I have some uncertainties about my midwives, and I wanted to run them by you awesome, knowledgeable ladies to gauge whether I am merely being oversensitive.
First, this is a new practice that I started seeing about 4 weeks ago. There are two midwives in this practice, both with about 6 years experience, as well as a student midwife. I transferred into this practice from a university (teaching) hospital OB practice.
Here's the first 'red flag' (not sure if it is, but you be the gauge). I have been going to a physical therapist since the 15th week or so of this pregnancy (I am now 30 weeks). Earlier, the PT diagnosed me with a bad case of sciatica, did a lot of massage and gentle re-alignment, and gave me several strengthening exercises to do. At this point, she checked to see if a pregnancy support belt would be appropriate, and when I found no relief upon wearing a couple, she concluded that the pelvic troubles that I was having weren't significantly SI joint or pubic symphysis related. Fast-forwarding about 10 weeks to 26 weeks, the situation changed. At this point, I needed some more intense physical therapy for pubic symphysis pain that was so bad that I was nearly unable to walk by the end of the day (serious 8/10, wanting to fall down and wail pain). The PT worked on my adductors (which were sad and ropy and unresponsive from the developing diaphysis), gave me more core-strengthening exercises, and we began looking at benefits of wearing a belt again. This time, I had enormous improvement with just a little bit of inward squeezing at the iliac crests, and we determined that the Mother-to-be belt would be a good option. I wore the belt, and along with the exercises and manual therapy, the pain diminished within a couple of days. Totally amazing.
Anyhow, when I went to my first midwife appointment, I was very happy about the belt (and the fact I could walk without significant pain). Perhaps too happy? Anyhow, I gushed about my wonderful physical therapist and the awesome belt, which allowed me to walk without intense pain. The midwife and her student were both very interested in the belt, and asked me where I had purchased it, what it was called, etc. I didn't think much of it, but at my next appointment (just this week), they asked me again about the belt and where I had purchased it. Then, they said that they had been recommending the belt for all their clients complaining of any musculoskeletal pelvic pain (!?!). And this is where I started to feel a little strange and uncomfortable. Because it's one thing for friends to recommend things to each other, just based on 'anecdata', but aren't midwives supposed to advise their clients based on either 'evidence-based' or 'tradition-based' approaches? I'm no medical professional; just because I can attest that the belt (along with manual therapy and exercises) worked for me doesn't mean that it's appropriate for anyone with back problems or a sore pelvis (as had been the case with me earlier in the pregnancy). It seems that the reasonable thing would be to write a script for physical therapy (hopefully with a good therapist), and allow the PT to determine the cause of the pain and determine an appropriate course of treatment (involving manual therapy, exercises, etc). At the very least, shouldn't they talk to the physical therapist about the kinds of musculoskeletal pelvic pain that would respond well to a belt, and not to one of their clients? OK, so this totally rubbed me the wrong way.
Then, there's the subject of the GD test. Basically, I was told that I didn't need to do it during the midwife 'interview' appointment (since I had no risk factors, etc), but was then strongly encouraged to get it done at the first appointment. Also rubbed me the wrong way, as though they wanted to appear to give me more 'choice' than they were actually willing to give me in practice.
Finally, I am not happy with the way the appointments are structured. The regular appointments are only half-an-hour, and my second appointment started 1/2 an hour late and only went on for about 20 minutes. Honestly, appointments with my OB at the big teaching hospital felt more thorough than this latest appt. During this 20 minutes, they spent the first 5 minutes advising me on my low blood pressure (nothing that I didn't already know, done by both the midwife and the student), the next five minutes giving me spiels on third trimester warning signs, and the last 10 minutes having the student take my vitals. Anyhow, the student got some crazy low bump measurement (25 cm, when I should be nearly 30 cm), which worried me for a minute about intrauterine growth retardation and all those other scary things, until the midwife came over and corrected it (it was actually almost 30 cm). Then, to add to the anxiety, they again did the palpation thing, and found baby's head was above my belly-button, meaning that my baby is breech at 30 weeks. Which isn't awful (they can still easily turn at this point, and usually do turn), but for someone with high anxiety about breech presentations (my grandmother had a footling breech baby die during labor due to likely cord entanglement), I definitely needed a little more reassurance than 'Oh, you're baby's breech. She'll probably turn into vertex position in the next couple of weeks. See you next time!' I understand that they were running late, but couldn't they offer a little more reassurance, or even an offer to call if I was feeling anxious?
So, those are my issues. Not huge, but they still feel like red flags. On the other hand, I know that I am very sensitive, and I hold my care providers to high standards. Possibly too high standards. I'm not sure.
I know that this post is ridiculously long, but if anyone has any thoughts about this, I would love to hear it and would be eternally grateful. I feel crazy for already thinking about switching providers again!