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Discussion Starter · #1 ·
I should first say that I'm 37 and just had a miscarriage in May. I am now pregnant again, and due in April.


Before my m/c I was seeing an OB in addition to my Midwife. After not hearing a heartbeat during my first visit at 10 weeks my OB scheduled an u/s where they found no heartbeat. If I had not known, I wouldn't have been prepared for what was coming so I am grateful for that.

Now that I'm pregnant again I'm not sure if I want to see an OB this time at all but I'm wondering if I'm at too high a risk not to. Any input or btdt experience?
 

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An OB is irrelevant unless you are having a problem. Don't count on problems before they happen. You can always see an OB. They're like the 24-hour Target.

Your age does not make you high risk. And neither does having one m/c.

If you have other factors that make you high-risk, then there might be a different answer.

mv
 

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I agree. From what you've told us, you don't seem to be high risk at this point. I don't think it's necessary that you see one. Unfortunately, OBs can't change the outcome of m/c. My midwife doesn't even start seeing women until 12 weeks, because there's just nothing useful that can be done before then (unless you have a history of multiple m/c caused by something like progesterone problems or some kind of blood disorder, etc. - that's when an OB comes in handy to help you get on the meds you need to be on to carry a pregnancy).

Good luck, and sending sticky baby vibes your way.
 

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I'm kind of debating this internally myself. I had slightly low progesterone with dd, but it wasn't diagnosed until 7-8 weeks. The ob did prescribe supplements, which I took until 11 weeks.

I've been insistent with dh that I want a homebirth, but I think I'll miss things like the big u/s at 20 weeks. I haven't broken the news to him that a dem (at least in our state) won't be able to offer those things to us.
 

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I think folks on here are sometimes a bit too anti-doctor for my personal taste. There's *nothing* wrong with seeing an OB if you want to.
 

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Discussion Starter · #7 ·
Thanks Mamas. My m/w is a certified nurse and is probably more experienced than my OB in all areas of pregnancy and birth. I think I'll fully trust her this time.

Heathenmom, I'm probably going to still try and find a way to get the u/s at 20 weeks. Just for a one-time thing. I'll try my OB and if she denies me then I'll try other OB's. My m/w said it is possible. I just hope I don't have to lie or withhold info (that I don't intend to return).

The only downside to a m/w is that our insurance won't cover it. A very small price to pay in my book.
 

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I never saw an OB during my last pregnancy, which was a planned homebirth with a CPM. I will not being seeing an OB during this pregnancy either. I wouldn't see any reason to see an OB if you get prenatal care from a midwife.
 

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Quote:

Originally Posted by mother_sunshine
The only downside to a m/w is that our insurance won't cover it. A very small price to pay in my book.
Ours either.
 

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I have three kids and have never met an OB. Dd1 was born in a hospital (planned that way) with a midwife. Dd2 was born in a freestanding birth center with a midwife. Dd3 was born at home with a midwife.

What can the OB do for you that the midwife can't? You can still have an ultrasound - just not at the midwife's office. But she can send you somewhere where you can get one.

And I'd have the midwife's billing person call your insurance. Ours covered all three births fully but a friend of mine's originally said no. Birth center's billing person called them, friend wrote a letter, and it was agreed to be paid by insurance. But even if it wasn't, it would be well worth the money.
 

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Quote:

Originally Posted by Kirsten
What can the OB do for you that the midwife can't? You can still have an ultrasound - just not at the midwife's office. But she can send you somewhere where you can get one.

And I'd have the midwife's billing person call your insurance. Ours covered all three births fully but a friend of mine's originally said no. Birth center's billing person called them, friend wrote a letter, and it was agreed to be paid by insurance. But even if it wasn't, it would be well worth the money.
CNM's do not attend homebirths in my state and direct-entry midwifery has been illegal here for many years. The state finally passed a law this year to begin the process for setting up a certification program, but I highly doubt that everything will be in place before we give birth.

RE billing: my insurance SPECIFICALLY lists midwives as care providers they will not cover.
So the only way I can use a midwife and have my insurance pay for it is if she is overseen by an ob and the billing is done through him. I *thought* that was going to work out with the freestanding birth center, because their director (an ob) is listed as a covered provider by my insurance. But the BIRTH CENTER *will not* accept insurance through an HMO.
: So here we are ....
 

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I'm certainly not anti-OB, I still recommend my previous OB to any mama looking for someone VBAC-friendly. This time around we just happen to be going with midwives and planning a homebirth.

I wouldn't see both an OB and a midwife (and am not) because it wouldn't be necessary unless you a) had a specific condition; or b) to keep a relationship with your backup doctor.

Although my midwives are a CPM and a DEM, I had an u/s last week because my primary care physician (a wonderful osteopath) wrote the order for it for me.

While I am not anti-OB, I'm also not in need of one this time around.
 

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Quote:

Originally Posted by mary3mama
Although my midwives are a CPM and a DEM, I had an u/s last week because my primary care physician (a wonderful osteopath) wrote the order for it for me.
Why didn't I think of that?! I don't know if he'd do it, but it can't hurt to ask!
 

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Quote:

Originally Posted by chinaKat
I think folks on here are sometimes a bit too anti-doctor for my personal taste. There's *nothing* wrong with seeing an OB if you want to.
I'm not anti-OB in the least. In fact, I *am* seeing one, along with my midwife. I find that my midwife gives me more/better prenatal care, but I do like my OB and recommend him to anyone locally who is wanting a hospital birth. He's really great to work with and very open minded (he calls himself gullible
). The only reason I'm seeing him is because my previous birth was very preterm, and there is a chance of it happening again, so if it does, I want him to be my OB in the hospital, and the only way to do that around here is to see him for prenatal care throughout the pregnancy. He knows that I am planning to birth out-of-hospital with a CPM (in another state, since homebirth midwifery is illegal in my state, and the closest midwife that would attend one is a good 1.5-2 hours away - too far for my fast labors).

That said.. The OP is wanting a homebirth, and we're just all stating that there is nothing she has mentioned that says she *needs* to see an OB. Sure, it's fine to go see one if you want. I and others just don't see anything high risk that demands she see an OB.

Btw, there are ways to get u/s without going through an OB. My CPM has a list of places her clients can go if they want an u/s (she personally doesn't believe they're entirely safe and doesn't in any way push people to get one - she just provides the info because some clients want one). One is an u/s tech school, where you can get free u/s's. So the OP can talk to her midwife and see if there is somewhere she can get an u/s if she ultimately decides she wants one.
 

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Quote:
CNM's do not attend homebirths in my state and direct-entry midwifery has been illegal here for many years. The state finally passed a law this year to begin the process for setting up a certification program, but I highly doubt that everything will be in place before we give birth.
Are you serious??? I'm in GA and we are researching/wanting a home birth with our 2nd - due in March!! Is it illegal just with a direct-entry midwife? Can you just not find a CNM that will do a homebirth? Or are they just anti homebirth??
:
 

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Quote:

Originally Posted by risen_joy
Are you serious??? I'm in GA and we are researching/wanting a home birth with our 2nd - due in March!! Is it illegal just with a direct-entry midwife? Can you just not find a CNM that will do a homebirth? Or are they just anti homebirth??
:
It's not illegal for you to have a hb ... it's just illegal for the attendant. Or, more accurately, alegal. The state law until the last month or two stated that midwives who completed the state certification program could be certified to attend births. Only they didn't have a certification program in place.
: There may be some cnm's in GA that do them, but to my understanding, they can lose their nursing license if caught. The climate is changing, but who knows how long it will take to get the program in place? I just moved back to Savannah about a year ago. In Atlanta, it seemed like every ob/gyn office had cnm's! I asked at the gyn office who did my last pap (in June) whether they had them and the response was that *no ob/gyn office in Savannah or the surrounding area has cnm's on staff* ... the ONLY place that has them is the freestanding birth center, who won't take my insurance.
 

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I did not see an OB with my younger two. (both homebirths with DEM) The midwife with my youngest was 3 hours away. When I first got pregnant I thought of seeing an OB for all my prenatal (with visiting the midwife a few times during the pregnancy) An online friend said something simple that really hit me hard. "you do what you feel comfortable with doing. Do not feel pushed into any decision" and I really thought about it and did NOT feel comfortable with seeing an OB. I ended up with a mostly unassisted pregnancy. I saw the midwife 3 times during my pregnancy.

The pregnancy ended up not being 'typical' and I am sure that an OB would have fought me on many many things. From placenta on the cervix (that moved up) to excess amniotic fluid (46 cm at 38 weeks), low iron at 26 weeks, to breech baby until 36 weeks.

Basically I am saying...go with your gut. Do what you feel comfortable with
 

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Quote:

Originally Posted by risen_joy
Are you serious??? I'm in GA and we are researching/wanting a home birth with our 2nd - due in March!!
There are midwives attending homebirths in GA - they are just doing so under the radar, and can be difficult to find. I think I heard that most of them are around the Atlanta area, but if you post in finding your tribe, you should be able to find out if there are homebirth midwives near you. It's not illegal for you to birth with them, it's illegal for them to attend your birth. But it's also their choice whether they want to break that law or not, and obviously they're willing to take that risk.

AL (where I live) has a similar situation. In AL, they are actively prosecuting homebirth midwives when they're discovered. But there are still practicing homebirth midwives here. They're just much harder to find! Most of the people in my area just cross the state line and birth in TN, as I'm planning to do. Thankfully, the "birth house" is only 15 minutes from my house, so not a bad drive. My midwife is an hour away, but one of her apprentices is nearby, so there will be *someone* there with me, and I'd be fine if the apprentice was the only one there when birth occurs - I like her alot and feel really comfortable with her. Actually, if I'm having a fast labor, I might end up an accidental UC, and that's fine too.
 

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I see a homebirh midwife and she doesn't have access to many things an OB does. I ran into some frustration with that this pregnancy because at 36 weeks my midwife was thinking the baby was breech. I needed an ultrasound to be sure, and we had a heck of a time getting me in for one. I had an OB that I saw with previous pregnancies, but they wouldn't see me b/c I was so late in the pregnancy and b/c of the homebirth (this state is not homebirth friendly either.) So, these are things to consider when using a homebirth midwife who may not have access to things that might become necesssary.
 

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Discussion Starter · #20 ·
Thanks Mamas, for the reassurance and self-empowerment that I needed to make my decision. I'm so much more confident now to just see a midwife. There isn't any reason to see the OB and I am much more comfortable with a m/w than in a medical atmosphere.

Unfortunately my state isn't m/w or HB friendly either. Only recently midwivery became "not illegal" but it still isn't legal either, unless overseen by an OB and birthed in a hospital or birthing center (which there is just 1 on the island). So there is no way around it for insurance purposes unless I want to drive 1 1/2 hours to a birthing center while in labor
.

Quote:

Originally Posted by mary3mama
Although my midwives are a CPM and a DEM, I had an u/s last week because my primary care physician (a wonderful osteopath) wrote the order for it for me.
I'm going to look into this as well. Luckily I have a pretty laid-back friendly pcp so maybe he'll be open to it. Thanks for the idea.


Thanks again Mamas.
I value all of your opinions.
 
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