How to "break up" with Midwife? (Long, Sorry!!) - Mothering Forums

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#1 of 15 Old 03-24-2013, 04:46 PM - Thread Starter
 
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I have been seeing a midwife since 10 weeks.  I will be 23 weeks tomorrow.  My pregnancy was conceived through IVF.  My husband hasn't really been 100% on board with a Midwife and a birth center birth from the beginning.  I have run into a couple small issues (bleeding at 12 weeks, lack of weight gain).  Hubby hasn't felt comfortable about the way the issues were handled when we have them.

 

Fast forward to Thursday.  I sent her an email letting her know that I have been having contractions since Wednesday.  She calls me Thursday evening to see what was up.  I let her know that I think I have been having contractions and it was worse Thursday then it was Wednesday.  She wanted me to come in on Friday and leave a urine sample and she wanted to do a swab for BV.  I went in and she got the samples she needed.  That was Friday afternoon.  She said the results wouldn't be back til Monday, probably.  I asked her how I know when the contractions aren't normal.  She never really answered my question.  I am a first time mom so I don't know what's "normal" and what's not.  On Friday evening, in addition to the contractions I was feeling a pretty constant pressure down in my pubic area.  At 7pm I paged her to let her know I would like to be checked out my an MD at the hospital.  She agreed with me going so off we went.

 

OB at the hospital confirmed I was having some contractions.  My urine came back fine.  The ob said I have an irritable uterus.  I am still currently having contractions (anywhere from 1-4 an hour) but they are not painful, just lots of pressure and tightening.  At this point I'm not sure that I feel comfortable with a Midwife and a birth center birth.  I want to make sure that I am not going into preterm labor.  I know there is only so much a Midwife can do since they mostly deal with low risk pregnancies.  Am I considered high-risk at this point?  I feel like I should set up a consult with on OB and see what they think.  

 

Any thoughts or advice?  If I do decide to go with on OB, how do I approach the Midwife?  I'm over halfway through my pregnancy.  I'm having a hard time feeling 100% confident with her care.  

 

Thanks in advance for any thoughts, advice or suggestions. :) 

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#2 of 15 Old 03-24-2013, 05:04 PM
 
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Go with OB. Considering you had to do IVF, this is  already so precious and hard.  Just tell MW that you are switching your care to OB.  IF you do not feel comfy doing in person, send her a polite email.

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#3 of 15 Old 03-24-2013, 05:12 PM
 
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Your intuition is good here. It's so great that you took the initiative to really find out what was going on with your uterus. I would just let her know, however you feel is best for.you, that you need your records transferred. You are thecustomer, you are unsatisfied, you owe her no explanation unless you want to give one. Great listening to your body and inner knowing.
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#4 of 15 Old 03-24-2013, 05:28 PM
 
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While I don't think it sounds like she has been negligent in her care of you at all (I also have contractions consistently from 20 weeks on), what IS important is that your intuition and your faith is directing you towards an OB. Also, husbands can play a HUGE role in the birthing process and the best births tend to  be where the husband is completely supportive and ITA with the wife.

 

Any midwife that is competent and doing home birth for the *right* reasons is going to want *You* to be in the place you feel the safest.

I would tell her over the phone that you just feel much more comfortable with a DR and giving birth in a hospital at this time. If you don't particularily like her or care for her, an email would be just fine as well.

I would give a bit of monetary compensation if you are able (and if she will receive none. I know with my insurance birth is billed with the prenatels, so no birth = no $$) but, even then that is just an optional "No hard feelings" and no burnt bridges way to end the relationship.

 

Above all else, absolutely listen to your intuition on this. I have had 4 home births and am pregnant with #5 and I've listened to my intuition on each one on where to give birth. I didn't automatically assume any where would be the best. We can't discount what we are feeling during pregnancy and birth...Complications and regrets do tend to arise if we do that.

So please, please, please listen to your gut!
 

 

Also, I've switched midwives at 28 weeks and I'm SO GLAD I did with one pregnancy!


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#5 of 15 Old 03-24-2013, 06:31 PM
 
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I would talk to the midwife and explain the concerns. She can arrange a consult with an OB and be kept in the loop. When you see the OB, he or she should be able able to tell you about risks and whether MW care is appropriate. Perhaps a compromise like a hospital birth with MW may be appropriate. Just some thoughts.
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#6 of 15 Old 03-24-2013, 07:05 PM
 
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ITA w PPs!

 

You need to be where you feel safest. A good midwife will want this for you. 

 

It seems you feel pressure & want to do right by her & that is kind, but both you & your DH are doing right by your baby first & again, she will understand & want this for you (if she doesn't or reacts badly, you will feel VERY relieved to have transferred care to an OB!)

 

Ask around or look for reviews in your area for a good OB & don't look back, if that's what you & DH want. Just tell her in as few words as possible in whatever way you feel most comfortable-- email, text, phone, in person; I sometimes literally write a script for challenging phone calls! I have also at times started the conversation by asking the other person to please let me go straight thru what I need to say & reply at the end bc I know myself & if interrupted with an emotional appeal, I may never go thru with it. (You prolly aren't as idk-what-I-am, maybe emotionally suggestible? conflict avoidant? as I am, so maybe you won't need to go that far, haha.)

 

Try not to stress yourself-- now is the time to stay as relaxed and calm as possible.

 

Taking it easy during pregnancy means emotionally taking it easy on yourself, too!

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#7 of 15 Old 03-25-2013, 12:03 AM
 
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We switched a little past 20 weeks, from a MW who was a poor fit to another MW we clicked with better, when I was pregnant with DS. I just sent the first MW a letter thanking her for everything she'd done for us and letting her know we were switching to another practice. MW2 told us we weren't obligated to inform MW1, because she knew how uncomfortable I was with the "breakup" part, but I felt it would have been improper to terminate the relationship without an acknowledgment. I will say, though, I was soooo much happier after leaving the first MW's practice. Good luck!
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#8 of 15 Old 03-25-2013, 12:38 AM
 
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Have you had a trans vaginal ultrasound to measure your cervix? I would transfer to an ob and also take it super easy until you know if this is more by or preterm labor.
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#9 of 15 Old 03-25-2013, 10:03 AM - Thread Starter
 
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Thank you everyone for your advice and reassurance!  I feel like it would be best for us and baby to switch providers.  I think I am going to call today and set up an appointment with an OB.  I would like to meet her and see how it goes before cancelling my next midwife appointment.  If things go well with the OB I will probably send the midwife an email letting her know that I would feel more comfortable with an OB at this point.  Thank you again!!

 

LLQ1011-  My last ultrasound was 4 weeks ago.  My cervix was 3.9 at that point.  The triage Dr. did a vaginal exam and said my cervix felt long, soft and closed.

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#10 of 15 Old 03-25-2013, 10:38 AM
 
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I could be wrong, but my intuition would tell me an IVF pregnancy would be more delicate than a naturally conceived one. I'd definitely go with an OB, but that's more my personality than actual medical advice. 

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#11 of 15 Old 03-25-2013, 10:43 AM - Thread Starter
 
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Originally Posted by Escaping View Post

I could be wrong, but my intuition would tell me an IVF pregnancy would be more delicate than a naturally conceived one. I'd definitely go with an OB, but that's more my personality than actual medical advice. 

We were told by the Dr at the fertility clinic that it was high risk but I wasn't having any issues so the Midwife felt comfortable seeing me.  I guess I should listen next time. . .I guess they know what they are doing! :)

 

DH wasn't totally onboard with an out of hospital birth but supported me because that's what I wanted.  He has told me a couple time in the last few days that this is not a normal pregnancy so try not to be too upset that things aren't going as "planned."  Makes sense but also makes me sad.  I'm not terrified of giving birth in a hospital. :/

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#12 of 15 Old 03-25-2013, 11:25 AM
 
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Quote:
Originally Posted by want2becrunchy View Post

We were told by the Dr at the fertility clinic that it was high risk but I wasn't having any issues so the Midwife felt comfortable seeing me.  I guess I should listen next time. . .I guess they know what they are doing! :)

 

DH wasn't totally onboard with an out of hospital birth but supported me because that's what I wanted.  He has told me a couple time in the last few days that this is not a normal pregnancy so try not to be too upset that things aren't going as "planned."  Makes sense but also makes me sad.  I'm not terrified of giving birth in a hospital. :/

 

I did it, it wasn't that bad :) I can imagine it would be nicer to be able to stay in your own bed at home, but the alternative isn't that awful. My son is just turning 1 now and his birth is just a distant memory. We've shared so many ups and down since he was born that his birth is probably the most "insignificant" part of his entire existence. 

 

For me, being in the hospital for 48 hours was even helpful. I got to focus on skin-to-skin, breastfeeding and nothing else for the first 2 days. At home I would have been doing laundry, taking pictures, entertaining a parade of guests, etc. I also found it comforting that I was responsible for this fragile little thing and if I screwed it up somehow, at least we were already in the hospital until I got comfortable with him... In fact, at night when I went to change his diaper and discovered he was peeing "brick dust" (I never heard about that and I though he was peeing blood) I freaked out and called a nurse. Just that little freakout made it worth it to be in the hospital. 

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#13 of 15 Old 03-25-2013, 11:33 AM
 
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Originally Posted by want2becrunchy View Post

Thank you everyone for your advice and reassurance!  I feel like it would be best for us and baby to switch providers.  I think I am going to call today and set up an appointment with an OB.  I would like to meet her and see how it goes before cancelling my next midwife appointment.  If things go well with the OB I will probably send the midwife an email letting her know that I would feel more comfortable with an OB at this point.  Thank you again!!

LLQ1011-  My last ultrasound was 4 weeks ago.  My cervix was 3.9 at that point.  The triage Dr. did a vaginal exam and said my cervix felt long, soft and closed.

I would ask for a follow up ultrasound for cervical length to see if it has shortened. No vaginal exams though they can introduce bacteria.
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#14 of 15 Old 03-25-2013, 01:00 PM - Thread Starter
 
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Originally Posted by LLQ1011 View Post


I would ask for a follow up ultrasound for cervical length to see if it has shortened. No vaginal exams though they can introduce bacteria.

I am going to call in a bit to try to get an appt, hopefully this week.  I will ask about an ultrasound.  Thank you!

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#15 of 15 Old 03-25-2013, 05:59 PM
 
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I had IVF and am now pregnant for the second time. High risk conceptions do not always result in high-risk pregnancies (although of course they can). 

 

In my experience, the midwives can do a swab which determines likelihood of pre-term labour. Although they don't normally get the results back right away (if they are normal), they do get the results immediately if they are abnormal. I got a call from my midwife within an hour of doing blood work when I had abnormal results.  However, when everything is OK, its normal to wait a bit.

 

I have a midwife now but I have also seen a doctor about certain issues, so I'm wondering if you could keep both? And then make up your mind as the time comes closer. I loved my last midwife birth but I might be too high risk this time. I still am keeping my midwife though, as I do not have to choose at this point.

 

Take care!

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