your child is crying and upset you have to attend to them regardless of what is going on. We regret taking our son to that class and we only took him because we misunderstood the invitation. Our son is very uncomfortable in new environments and has a lot of social anxiety issues. He is currently under treatment of developmental pediatricians for these issues. It was in our poor judgement that we took him with us and for that we take responsibility. Both M and I were deeply offended and shocked that our need to properly care for our child has been used as an “example” of our lack of love in our marriage. I’d like to follow that by stating that my illnesses over the past few months are in no way tied to being deeply, emotionally disturbed or sad. I have been under quite a bit of stress with a car accident and an international vacation that was plagued with difficulty. Perhaps these stresses could have contributed to lowering my already compromised immune system but the single most significant contributing factor has been that both times I was left to care for a sick toddler on my own. We co-sleep and have very close contact. When N gets sick, I usually get sick. I don’t feel sad and unhealthy. I’m thoroughly enjoying my pregnancy, in spite of the fact that it was unplanned, and I continue to find enjoyment in staying active and growing my baby in the best way I can.

Second, I’m deeply bothered that my attempts to prepare both myself and my home for this very special event have been looked upon as “materialistic”. I’m a firm believer that women need to do everything in their power to set the right stage for their labors. This means choosing the right care provider, preparing ones mind and body, and creating the right setting and conditions for birth. I have a clear picture of what I want for my labor and I’m trying to make the appropriate preparations so that I can realize that image. Obviously, unexpected thing happen during birth but that should never discourage a woman from taking steps to realize her dreams for her labor. There is an old saying, “Success is what happens when preparation meets opportunity”. I’m a believer in this method of thinking as I have used it in my own life to realize past successes. It is with great enthusiasm that I share with my care providers these preparations that I’m making in my home and with myself. I should hope that my care providers would encourage and praise that enthusiasm instead of using it against me.

Third, I feel that due to the unnecessary deep probing of my past, as you both seek to resolve the mysteries of my marital conflicts, you are taking away time from discussions about things that I might feel or want to discuss. We are spending an awful lot of time on your concerns and very little time on letting me vocalize some of my concerns. I actually don’t feel like my marriage struggles are what will have the most impact on my birth. There are other things in my life that I feel are far more important during this time. M and I do have some problems but we are working already to better those, we have a plan for those. I’m not concerned that it will be something that plagues our lives forever as we are already working on those issues. Plus, I have the comfort of knowing that we are excellent parental partners and friends so we do have a great foundation for working together during birth. I’m actually more concerned with my fears about losing my independence and freedom after the birth of this child. It has been very hard for me to accept the limitations of pregnancy and there will be even more limitations once the baby is born. I think these fears will play a more significant role in my labor at this point. Though you are welcome to conduct your appointments in the way you see fit, I feel that open ended questions that enable discussions about things other than my marriage would be a good way to foster two-way communication. I’m not saying that we can’t talk about my marriage, but I don’t feel it should consume our preoccupations at this point. Also, I don’t feel it is appropriate to challenge my decision to remain in my marriage. I’m well aware of my situation and how to best care for my children and myself at this point. I absolutely don’t need to spend time defending my reasons for remaining in a marriage that might lack what you consider to be essential to a loving relationship.

Forth, and lastly, as you both know, I am very weary of interventions during my pregnancy and labor. I’d like to point out that interventions can come in the form of medical or emotional intervention. For this reason I feel it is important for you both to consider how certain statements and assumptions by my care providers can actually have a negative impact on my pregnancy and labor. I am very adamant about maintaining a positive attitude about my body’s ability to birth and the birth process as a natural, normal process. More specifically don’t wish to be reminded of how the cervix might not respond during labor (or any other complications that could arise) or how my complicated past makes me at higher risk for dysfunctional labor. I’m already acutely aware of complications during labor and of my past traumas. I prefer to spend my pregnancy thinking about how my body WILL respond and unfold during the labor process. I wish to fill my environment with positive thoughts and affirmations that will further my already profound belief in my body’s ability to birth my baby normally so I ask that you please take the into consideration during our interactions.

In closing, it is my hope that we can move forward from this point and continue our relationship in a more positive manner. I hope you can both understand my concerns and I thank you for taking the time to read such a lengthy explanation. I look forward to my trip to the US so that I can work on relaxation methods and continuing to prepare for the birth. I have have set appointments with a licensed professional counselor so I can have someone to talk to about things that I feel are weighing on my mind. I also plan to meet with a naturopath and chiropractor during my trip. As always, I will continue to do what is in my power to give myself and my baby the very best.

Lots of Love,
J

[faerymagick34]

I feel for you, I really do, this also happened to me due to certain reasons. I once drove mself to the doctors at 5am in the morning, one hour after my husband cam home from work, (he worked night shift a long time ago) and I didn't want to wake him. I was in my second trimester and was having contractions. Anyway, i safely drove to my hospital, and boy did they yell at me! they told me my marriage must be unstable if my husband was unwilling to drive me. I said he wasn't unwilling because he doesn't know I am here he just got off of work, and blah, blah, blah. Anyway, fater that I decided not to give them updates on my marriage, because it had nothing to do with pregnancy. 

This time around i have decided not to go to a doctor, there are many reasons why, first off they gave prescribed prenatal vitamins, I don't need them prescribed because I can get them at my grocery store. Every time I take their prenatal vitamins I immediately got early contractions. This time around no prenatal vitamins, and no contractions at all. Plus, i am finding out now that doctors give you medicine for everything, and I am trying to be med free. Also, now doctors try to induce, and encourage c-sections more than ever, I don't need a c-section as I have had all my three kids vaginally, with some tearing to no tearing. Plus, since no doctor visits my nausea seriously lasted 3 weeks, I do throw up here and there off and on, every 2-3 dys but otherwise I am able to eat and drink normally now at 8 weeks. My energy levels are up, and otherwise I am fine! I wish much luck, and try stay away from personal stuff with doctors, and don't let them put you on an antidepressnts they hand those out like candy!

[Lisa1970]

I learned long ago that my marriage...or any other issues, can quickly become gossip at a doctors office and something they might use for power to do whatever they want. I am so sorry things went this way. Next time, you will know to keep the visits with doctors and midwives to what they are educated and trained in. As in, the doctor - medical issues, and the midwife- childbirth and prenatal care.

[Lisa1970]

I do not think you should send that letter. Your marriage is not and never has been their business. Nothing should have been shared about it in the past and the only thing you should do now is cut off any future discussion of it. Sending them a letter trying to justify anything will only make them feel more justified in what they are doing.

[calldeville]

I'm sorry for the challenges that you are facing. It sounds very anxious and stressful. I'm confused why the doctor and other people would ask repeated questions abotu "intimacy." That seems coded for something. Tutucrazy, I feel like we're talking in riddles.

Reading between the lines here. Is the baby someone other than your husband's? If so, I can see how that would complicate things for you and your husband regardless of how well you work together or what you may be planning to do with the birth and raising the child. On an anonymous forum such as this, please feel comfortable to talk about this (in private messages, if you prefer) with a variety of supporters and people who mean well and are willing to listen. 

[Devaskyla]

I'm really not sure I'd bother with a letter. A simple statement that your marriage is not up for discussion & if they can't respect that, you'll have no choice but to leave their practice should suffice. You're already considering UC, so it's not as though you don't have other options. And if they can't respect your boundaries, they have no business being at your birth, anyway.