[Spiralshell]

So I had my second midwife appointment today. It's a practice of two midwives, and I saw the other one last time, so this was my first time meeting this one.
Both seem very pleasant and friendly, which is nice. I don't really have other options for midwives in this area, so I really want to like these two!
At the last appointment, nothing was said that made me feel funny, but this time a few things seemed kind of... odd...

RHOGAM: My blood is O-, and S is O+, so because of the dreaded possible Mama/Baby blood mixing sensitization issue, I will need Rhogam. She did a good job of explaining the blood surface protein situation (I am a former Biology teacher, so I didn't really need the explanation, but I was glad that she took the time to explain it clearly). Now I recently read that there is some danger to being vaccinated during pregnancy, and that it's perfectly safe to wait until after birth to get the Rhogam. I asked about this, because I'd rather not get any shots during pregnancy I don't need... but she just dismissed my concerns as nothing to worry about. I'm surprised she didn't even acknowledge that there could be some concerns, but that these are outweighed by evidence, etc.

PEOPLE AT BIRTH: I will be giving birth in a hospital (I'm not ready to have a home birth for my first) and I know that some have restrictions on how many people can be with you during labor. So I wanted to know if S, my mom, and my friend could all be with me. She said yes, sure, but you probably won't want anyone there other than S. I love S, don't get me wrong, but I really don't expect him to be a great support to me during labor. Even just talking about some pregnancy stuff freaks him out, and he has said several times that he doesn't want to have to watch. He also thinks I won't be able to handle labor without drugs, and doesn't seem in general to support my hopes for a natural birth. So I told the midwife this, and again she dismissed it, saying that once he attends a class, he'll be fine. (I was expecting her to say something about how some men do great and some don't). I really think I need the support of other women during labor to focus me and guide me -- my friend who will be with me is a master at this which is why I want her there. She also said, after we talked about it a bit more, that 50% of their patients get an epidural, but that's still natural childbirth. (This really surprised me! 50%!) I know that I cannot predict what my experience will be like, and that I may need interventions, but I don't want to go in with the mindset that my body is a lemon, and that I cannot bring this babe into the world without drugs. I can do it!

Anyway, I was just kind of surprised to hear this from my midwife... I want to know that she and her partner are really committed to helping me bring this babe into the world in the healthiest possible way, avoiding unnecessary interventions. I want to talk more about it with her next time and set my mind at ease.

 

[boobs4milk]

Totally not what I'd expect to hear from a midwife. I guess she's been jaded by hospital births???

I thought I'd want my mother or at least another woman in with me that I knew. I had a labor trauma (cervix started closing) with my first and they evacuated the place in prep for an emergency and asked me which one person I wanted to stay. Even though my then husband (now ex) hadn't been very supportive during the pg, I knew that he was the one I wanted to stay. In a pinch, he turned out to be the best support person I had! I've only had one other non-medical person be with me during labor that wasn't my spouse and that was my g'ma who had to drive me to hospital.

Good luck, I hope things work out for you!

 

[Ms. Cellaneous]

Sorry you didn't get a good vibe from her. I'm never sure how to handle people like that -- she sounds like sort of a know-it-all, and while it's good to have a midwife who's knowledgable, the whole "I know what I'm talking about so just trust me" approach does not sit well with me. I think some care providers mistakenly believe that acting authoritative and kind of imperious reassures people about the quality of their care, but on me it has just the opposite effect. Like you, I'd much rather have someone discuss with me and say, "well, these are the concerns, and this is the evidence" rather than just say "oh that's nothing to worry about."

I would probably try to let some of her comments just roll off your back. Like the people at the birth issue -- as long as she's ok with your friend being there, then it doesn't really matter in terms of what she thinks you're going to want. The epidural issue, on the other hand, I would definitely talk about and reinforce with her so that everyone is clear going in to the birth about what you want and expect. You might have to be a little repetitive with her to make sure she gets it. That said, I think 50 percent is probably a pretty low rate compared the general population!

Good luck with everything!

 

[firewoman]

HMMMM.....Maybe you could speak to the other midwife about some of these concerns. I am Rh-and I waited for the postpartum shot. Unless you have a bad fall or a car accident that may cause mixing of the blood, I'd avoid it. The CNM's that I co-cared with during my last pregnancy didn't understand my desire to avoid the prenatal shot either. I still refused it.

I think having a couple of close females with you is a good idea, especially if you have an anxious husband. If, once labor begins, you decide you don't want as many people around you don't have to call and tell them both you are in labor. I have always had women around me durin gmy births, but I know everyone is different. I understand what the midwife is saying, though. Sometimes having people around is like having an audience. I didn't want my husband in the room too much while I labored because he has a nervous energy and wants to talk to me. While I think this is sweet, I need total silence during contractions and don't wish to speak to anyone. You'll get it all figured out. This is your baby and your birth and these are your decisions to make, not the midwives.

 

[esmejane]

It's not too late to get a new midwife. I always felt slightly uncomfortable with my midwife and didn't want to make a fuss by leaving but she completely disregarded my wishes when it came to the birth so in hindsight I probably should have gone with my gut instead of worrying about being weird.

This time around I have someone that I trust a lot more, and I also feel a lot more confident so I'm not worried about having that control taken away from me again.

I do have to agree about people at the birth though, my mother was there and drove me insane and the only person who was truly comforting was my husband. He wasn't the best during pregnancy but was amazing at the birth. Of course everyone is different, and I hate being told by someone else how I will feel (because they know better than me) so that would have bothered me as well.

 

[Spiralshell]

Thanks very much for your thoughts everybody!
esmejane - I wish that there were a variety of midwives to choose from around here so that I could interview several until I got a good vibe, but the pickings are very slim. I'm still early, and I think over the next few months I will get a chance to know these two midwives better.
firewoman, her point was that the placenta is like a screen door that could have tears in the fabric through which maternal and baby blood could mix during pregnancy even without trauma. This doesn't mesh with what I've read about sensitization -- if the placenta were so imperfect, then why wait until 28 weeks for a shot? Wouldn't our blood be mixing even now? I need to read up some more and ask about this again.
I will bring up some of these questions again and I hope that I'll get some reassurance.

 

[star*mora]

i'm also rh- (a-) and my dh is o+
i had the winrho (canadian version of rhogam or anti-d) only after my son's blood was tested (he is a+). so about 24hrs after he was born i had the shot.

my midwives were supportive of my decision. my secondary midwife is from northern ireland and she was like "it's only in these rich countries where they scare you into the 28wk shot". anyhow, it helped having their support. i did have my titers checked nearly every week as an alternative - tiny bit of blood drawn seemed way less invasive than the shot, and felt really good about doing that instead. this time, i won't bother with that, i'll just do the post labour shot and only after i have confirmation that this bub is rh+

there are lots of good threads on here if you do a search for rh-, covering all sides of the equation.

 

[mommam]

Please do consider your gut feelings as you go through this pregnancy and have more appts/experiences with her. As a pp said, it really all comes out in the birth, and my sis had the experience of having her mw at the hospital and being no help whatsoever. A lot of time, in most hospitals, unless it's one of that hospital's mw's, your mw has no authority or say in what goes on and some doctors and nurses find them to be "in the way" or act threatened by a "nonmedical" professional in "their" business.

I guess my point is to make sure you feel this mw will give you the support you need when you need it, because, as you know, when you are in the moment (all 30 odd hours of it

) you won't be in a mental, emotional, or physical place to redirect her. Not to mention, that's why you pay her (yah, I know there's more), to help you birth YOUR way, safely.

 

[Spiralshell]

I remembered two other things she said which seemed odd -- not sure why I didn't remember them when I wrote my first post. (Maybe it seemed too long already so I blocked it out!)

When talking about the who would be with me at the birth question, she said that she or the other midwife would be there the entire time, which sounds cool but I wasn't really expecting it. So I asked about what if there were other moms laboring at the same time as me -- and I asked how many other patients they had who have a due date around mine. She wouldn't answer that question -- said that it was far too soon to tell. (huh? Shouldn't they have a limit of how many people they take on for a given due date or a given range?) By now everyone birthing around when I will is through their first trimester -- I'd think they'd have a good count by now? Or do women keep shopping for providers into the 2nd trimester?

Also, she emphasized that I will likely do most of my laboring at home, which I definitely do want to do. It's a 45 min drive to the hospital though, so I have to find the right time to get in the car so that the ride is still bearable, but I don't get to the hospital too soon. She said something which also seemed weird since this is my first baby -- she said that she'd expect me to go for maybe 3 or 4 more hours after getting to the hospital. What if I'm not that quick in labor? I definitely need to ask more about this. I don't want to feel like I'm "on the clock" during labor. Babies come out when they (and my body!) are good and ready and not a minute sooner.

I am remaining calm, and will ask more about these things next time. I really wish I had more options, but it's pretty much this practice, or the OB/GYN and I'd much rather be with a midwife. We'll see!

 

[Pookietooth]

Seems odd. I would listen to your instincts on this one. Are there any other midwives? Are there any free standing birth centers that you might be comfortable with?

 

[kjs]

With my first pregnancy I had chosen a midwife initially who ended up giving me and my partner negative vibes. I ended up switching at like 6 months, and I am so grateful that I did. The new midwife was so supportive, calming, and very involved with my natural pain management (ie. back pressure, chanting, massage, dancing,etc). She was essential since my labor was 40+ hours and my partner needed to sleep eventually (how dare he

) However if you do not have many midwives to choose from you may want to discuss your feelings with the midwife you like. Maybe she can voice your concerns? It is their job to care for you and nurture you through pregnancy and birth,and you deserve to feel supported throughout this whole experience. You are in control of the energy you want in the room with you during you labor as well, so if inviting some supportive women to be there will help you, then that is your right too.

 

[mamatolevi]

I'm rather surprised that a midwife would dismiss the idea of other women there to support you.

have you considered a doula? Not only can she support you but she can also do a lot of reassuring your husband that things are fine and that you can do this naturally. My doula for my VBA2C was wonderful with my husband and he's a very difficult person to read.

 

[mrs*kewpie*pie]

while you should definately listen to your instincts, you may not necessarily need to switch providers (although you always can of course)

i'd revisit any topics you don't get a good feel on with both midwives and definately work it out asap

i wouldn't necessarily argue about wether you should have whoever in the birth room just clarify that you want to know hwat restriction there are on the number of people....you might call the hospital to verify that

if you can't get a good agreement with these mw's, you might have a consultation with an ob practice just to see what they have to saay. it may be rare but some obs do have more of a midwifery mindset towards birth

 

[fyrebloom]

why NOT look into homebirth for you first? Fear? Money? Tradition? I am seriously worried about this MW. I had an ob for my first and she was also dismissive. Turns out she was dismissive of my entire birthplan when I was in labor and too weak to fight and I was birthraped and threatened with having CPS called on me if I didn't do what she told me. My MW practice (I switched care at 32 weeks with my twins) was also a mixed bag. They were hospital midwives as well and they varied from totally supportive of vaginal birth to pushing a c-section on me! Turns out the practive has a 22% c-section rate

. I didn't find this out until AFTER my c-section but that's an appauling rate for a MW practive to have. If you have doubts don't dismiss them because you don't think you don't have a choice, there is ALWAYS a choice, you just have to look for one.

Seriously, just because your a first time mom doesn't mean your body won't work or that the baby will be in danger. Homebirth is a really good option for ALL low risk women regardless of how many kids you have had. I know so many women (myself included) who wished they hadn't experienced the trauma of birthing in a hospital. I mean you gotta do what you gotta do, but don't dismiss the idea because of fear of the unknown or fear that something might happen to the baby. Your risks are far worse birthing in a hospital.

I'll get off my soapbox now.

 

[Degas]

The midwife you have concerns about sounds similar to the midwife I had with my first. She was dismissive as well. When I asked if I would be allowed to walk around during labor she told me that I couldn't but I wouldn't want to. I told her that I wanted a natural birth, and she told me that I could try but most women ended up wanting something. I asked her if she did episiotomies very often; she replied that she didn't like to cut and stitch so she would totally avoid it. She also said a few other things that I thought was weird and didn't jive with me. My instincts were making me a little wary that she would respect my wishes, but, like you, I felt like I didn't have any other options. I also felt like, well I knew what I wanted and she said I wouldn't want those things, but I did - so I was just going to do it anyway. What I didn't realize is how these things that didn't jive with me should have set my alarm bells blaring and send me running.

I ended up having a horrible experience at the hospital. She told me that I could walk around, move, etc., during labor, but what she didn't tell me was that the hospital wouldn't let me walk or move around if my water had broken (my water was just trickling out and they wouldn't let me get off the bed). She also didn't tell me that they would make me lay down on my left side my *entire* labor because "the baby didn't like me sitting up on the bed."

She told me that I could "try" to have a natural birth. What she didn't tell me was that the nurses would be pushing epidurals and drugs on me every 15 minutes. I ended up with an epidural after six hours of the nurses asking me every 15 minutes didn't I want one.

I had asked her if they would let me progress naturally, she said yes, I could do that, but she didn't tell me the hospital would give me pitocin after only two hours of extremely mild contractions (I went to the hospital too early, but they admitted me anyway since my water had "broken," and they didn't want me walking around).

I asked her if she did episiotomies; she replied that she didn't like to do them any more than I would want to have one, she didn't like to cut and stitch so she would totally avoid it. Well, what she didn't tell me was that if I was going to tear even a little tiny bit, she would do an episiotomy. She ended up sewing me up so tight that I was in major pain for over a year (I couldn't walk for more than 10 minutes without it being really painful).

Not trying to scare you, but I would find someone else if I were you. I should have. Some OBs actually end up being better than the midwife. Check out Family Practioners, some of them will deliver. Rethink homebirth.
Good luck. Just don't think this is your only option like I did.

 

[notjustmamie]

I would also like to know why you are hesitant to homebirth with your first. It doesn't sound like these midwives really are prepared to offer you the support you are looking for to have a natural birth (unless you define it by their terms, which seems to be "vaginal birth").

I don't have any personal experience with Rhogam, but as the PP pointed out, you don't need it unless your baby has a positive blood type. From what I understand, you aren't generally sensitized until after you give birth to a baby with Rh+. Even if I'm wrong about that (and I could be), there are tests they can do to check your ... titres (?) to see if they are high enough to be concerned about.

As for the number of people at your birth, with DD, I had my DH plus three friends, which was just the right number of people for me. I also had one MW tell me that many FTMs invite "too many people" and it slows down their labor, but she didn't make any effort to limit the number of people we'd invited.

I would certainly expect them to be able to tell you how many people are due around when you are. Perhaps they are used to clients coming in a bit later in their pregnancies, so they don't have a good number for you now? Trying to give them the benefit of the doubt on this one.

It does sound like you have some pretty significant concerns. I know you said there aren't too many choices for you, but is this the ONLY practice that you can go to? If there is another, have you checked them out? Would you even consider a homebirth or birth center? Are there any FPs or naturally-minded OBs who practice in your area?

I went with a practice that I felt was my only choice for DD's birth and I was not happy with my experience with them. I really wish I would have investigated more options when I'd had the chance.

 

[Spiralshell]

Thanks very much to everyone for your thoughts -- It really helps me to put my concerns into perspective.
There is not a single birthing center within driving distance, unfortunately. I believe that New York State is particularly bad with the malpractice stuff, so even though there were apparently a number of birthing centers to choose from some years ago, there are none now.
I was able to find exactly one home birth midwife in the area, and she was already booked. (Also, something about her manner on the phone rubbed me wrong. She was SHOCKED to hear that I was not eating an entirely organic diet. I eat healthy food, but I also believe in moderation in all things. I didn't think I could go with someone who would be so judgmental about my nutrition choices.)
Unassisted childbirth scares me for my first time, and I am certain that my BF would flip at the very mention of it.
Also, we are currently renting in two different locations, and looking for a house to buy somewhere in between that will be driveable to both of our workplaces. Not yet having a home makes me not want to plan to birth at home -- I would not be comfortable birthing here where I rent. And while I have good friends in the area, birthing at one of their houses wouldn't be workable.
This practice is the only midwife practice I was able to find. It was also recommended to me by a doula and childbirth educator who works with my mom. She said that they are good -- very hands off, let me birth the way I want to birth, relaxed people. Which sounds great! But doesn't really mesh with everything I have heard so far.

I am not going to count them out yet, because if I do give up on them then I will have to search around the OB/GYN practices, and I don't expect to find a LESS medical model there....

I am formulating my thoughts better now, and I will go into my next appointment with a very clear set of questions based a lot on the discussion in this thread. These questions will be written down so I can keep my wits about me as we talk, and then we'll see. Thank you to all of you for giving me much food for thought!

 

[Pookietooth]

Did you already post in your area of FYT a request for midwives?
Is this the practice:
http://www.hudsonvalleybirthnetwork..../midwives.html

 

[Spiralshell]

Thanks for looking! That practice looks nice, but they're too far away from here -- over an hour drive, and across the Hudson River on a bridge with a lot of construction. So unfortunately not feasible for me. (Unless I can get a helicopter, that would be cool!)
What is FYT? (Sorry, I'm acronym-challenged!)

 

[Degas]

FYT is Finding Your Tribe - It's a subforum that has a regional subforums as a part of it. It's a good place to find midwives, pediatricians, doctors, and other local information. I think your subforum (I think you said you were in New York?) is New York, New Jersey, and Pennsylvania.