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Discussion Starter · #1 ·
I finally had my meeting with the mw. Personality wise I really liked her, very personable etc. However, I am uncomfortable with her lack of experience. I cannot decide if she is very humble and honest, or unsure of herself. Dh didn't seem worried a bit after talking to her (although he doesn't know how much experience she actually has- I left the info out, but he never read it). The fact is she has attended less than 50 births. She has been in practice for 10 yrs or so, apprenticing before then. However, in our state lay midwifery is a felony and we are in a rural area to top it off. I cannot decide if my mommy intuition is giving me good warning OR if I have just been indoctrinated with the current birth culture of fear and what if's.

My other 2 options are this:
A FP who does homebirths- has 30 yrs and 3000 births experience- and is legal. However, he lives 2.5-3 hrs away, charges considerably more and personally although he was nice I just didn't feel like I clicked with him on that level and I am really not terribly comfortable with the distance.

The OB who attended my last hospital birth. Personally I really like him. For a hospital birth it was great. I labored at home in the pool until transition. Got there at 8/9, no iv, drank what I wanted and when. When I felt ready I started pushing, squatted, hands and knees etc. No episiotomy, small tear with a local was my only "drugs." Baby went straight to chest, cord clamped after pulsing stopped as the placenta was coming out. Baby was not separated at all, bath and all checks done in our room, or dh went with him.

Other concerns are this; I am RH -, so I want the shot after birth. The mw says she can get it, but it is expensive. Plus, in the rare case that I needed to transfer I don't want to play russian roullette and get one of the other dr's in town none of which I want touching me. So, this would mean concurrent care. Thing is I know I cannot tell the ob, as he would drop me. I guess that means lying and telling him that I just didn't make it in time (which I think woudl be likely given my history). The mw stated that she likes her clients to give their other practitioners a heads up that they are planning a hb, I am not comfortable with that. However, I am wondering how it will all go down. I would like to keep my OB for paps etc.

I don't even know if it is making sense. I guess mostly I hate the conflict and potential conflict of it all. Which I know is a very stupid thing to let bother me....

Any words of wisdom here????
 

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Oh mama, I am so sorry you have to be in such a quandry - such a stupid state you live in with regards to midwives (and I personally love missouri). So hugs to you!!


I think you must follow your gut on this which is you'd like someone with more experience. I really get that - I decided against a very nice midwife for this reason. Plus, it sounds like you would feel uncomfortable with the illegality of it because it would put you in a position of having to hide information/lie. etc. You won't be able to have a peaceful easy birth experience if you don't trust your birth provider and you're worried about the what ifs.

I think you need more info from your midwife. You should go back and ask her specifically what she has dealt with (emergency-wise) and how she dealt with it - all the what ifs. Ask her what she would do in your situation since you're in a rural area. Tell her you don't want to tell the OB that you're homebirthing and see her reaction to that.

And it sounds like you want the safety of the concurrent care with the OB - if that makes you comfortable, do that! I agree it would suck to lie about the homebirth to the doctor - but the state (and the doctor) is kind of forcing your hand on this, you know?? I wouldn't feel too bad about it.

You deserve the birth of your dreams my friend!!
 

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I'm a big believer in following your gut. If this situation doesn't feel right to, don't go with it.
 

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Does your FP have rights to deliver at a hospital? Could you get concurrent care with him and have him catch the baby only in the case of a transfer?
 

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Maybe some more information will help you make your decision.

Call her up or get another meeting, and ask her how she has or would handle certain issues. Maybe come up with 3 scenarios. You don't have to know the right answer yourself, you can either just feel with your intuition how "right" she reponds, or you can look it up after she responds.

And it's not just the actual answers she gives you, but also how she presents it. For example if you asked "How would you handle post-partum hemmorage?" if she says "um, I dunno, do you mean like a LOT of blood loss, or....?" - then I would feel doubtful about how decisive she could be if push came to shove. A better answer would be "I've had a couple of patients with blood loss, and neither was a true emergency - we just tranferred to the ER but didn't panic." A bad answer would be "Blood loss is never as big a deal as people think it is" - if she didn't follow up with some answer that indicated that she was aware that it can indeed be a big deal, and how she would decide that and what she would do. A good answer that indicates she's thought about it: "If I saw a patient get pale or act out of character, I would transfer immediately." (Don't go by the content of my answers, I don't know the right answer - but rather just trying to have examples of how you could see a thought process in her answers).

Besides asking her a couple of specific scenarios, you could also ask her to describe a stressful birth she attended, or something like that.
 

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Where are you in MO? I used to live in St. Louis and was at a friend's HB in Columbia. PM me if you're interested in the MW's name. I think I could probably find it for you.
 

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Discussion Starter · #8 ·
I live 2.5 -3 hrs south of St. Louis that is where the FP is from. No, he would not have any privleges at our hospital.

I did ask her about different scenaries. Hemorrhaging- she said she has handled some cases, maybe one that transferrred, not a true emergency though. I asked her about shoulder dystocia, she says that she has different maneuvers to try and not had one that it took more than a little bit to unstick. We talked about babies being slow to start and she went over the different degrees of that, she is certified emergency responder and certified in infant resuscitation as well. She says that she has transferred a few babes due to them not doing well enough, but then again they were all able to be stabilized and were taken without a big emergency.
 

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Crunchy,

First, I completely understand about the parallel care dilemma. I'm in St. Louis. Last time I didn't keep up with the prenatal visits because they were such a waste of time. It was a huge hassle to get FMLA papers signed, and then it was a huge hassle when we had to transfer, stupid doctors freaking out because I had "no prenatal care." Yeah, I had better prenatal care than you gave your wife, bastards. sorry. (i didn't really say that, too busy laboring to be a smartass)

It is really up to you. Definitely if you choose the midwife do the parallel care, and just "don't make it in time." That's my plan this time. Like a PP says, it's the legal environment and the doctors themselves who force us to lie to them.

Can you do both, planning to stay home, but then when labor starts go with your intuition? If my gut says "get thee to a hospital" when labor starts, then I'm going, midwife or no.

If your doctor is not on call when you give birth, will you be stuck with one of the other ones? It sounds like you have a great doctor, and your hospital birth sounds pretty great for a hospital birth. But you still run the risk of getting a bad nurse, and you have to put up with the hospital afterward.

I too would be nervous about that low a level of experience. But if I didn't have a midwife, I'd be waiting until the last possible minute to go to the hospital, silently hoping that I wouldn't make it in time. In my case an inexperienced midwife (who becomes a doula at the hospital) would likely be better than none. If nothing else, the prenatal care can make hiring the midwife worthwhile.
 

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Discussion Starter · #10 ·
Thanks so much for your reply. I have really been mulling this over. You are totally right, I can always go to the hospital if I don't feel like things of right (of course that means I put 1000 out of pocket for nothing though, however with an emergency that would be the case as well). Last time I stayed at home as long as possible too and then kind of hoped I might not make it either
I will be having a doula as well, that was my doula last time. She had her babies at home, this lady was her mw and after advocating for birth and such decided to go into nursing, now she is an l and d nurse - generally I wouldn't be for an l and d nurse, however with her point of view and background it does make me feel better that with the both of them if something came up they would catch it. OH, and my doc would almost definitely be my dr, barring unforesoon circumstances. It is just him at his practice and he very, very rarely misses a birth, last time he couldn't even recount the last time that happenened, he pretty much lives at the hospital.
 

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Quote:

Originally Posted by Briannasmom View Post
I think you must follow your gut on this which is you'd like someone with more experience. I really get that - I decided against a very nice midwife for this reason. Plus, it sounds like you would feel uncomfortable with the illegality of it because it would put you in a position of having to hide information/lie. etc. You won't be able to have a peaceful easy birth experience if you don't trust your birth provider and you're worried about the what ifs.
I agree. You must feel 100% comfortable with your homebirth midwife!! That's such a must. I met with 4 midwives and emailed the other until I found my perfect midwife.

Best wishes in your quest and your birth!
 
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