Let's talk about our prenatal care so far

[BookishVonLiberal]

We're down to our last one or two months of pregnancy. Let's evaluate our experiences so far.

Me, I'm seeing a practice of CNMs that attend home births and offer a birth center. There are five of them. I have met four, plus one other who was there on a trial basis. I loved her so of course she doesn't actually work there. :

One midwife annoys both me and hubby. One we both like but don't love. One I really like and he didn't get to meet because he was sick. The one we met last week is not coming anywhere near my vagina because of the damage she did to my ARM when she drew blood. Y'all should see the bruise she left. I look like someone tried to saw my arm off with a butter knife.
Our plan is to consult the calendar of who is on duty when I go into labor and if it is one of the ones we don't like, we won't call until either I'm ready to push or they go off duty.

This practice has been a lot more medical-minded than I expected or desired. They gave me a really hard time about the glucose test and about the 28-week Rhogam. Now that it is time for the GBS swab, we have another problem. I wanted to be tested last week at 34w6d so that if it was positive I would have time to fix it and retest. I am allergic to so many antibiotics that if I test positive, we're going to have a real problem on our hands. The midwife (the arm destroyer) told me that was a dumb idea because no one can change their GBS status. Then she gave me sheet filled with GBS statistics which was probably supposed to scare me into taking antibiotics but instead just reaffirmed what I already knew. Frankly, if I do turn up positive I will be inclined to birth in a hospital because if I get antibiotics I want to be where people will be standing by to save MY LIFE when I go into anaphylactic shock.
DH was offended that we have to buy the eye ointment when he was told that it is for the treatment of gonorrhea and chlamydia. Sure, if someone comes in off the street with no history of prenatal care, no medical history at all, I can see where all manner of preventative measures would be taken. But these people know I'm negative for all diseases.
Finally, the arm-destroyer gave me a freaking waiver to sign for declining the Vitamin K shot. I've already talked about this with three other midwives and I specifically said that in the absence of birth trauma we don't want the shot.

Overall, I'd say I'm neither happy nor unhappy with them. Our insurance pays for everything which is a big plus and the deciding factor as to why I stayed. I feel confident in my own research and decisions and I am fine with being a pain in the ass patient.



NEXT!

[kitkat5505]

At first I was seeing an OB at the nearby hospital. I always had to wait at least half an hour for my appt and then another 15mins before the OB actually came in the room. She was nice enough and was fine with most of my birth plan, but I felt like I was just a number to them, being herded through the process like sheep. Plus they were horrible about getting info to me. Didn't tell me I had a possible yeast infection until 3wks after my pap, and didn't tell me I'd failed my glucose test until I called and asked them about it 2.5wks later. I just had a bad feeling in my gut and felt sick to my stomach every time I thought about giving birth there. So at 28wks when I found out my insurance would cover a midwife I'd been wanting to go to, I switched, and it was the best decision. I'd been emailing back and forth with her since before I got pg, so it was almost like I'd been with her the whole time. She just barely opened up her own birth suite, has wonderful reviews (I first heard about her on my tribe here), and she has just been so wonderful. She loves me bringing my boys to my appts and she plays with them and has lots of kids stuff. Her facility is perfect for what I want, pretty much like a home birth away from home. There is no wait to see her because she only takes on 3 clients a month and I can sit and talk to her for an hour instead of the 3 mins I got with the OB. She goes over everything thoroughly, like my old OB records, explaining what everything means so I am informed. I am so much more relaxed and comfortable and actually looking forward to this birth now.

[Patchfire]

Well, I haven't had any formal prenatal care, though I certainly think that my chiropractor and massage therapist have given me great care throughout. :

I did speak to one supposedly UC-friendly midwife in August, because I thought it would be nice to have some kind of informal contact, back up if I did want suturing, or something similar. It was an interesting experience. I talked to her on the phone for an hour, and she promised to call me back "in about an hour" so we could set up an appointment to talk in person if I so desired... I got a call from her finally two weeks later. This was after I had time to evaluate all of her "dead baby" scare stories. The stupid thing is that one of her stories was from a birth she had actually attended (so... what good did having a mw do in that case??), and another was supposedly a UC stillbirth in my city... the thing is, I know the local UCers and none of us have heard of this occurrence, yet she, who is new to the area, had? Smelled fishy.

So - it reaffirmed my decision not to seek out formal prenatal care. I feel better at this point in pregnancy than I have with either of my other two.

[goodheartedmama]

My new midwife is awesome--I've only seen her twice, but she's spent so much time getting to know me and making me feel at ease!

I'm still seeing the OB/midwife at an office for back-up care. They're actually really cool with me declining anything I want, but they did say that they've never had anyone successfully decline the eyedrops, and that I can wipe them off immediately :

[coyotemist]

The eye ointment is my only real concern. Everything else about my OB care is exactly as I want it. My OB calls me with any suspicious blood work (and even to reassure me when tests come back perfectly). Their office is just across the parking lot from the birth center, and everyone is efficient, speedy, and kind. No bruises from needles, no waiting in rooms for long periods of time, snacks if I forgot one, cold water in the alcove, intelligent ultrasound techs, willingness to listen to my concerns (and validation of them!).

I made the right choice.

[chisub]

So far I have no complaints. I see two midwives that are part of an OB practice and am hoping for a hospital birthing center water birth. They are really laid back, the hospital itself has a pretty low epidural rate relative to those in the area (about 35% lower) and my midwives are very go with the flow with my plans. They spend time with me and DH and I am feeling very empowered going into my first birthing experience with only about 5 weeks left to go.

[OkiMom]

My opinion has been really mixed.. My first OB I really liked. She was very kind and reassuring and didn't give me a hard time about not having an appointment until 16 weeks. The lab guy is awesome and is the only corpmen I know to get my vain the first time every time. I keep teasing him that Im going to call up the clinic when I go into labor and ask to have him sent to the hospital (when I was in labor with DD they stuck me 10 times before getting anything, I looked like a human pin cushion).
The second OB I saw was just aweful. She talked to me like I was some kind of stupid kid who didn't know anything. She belittled me about nursing DD (because obviously Im going to go into labor if I nurse her.. umm, no). According to her you HAVE to supliment, there is no way to breastfeed solely while you have another child. I wasn't eating right (even though she never asked what I ate or anything) and I was gaining to much weight (I was 30 weeks or so and had gained 20 pounds). I could go on but you get teh drift, the lady was a little off.
The specialty ob I saw at the hospital was great. She was very reassuring and caring. She even took DD onto her lap and pointed out the different body parts on the ultrasound to her. DD loved her.
Im seeing another new OB on Wednesday and we will see how this one goes.

[BookishVonLiberal]

We really run the gamut here don't we? So interesting how the experiences are so different.

[nurnur]

I have done my own prenatal care (ie. tracking bp, fundal height, fht, iron checked 2x, pee sticks to check glucose,protein) I also did have a early (12wk) US because of anxiety I was having thinking TWINS? again. I have been relaxed about my care, this last 6 weeks I will track my bp a little closer. I would have refused all the tests that I couldn't order myself anyway. This pregnancy has been wonderful, as was my last one with a wonderful MW who is no longer practicing, I refused everything in her care without any issues and that was lovely. I have experienced both ends of the prenatal care spectrum.

[Alison]

Originally Posted by BookishVonLiberal

Now that it is time for the GBS swab, we have another problem. I wanted to be tested last week at 34w6d so that if it was positive I would have time to fix it and retest. I am allergic to so many antibiotics that if I test positive, we're going to have a real problem on our hands. The midwife (the arm destroyer) told me that was a dumb idea because no one can change their GBS status. Then she gave me sheet filled with GBS statistics which was probably supposed to scare me into taking antibiotics but instead just reaffirmed what I already knew. Frankly, if I do turn up positive I will be inclined to birth in a hospital because if I get antibiotics I want to be where people will be standing by to save MY LIFE when I go into anaphylactic shock.

Okay, I thought the tests for GBS were only considered good for 5 weeks because so many women DO change their GBS status? I'm fairly sure that's what both my doc and midwife (we have to do shared cared here) said to me.

I'm fairly happy with my prenatal care. Midwives aren't regulated here, so you need to do shared care. There are a number of docs who will work with midwives, and those tend to be the most flexible and most supportive of natural birth. I'm planning a hospital birth, unless things go too quickly. DH is impressed with how much the midwife's prenatal care is actually about our whole family, not just about my pregnant body, and keeps comparing it to our last pregnancy (doc only, no midwife, hospital induction, cascade of interventions, ending in c-section). Midwife visits are 1/5 to 2 hours long and cover everything that's going on. Doc visits are 15 minutes mas, include BP, heart rate, and feeling for the position of baby. It's been a big shock to him how different the care is with a midwife!

We're dealing with the whole GBS thing right now. It wasn't standard testing when I had DS--they treated based on risk factors like prematurity, or waters that had been broken for an extended length of time, or fever during labour, and we didn't hit any of those risk factors. So I have no idea if I was + or - last time. The midwife seems to feel that even if I test +, we'll be able to make a strong case for not treating as long as I have no other risk factors. The doc didn't seem quite so sure--she said if I was + I could refuse antibiotic treatment in the absence of other risk factors, but in the hospital that would cause "ruffled feathers" and may or may not be successful. So right now I'm stalling on it cause I truly can't decide what to do.

[BookishVonLiberal]

Originally Posted by Alison

Okay, I thought the tests for GBS were only considered good for 5 weeks because so many women DO change their GBS status? I'm fairly sure that's what both my doc and midwife (we have to do shared cared here) said to me.

EXACTLY why I decided this midwife wasn't a good match for me. Ideally I would like my birth attendants to be at least as smart as I am, but since that is not going to happen I would settle for at least as well informed.

[mochimama]

I've had one midwife throughout who comes to my house for visits. It's going great. She lives about 2 miles away so I have no doubt she'll make it here in time for our birth. I've been very pleased with her care.

[magpiedee]

I adore my midwife! She was one of 3 MWs with the practice when I delivered DD in 2006, and now she is on her own with a new OB who lets her set her own initiatives. She is very laid back, doesn't consider me unusual or high risk because i'm a VBAC, takes time to answer all my questions, laughs a lot, and really listens to me. I love her office staff, and the nurses hit my vein the first time, every time. The wait isn't generally too bad, although I do prefer appointments when my toddler isn't with me. I also really appreciate that she is attuned to making sure this baby stays head down, doing a 15 second ultrasound to confirm position, since my last DD was a surprise breech.

I am not comfortable with OBs, and i'm not comfortable without prenatal care, so this is the perfect choice for me. I'm also excited because it looks like she'll actually be present for lots of the labor, since she has a smaller patient load and Nov/Dec is less busy than August, when DD was born. My poor midwife last time had 6 women in labor and was being totally run ragged that night.

[titania8]

i have had one prenatal appt, another one coming up this friday. mine has been a UP up until a few weeks ago. it was lovely. still is, but now im wrestling with so many conflicting emotions, feelings, thoughts, etc that i just want to be done already. but at the same time, i want to sort through this mess so i have no regrets. sigh. if only my dh were on the same page as i am, that would make everything so much easier.

all in all i like the mw i am seeing. she comes here to the house and is very relaxed and respectful of my wishes. she's willing to wait out of the way/sight if that's what i want.

[selena_ski]

Right now I am unsure with my MW. She supposedly only takes 4-5 moms a month, but always seems to be just coming from a birth, or had a heads up call. She rushes every appointment. I still feel slightly uncomfortable with her and i have been seeing her since 7 weeks, and meet her at about 5. She seems to brush off my concerns, which really bothers me.

She seems hesitant to come do my home visit, which is odd to me. Then 2 weeks ago she had a MW friend in from texas. she sat in on my appointment without being asked for permission or invited. This other woman just totally rubs me wrong. She is still here and apparently attending births. I love the student MW though, and have hired a great doula. So i am hoping the MW will just sit back and make sure everything is going okay. If i hadn't already paid her in full at the first visit, i would be reconsidering right now. But i cant afford to pay two mws so i am stuck.

[Bella Catalina]

I love my midwives : They're licensed so they need to follow the CA laws which means transfer if I hit 42 weeks, but they are great with me declining GD, GBS and anything else as well. I just had my home visit this morning.

Appts are great, they schedule them well apart and we may see the person before or after us waiting, but that's it - their office is in their home. They love kids and really involve Adrian in the visits.

[CheriK]

I also love my midwives. :

I'm using a private, homebirth practice with three midwives and one student. Any/all of them could end up attending my birth (usually 2-3 midwives attend), and I'd be happy no matter what. We're now having visits every 2 weeks, which means that someone comes to my house, and we sit around my dining room table and chat, check my blood pressure and urine, then "play with the baby" (listen to heartbeat w/ fetoscope, no dopper, and watch it move around). They're here for at least an hour and it's so nice to be at home with my big kids running in and out. They have dietary/homeopathic/herbal/chiropractic/massage suggestions for the aches and pains I've been having. They are very low-intervention, which is exactly what I want. Every test option we discuss, and they are completely willing to abide by my decision. The only test they really wanted that I would have avoided was an US to confirm placental placement (just because I'm planning a VBAC and they wanted to be sure the placenta wasn't over the scar).

Only bad thing is that insurance won't cover their charges. If I went to the local OB group and local hospital, where I'd be required to have another cesarean, insurance would pay with no questions and no copay at all. But they won't pay for a nonsurgical homebirth, which is about 10% of the cost. Argh. Even with this, I'm looking forward to the birth, having my baby at home with their support, and immediately snuggling with my new little one in our own bed with the rest of my family right there!

We had about 3 appointments with an OB group that works with the hospital in the next county that will support VBACS and is covered by my insurance. It was horrible. We wanted to be established there just in case we need to transfer care for whatever reason, we would have a file and history available. Plus, we wanted insurance to cover the lab tests. At every single visit (my first was around 14 weeks or so), they discussed going beyond 41 weeks and induction. Um, why are we even mentioning this during my SECOND TRIMESTER?!? They refused to accept my due date based on date of conception (of which I am 100% confident, which says something sad about my sex life )and were unhappy that I hadn't had an US at 8 weeks to establish my due date. My husband and I joked that it was the "disease of the month club" - every time I went in, they wanted to test for some catastrophic but rare condition, and I had to fight and argue to avoid the testing. I'm sure I had "noncompliant patient" stamped all over my file! When we discontinued care, I got a very nicely worded letter acknowledging that I was leaving the practice and letting me know how to re-establish care. I didn't even notice, at first, that across the top of the page in bold print was "Non-Compliance Warning Letter"!

[natalieadw]

I absolutely positively love my midwife! She was really the only midwife that would do a homebirth that could accept insurance (I didn't have the money to shell out for a DEM). Anyways, it feels like fate because my DH's uncle was her best man, which is crazy cause she lives pretty far from us! She lives on a working farm out in boofoo (1h 15min away from me), and has a charming little farmhouse in which she practices out of.
The guest bedroom has millions of AP, NFL, and natural birth books for checkout, fishy pools for sale for mamas who are planning a waterbirth, and a dresser that holds all of her equipment.
She is very LOW intervention, and has happily accepted the refusal of the glucose test, eye oint, K shot, etc. She hands out research that SHE has done and written papers on showing the pros and cons and stats of each. So that I/her patients can make informed decisions.
She is the most gentle and soft spoken and genuninely nice person I have every met!!! She doesn't have a mean bone in her body, and has such a peaceful way of getting her thoughts across. We totally click and are one the same wavelength. Some appts we just sit there and chit chat about birth stuff, it is so laidback and lowkey. ITS HEAVEN! I love this woman, and will always stay in contact with her after the baby's born!
I made her a baby scale sling out of a old Hoppediz wrap as a gift. Spencer will be the first baby weighed in it
She sees her role in my birth as a support person, and stays in the background unless needed (which is sooooo what we want). She fully expects myself or DH to catch the baby, but would of course do it herself if we wanted. Any of my crazy requests have been met with understanding, like no vigorous rubbing or attacking the baby with a suction bulb syringe.

Plus I'm a hypnobabies mom, and she has totally taken it upon herself to learn all about it.

Ok, I'll stop gushing now