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I just recently had two back-to-back miscarriages so now I am 'high-risk' (both losses were never found to have a reason and I have had ALL of the testing done and am supposed to be in 'super reproductive health' and I have had 3 births 2 at home with zero complications throughout)
So I'm pg again and am sticking w/ the OB who helped me thru the past two losses. I'm grateful for all of the extra care I am receiving even though I have been told I'm really at no higher risk. Anyway I still want to birth at home and I have found a MW who will just attend the birth and not do any prenatals if that is what I want.
My question is, do I tell my OB what my plans are? I don't live in a very progressive area so I have very little support for this way of thinking. Although my OB is really great, and he does know about my past homebirths, I highly doubt he will condone my choice. Could he refuse to see me any further b/c of liability reasons? That is what I am afraid of. I also don't want to be sneaky and pull the old 'Ooops! I just didn't make it to the hospital! He will see right through it.
I know I shouldn't care, and the truth is he is in a practice w/ 8 other docs and you get who is on call so I may not even get him for the birth!
Has anyone done this before? How did it work out?
 

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In your case I would probably just lie by ommission I guess. (Which I don't always think of as lying anyway) I'd probably say something around 38 weeks or so. Just mention that I've decided to have the baby at home.

And I'd like to add that it stinks that so many Dr.'s are not okay with homebirth. I didn't think I lived in a super progressive area, but both my Dr. and my son's are perfectly okay with homebirth. Whew.

ETA: If you are up for switching doctor's, sometimes people have better luck with family practice doctors being more supportive. But you might be considered too high risk for them too.
 

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I got kicked out of a local clinic where I saw the midwives (CNMs) for some of my visits and labs even though I was planning a HB (for insurance, distance, etc...). I have heard of this happening a lot but I think it is unfair and should be challenged. If you are ok with the thought that the OB might stop seeing you then I think you should be honest. If you cannot live with seeing anyone else then I wouldn't risk it, and maybe you can explain after the baby is born. Personally, I am big on getting this silly system changed so I like the honest route, but do understand that for various reasons sometimes it isn't practical to speak the truth.
 

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Is there a reason that you don't want to have your attending midwife do your prenatals? I think that is one of the biggest benefits to home birth is the personalized attention you receive and how your provider is really able to get to know you prior to your birth. I'm glad that you have an OB that you feel comfortable with for other things, why not continue seeing him after you deliver for well-woman care? He doesn't provide the care you need right now---you wouldn't try to see an oncologist even if they were fantastic if you didn't have cancer would you?

I'm a big advocate of being honest with your provider--tell him you've enjoyed and appreciated his experience but are planning on going a different route for the birth and you'd love to see him afterwards. It's also the most courteous and ethical thing to to in the situation, although I do understand and lament the fact that we have such poor collaberative care for home birth that some women feel lying by omission is their only option.
 

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My last birth I had dual care, a mw and an OB. I lied by omission to the OB. I found a hands off OB and we had a huge talk about responsibilities and liability. She confirmed my thoughts, while she was ok we us taking responsibility she knew that others in her practise would not be. She did tell me at.every.appointment. near the end that she would be happy to schedule an US for that day if I wanted. I declined. I ended up transporting (overbooked mw) to a much closer hospital. There was no way I was going to ride 1 hr to her hospital and HOPE she was on call, also 8 other OBs in practise. In the end I felt bad about her spending all that time on prenatals and not being able to bill for the birth. I would think that may be a reason some OBs don't want to do it, besides the liability. I read another thread here that the mom just told the OB that her telling him was a curteousy. That he didnt have to do anything,no prenatals, no tests, but if she transported then she was gonna tell the hospital he was her OB. So she just thought he should know. I about fell out of my chair, I thought it was so great! For this pregnancy I did find a family doc willing to do shadow care but only because I know she had her last w/ my old mw. I met her socially first and we were able to talk about our births. When I made the appointment and asked if she did shadow care or did she know anyone who did. I think she's done it before because she didn't seem to need to consider it. So far, it is going well. Good luck with whatever you choose.
 

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Could you feel out your OB? If he already knows about your past HBs, tell him that you're considering a HB for this pregnancy and see what his reaction is? Ask specifically whether he would continue to see you if you chose a HB? Saying that it is just a consideration and all hypothetical at this point. If he reacts positively (or even neutrally), then at the next visit you could let him know that you have thought further about it and decided that you are doing HB. If he reacts negatively or tells you that you are likely to be dropped from the practice, then I wouldn't say another word about HB. There's unlikely to be any consequence just for discussing the possibility of HB.
 

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Quote:

Originally Posted by jdg View Post
Could you feel out your OB? If he already knows about your past HBs, tell him that you're considering a HB for this pregnancy and see what his reaction is? Ask specifically whether he would continue to see you if you chose a HB? Saying that it is just a consideration and all hypothetical at this point. If he reacts positively (or even neutrally), then at the next visit you could let him know that you have thought further about it and decided that you are doing HB. If he reacts negatively or tells you that you are likely to be dropped from the practice, then I wouldn't say another word about HB. There's unlikely to be any consequence just for discussing the possibility of HB.
That's what I would do. Just see what he thinks about it in an indirect way. Especially since he already knows about your past HBs and says you are in super reproductive health. Maybe he won't react as negatively as you think.
 

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Quote:
Could you feel out your OB? If he already knows about your past HBs, tell him that you're considering a HB for this pregnancy and see what his reaction is? Ask specifically whether he would continue to see you if you chose a HB? Saying that it is just a consideration and all hypothetical at this point. If he reacts positively (or even neutrally), then at the next visit you could let him know that you have thought further about it and decided that you are doing HB. If he reacts negatively or tells you that you are likely to be dropped from the practice, then I wouldn't say another word about HB. There's unlikely to be any consequence just for discussing the possibility of HB.
I second this. I'd just ask, especially since you've already had homebirths. I'd just maybe say something like I've really been thinking about having another homebirth, would you be willing to continue to see me and do my PNC if I choose this option?

I'm also wondering why you're not comfortable seeing a MW for your regular PNC. If you want to have a sono etc, you could certainly ask if the OB would do that for you if they won't do your "regular" care. Personally, I'd rather have my MW do my care just so I can develop a better rapport etc.
 

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Discussion Starter · #9 ·
I guess I'm scared that if something does go wrong, I will be returning to him for that care and will feel a little bad that I wasn't seeing him from the start. I know in many countries, this is exactly what OB's are for, when problems arise, not for routine care. Well, not where I live. I have basically 1 HB midwife to choose from and we already have a good rapport. She is OK with stepping in just for the birth.
It's just so weird, b/c neither of my miscarriages could have been prevented by more intense care. They were just 'flukes' (their words). But for some reason I feel like I have to take every precaution this time. The OB, to his credit, said when my water broke at 16wks, he knows there was nothing he could of done to predict that, if I was seeing him. I thought that was really big of him.
This may sound stupid but I am afraid of being 'blacklisted' from Ob care if I tell my plans. There is 1 hospital that delivers in my area and only 2 OB practices. I'm sure they all talk.
I know what it feels like to be blacklisted too. When I moved here from the other coast 9mnths preg no one would take me on b/c I had midwife care that they wouldn't acknowledge.
 

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So I would say don't tell him your plans. Just feel him out. Say something like I really enjoyed my last 2 homebirths and I'd kind of like to consider it again, but I really enjoy seeing you and the kind of care I get here. If I would choose to do a homebirth, would you consider seeing me throughout my pregnancy just for my added comfort? And that way we already know eachother and you know my history if I would have to transfer for some reason. Then if he says no, you could say thank you for being honest with me. Then I'd add, again I'm just considering another homebirth, I'm going to think about my options and I'll be sure to let you know.

Then you make your decision. You either choose to go with the MW for your PNC etc or not to tell your doc you're definitely doing another HB. But you'll at least know where he stands.

I understand the feeling of needing to take every precaution, but what additional precautions is your OB going to take that the MW wouldn't/couldn't take? If you for some reason went into PTL, you'd be transferred to the OB care anyway. What you're saying makes sense, but I think you could just feel him out and see how he feels about it. Has the MW given any indication that the OB doesn't care for HB or her?

Best of luck to you whatever you decide.
 

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After four miscarriages (and a D&C with the last one) I decided to use the OB who had done my D&C because I knew he'd do an ultrasound with my very first visit since he has one in office (otherwise, I'd have to schedule one with the lady my MW recommends).

I made the mistake of mentioning it to my OB and... WOAH.

He pretty much yelled at me for being "irresponsible". He is VERY anti-homebirth and feels that pregnancy and birth is the most risky time in a woman's life. (I feel the opposite. I feel pregnancy and birth is completely natural and not to be treated as an illness!)

It was eye opening, and while he nearly kicked me out of his office (I back tracked and said I was only thinking of homebirth, etc etc so I could get the Ultrasound and bloodwork done and get my booty out of there... afterall, I had to find someone to watch my kiddos and I didn't want to make a waste of the visit!).... the experience was actually good.

I'm glad I didn't try to double the care because I really feel this man could have messed up my desire for a homebirth by doing some intervention against my desire. (I had an OB strip my membranes at 37 weeks without my asking him to.)

This really brought his "god-complex" out in the open, and I was glad to have a good view of who he was so I could find a better homebirth supporting OB should I need one. (My midwife has a great supporting OB- but shortly after my due date, he's retiring! BUMMER!)
 

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Btw- my OB already knew about my past unassisted birth and didn't say anything negative about it- so I kinda thought he was supportive of homebirth. (Most OBs will say, "Wow, really? That's dangerous/risky" if you tell them that.)

So, telling your home birth history is not necessarily a way to feel him out.

My OB thought I had chosen him because I was "over" my homebirthing ways. He proceeded to tell me horror stories of homebirthing gone wrong (which were obviously not a case of homebirth gone wrong but IDIOTS trying to homebirth.... they were completely ridiculous stories and any educated homebirther would have known it was time to head to the hospital).

He also told me that, if I wanted a home birth, I should "get out" of his office... "NOW."

Yeep.
 

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I went to a midwife that was part of a practice of obs. I was intending for her to be my back up in case of a transfer. She seemed ok with it but two days after the appointment I received a letter saying they were dropping my care. I haven't read the other responses but my advice would be to only answer direct questions, don't volunteer information since they might decide they don't want the 'risk'.
 

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You might also try asking in your Tribal area if anyone has experience with your OB doing concurrent care. That was actually how I found my current OB, and how I found out that while he is very good about being non intervention when it comes to pregnancy and labor (I've been able to decline any and all tests I've wanted so far), he is NOT ok with doing concurrent care for a HB, so I'm keeping mum about it.
 
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