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Got an interesting letter from my OB office today

1154 Views 24 Replies 16 Participants Last post by  ebethmom
I am having a homebirth, attended by midwives but I'm also seeing an OB as backup. I only told them about my homebirth plans two visits ago. During my last visit I was first told that because of my decision they could no longer see me, but after further discussion they figured out that they can't legally deny me care this late in my pregnancy (40 weeks on June 28th). Therefor it was my OB's duty to inform me of all the disasterous things that can be very dangerous during a homebirth. I listened politely, I understand they can't support homebirth and I understand that for whatever reason they have to cover their butts. She also told me that she'd have to send me a letter pretty much saying exactly what she told me in the office. Well, I got the letter today, and here it is:

Dear Crystal:

As your OB physician, we were recently made aware that you plan to deliver your baby at home. All of us here at S. Clinic agree that home deliveries are not always safe and, therefore, we do not condone a home delivery. Per our conversation on 6/18/04 at your last OB visit we did discuss the risks of home delivery which may include maternal or fetal hemorrhage, malpresentation, fetal or maternal death due to complications at delivery. We would like to stress that we are happy to see you here in the office, however we will continue to see you here in the office. We will continue to discuss and offer delivery in the hospital. We are available to provide emergency service in case you need us.
Sincerely
Dr.R.


I think the line "We would like to stress that we are happy to see you here in the office, however we will continue to see you here in the office" was a typo.

Now I'm debating letting it go or taking in research that shows that home*births* (I hate the term "delivery") are just as safe, if not more so than hospital births in low-risk pregnancies. What would you do?
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heh heh heh...I think it depends on how much free time you have!

How awesome would it be for you to respond to their letter in kind, saying something like:

As your OB patient, I recently received your letter reiterating the discussed "risks of home delivery which may include maternal or fetal hemorrhage, malpresentation, fetal or maternal death due to complications at delivery."

As an educated pregnant woman, I have studied the literature supporting both hospital and home births, and am aware that these previously mentioned risks cited as "risks of home delivery" (homebirth) are actually the risks involved with any and all birth, transpiring in any building, be it hosptial or home, as birth--like any activity in life--involves risk to one's person.

Furthermore, it is the risks associated with obstetrical management of labor, such as risk of infection and cord prolapse associated with AROM, frequency of Pitocin-augmented labors of women who labor at hospitals, routine IVs, directed pushing, frequent vaginal exams, increased risk of operative delivery, both vaginally and trans-abdominally--for reasons both actual and percieved--and the absence of physical labor support (like a nurse to massage my back during contractions is not available; patient options are limited to pharmaceutical ones) all compell me to choose the safer birthing option for my herto normal, average, unremarkable pregnancy: home birth.

I am grateful that your practice sees the wisdom in offering emergency care if neccessary; in my opinon, that is precicely where obstetrics should focus its scope.


Then you could enclose some bad-a$$ references, or a copy of Henci Goer's book or something.

I suppose your OB sent you that letter so you can't sue them when you have a pleasant birthing experience, devoid of unwanted episiotomy and other hostile labor procedures.
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I might drop some info by but I would probably just let it go. You feel secure in your decision and that is all that matters. Good luck with your birth.
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Quote:

Originally Posted by tinyshoes
I suppose your OB sent you that letter so you can't sue them when you have a pleasant birthing experience, devoid of unwanted episiotomy and other hostile labor procedures.
:LOL Precisely. Love that sample letter, I just may use it as a guide if I decide to take anything in to them. Which reminds me, I have an appointment with them tomorrow...oh joy
I may just let this be my last appt until I call to schedule a post-partum checkup.
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Tinyshoes, that was an awesome letter! So well written. You could start a business writing letters for people!

Carolynn
I got something similar from mine when I had my first homebirth.
They're just CYA.

I love the rebuttal letter idea
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Sending home birthing vibes your way


Tell the Sob to kiss your homebirthing a$$, and keep his Sob hands out off.
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Quote:

Originally Posted by applejuice
Sending home birthing vibes your way


Tell the Sob to kiss your homebirthing a$$, and keep his Sob hands out off.
But applejuice, I'm not sure how you really feel about this doc?


:

Crystal - you'll have a wonderful, normal, birth dear. And I can't wait for the letter you'll send them then!
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Tell him that obstetricians are like firemen, they both save lives; but firemen do not start the fire.
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Quote:

Originally Posted by tinyshoes
heh heh heh...I think it depends on how much free time you have!

How awesome would it be for you to respond to their letter in kind, saying something like:

As your OB patient, I recently received your letter reiterating the discussed "risks of home delivery which may include maternal or fetal hemorrhage, malpresentation, fetal or maternal death due to complications at delivery."

As an educated pregnant woman, I have studied the literature supporting both hospital and home births, and am aware that these previously mentioned risks cited as "risks of home delivery" (homebirth) are actually the risks involved with any and all birth, transpiring in any building, be it hosptial or home, as birth--like any activity in life--involves risk to one's person.

Furthermore, it is the risks associated with obstetrical management of labor, such as risk of infection and cord prolapse associated with AROM, frequency of Pitocin-augmented labors of women who labor at hospitals, routine IVs, directed pushing, frequent vaginal exams, increased risk of operative delivery, both vaginally and trans-abdominally--for reasons both actual and percieved--and the absence of physical labor support (like a nurse to massage my back during contractions is not available; patient options are limited to pharmaceutical ones) all compell me to choose the safer birthing option for my herto normal, average, unremarkable pregnancy: home birth.

I am grateful that your practice sees the wisdom in offering emergency care if neccessary; in my opinon, that is precicely where obstetrics should focus its scope.


Then you could enclose some bad-a$$ references, or a copy of Henci Goer's book or something.

I suppose your OB sent you that letter so you can't sue them when you have a pleasant birthing experience, devoid of unwanted episiotomy and other hostile labor procedures.



You are awesome! I love this letter!
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Quote:

Originally Posted by applejuice
Tell him that obstetricians are like firemen, they both save lives; but firemen do not start the fire.

Oooo, good analogy! I really like that


Quote:

Originally Posted by mamabutterfly
Crystal - you'll have a wonderful, normal, birth dear. And I can't wait for the letter you'll send them then!
Hehe actually I planned on putting something very nice together for them to pass around the office
Pictures (not of the midwives of course since I live in Illinois), detailed birth story and some hard numbers and facts regarding homebirth
I'll probably make it into a packet or something like that and keep a few copies with me (for when people look at me as if I have three heads upon hearing I had a homebirth). I also plan on including an outline of the midwifery model of care and gushing about the personal relationship formed with the midwives, etc.

I guess more than anything I'm amused by the (certified) letter. Luckily my OBs aren't aggressive in their coaxing towards hospital birth.
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Of course, the other thing that is just
about this is that it doesn't matter which way it goes. Either you will have (probably not!) some complication - which you & your midwives will handle, perhaps by choosing hospital transfer - and they'll say, "See, What a good thing modern medicine finally saved her & baby's life!"
Or you'll have a smooth-sailing birth and they'll say "How lucky that she coincidentally escaped the jaws of death that time. What a huge coincidence that there were no complications."

You may've read my story of being a doula at a woman's twin birth and they did the Top 5 Things To Ensure a Baby in Grave Distress all in a row... And then performed a cesarean to save everyone's lives.
: Totally fireman example.
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I'm juts impressed that they'll continue working with you. sad that it takes so little to impress me, eh? We had to pay an OB "under the table" and off the records to see us at all while planning a homebirth. That was in CA where I think maybe they're tougher.
As much as I would love to send a letter back, I would probably just leave it alone. I think it's great that they are at least willing to acknowledge that they will still see you if you choose, and provide emergency care. It's sad that just that alone is something to be appreciative these days.

When I pre-registered at our backup hospital, I had to sign a paper saying that I understood that the docs there did not support homebirth, that they were not official backups, that they thought there were risks involved, etc. etc. Yeah yeah.
Ohhh, your in Illinois? There is a group of drs out of Chicago that do homebirths because they realize that pregnancy isn't a medial condition to be managed. Maybe you could send your doc their brochure!
Illinois is where the AMA resides. It's no wonder in a state where they are actively prosecuting midwives that there is an attitude like that. Heck, even in my state of Oregon, that is VERY supportive of midwives there is an attitude like that.

I'm shocked that they will still see you. At first, I thought it was a letter stating that they will not see you any longer for liability reasons. !

Oh, and Laura, I wouldn't say that the Chicago homebirth doctors don't medically manage the birth. In their words, they "bring the hospital to" you! Blech!
Legally, they have to give you a certain amount of time (30 days maybe, I'm not sure) to find another doctor. I'm surprised they did not send it certified, signature requested because thats what they usually do.
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I love the rebuttal (sp) letter!


I really think that you should send them something!! It may not change their attitude but it may make them think yk?

T if your baby is born on the 29th June s/he will share a birthday with me!
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The rebuttal letter is a good one, but obs already know all that stuff. They don't want to admit there isn't anything that justifies their existence in a non-emergency situation.
Quote:

Originally Posted by mamabutterfly
Or you'll have a smooth-sailing birth and they'll say "How lucky that she coincidentally escaped the jaws of death that time. What a huge coincidence that there were no complications."
Totally agree--well said!!!
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