My OB gave me an ultimatum!!! - Mothering Forums

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Old 05-31-2006, 08:51 PM - Thread Starter
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I've given birth at home, unassisted, twice already. I was hoping if everything went okay this time around, to have a homebirth again. My ob/gyn obviously knows my birth histories. She basically told me if I give birth at home, she'll have to drop me as a patient due to medical malpractice/insurance reasons. This OB is awesome, though. She's the one who encourages natural family planning, loves mothering magazine, and is an all around great woman who hates these rules and regulations placed on her.

She also warned me that I will be dropped from her practice even if I have an "oops" homebirth.

I have to stick with the OB/GYN for at least the next few months, because there are some potential problems that may arise (we have to watch out for some birth defects that could be inherited, or due to medications I was on when I got pregnant). If the baby does have a birth defect, I'd have to give birth at a hospital anyways, so this all may be a moot point.

This OB/GYN is the best in the area. She has the lowest cesarean rate, and she likes when the women take an active role in their care. It really is a decision out of her hands.

So, I could easily see her throughout the pregnancy, and if everything seems fine, have a UC anyways, then be banned from the practice, right?

But here's the catch... this OB/GYN is willing to prescribe Reglan so I'll be able to nurse exclusively (I have a medical problem that makes it impossible for me to nurse exclusively without assistance)! She's the only doctor out of MANY I've contacted, who'd be willing to do this. If I want the Reglan, I have to give birth at the hospital. This has me very torn and frustrated.
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Old 05-31-2006, 08:53 PM
 
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Wow. You are really being placed between a rock and a hard place. I am so sorry! (I'm not in your DDC; I just saw this on my new posts page)

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Old 05-31-2006, 08:54 PM
 
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Oh wow. Also not in your DDC. I hope you can figure everything out!

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Old 05-31-2006, 08:56 PM
 
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what about ordering domperidone from new zealand?
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Old 05-31-2006, 08:58 PM - Thread Starter
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I'm poor. I wouldn't be able to afford it without the prescription. It's WAY too expensive (as is formula, but still!).
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Old 05-31-2006, 09:45 PM
 
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Just curious.. If you give birth at home and she is not there, how is that a malpractice issue for her? Also, how is it possible that you are not "allowed" to have an accidental home birth? I mean, that could happen even if you are really planning on going to the hospital this time.. Is everyone in her practiced kicked out if they happen to deliver accidently at home with no assistance or is it just you because you have elected to go unassisted before? Are you supposed to hold your baby in and keep him/her from coming out until you get to a hospital just to save her from malparctice troubles? I feel for you because the circumstances here makes this a very tough issue..


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Old 05-31-2006, 10:05 PM - Thread Starter
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How she explained it is if I gave birth at home, either planned or unplanned, and something went wrong, my lawyers could argue that it could have been prevented through better obstetrical care, or that a quick delivery leading to an unplanned homebirth could've been avoided with better obstetrical care. So, the insurance company requires she drop patients who give birth at home, even if everything turns out fine.
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Old 05-31-2006, 10:10 PM
 
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hrrrm....well not a great suggestion, maybe she will allow you to "drop" her as your OB....and you can get someone else for your OB care until the birth, then go back to her??

that way she's not your ob when you deliver...yk?
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Old 05-31-2006, 10:51 PM
 
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I guess my concern here would be that someone who is that concerned about malpractice may not be looking out for my best interest come birthing time.. I am not suggesting that she is a bad doctor and I know that ob's do have malpractice to worry about.. Its unfortunate that she is in that position.. You say that you have to stick to an ob for the first few months.. If everything looks ok at that point could you get the rest of your prenatal care from a midwife or a different ob and then return to her practice after the birth?

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Old 05-31-2006, 10:58 PM - Thread Starter
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That is a thought. Should I talk with her about this possibility? But there's only one other OB practice around that I can see. I've already been banned from one practice because of homebirthing. The only other OB that I could switch to and have an accidental homebirth, are these awful docs who give internal exams with no gloves, while wearing this huge garish rings. ICKY! If I could find transportation, I may be able to see these midwives in the next state, but I don't know if they'll accept my insurance, or attend a homebirth. I'll give them a call tomorrow and see.
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Old 05-31-2006, 11:08 PM
 
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Originally Posted by a_work_in_progress
The only other OB that I could switch to and have an accidental homebirth, are these awful docs who give internal exams with no gloves, while wearing this huge garish rings. ICKY!
I am not in your DDC either, but OMG!!! Is that even legal???
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Old 05-31-2006, 11:18 PM - Thread Starter
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It's nasty. And those docs have a cesarean rate that's shameful. Some estimate at least 50%, though I don't see how that's possible but almost every woman I know who's had them for an OB has had a c-section.

I found out by searching online that the midwives in the next state over DO accept my insurance. Now I have to see if they'll attend homebirths, and see about transportation out to the appointments.
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Old 06-01-2006, 12:35 AM
 
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Is there no way at all that you could cut some things out and afford the Domperidone? I am on it myself and from my research it is pretty dangerous to take Reglan long term as it crosses the blood/brain barrier and can lead to depression/anxiety problems.

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Old 06-01-2006, 02:15 AM
 
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Originally Posted by a_work_in_progress
That is a thought. Should I talk with her about this possibility? But there's only one other OB practice around that I can see. I've already been banned from one practice because of homebirthing. The only other OB that I could switch to and have an accidental homebirth, are these awful docs who give internal exams with no gloves, while wearing this huge garish rings. ICKY! If I could find transportation, I may be able to see these midwives in the next state, but I don't know if they'll accept my insurance, or attend a homebirth. I'll give them a call tomorrow and see.
Why just look at OBs? I choose to have hospital births because assisted hbs are illegal here (SD) and I'm not personally comfortable with UC. But I don't see and OB - I see a family practice physician. She's my doctor for everything from broncitis to plantar warts to prenatal care and birth... and she's my husband's doctor and our "pediatrician" as well.

I agree with talking to her about "switching doctors" toward the end of your pregnancy and seeing if she'd take you back on with the next one after that. If you want to have an MD rather than a midwife as your "new doctor" (that you won't be seeing for the birth anyway), just know that's another avenue that you can explore.

Hope it works out for you!
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Old 06-01-2006, 03:17 AM
 
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Tough one...
I had a tough hospital birth and in Nov I will have a home birth...

Hmmm...Well...I would definitely want to nurse...so that really would play into it.
If you really think she would dump you and you really want to stay with her, I would wait until the last minute at home and be rushed to the hospital and deliver there...with your Dr (if she makes it) and make SURE you have a doula or two to stand by you and make sure all your needs are met and all of your desires are adheared to. I would also get OUTTA THERE as soon as possible...
JMO...
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Old 06-01-2006, 11:54 AM
 
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If anything were to go wrong in your delivery (at home) do you intend on blaming her? I doubt it. So, ask her if you would be able to write up a notarized contract signed by both of you stating you would not hold her liable for anything that happens at your home birth. Do you think that would work?

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Old 06-01-2006, 12:20 PM - Thread Starter
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Well, I called the CNM. They don't attend homebirths.

Getting an agreement signed wouldn't work.
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Old 06-01-2006, 01:56 PM
 
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Could she prescribe the Reglan now and you fill it later? Why would you have to get Domperidone from New Zeland?? Is it not available in the US??
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Old 06-01-2006, 11:48 PM
 
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I second asking her to write the script early. That way, no matter what happens you have the prescription ready to go.

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Old 06-02-2006, 12:06 AM
 
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Quote:
Originally Posted by a_work_in_progress
or that a quick delivery leading to an unplanned homebirth could've been avoided with better obstetrical care.
Not in your DDC, but I saw this in the new posts... Wow, I'm so sorry you're having to make this decision. It really sucks!

And how on earth is obstetrical care supposed to prevent a quick delivery leading to unplanned homebirth?!?!?!? Induce every woman at 37 weeks on the nose?

I too am planning to birth out-of-hospital, but am seeing an OB for prenatal care just in case I need him (I had PPROM at 29 weeks last time, and there is a chance it could happen again). My OB and I discussed it, and he said I could sign a waiver stating that I relieve him from all responsibility for my care once I stop seeing him. But I understand that laws vary from state to state.

I hope you can work things out. In my own case, if I *had* to birth in the hospital, I'd want it to be this OB, and I think I could have a good birth. It helps that I do have fast labors (first was 2.5 hours, and fast labors run in my family), so they don't have time to do much in the way of interventions. My biggest worries about hospital birth are a) directed pushing (tore last time with a less than 4 lb baby because of that), b) whether I'd be able to use alternate birthing positions like squatting or hands and knees (I think my OB would be cool with either), and c) NO UTERINE MASSAGE during the postpartum timeframe (OUCH!). Those were the things I didn't like about last hospital birth, but I didn't have an OB going in, so didn't have as much say. Plus I wasn't really prepared to be in labor - I was supposed to have at least 2 more months!

Mama to Tornado Boy (6/04), The Brute (11/06), and Mischief (05/09)... expecting in February '15
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Old 06-02-2006, 12:14 AM
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Originally Posted by gribbit
I guess my concern here would be that someone who is that concerned about malpractice may not be looking out for my best interest come birthing time.. I am not suggesting that she is a bad doctor and I know that ob's do have malpractice to worry about..
My OB and her partner both had to stop delivering babies because their malpractice insurance premiums increased so dramatically. They both have kids and don't work full time and they could not afford to pay $75,000 a year (each) for the insurance. My OB still does gyn stuff but the other doc quit all together. My point is that this is a serious issue for a lot of OBs. If I were you, I would tell the OB you are rethinking your birth plan and leave it at that. Maybe if you are vague enough you can still see her. If not, then perhaps you can convince another doc of your medical needs or perhaps this OB can make a referral for you. It is really sad that this OB has to practice with such fear in her mind but this is the climate in which we live.

But, I would also take this opportunity to write to your lawmakers about this problem. I have heard that this is a state by state issue - some states have laws to prevent huge lawsuits and somehow this lowers insurance costs for docs. It is a shame that we live in a country so full of so many rich people but we cannot support a health industry that fully supports people.
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Old 06-02-2006, 01:20 AM
 
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another one who saw this on the new posts and had to reply

if you do get a prescription written early have her write it out as late as possible with 12 refills. consider having her date it for sometime around your due date if possible. prescriptions expire one year ( except controls and narcotics) from the date written. if she writes for a one month supply (usually all insurance will cover anyway) with 12 refills you'll be covered for a year from the time it is written.
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Old 06-02-2006, 08:58 AM
 
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Originally Posted by taylor
So, ask her if you would be able to write up a notarized contract signed by both of you stating you would not hold her liable for anything that happens at your home birth.
I did this with my backup OB last time, since I was birthing at home with a midwife. He wanted to cover his a**. It might be an option to suggest to her.

ETA: Oh, sorry. I just saw your post where you said this won't work.
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Old 06-02-2006, 12:03 PM
 
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Originally Posted by a_work_in_progress
The only other OB that I could switch to and have an accidental homebirth, are these awful docs who give internal exams with no gloves, while wearing this huge garish rings. ICKY!
This CANNOT be true, no gloves? and they stick rings up in you? I think not...

Gotta be some bad press there somewhere, I can see that they may not be your cup of tea, but if they actually did this to you, you would have reported them right??

I hope you can come up with a solution!

Catherine
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Old 06-04-2006, 11:26 AM
 
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Personally, I would go with the hospital birth in order to stay with the doctor I really liked. (But then, that's a decision I've already made once.)

It seems to me that the birth of a child is something that is generally over in 1 day -- while your breastfeeding relationship with that child will go on for far longer.

Of course, it would be nice to have the perfect birth experience, but in the grand scheme of things, it's just one day in a lifetime.

Sonja , 40, married to DH (42) since 5-29-93, DD born 11-3-2004, DS born 1-18-2007.
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Old 06-05-2006, 02:56 PM
 
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You should be able to sign a waiver with her that would legally not hold her responsible for anything should you decide to have oohb. But, she may have to ask her hospital legal department to draw this up, and it may be too political a situation for her.

Best of luck, Paige
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Old 06-09-2006, 05:10 AM
 
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That'd tough. She primarily concerned about the unassisted part, not the homebirth part, right?
Maybe you could ask her if she can suggest any midwives that do homebirths in your area. It sounds like she would want to help you out, from what you said.
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Old 06-09-2006, 05:31 AM
 
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Originally Posted by a_work_in_progress
The only other OB that I could switch to are these awful docs who give internal exams with no gloves, while wearing this huge garish rings. ICKY!



Has anyone reported this!!! I am just totally dumbfounded!!!
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Old 06-09-2006, 01:36 PM
 
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[QUOTE=a_work_in_progress]Tare these awful docs who give internal exams with no gloves, while wearing this huge garish rings. ICKY!

I'm sorry, but I don't believe that a doctor would want to risk his own health by doing that. I believe he/she may have worn huge rings (and I am NOT saying that is ok by any means), but not without gloves. Cervical exams are given with sterile gloves. The gloves are not only to protect you, but the health care provider as well.

I hope that you come to a decision that suits your needs. Good luck
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Old 06-12-2006, 02:50 PM
 
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I thought I saw something recently about Domperidone being available in the US now. It might not be that hard to get ahold of. Maybe you can find a doc who's a bit farther away for that. You'd only have to see him/her once, right?
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