Back Up OB

[heart-n-bones]

I met with a home birth midwife this week and really liked her. We are hoping to do a homebirth. The midwife said that some of her clients will also see an OB while working with her in order to establish a relationship should they need back up care or transfer to a hospital.

How do folks here in GA/Atlanta handle that? Are there any OB's in the area who wouldn't balk at the whole homebirth thing? Can you see an OB just a couple times or do they expect you to come in for the normal course of pre-natal care? How do you handle it with insurance or payment?

Thanks!

[gratefulmama2isaac]

Dr. Joseph Tate, who delivers at Emory Crawford Long, sees mom's who are planning homebirths. I'm not sure what is official stance is, but I know of at least one direct-entry midwife who works with him. Sorry I can't answer your other questions!

[heart-n-bones]

That's perfect! Thank you. Crawford Long is the hospital closest to my house!

[doulanichole]

I know anything is possible, but....while Tate may have received a transport in a specific case, he is pretty outspoken about being against homebirths. He will not knowingly provide backup care and gets pretty angry about being unwilling backup (ie being told someone will birth w/him and then them choosing to do so at home).

[gratefulmama2isaac]

Ooops, thanks Nichole! I'm confused, though, because a doula friend of mine who is preganant right now (planning HBAC) is seeing him for prenatal care, and told me that her midwife (not a CPM, but traditional) uses him. I have also been told this by another doula who works with this same midwife.
It did surprise me, as the stance you suggested certainly fits my picture of him, but I took them at their word.

[doulanichole]

Very interesting. Email me when you get a chance!

[SublimeBirthGirl]

Yes, Dr. Tate confuses me. In many ways he's really awesome. He is definitely outspoken against homebirth, but also seems to be pretty respectful of women making their own decisions. You could try Kay Johnson at Isis OB/GYN if you don't have any luck with Dr. Tate. Otherwise, you will probably have to lie and get full prenatal care (I'm one to forego back-up care; too stressful-it's an option to do that, there are pros & cons).

[doulanichole]

I am just relaying what he has said on another forum and he may be playing CYA over there. However, when I was at a birth with him and explained my screename on said forum and described my avatar, he said "oh, you had a hb. Let me just say cra-zy, you are cra-zy, anything can go wrong at any time." I didn't even mention hb at this point or any other. Not real sure it was appropriate to go on about it w/me while at another's birth either. But whatever, there are ceratinly good reasons to have him around, I just don't feel the need to debate my choices with him.

As for Kay, she is unable to provide open backup care as well.

[lovingmybaby]

So do you think that one could do shadow / back-up care with Kay, while planning a hb? Would she be okay doing that, off-the-record? What happens if you do shadow / back-up care with a cnm and then birth at home without telling the cnm your plan?

Originally Posted by SublimeBirthGirl

Yes, Dr. Tate confuses me. In many ways he's really awesome. He is definitely outspoken against homebirth, but also seems to be pretty respectful of women making their own decisions. You could try Kay Johnson at Isis OB/GYN if you don't have any luck with Dr. Tate. Otherwise, you will probably have to lie and get full prenatal care (I'm one to forego back-up care; too stressful-it's an option to do that, there are pros & cons).

[SublimeBirthGirl]

I had a studnet very recently who got HB back up care with Kay (and Kay knew). Maybe things have changed though.

Nichole-he did the same thing to me. I attended a VBAC for a past student of mine w/ him and he brought up our differing philosophies on homebirth while she was laboring. He did several things I thought were insensitive, but the mom loves him so if it didn't bother her...*shrug*.

[kbuglove]

I had backup from Kay for my homebirth. She was awesome!

[doulanichole]

Kay did backup, she no longer does.

[kbuglove]

really did the change just in the last couple of months? It seems
I just saw her and everything was working great?

[doulanichole]

She brought it up to me when I saw her last (outside the office) and that was maybe 2 months ago. Too bad too because it was working well....for many of us!

[SublimeBirthGirl]

I have a student who's using Kay & Margaret. She's had some issues come up and had to consult with Dr. Fredericks. She was not impressed and is considering switching since she may have to deal w/ an OB one way or another. So I guess maybe he vetoed the HB back ups?

[MichelleAnnette]

Dr. Barrett did back up for me in 2007, but I don't think he does anymore.

[gratefulmama2isaac]

O.k, I checked with my friend, and she said she is unsing Dr.Tate as back-up unbeknownst to him. So, I did receive misleading/bad info. Hope you're still reading this thread, heart-n-bones; so sorry!

[heart-n-bones]

I am still reading. Thanks for all the good info. It's rather discouraging that there isn't really anyone willing to be a back-up. My GP was really supportive of the decision to do a homebirth, so hopefully I can get her to do some things for me. But, she's not an OB should I need that in the end. Here's hoping for a really easy, uncomplicated pregnancy and birth!

[doulanichole]

You know, I often wonder why women (me included) don't approach their PCP/GP/family dr about providing back up care or doing basic labs. I would think they would be able to do labs and order an u/s if needed and could refer you to an OB if needed. Obviously this has only occurred to me in the last few months, but it seems like a much easier route esp if you have a relationship with a dr already. And I would think they would have alot less interest in where you birth, yk?

[GAmomto5]

On my first visit with my new GP, we discussed whether or not I would be having any more children. I told her that we were thinking about one more. She asked who I see as an OB. I told her that I have homebirths. Her face kind of fell and she said, "Well, please don't ask me to do anything for you there. I wouldn't feel comfortable with that." I asked her if she would still check my thyroid function every six months (I don't have one) as usual and she agreed. I don't do any prenatal lab work anyway, it still rubbed me the wrong way for some reason.