Switching to a midwife...dr wants to 'chat' about it....

[~*~MamaJava~*~]

First of all, I have a fabulous female Dr (GP) who delivered our first two babies in the most natural way you can in a hospital setting She is just awesome and goes with the flow of whatever I want. She's even ok with our not vaxing the kids.

But...I have been thinking I want the support of a mw, because during labour normally I just have dh (who is excellent) and nurses (who are, well, okay). And, I'm thinking about having this baby at home.

I've had a u/s done under the dr's care, and have an appointment booked for Monday for the 12-week visit. I called to cancel the appointment today. A nurse called me back an hour later to say that Dr. M wants me to come in anyways, even though I want to switch, to chat about my decision. Do you think this could be related to the u/s? I had it this past Monday, so she'd have the results by now, possibly. Or would she really just try to talk me out if this? It seems crazy, because she is just the busiest doctor around, and one less preggo mama would be a relief (I would think). I've had very uncomplicated births, but my labours have been loooooong, to the point where I know the nurses are discussing c/s.

Any thoughts? And what should I say to Dr M on Monday?

[cornflower_3]

She may just want to make sure she didn't do anything to make you want to switch. Friends I know who have switched OB's from one pregnancy to the next often get phone calls from the dr's personally to inquire as to why. Best of luck with your wonderful home birth.

[milk_maker]

Yeah, if she's a good doctor she probably just wants to make sure she didn't do anything to upset you.

[~*~MamaJava~*~]

Hey, good point. I *did* have some wild stuff happen with my last birth, and she might be worried that put me off of doctors. Although, it didn't and wouldn't - it had nothing to do with them. DS2 was born with his cord wrapped around his neck six times, under his shoulder once, and it had at least two knots in it (dh says he saw more). No one knew that was coming! He was 100% okay though. It was a miracle. He still IS 100% ok, no lasting damage at all as far as we can see. The Dr was amazing with all that. But maybe she thinks it was too traumatic for me. (It WAS traumatic, I cried for days, but I'm okay with it now).

[boscopup]

I agree that she could be just wanting to know why you're switching. Or she might be concerned if she knows you're planning to go to a midwife. When I discussed this with my OB at my 6 week visit (I'm seeing him and a midwife in tandem, in case I'm preterm again - I'd get HIM instead of the teaching group). My OB said he had some concerns with the out-of-hospital birth, but that he'd do his research and maybe ask me some questions later. At my 12 week visit, I remembered to ask him about billing (that had been another concern of his - how to bill it), and he said billing was no problem and that he'd had some concerns (didn't say what they were, but I assume safety), but that he'd talked with another medical professional and was ok with it.

My OB was truly concerned about whether this was a safe decision or not, and he at least did some research to alleviate those fears a bit. I really like my OB. I too just don't want to be in the hospital dealing with the nurses, etc. My last birth was in the hospital because DS decided that 29 weeks was a cool time to come. The birth was very short (2.5 hours - and he was my first!), and it went very smoothly. No pain meds, etc. Pretty much shocked the nurses that I went so fast, and because of that, they never did anything during my labor. They didn't even think I was in active labor! All in all, my birth went well, but there are things that would be improved if I had a midwife in attendance and was not in a hospital. So we'll see if this baby decides to stick around long enough to do an out-of-hospital birth.

[~*~MamaJava~*~]

See, Vera, that's what I was thinking of doing - kind of having both...but I have no medical reason to do so, and since I'm Canada, I don't think they *both* can bill the province for my care And I like free health care . I guess doctors really DO care a lot - good ones, anyways!

Hope your baby cooks just as long as it should this time!

[afishwithabike]

NOTHING. I switched to a mid-wife at 5 mos gestation with DD and NEVER looked back. I'd stay home, or do whatever else you would do that day. ANYTHING except go see that Doc.

[elisheva]

I'm also planning a home birth, Gd willing. I've had LOADS of people "poo-poo" our decision, but I'm more and more sure about it the longer I contemplate it. We have agreat midwife who is very flexible and competent. She said they bring the equivalent of a Level 1 ER with her when she comes to a birth.

Also, I read Ina May Gaskin's Spiritual Midwifery and all the stories about successful home births on the Farm and successful hospital births when they had to go really helped me wrap my mind around what to expect.

[boscopup]

Originally Posted by ~*~MamaJava~*~

See, Vera, that's what I was thinking of doing - kind of having both...but I have no medical reason to do so, and since I'm Canada, I don't think they *both* can bill the province for my care And I like free health care .

Yeah, I have to pay out-of-pocket for my midwife, but insurance pays the OB (and if I were in the hospital, it'd be free, basically).

Since your province covers homebirth, how about you tell the doctor that you have chosen to go the homebirth route, but if you do end up in the hospital for any reason or if you need doctor care due to any complications, you'll come back to her (I assume that would be possible?). I think if you're nice about it and let them know that you DO like them, but that it's just the hospital birth experience you're trying to avoid, you can still remain on good terms, ya know? Sounds like you have a good doc there.

If I had the choice, I wouldn't bother to see the OB for prenatals at all, but just go see him when/if needed. But insurance billing is so screwy that you can't just schedule one appointment to check something out. You have to do prenatal care 100% or none at all. It's really stupid, and my OB even says the way billing is done is stupid. So in order to have my OB in the hospital, if I end up there again, I need to see him for prenatals. Otherwise, they stick me with the teaching group, and I liked the residents last time, but the attendings (who actually make the decisions) never talked to me. The residents had no power, so it was just sending messages back and forth, with no discussion about why they're doing something, etc. And especially after talking to my OB, I think the teaching group took a big risk in my care - they LET me deliver at 29w4d. I was not contracting while on medication, my baby was fine, I had a decent amount of fluid for being post-PROM (it was "low", but I've seen women with lower fluids last several weeks and have healthy babies), etc. I think they should have kept him in longer. Thankfully, it turned out ok - he was breathing on his own when he came out (thanks to steroids given 4 days earlier), and he was a big boy for his gestation. But my current OB said *he* would have kept him in longer as long as mom and baby were both fine, which we were. I would have rather him gone 32 weeks or so.

But yeah, not all doctors are evil. There are some really good ones. And I think they deserve some common courtesy. When I was talking to my OB about the midwife thing at my 6 week appt, he said he'd had some clients "not make it to the hospital", and while he knows that some seriously just didn't make it (I know of one in particular that got in the car, then her water broke, then she ran back inside and birthed her baby in the bathroom a few minutes later - she said she was NOT having that baby in the car! ), others were planning a homebirth all along and were just stringing him along. He was hurt by that - that they didn't tell him what they were planning. This is a doctor that really does care, and he's very open minded (he calls himself gullible). No, most OBs are not like him. I can't think of any others in my area that are like him, and we have a ton of OBs to choose from! But if you find yourself a good doctor, I recommend keeping on good terms and being courteous, just in case you ever do need their services!

[afishwithabike]

I have been checking back to see how it went? Did you go speak with the Doctor?

[Naughty Dingo]

Yeah Mama, enquiring minds want to know!

ND

[~*~MamaJava~*~]

Hey, yes, I did talk to her! I forgot to update you all.

She said it's fine with her if I use a midwife, but she would prefer I did a hospital birth. I expected her to say that - I don't think too many doctors would say 'go ahead, have it at home'.
Her main issue was ensuring that I had lots of testing done to make sure this baby isn't going to have cording like Luke did. She wants me to have several (like, 5) ultrasounds done, including a cord flow ultrasound (which I have to get done in a major city). So she asked that I explain that stuff to the midwife and ask to have those tests done. I did bring up the fact that there is virtually no possibility of that situation repeating itself, and she agreed - but still asked that I get those extra u/s done in the second trimester. So I said I'd talk it over with the midwife!

I'm not sure what to do exactly - obviously I want the mw's .02 on this one. I don't really feel that it's necessary to get all those tests done, because as the Dr. and I discussed, we could have had all that done with Luke, and we would have never known. She said she had no idea that he had those knots or that much cording. Kind of just reinforces my belief that God's hand was on my baby for all those weeks, and especially his birth - keeping him safe!

It was a really good chat, and it was extra good because a student was there, so she explained everything in great detail. She's totally fine with my decision to have a different care provider, and I told her it wasn't about her - because it's not. It's about the environment for giving birth.

I'm still going to consider a homebirth.

I think I'll post this issue in the Midwives and Doulas forum, just to see what they would say about it (the extra u/s, that is).

Do you think I should have them done?

[~*~MamaJava~*~]

Oh, and if something does go funny, like another cord issue, I have to switch to an OB. She's not one, just a family doctor. In a way, though, it's not a big deal, because any complication under her care as well would merit a transfer to an OB.

[Hayes]

for my last birth, and this one, I have had US to make sure everything is clear. I check spine, kidneys, bladder, heart, nuchal measurements to check for Down's Syndrome, and face for cleft lip/palate possiblities.

[sbm1001]

The majority of babies who have extra long cords like that will have a cord accident before the birth, if there's going to be one. Your ds was indeed very blessed to be born alive that day! Most of the time the outcome isn't so good. The likelyhood of it happening again isn't much but I'd go in for at least 1 u/s to see if they can determine if it's a normal cord or not. I don't know that it would make a difference, but it might put your mind at ease if it's something that's weighing on you when the time comes to be able to tell.

My sil had a late loss due to a cord accident & then her next baby also had a very long cord that was wrapped around her & in knots in a few places. She was born small but healthy. It's possible to have more than one baby with a long cord, but not likely. BTW, this was her 7th & 8th pg's & none of the other kids before these two had this problem.

Shannon