Is it normal for OB to ask NO prenatal questions? - Mothering Forums

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#1 of 73 Old 07-17-2007, 09:52 PM - Thread Starter
 
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I mean, this guy is in and out of the room in less than 2 minutes. Checks heartbeat, checks where uterus is, asks, "how are you feeling?" (my answer has been, "fine") and is pretty much gone after that.

Is this NORMAL???!!!

I'm switching to a homebirth midwife, I'm totally unhappy with this doctor, but just was wondering if this is a standard thing.... If so, that's terrible!!!

Anyone else experienced a doctor like this? How can he be giving NO prenatal evaluation of his pregnant patients? (like nutrition, exercise, sleep, etc.) I'm interested in hearing what others have to say!

Mama to dd born 7/2005, dd born 12/2007 and dd born 11/2009.
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#2 of 73 Old 07-17-2007, 09:54 PM
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I think thats fairly "normal" for an OB.
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#3 of 73 Old 07-17-2007, 10:00 PM
 
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Unfortunately in my experience that is fairly normal.
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#4 of 73 Old 07-17-2007, 10:00 PM
 
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That is normal for an obstetrician. That is the American medical model of prenatal care.

I have had friends who delivered in foreign countries and I know that there is much more attention paid to diet, environment and family life.

How long have you been a member here? You really need to know that this is the way medical doctors treat all their patients (o.k. big generalization, but my experience of 53 years is that it is true). Why do you think people here complain so much?

Get a midwife (not medwife) and while you are at it, consider a homebirth. A good homebirth midwife will pay attention to your diet, exercise and other concerns if you are going to deliver at home. If you need the surgical technique of a surgeon later in pregnancy, the experienced homebirth midwife will send you; however, 85% of most women in labor do not need surgery. A pregnant woman is a healthy person who deserves to be treated that way.

"The great enemy of the truth is very often not the lie, deliberate, contrived and dishonest, but the myth, persistent, persuasive and unrealistic."
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#5 of 73 Old 07-17-2007, 10:40 PM
 
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I really like my two OBs, and from the ones I interviewed, they were the most supportive of natural, intervention-free childbirth. Unfortuntately, they are still in and out with very little discussion of diet, exercise, life, etc.

However, I have found that if I initiate discussion or have questions, they both have been very responsive and informative. Working within this paradigm of medicalized care does require mamas to ask more questions and advocate more for themselves.

Maybe it is because most mamas don't care or aren't interested in making different lifestyle choices?

Happy wife to DH superhero.gifand mama to DS signcirc1.gif11/05 and DD energy.gif8/07.
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#6 of 73 Old 07-18-2007, 12:49 AM
 
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My OB is fantastic, but I never get to see her.


Yesterday was an appointment with one of the other OB's, another female, and next month will be more of the same.
She was in and out in 2 minutes, told me some mildly false information (theres no such thing as a false positive HIV test because of pregnancy, okay - whatever,) and left.


Thankfully, I'm doing My Own prenatal care, but its nuts.
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#7 of 73 Old 07-18-2007, 01:48 AM
 
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Maybe it is because most mamas don't care or aren't interested in making different lifestyle choices?
If doctors told them it was important, perhaps they would care.

Laura, CBE and mom to Maddiewaterbirth.jpg ( 06/03/04) & Graceuc.jpg (  09/10/06)
 
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#8 of 73 Old 07-18-2007, 02:25 AM
 
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At my one OB visit, she didn't want to know anything about how/what I was feeling. She just wanted a bunch of tests. When I resisted the tests, she told me that my baby would end up brain damaged and only be able to get a job in McDonalds. Then her entire nutritional advice was "3 meals a day plus 2 snacks, and drink lots of water."

I switched to a HB MW.

Leigh, mama to Rostislav homeborn Aug 9 2007, and Oksana homeborn Feb 24 2011.
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#9 of 73 Old 07-18-2007, 02:42 AM
 
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I think it's totally wrong, but VERY normal.

When I was pregnant with DD#1, the doctor never asked me any questions. Just measured my uterus, listened to the baby and "see you in a week." If I asked him a question he would reply - "Ask the nurse on your way out!"

I wish I had known better then....
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#10 of 73 Old 07-18-2007, 05:55 AM
 
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I'm switching to a homebirth midwife, I'm totally unhappy with this doctor,
WOOHOO!!! Good on you for noticing you were being treated badly and thus making a very wise decision to walk away and get proper care. Imagine that attitude when you're birthing
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#11 of 73 Old 07-18-2007, 06:06 AM
 
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Yup, sounds about normal to me.

Ruth, single mommy to Leah, 19, Hannah, 18 (commuting to college), and Jack, 13(homeschooled)
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#12 of 73 Old 07-18-2007, 09:56 AM
 
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It amazes me that this is the quality of care that most insurance companies support. They could pay thousands less for a HB midwife who provides an excellent standard of care and support to her clients. Its shocking.

I have had one OB attended pregnancy, and I would never do it again unless I HAD to have a c-section.
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#13 of 73 Old 07-18-2007, 10:01 AM
 
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Normal for an OB, and even for a CNM that works with OBs. I compromised with DH last time and chose a CNM for a hospital birth. She was in and out of my appointments (after making me wait at least an hour). I wish I would have wised up and switched to a homebirth midwife, I wouldn't have ended up with this scar on my uterus. I am glad you are switching.
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#14 of 73 Old 07-18-2007, 10:08 AM
 
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Heinous, but unfortunately normal.

I found that they asked even fewer questions during my second pregnancy. I guess they were trusting that I already knew the score since I'd already had a baby, and they left full responsibility on my shoulders to ask for info. Fortunately I'm a pretty darned informed mama (who is now informed enough not to want to see an OB during a healthy pregnancy ). But they didn't necessarily know that about me, and it seems irresponsible to me that they never did any patient education, didn't really check in with me. How can women ask for information if they're not healthcare experts and don't even know what questions to ask??

BTW, LOVING my midwife, who spends lots of time sharing information with me and asking questions about various aspects of my life. It's a little ironic that I went down a couple of steps on the caregiver model, but I'm actually receiving much more *care*.

may my heart always be open to little birds who are the secrets of living whatever they sing is better than to know  - e.e. cummings
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#15 of 73 Old 07-18-2007, 10:13 AM
 
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Wow.

I guess I must be a bit of a UCer at heart, but I was really put off by the invasive questions of birth practicioners I interviewed/saw this pregnancy. These include OBs, CNMs at a birth center, and a homebirth midwife. If the "American Model of Care" includes NOT grilling a woman about her "lifestyle"(?) I haven't seen any evidence of it. And a midwife who felt she was entitled to ask "various questions about my life"? *shudder*

I chose the midwife I have now largely based on the fact that she's very respectful of boundaries. I'm not a child. I'd rather have a practicioner who, once having established that all is well and there are no immediate problems, trusts that I can feed myself and will bring medical problems to her attention without being coaxed and cajoled. Maybe this is because I see a lot specialists, and thus see a midwife/OB as simply another specialist, rather than my new best friend/protector/nutritionist/psychoanalyst.

I actually fired a midwife partly overly involving herself in other aspects of my medical care. I found it inapporopriate (she was the wrong midwife for other reasons as well). Seriously, though, OBs may stop being so controlling and paternalistic when women stop needing to have their hands held and their hair stroked throughout their pregnancies.
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#16 of 73 Old 07-18-2007, 10:19 AM
 
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Individuation,

The question is, how can they expect to diagnose any potential problems if they don't have any interest in any pains you are feeling or any other symptoms?

The problem is that they don't trust OUR perceptions of our own body, so asking how we feel is just inconceivable. They don't even trust THEIR perceptions -- having to use devices and tests that return numerical data.

Leigh, mama to Rostislav homeborn Aug 9 2007, and Oksana homeborn Feb 24 2011.
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#17 of 73 Old 07-18-2007, 10:45 AM
 
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Wow.

I guess I must be a bit of a UCer at heart, but I was really put off by the invasive questions of birth practicioners I interviewed/saw this pregnancy. These include OBs, CNMs at a birth center, and a homebirth midwife. If the "American Model of Care" includes NOT grilling a woman about her "lifestyle"(?) I haven't seen any evidence of it. And a midwife who felt she was entitled to ask "various questions about my life"? *shudder*

I chose the midwife I have now largely based on the fact that she's very respectful of boundaries. I'm not a child. I'd rather have a practicioner who, once having established that all is well and there are no immediate problems, trusts that I can feed myself and will bring medical problems to her attention without being coaxed and cajoled. Maybe this is because I see a lot specialists, and thus see a midwife/OB as simply another specialist, rather than my new best friend/protector/nutritionist/psychoanalyst.

I actually fired a midwife partly overly involving herself in other aspects of my medical care. I found it inapporopriate (she was the wrong midwife for other reasons as well). Seriously, though, OBs may stop being so controlling and paternalistic when women stop needing to have their hands held and their hair stroked throughout their pregnancies.
:

I'm a very private person-- when I go to a doctor, it's because I have an issue, not because I want my life overhauled. I would have been thrilled if my pregnancy had been a little more hands-off-- we made the terrible mistake of switching to the military's health-care system to use the "midwives" (CNM's).
They actually continued to try to diagnose me with pre-e, based on my blood pressure spikes at the way I was treated (bp was normal using home monitoring system I bought myself, no proteins in urine).

That said, everyone has their own preferences for health care providers, which is why it's so very important to have range of options.
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#18 of 73 Old 07-18-2007, 10:45 AM
 
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Wow.

I guess I must be a bit of a UCer at heart, but I was really put off by the invasive questions of birth practicioners I interviewed/saw this pregnancy. These include OBs, CNMs at a birth center, and a homebirth midwife. If the "American Model of Care" includes NOT grilling a woman about her "lifestyle"(?) I haven't seen any evidence of it. And a midwife who felt she was entitled to ask "various questions about my life"? *shudder*

I chose the midwife I have now largely based on the fact that she's very respectful of boundaries. I'm not a child. I'd rather have a practicioner who, once having established that all is well and there are no immediate problems, trusts that I can feed myself and will bring medical problems to her attention without being coaxed and cajoled. Maybe this is because I see a lot specialists, and thus see a midwife/OB as simply another specialist, rather than my new best friend/protector/nutritionist/psychoanalyst.

I actually fired a midwife partly overly involving herself in other aspects of my medical care. I found it inapporopriate (she was the wrong midwife for other reasons as well). Seriously, though, OBs may stop being so controlling and paternalistic when women stop needing to have their hands held and their hair stroked throughout their pregnancies.
My midwives never asked me invasive questions. We talked for 30-60 minutes about anything and everything.

I don't expect my midwife to be my new best friend, but I do need to get to know someone who is going to be at one of the biggest events in my life.

Jam 7, Peanut Butter 5, and Bread 2.

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#19 of 73 Old 07-18-2007, 10:53 AM
 
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To each her own.

Lilya, the OP stated that the doctor asked how she was feeling. I don't think we're talking about a situation where a doctor was "not interested in any pains she was feeling." Naturally, you should let your doctor/midwife know if you're having any alarming symptoms... but a normal, low-risk pregnancy? Not a disease, and there's not really that much to talk about if you're having your emotional needs met elsewhere.

The_lissa, I think it's wonderful that you were able to find someone to spend an hour talking to you about "anything and everything," and I'm glad that option obviously exists for the women who need it. I just question whether it should be the standard of care.

Sheesh, I can't talk to my own husband about being pregnant for an hour straight. Different people have different needs. I'm not saying there's anything wrong with women who need a lot of interaction and emotional support from their practicioner during their pregnancies, but I found it viciously unfair and strange that this doctor (and by extension ALL practicioners with a similar style) were being decried as "heinous" and "awful." There are women who would be thrilled at a hands-off style.
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#20 of 73 Old 07-18-2007, 11:14 AM
 
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I saw OBs for part of my first pregnancy. They obviously wanted to be in and out and seemed annoyed when I asked questions. I switched to the midwife practice and never got that impression with them.

I later got copies of my medical records to decide for myself whether homebirth was an option for me. I noticed that the OBs had noted on my chart, in rather large and angry-looking letters, "Patient had MANY questions" (emphasis theirs).

Geez, how dare I ask questions.

Makes me wonder exactly why they felt they had to make a specific note about this. From the tone of the rest of the entry, they did not feel my questions were a good thing.
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#21 of 73 Old 07-18-2007, 11:23 AM
 
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The_lissa, I think it's wonderful that you were able to find someone to spend an hour talking to you about "anything and everything," and I'm glad that option obviously exists for the women who need it. I just question whether it should be the standard of care.

Sheesh, I can't talk to my own husband about being pregnant for an hour straight. Different people have different needs. I'm not saying there's anything wrong with women who need a lot of interaction and emotional support from their practicioner during their pregnancies, but I found it viciously unfair and strange that this doctor (and by extension ALL practicioners with a similar style) were being decried as "heinous" and "awful." There are women who would be thrilled at a hands-off style.
Well it isn't like they lock the door and make you talk for an hour.

Hands off is good, but I think that for most obs, it more of a way of being dismissive, and it doesn't bode well for the labour or birth.

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#22 of 73 Old 07-18-2007, 11:36 AM
 
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Well it isn't like they lock the door and make you talk for an hour.

Hands off is good, but I think that for most obs, it more of a way of being dismissive, and it doesn't bode well for the labour or birth.
That's probably true--if you're in the position of making birth plans, etc., it's nice if the OB has some interest in what sort of person you are.

(In my case, a ridiculously private, "none of your business," "I'll call YOU if I have a problem, thanks" type of person! : )
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#23 of 73 Old 07-18-2007, 11:40 AM
 
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Yep.

I think for some care providers, they are hands off because they don't respect you enough to tell you things. That, and they know that they are going to determine what happens at your birth and not you.

While for other care providers, they are hands off because they trust you, will defer to you at your birth, etc.

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#24 of 73 Old 07-18-2007, 11:45 AM
 
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Individuation, could you tell me what kind of questions you found invasive and irrelevant?

I ask because as a CAM HCP I often ask questions that might seem irrelevant but are pertinent to my grasp on the case. If I get the slightest pause or bristling from any question, I immediately explain *why* I'm asking the question. I like to think it builds trust between me and my client and teaches them more about how their bodies work.

I think too many HCPs consider their technical skills and knowledge base sufficient to be excellent practitioners while not considering how much a lack of inter-personal skills can negatively impact the care their clients receive.

If I were to whip down a list of questions including things like "Do you wear a seatbelt on every trip?", I can easily imagine a woman feeling I was wasting her time and *assumed* she was stupid or irresponsible. I wouldn't do that. I'd ask something like, "How's your car seatbelt working for you this pregnancy?" A woman would then be free to share if she didn't use them, if she thought they would do more harm to a baby in an accident than no seatbelt use, if it was riding over her belly and breast and across her neck, etc and I'd be free to clarify study results and offer positioning tips and devices for seatbelts that were designed for the non-pregnant body. I *like* to think my way comes across less as a pass/fail test and more as an opening for discussion. I'm sure I won't succeed every time but my desire is for my clients to view our relationship not as patient & HCP but as a health care partnership.

BV, who rambled but isn't going to edit as kids are hungry
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#25 of 73 Old 07-18-2007, 11:48 AM
 
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You ask about seatbelts?

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#26 of 73 Old 07-18-2007, 12:47 PM
 
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I have to agree with both individuation and the_lissa very equally.
Unfortunately when I made my first prenatal appointment, a few days later - I had a nurse call me, whom asked hundreds of some not-so personal and some quite-personal questions. I was on the phone with her for 30-40 minutes.
A lot of questions were a personal intrusion - and I told her to bugger off, in a lot more respectful terms.

It just shows a complete lack of intimate care in this industry. A nurse whom I'll never meet is asking me these questions - I understand OB's are busy, I'd rather just fill out a form.

I am like you, extremely private about many things - but I still absolutely need to build a rapport with the individual who is supposedly coming to birth my child - an extremely vulnerable time (where frankly, I don't feel they belong) that I need them to be a bit in tuned with me, and understand my wishes.

If they never give women a chance to speak these wishes or needs, these women get left by the wayside. I'm not talking about coddling, I'm talking about one on one real conversation about what is going to happen in the 'delivery room' or 'OR'. I don't need my OB to hold my hand, but I need her to absolutely respect me as a person and not as another person processed in the babymaking factory.

Its just another example of authority railroading women to suit their preferences and conveniences.


Ramble ramble. Hunger calls, bbl.
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#27 of 73 Old 07-18-2007, 12:55 PM
 
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You ask about seatbelts?
No. I'm not a MW or OB but could imagine one asking because seatbelts are not designed for the pregnant body so many pregnant women end up not wearing them or wearing them incorrectly. I used to work for Physical Medicine and Rehabilitation and was continually saddened by steady stream of patients whose injuries were 100% preventable.

I can understand how, presented the wrong way, someone could easily think the HCP was a nosy, judgmental busybody. I tried to give an example of the same topic approached in a non-judgmental way through an open ended question.

FTR, if I were a pregnancy HCP and asked my version of the questions, these would be my responses. If someone said they weren't wearing them because of babies injured from seatbelts, I'd explain how that happens from improperly positioned lapbelts and how you need to maneuver it into position properly. If they complained about the shoulder harness riding over their belly and breasts and across their neck (VERY DANGEROUS!), I'd talk about shoulder belt positioning devices designed for short people which can help a pregnant woman position the shoulder harness over the belly and between the breasts. If the woman said she wasn't having any issues with her seatbelt, I'd say "Good. Often they can become troublesome women's shapes change during pregnancy and, if it becomes a problem, let me know and I'll have some suggestions for a safer more comfortable ride."

My goal is to be respectful and practice the Golden Rule in all areas of my practice. If people disregard the information I present and end up suffering because of it, I'll feel bad for them but not guilty. I probably reexamine my approach and see if I could make my message easier to receive, remember, or implement but I wouldn't feel responsible for not preventing a preventable injury.

Just my 2c.

~BV
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#28 of 73 Old 07-18-2007, 01:02 PM
 
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I have to agree with both individuation and the_lissa very equally.
Unfortunately when I made my first prenatal appointment, a few days later - I had a nurse call me, whom asked hundreds of some not-so personal and some quite-personal questions. I was on the phone with her for 30-40 minutes.
A lot of questions were a personal intrusion - and I told her to bugger off, in a lot more respectful terms.
<snip>
Its just another example of authority railroading women to suit their preferences and conveniences.
Please humor me here. I have only had prenatal care from one DEM over a decade ago. Other than quite-personal and not-so personal, can you give me an idea of what kind of questions you find intrusive?

It's frustrating for me to engage in a conversation with people who won't explain WHAT is the problem. If I knew what it was I might agree completely, or disagree with the irrelevance of the information but agree it was presented tactlessly. I can't know what to think if the facts are never presented.

~BV
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#29 of 73 Old 07-18-2007, 02:43 PM
 
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The lack of time has less to do with the "American model of prenatal care" or OB training than with the financial reality of modern medicine. OBs simply do not have the time. Doctors in general don't have the time. Most homebirth midwives are operating under a different set of financial constraints. If they operated under HMO rules, they might not have as much time to devote to you either.

Most doctors will actually say they would prefer to spend more time talking to their patients--a clear patient history and good questioning can provide a great deal of information. A good doctor isn't dazzled by technology. It can provide useful information, but it may not tell you what you need to know. Unfortunately, the way insurance billing works, doctors don't get paid to talk. They get paid for procedures.

The midwives here never took time to talk to me either: they had too many patients to see. The consultant OB would ask me a couple of general questions, but that's all she had time for.

DD 01/2007, DS 09/2011

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#30 of 73 Old 07-18-2007, 03:31 PM
 
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Wow. It never occurred to me how fortunate I have been in the past with my old OB, at least when it came to prenatal care. She would come in and do all the technical stuff (weight, BP, listen to the heartbeat), and then she would sit down and ask if there was anything I wanted to talk about. If I didn't have anything specific, she would start asking me about my energy level, appetite (and what types of meals/snacks I had been having, and give me suggestions for keeping them well rounded), types of activity I'd been doing, and also if I had anything going on emotionally-how I was feeling about this or that in regards to my pregnancy and life in general, and then we'd talk about anything that would be coming up in regards to the pregnancy, and things to keep an eye on in terms of possible problems-what to do, when to call, etc.

It makes me very sad to realize so many women DON'T get that. : The only issue I really had with her, and it was only in hindsight, was that she was much too quick to resort to interventions during labor, and didn't let things progress naturally, and with my second, she induced at 39 weeks for the convenience of it. At that point, it didn't even occur to me to not just say ok to whatever the doctor suggested-you live and you learn.

My new OB is also very good about prenatal care...we've spent at least 25-30 minutes discussing things after all the routine care is out of the way at each of my appointments-including my first appointment with her when I went for my yearly, before I was pregnant-and what nutritional/lifestyle changes would be best before even actually being pregnant. Plus, she has 2 children, and had natural childbirth with both. For an OB, I think she's awesome.

My last appointment was with her midwife, because she's on maternity leave. She was great too. We got to talking about the political climate in the area (and state for that matter) when it came to midwives in general-not being able to attend hospital births, CPNs being felons, etc. What really made me super happy was when she said that my doctor was 'one of the good guys' when it came to supporting midwives, and said she wishes that all OB's were more like my OB, because there would be so much less 'medical junk' to pregnancy and childbirth. :

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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