I work for my OB and want to HB. What to do?

[Mom2SammyJoe]

I'm a nurse at my OB/GYN office. I have worked there for more than 2 years, since right before I found out I was pregnant with DS. We are expecting again, and I really want a HB. These are great doctors, but they are doctors. I have already made some waves by switching doctors in the practice for my 2nd baby.
DS was born by C/S for failure to progress after 20+ hours of induced labor for being "post-dates" at 41 weeks. I know my body just wasn't ready, but that is when they induce. After 12 hours of Pitocin hell, I was asked by my doc, "Do you want your epidural now or your C/S now?" I thought those were my only choices, so I picked the epidural. I dilated 2 more cm (7cm total) before they recommended a C/S. I feel like I was set up for failure. That is why I changed docs. I really want a VBAC, but I don't know if they can truly help me get there. I think they will be supportive until I'm term and then want to section me. I can't even think how they will be after 40 weeks.
I am 10 weeks along now, and DH and I are interviewing midwives. I want to continue care at the office until my U/S at 20 weeks, but I don't know what to do after that. Our office puts out a statement to pregnant moms saying that homebirth is dangerous to the baby and that they will not provide prenatal care to anyone planning a homebirth.
I think that when 20 weeks comes, I will have to discuss my HB and quit my job. ( I am not planning to work after baby, anyway.)
I guess I am just looking for some encouragement. I can't imagine that this is a common situation.
Thanks for listening.

[kangaroomum25]

Originally Posted by Mom2SammyJoe

I think that when 20 weeks comes, I will have to discuss my HB and quit my job. ( I am not planning to work after baby, anyway.)
I guess I am just looking for some encouragement. I can't imagine that this is a common situation.

Sounds good to me I wouldn't even bother discussing it with them, sounds like they've already got their minds made up.
Have a great homebirth! I absolutely loved mine.

[MelW]

If you didn't want to quit until later, I think you could just quit your job and quit their care at the same time in late pregnancy (36 or 37 weeks?). You would have to be secretive about the midwifery care until then, though, which may or may not be okay for you. Then again, if you can afford to quit at 20 weeks, why not?

[Mom2SammyJoe]

I think it would be mentally hard on me to "hide" midwifery care. Like, if I am getting care from both places, then maybe I won't feel totally comitted to my homebirth plan. And I would feel like I am lying, and I try not to do that.

[peainthepod]

It sounds like you already have your mind made up and frankly, after the experiences you've already had with them, I don't blame you. And I wouldn't want to hide the midwifery care, either. It's nothing to be ashamed of, after all.

Happy homebirthing and congratulations!

[LemonPie]

I think I'd go outside the practice altogether and just state "privacy concerns" if you are asked. My DH is a physician and I don't go to him "officially" for anything (of course he takes care of a lot of stuff at home/on the side) because I don't want a chart that his entire med staff can read and be in on my personal business. HIPAA is a joke when you/your family works in the medical field.

Your decision to HB is personal and they CANNOT fire you over that, of that I'm fairly certain.

[dogmom327]

You see a doctor in the office you work for? Seriously? I'd have a hard time spending time in stirrups when I work with the person. I agree with PP, I'd say I'm seeing another provider and cite privacy concerns. No need to quit your job (unless you want to--which maybe you do considering that they fire patients for pursuing "dangerous" HB).

[*MamaJen*]

Have a great homebirth! I think you will find the midwife model of care to be like night and day from your previous experience.

[Jojo F.]

Would they actually fire you if you are planning to have a HB? Would they yank your insurance coverage?

So at 20 weeks you plan on seeing a MW. Since you don't want to hide the fact you are seeing a MW you are going to tell them your plans and quit. Do I have this right?

I guess I'm just trying to figure out timing issues- 2 weeks notice- and whether or not you are going to have insurance.

Personally, I would just tell them that I was quitting my job for personal reasons and discontinuing prenatal care for personal reasons and leave it at that. What business is it of theirs where you plan to birth?

Maybe my opinions are effect by the fact that I used to work in an OB/GYN office and now see one of the OBs that was in the office I worked at. It's a little bit of a different situation but I'm still hoping for my HB to work out and if it doesn't I'm still going to swtich providers- a MW either way. I feel weird about it just because this OB is a great doctor, super nice, and I used to work with them. But there is not in heck I want to birth at the hospital the OB delivers at.

[paintedbison]

If it were me, and this is just what I would do, I would not even begin care with an OB that I work for... especially if you've had a previous experience with them that was not the one you desired. I'd just go strictly with the mws care. I've never understood how people keep up with two separate sets of prenatal app'ts anyhow, lol.

If they ask, tell them you're seeing a mw this time around and leave it at that. Then, keep your job as long as you want. As far as I know, they can't fire you for not being their patient.

I worked postpartum at a hospital and chose to have my baby at a birthing center instead. I caught some flack, but after it was all over, everyone wanted to hear all about it and seemed very impressed. I'd say as little as possible ahead of time (because you'll catch a lot of discouragement) and then brag like crazy after it goes well, lol!

[pantufla]

Originally Posted by paintedbison

If it were me, and this is just what I would do, I would not even begin care with an OB that I work for... especially if you've had a previous experience with them that was not the one you desired. I'd just go strictly with the mws care. I've never understood how people keep up with two separate sets of prenatal app'ts anyhow, lol.

It's none of their business where you go for prenatal care. I can't imagine going to someone I worked with for care, it would just be too weird. "Hey, who was eating that yummy curry for lunch? It smelled delicious! Did you hear about Susan's husband, poor thing. Ok, take your pants off and hop up on the table.." Yeah, I don't think so.

They can't fire you because you aren't using their services for your pregnancy. And if they ask who you're seeing for prenatal care, it's really none of their business.

[etoilech]

I would see the midwife as sole provider for my care and cite privacy for the reason. That should end the discussion. That way they don't have to provide prenatal care and hence do not have to "bend their rules", as stupid as they are, for you. Why do you want you prenatal care till 20 weeks with them? I'd have made it clear from the beginning I wanted to go somewhere else.

[Belle]

I would just site privacy concerns and tell them you are switching to a different health care provider for your pregnancy. They can't fire you over that. No reason to quit unless you want to. If they ask who you're switching care to, just tell them that you want to keep that information private. Its better for your sanity anyway. The idea of providing prenatal care to an employee is a serious conflict of interest for them. Even if you weren't planning a home birth I'd get out of there.

[slave2myprincess]

Originally Posted by Belle

I would just site privacy concerns and tell them you are switching to a different health care provider for your pregnancy. They can't fire you over that. No reason to quit unless you want to. If they ask who you're switching care to, just tell them that you want to keep that information private. Its better for your sanity anyway. The idea of providing prenatal care to an employee is a serious conflict of interest for them. Even if you weren't planning a home birth I'd get out of there.

Ditto. i don't think you should have to quit because you plan on having a HB. Like the poster said you can keep that private. Good Luck !!!!

[Mom2SammyJoe]

Thanks everyone. I appreciate your imput.
Just to clarify, I only work 2 days per week now, and my insurance is through my husband's employer. The insurance will pay 100% for OB care and hospital delivery, but homebirth and care with a CPM is "excluded" from the policy. We plan to pay the midwife ourselves, but the insurance will cover any OB visits.
I am starting care there because I hadn't really thought through all of my options (ie: I didn't think I was "crazy" enough to actually have a homebirth). I have my first OB appointment in the morning, but we are not meeting with the midwife I hope to have care with for 2 more weeks.
I do want to have a 20 week U/S because I want to know where my placenta is, especially if it is over my scar.
People who work at the office go to the office. I thought it was weird when I started, but that is what everyone does. I think it helps some that the docs I see are women, but it is weird to look around the lunch room and know that least 3 people there have seen my vagina.
Maybe I'm just scared of answerring the questions about switching providers. I already have one doc pissed because I switched to her partner, who is a little more friendly towards natural childbirth.
I think that if I kept working after leaving their care, I would philosopically have a difficult time telling my patients something I don't believe to be true. Maybe, deep down, I am already done working.

[Thefrawg]

I don't work for an OB but I understand where you are coming from. I am waiting for my 20 week US before moving to a midwife if I can. I want to US to confirm I don't have any placental problems before I move. C/S can increase that risk so I don't want to lose my doctor until I am sure I am a safe candidate for a homebirth.

Does your midwife have a backup OB? Mine doesn't since I am so far from her office. I am hoping my OB will stay on as my backup in case of transfer. I have heard horror stories of mom's standing around at the hospital emergency room begging for care because they think something is wrong in their labor, and not getting a quick response...

I hope your ultrasound comes out clean and happy birthing!

[Belle]

Originally Posted by Mom2SammyJoe

We plan to pay the midwife ourselves, but the insurance will cover any OB visits...I do want to have a 20 week U/S because I want to know where my placenta is, especially if it is over my scar.

Even so, it might be better to switch to a different OB or maybe a CNM for those same privacy reasons that I mentioned.