Would you tell your friend she has no chance at the birth she wants? UPDATE! posts 35 & 36 & 41 - Mothering Forums
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#1 of 43 Old 02-09-2010, 05:26 PM - Thread Starter
 
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I have a pretty close friend that I have watched kind of transform over the last year from very mainstream to crunchier and crunchier. She bought my baby pacifiers 8 months ago, and 2 weeks ago made fun of the people that gave her pacifiers at her baby shower. She used to think breastfeeding was something to be done in private, now she talks about nursing her future toddler. She is stocked on sposies and today she asked me about cloth diapers and said she thought they would be better!

She is 38 weeks pregnant with #1 and within the last 3 weeks has decided she wants a natural birth. The OB she chose (I think because her sister used him) won't let her go past 41 weeks and when she told him she didn't want an episiotomy, he said that he would "try" but that they probably wouldn't be able to avoid it because most women need one. She and her dh just made out their birth plan and it's full of things that I KNOW will not happen with this doc, or are extremely unlikely. DH wants to catch the baby, she wants a natural birth, they want to delay cord cutting etc etc. I mentioned to her a few days ago that the hospital has a great midwives program that is who I transferred to when our homebirth didn't work out, and that I know lots of people that switch this late in the game. But for whatever reason, I don't think she's interested in changing docs. My dh and I tried to tell them the other day that their doc was not going to be cooperative their plan, but I don't think it sunk in. At one point she mumbled about how it probably would be better to just have the baby at home, but it would be pretty expensive at this point. I just know they will be disappointed, possibly end up with a c-section or other traumatic birth when it might be avoided. I let her borrow some mothering mags and Birthing from Within (l'm looking for my Ina May books too) when she asked me the best way to prepare this late for a natural birth. I also told her to hire a doula if they could, and to stay home for as long as possible (among other things). Should I be more blunt about it? From reading this, it sounds like I have done enough, but I feel like I could have been more straightforward with how unlikely it is and that if she chooses to stay with this doctor, she should just accept a different kind of birth. DH thinks I should not say anymore, they'll have a bad experience, and then they'll be prepared next time. I just don't want to see them get hurt, because I had a traumatic birth. What do you think? Shut my mouth?

Mama to my little social butterfly 6/13/09

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#2 of 43 Old 02-09-2010, 05:37 PM
 
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this is a hard one. i have the other side of the fence and WANT a HB, but everyone feels the need to tell me the dangers of a HB and what not. its funny how its 'ok' to blab the dangers of a HB to someone who wants it, but you have to shut you mouth in this situation...

if it were me i would ask her how much she REALLY wants this. if she say something like "i want this so bad it hurts" or whatever i would tell her your thoughts. but make sure you point out you are only doing this because you want to support her.

i am sure others will have a more wise POV. but i think supporting her and helping her put the plan into action (even if that mean moving to a MW) is the best way to go about it!

s and good luck!

Your life doesnât change by the man whos elected. If your loved by someone you can't be rejected... decide what to be and go be it! If your a caged bird brake in and demand that somebody free it.
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#3 of 43 Old 02-09-2010, 05:40 PM
 
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I'm a mother that no one said anything to and ended up with a c-section. If you don't think she's really heard you I'd write her a very blunt email and end by saying you won't bring it up again but you are available is she has any questions. I wish someone would have said something to me. So many people did after the fact but not one did beforehand.

If she sticks with her doctor, that's her choice. If she has the terrible birth you think she will, don't say a word. Hug her and listen to her and help her prepare for next time.

A, WOHM hoping to be a SAHM married to E (7/7/01), mama to R :: (2/8/08) : : hopeful for ::
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#4 of 43 Old 02-09-2010, 05:41 PM
 
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I think that the most important and determinative factor in whether a woman gets a desired NCB is who her HCP is. And I tell anyone who is interested in NCB that. So I would be very straightforward and tell her in a kind but very honest way, saying, "I care about you and I just want to see you able to have the kind of birth you feel is best for your baby. I completely understand if you decide to stay with your OB, but in my experience it would be very unlikely for you to be able to have a NCB with this OB, based on what you've said about him. There is no harm in just meeting with one of the midwives to discuss your pregnancy and your options. Here is the number for the group. No matter what you choose, I hope you have a wonderful birth. I just wanted to share that with you since I didn't know until recently that you wanted a natural birth."

Something along those lines. But I would tell her. I think the mother's preparedness is very important, but especially for a first-time mom, choice of HCP is more determinative as to success in getting a NCB. GL!
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#5 of 43 Old 02-09-2010, 05:41 PM
 
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I would be VERY blunt about what I knew. I would also encourage her to talk more with the OB about the birth plan. Ask her what she plans to do if she gets to 41 weeks. Ask her what she plans to do if the OB is getting ready to cut an episiotomy. So many moms just kind of go along hoping for the best and don't want to think about the concrete realities of their situation. I would want a friend to figuratively slap me upside the head if I was headed down that path.

Fledgling midwife on hiatus, Wife to B, mama to C (c/s ribboncesarean.gif 12/04) and S hbac.gif (12/07), angel3.gif m/c (3/12) and expecting another bean 6/13 stork-suprise.gif.

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#6 of 43 Old 02-09-2010, 05:45 PM
 
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I'm not sure what more you *can* do. It seems to me like you've already told her your opinion on her doctor as well as suggesting alternatives. It's really up to her at this point. And who knows? It might not be as bad as you are imagining.

I don't know her, but do you find she processes her thoughts by talking about them? Perhaps she's just working out certain fears by verbalizing different scenarios, and is in actuality OK with this doctor.
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#7 of 43 Old 02-09-2010, 06:18 PM - Thread Starter
 
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I think part of the reason for not switching is that she is worried about cost (they are pretty poor right now, on a payment plan with current doc, but do have insurance), and maybe she'll think it's rude or mean to drop the doc. She's a very nice, giving person. They don't have internet, so I can't point her here, or write her an email. I think I will try to tell her though. I like the idea of saying that I care about her, want her to be happy, and if this is what she really wants, this is what she should do, but if not, that's ok too. Keep the ideas coming!

Mama to my little social butterfly 6/13/09

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#8 of 43 Old 02-09-2010, 07:52 PM
 
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I had a close friend who was interested in a natural birth after I had ds. I gave her all the info she asked for, etc. and was supportive. We talked about the importance of your practitioner being on board with a natural delivery. This was her third child and she has high risk pregnancies and was in the doctors office once a week. He told her early on that she could have a natural birth and that he would 'do his best' to support it, no episiotomy, etc., so she thought she was prepared. Until the delivery. When he asked her repeatedly if she wanted an epidural, was induced and told her he had to use an internal fetal monitor, and would only let her deliver if she was in stirrups. That friend is my hero b/c she did it without any pain meds, and I don't know that I could honestly have done it her way. She was really lucky in that she had a fast labor and her body cooperated with all the demands of the OB. She told me her birth story and I had to bite my tongue through the whole thing because she was really happy with her birth and I didn't want to ruin it for her (she was still on her birth high). After a couple of weeks, we were able to talk about it more objectively and I think she gets why I was kept harping on her to consider a different labor approach. I guess what I'm trying to say is that even though she thought she knew what a natural birth actually was, she still pictured the Hollywood version only without an epidural. Your friend may be thinking the same thing despite all the talking you've done about the subject so far, and it may take actually having the cascade of interventions for her to understand. Definitely talk to her about it again, maybe watch 'The Business of Being Born' with her, and be supportive if she ends up sticking with her OB. You're a good friend to be so concerned and she'll appreciate it whether she takes your advice or not .

Mama to Ahnna-Bella (Dec 05) dust.gif, Harrison (Oct 08) kid.gif, and Kellan Wilder (Jan '12) baby.gif

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#9 of 43 Old 02-09-2010, 08:04 PM
 
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Normally I err on the side of not butting in, but since she came right out and asked you "what she could do?" I think the door has been opened for you to be (lovingly) blunt with her. I would either call her or ideally arrange a sit-down and really lay out your thoughts and feelings about the reality of her plans.

Also, I would suggest she come to MDC and read some of the stories and experiences that moms have had...good and bad...which can help add some perspective beyond what you yourself are able to share.

jamie. crinkly (not quite crunchy) mama to 3 amazing little girls, an awesome little boy, and a baby girl making her debut at the end of this summer.

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#10 of 43 Old 02-09-2010, 08:07 PM
 
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A friend's daughter wanted a natural birth but was seeing a very mainstream OB. Midway through the pregnancy, I helped her find a free doula, and that kind of opened up the floodgates for her. She started doing more and more research, I was on the phone with her a few times. At 37 weeks she went in to her OB with her doula and her birth plan, and the experience was so horrible she called her mother in tears. At 38 weeks I helped her find a midwife who would take her on for a really reduced rate, and around 40 weeks she had a beautiful homebirth that she'll cherish forever.
I think your friend deserves to have someone speak honestly to her about birth. I would give it one more try. Tell her about the standard hospital interventions, and why she might run into obstacles. Tell her she still has the option of switching providers. If she doesn't want to hear it, don't push it, but she deserves to at least have access to that information.

Jen, journalist, policy wonk, and formerly a proud single mama to my sweet little man Cyrus, born at home Dec. 2007 . Now married to my Incredibly Nice Guy and new mama to baby Arthur.
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#11 of 43 Old 02-09-2010, 08:11 PM
 
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Also, have they seen Business of Being Born?

Jen, journalist, policy wonk, and formerly a proud single mama to my sweet little man Cyrus, born at home Dec. 2007 . Now married to my Incredibly Nice Guy and new mama to baby Arthur.
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#12 of 43 Old 02-09-2010, 08:21 PM
 
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I would say something. I watched the Business of Being Born and thought I had all the things I needed in place to have a natural birth at a hospital with an OB. While I ended up having a vaginal birth that was 98% positive I did end up with many things (epi, pit, internal mointoring, purple pushing, threatened with a C/S, ect) I didn't want because in truth I was NOT prepared. I wish someone had been more blunt with me the first time around. That just the will to have a natural birth and a husband that was supportive was not going to be enough in our case to avoid all the interventions. I lived and I learned and I will do better next time. But if I had known then....

As a side note I watche BOBB again after my birth and saw it in a different light having been through birth.

Mama to DS (03/09) and DD (10/11) and married to the love of my life

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#13 of 43 Old 02-09-2010, 08:46 PM
 
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Originally Posted by *MamaJen* View Post
Also, have they seen Business of Being Born?

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#14 of 43 Old 02-09-2010, 09:33 PM
 
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Give her the name of a local midwife you would recommend. The rest is up to her.
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#15 of 43 Old 02-09-2010, 09:56 PM
 
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As a side note I watche BOBB again after my birth and saw it in a different light having been through birth.
That's interesting... What struck you differently the second time around?

Me, DH, DD1 (5/2009) and DD2 (10/2011).
I'm not crunchy. I'm evidence-based.

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#16 of 43 Old 02-09-2010, 10:02 PM
 
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I also told her to hire a doula if they could, and to stay home for as long as possible (among other things).
I'm 36weeks along with my 1st, and am pretty new to the NCB scene. I didn't understand what a doula was or how helpful they could be until a few friends explained it to me. (We've hired one and switched to a MW). You said $ is tight for her, but perhaps you know of a lower cost or free doula? Or maybe folks in the finding your tribe section might know of one. Your friend might be open to that even if she's not comfortable switching providers, and would have someone to help with comfort measures and advocacy.

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#17 of 43 Old 02-09-2010, 10:22 PM
 
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I would be frank with her, she's making these birth choices for herself, you're not pressurising her and I'd be upset with a friend who knew my doctor wouldn't allow them, but kept their mouth shut.

Ask her if she's asked her doctor if DH can catch the baby (and the other things) and if she believes the answer. Ask her what she is prepared to compromise on.

It is possible to have a great natural birth in hospital with an intervention happy doctor, but you do need to be prepared for it. I have a friend who waivered at the end between switching to a midwife and working with her doctor, in a hospital which doesn't really do choice. When it came down to it, it was her husband that made the difference, though it definitely helped that he is a doctor in the same hospital. I quizzed him on how he managed it and he said he just told people what to do - which sounds bossy, but you can still be polite, just phrase things as this is what we are doing, not we'd really appreciate it you could possibly allow us to do this.

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#18 of 43 Old 02-09-2010, 10:50 PM
 
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I'm 36weeks along with my 1st, and am pretty new to the NCB scene. I didn't understand what a doula was or how helpful they could be until a few friends explained it to me. (We've hired one and switched to a MW). You said $ is tight for her, but perhaps you know of a lower cost or free doula? Or maybe folks in the finding your tribe section might know of one. Your friend might be open to that even if she's not comfortable switching providers, and would have someone to help with comfort measures and advocacy.
Yeah, at the very least, strongly urge her to get a doula.

Jen, journalist, policy wonk, and formerly a proud single mama to my sweet little man Cyrus, born at home Dec. 2007 . Now married to my Incredibly Nice Guy and new mama to baby Arthur.
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#19 of 43 Old 02-10-2010, 12:40 AM
 
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I had a close friend who was interested in a natural birth after I had ds. I gave her all the info she asked for, etc. and was supportive. We talked about the importance of your practitioner being on board with a natural delivery. This was her third child and she has high risk pregnancies and was in the doctors office once a week. He told her early on that she could have a natural birth and that he would 'do his best' to support it, no episiotomy, etc., so she thought she was prepared. Until the delivery. When he asked her repeatedly if she wanted an epidural, was induced and told her he had to use an internal fetal monitor, and would only let her deliver if she was in stirrups.
I'm sorry, not to go off topic, but this is just so absurd that I would be hysterically laughing if I weren't so awful. What did he think he was going to do, hold the baby in there until she got in the stirrups? Like a finger in the dam, or what?? How utterly ridiculous..."won't let you deliver"...okay, as if you can stop that or she needs your permission, dude. Good luck with that!

I agree with what most have said, these are HER choices she's making, it's not like you're pressuring her, you're helping her understand the best way to meet those goals. Good luck!

Em, married to Alex, mom to Samantha (11 yrs) and Cullen (5yrs) and Maybe (5/16/2010) Trying to grow 4,000lbs of produce on .2 acres. See my blog!
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#20 of 43 Old 02-10-2010, 01:29 AM
 
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I think the real issue is that she has something that seems FINE. So right until she decides it's not fine, she is going to cling to it. I remember feeling the same way about my first group of medwives. And about the first daycare that my son went to. In both cases, I stuck with it because it was a LOT of effort to make a change. I convinced myself that it was ok. I was worried that I would hurt someone's feelings by switching. I actually stuck w/ the medwives through my son's birth (he ended up breech, and a scheduled c-section, so it didn't matter at the end of the day how great - or not - they would have been). But I pulled my son out of the daycare 1 month into it because I wasn't happy.

Anyway, my point is, she's afraid to switch this late in the game. She probably thinks she *cant* switch this late. My mom actually switched from an OB to a midwife when she was 36 weeks pregnant with me for the exact same reasons. (She had a great natural birth and I was over 10 lbs!)

I think the only way she can really get it through her head that this doctor isn't going to help her get what she wants is if she sits down with the doc and talks through her birth plan and gauges the reaction. Then, if your friend is receptive to the idea, maybe you could hook her up with a midwife who could take her - possibly just a phone conversation or similar - so that she could go through her birth plan with that midwife too. Once she can compare and contrast the two conversations, you've done your job, and the decision that she makes will be truly informed. That's all you can really do.

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#21 of 43 Old 02-10-2010, 01:34 AM
 
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Wow, same friend? lol

I heard the same things filter through whenever my friend mentioned her OB. Not as heinous as yours, but still, you could "hear" it. (E.g. she excitedly told me that her hospital allows rooming in! And her OB agreed to it! Woohoo! )

She lucked out big time. OB was on a vacation and she got a natural nurse who advised against an epidural.

So pray that her OB is on vacation I guess...

ETA: I think the difficulty here is that these particular women are really intelligent. This is the most intelligent friend I've bumped into in awhile. She didn't make changes (like S&D vax, ebfing, eclusive bfing, no circ etc) out of fear. She learned about the issues quickly and made the logical choice. BUT I think over this span of 9 months, they make SO MANY changes, that their world becomes topsy turvy. It's scary to change everything. To find out that everything you were doing just b/c someone told you to, is potentially harmful to your infant or yourself. Anyways, it seems that they hold onto the last thing: the OB/hospital. They want to trust him and remain loyal to him. As if to consider other options would betray him.

Mama to expecting Babe 2
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#22 of 43 Old 02-10-2010, 02:13 AM - Thread Starter
 
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Thanks everyone! I've contacted a few people and posted looking for doulas, so hopefully I'll find someone that would work with them. I also called her today and offered to watch the little girl she nanny's so she can go to her appt with the ob and talk about the birth plan (no kids allowed b/c of h1n1). I mentioned the midwife group, where they are located and how she could talk with them for free just to get a feel for them and see what she thinks. She wants to come over and use my sewing machine sometime soon, so maybe then we could have a good talk.

She is intelligent and makes good decisions when she has time to think it through and research and everything. So it does make it hard when she seems to be holding onto something I really don't think she wants!

Does anyone know a good place I could get BOBB fast? I know netflix has it, but they don't have the internet to download it, and I'm not sure it would come in the mail fast enough if I signed up. I would like to have a copy anway.

Mama to my little social butterfly 6/13/09

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#23 of 43 Old 02-10-2010, 03:25 AM
 
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There are good suggestions here. All I would add (or elaborate on) is that if she does decide she trusts this OB and wants to stick with him, she should:

A. Wait as long as possible before going to the hospital (OB and staff have less time to interfere, intervene - and who knows, maybe her OB won't make it and she'll get a better fit?).

B. Plan how she/her husband will react if the doctor tries to do things that don't follow the birth plan. The pp who mentioned the doctor-husband who was 'firm and bossy,' and that would probably need to be the role that the dh will need to take. So - what will they do if the doctor tries to insist she use EFM? What if the doctor wants to break her waters? What if the doctor tries to cut an episiotomy? What if the doctor wants her to .....???? And especially in re: the episiotomy, the husband needs to feel comfortable with the information (if he's the one who's going to be talking at that point, which is likely since many mothers are rather busy at what point the doctor is thinking about an episiotomy). So when the OB starts to say that the cut is better than a rip, etc., dh needs to feel confident to say, "We still prefer to tear naturally." [and then if she does tear, she should insist on a local numbing agent when he stitches her up].

If I were you, I'd start the conversation with the same line that you ended your OP with. "I had a traumatic first birth which I regret. I wish someone had talked more openly with me ahead of time. I know that we've talked about this, and you can take or leave what I say next, but I want you to have a birth that you look back on with joy - and I think you're most likely to feel that way about your birth, if you find a different HCP. [blah, blah]. And if you don't feel you can switch, can you get a doula [blah, blah]? And I'd suggest that you do [x, y, z] to make it less likely that your OB will try to do interventions you don't want.

If she does go with this OB, you don't want her to go in super-tense and have that affect her body's labor.

All that said - one of my sisters, for her first birth, had what I would consider an awful experience (it didn't end in a c/s but came within about 20 minutes of it, per her OB's 'deadline.'). It involved an induction following spontaneous ROM, they gave her only 3 hours to go into labor on her own, then gave pit and upped it every half hour without stopping. After 4 hours, she was 'only' at 3 1/2 cm, the OB told her she would probably have a c/s if she didn't make significant progress within the next half hour. Half an hour later, she was 10cm and pushing (thank goodness). Her OB cut a giant episiotomy, told her that she "had to."

All that said - my sister still thinks it was a wonderful birth, she's very proud that she did it without pain meds at all (as she should be especially the way they cranked her through it), and she thinks despite my input, that the episiotomy was necessary and "everybody gets them." She's due this summer again and I'm praying she gets a different OB from her practice this time (she did say she never liked that particular OB, but she was the one on call that weekend).

So -- it's possible that your friend could come through this birth with her OB feeling like she did great. And maybe more confident to make changes with a subsequent birth, given continued positive support from you.

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#24 of 43 Old 02-10-2010, 12:56 PM
 
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Would you consider printing out this thread and giving her a copy so that she can read about your concerns and everyone's responses? I can see that as being very awkward in some friendships and a great communication tool in others, so it really depends on what your friendship with her is like and on her personality in general, but I thought it would be worth a suggestion....

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#25 of 43 Old 02-10-2010, 01:17 PM
 
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Does anyone know a good place I could get BOBB fast? I know netflix has it, but they don't have the internet to download it, and I'm not sure it would come in the mail fast enough if I signed up. I would like to have a copy anway.
If you sign up for netflix today, the movie will probably be there tomorrow. It's crazy fast. You can do the single movie plan for like $5, then cancel after you return the movie.

Jen, journalist, policy wonk, and formerly a proud single mama to my sweet little man Cyrus, born at home Dec. 2007 . Now married to my Incredibly Nice Guy and new mama to baby Arthur.
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#26 of 43 Old 02-10-2010, 05:38 PM
 
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Originally Posted by myfairbabies View Post
when she told him she didn't want an episiotomy, he said that he would "try" but that they probably wouldn't be able to avoid it because most women need one.

WHOAA!


I would lend her "Thinking Woman's Guide" & just suggest she read the chapter on epis. That alone for me is reason to run for the hills. If he thinks "Most Moms' need one" he is CLUELESS! And he's only doing things PROVEN to be HARMFUL to Moms. Period.

That, to me, is the easiest way to attack this guy & convince her she needs to not birth with him. Thankfully, switching to the hospital-MWs should be easy enough.

I would focus on empathizing with her on how tough it will be to switch so late in the game. (I.e. "of course you're going to switch..."

This, to me, is NOT just about NCB vs. epidural vaginal birth. Someone who thinks epis is necessary is really, actively, harming women. She needs to not birth with him... IMO. I would NOT focus on "I know you want an NCB" since, she can probably still get an epidural even with the MWs, but overall care less damaging.
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#27 of 43 Old 02-10-2010, 05:46 PM
 
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I think that the most important and determinative factor in whether a woman gets a desired NCB is who her HCP is. !
Very well said...and it isnt always a midwife. I have had a OB at all my deliveries and they have been WAY more supportive than any of the midwives I had met. But I purposely sought out HCP that similar viewpoints and respected my wishes on what I wanted.

I think if they have a "plan" i think it would be good that they discuss it with their HCP and get their "take" on it. It might be there that she realizes that they will/will not support the decisions that they have made. i think also its important to let her know that people change HCP even late in the game, I knwo that once your coming to the home stretch that it can be overwhelming or even intimidating thinking about changing practicioners.
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#28 of 43 Old 02-11-2010, 03:55 PM
 
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That's interesting... What struck you differently the second time around?
The first time I watched it I was just focused on why would you decide on natural childbirth. I knew why I wanted to birth with out drugs, but had no clue about all the other interventions, ect. I showed it to my DH to win him over on the without drugs aspects it covered. He thought I was nuts and then he got it after watching it. I just missed the whole point of hospitals are full of interventions and how wonderful homebirth could be point, because I wasn't looking for that, I was looking for back-up to my stance about wanting to birth without drugs.

The second time I watched after I had my hospital birth full of interventions and I kind of just got it. To get the birth I want I will need to plan a home birth.

Mama to DS (03/09) and DD (10/11) and married to the love of my life

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#29 of 43 Old 02-12-2010, 06:56 PM
 
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I had a friend like this - she was having twins and she wanted a natural birth and to breastfeed. I asked her, "How important is it to you?" and she said, "Very." So I told her what would likely happen with her current OB (scheduled section, babies would not get to nurse right away and would have a hard time latching, she'd be too tired and in too much pain to try, someone would give them a bottle, and nursing would fail.) I also bought her a good pregnancy book for multiples and then left it at that. She never changed doctors and when I saw her after they were born, she said, "It happened exactly like you said and I can't nurse them and I am so sorry for it all." So, long story short, I would be completely blunt and to the point, and then let go of what she does after that. Some people need to learn the hard way, unfortunately.

DS1 2004 ~ DS2 2005 ~ DD1 2008 ~ DS3 2010 ~ DD2 due Dec. 2014
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#30 of 43 Old 02-12-2010, 07:13 PM - Thread Starter
 
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I have a long list of free doulas (thanks for that idea!), bobb in my mailbox, and friend coming over to sew on monday! I think printing this thread would be awkward, but I am definitely taking notes to include in our talk. I definitely want to mention that she can still get an epidural with a midwife if she wants (maybe she's worried about this?), why doulas are so awesome, and that I just want her to be happy. Then I will let go and hope she is satisfied with whatever the outcome. Wish me luck!

Mama to my little social butterfly 6/13/09

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