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This is a long rant, so bear with me...<br><br>
As most of you may recall, I decided about a month ago to switch to a new women's health center so I would have the benefit of using the gorgeous family beginnings birth center (which I toured, and loved) rather than be stuck at the sucky military hospital where I had been going. I loved my midwife there, but she was the only one on staff, and only worked 8:00 - 4:30 M-F, so if the baby came during non-business hours (or if I labored past 4:30 on any given weekday), I would have been stuck with the normal OBs and L&D nurses, and I knew from past experience that I didn't like them, and definitely didn't feel respected by them.<br><br>
So yesterday was my first visit with the new midwife, and I had pretty high hopes. I left feeling very damn disappointed, and fed up with the way that pregnant women are treated in general, at least in the US.<br><br>
When I arrived, I was taken back by a nurse (not the midwife) and she got my weight and blood pressure, and reviewed my past medical records from the military hospital. She had prepared a pap smear and an STD screening test, and told me I'd be getting both of them during that visit because I had opted not to have them at the previous hospital. I told her that I would like to wait until after the baby is born to get the pap smear, and that an STD screening was unneccessary because I had had one with the previous pregnancy (last summer), and it was of course negative, and I haven't had any other partners since then! She started giving me attitude right away, and telling me about "Ohio law" which mandates that a pap MUST be given during pregnancy and that if I didn't have it this visit, I would certainly have to have it at the next visit. "But you can talk to the midwife about it." Then she said, "Oh, your bloodtype is A-, so you'll have to get a rhogam shot at 28 weeks." I said, "Jason is also A-, so we're OK," and she had the nerve to act like we couldn't possibly BE SURE that he is also A-, and I mean, come on, he's in the fricking military, they know what his blood type is! So she said, "Well you will have to bring in documentation for your file next time you come in..." OK, fine, I'm sure I can manage that. She then asked if I wanted the AFP triple screen, and I declined, and she told me that at 36 weeks I would be tested for group-B strep, "do you know what that is?" and I said, "yes" and she said, "well the only thing they would have to do if you are positive is give the baby an antibiotic, because you know it can KILL the baby if you have it, and I say, it's a blessing if they can give the baby an antibiotic." OK, whatever. So then she got on the whole pap thing again, and told me about the law - AGAIN - and said, "I am just telling you what we're required to do." and I said, "I'm just telling YOU that I have very strong feelings about it." and she gave me the old, "Oh, I understand, I understand!" song and dance, but clearly thought I was a retard, not to mention hostile. So she told me once again to talk to the midwife about it.<br><br>
OK, so she leaves, and I look at Jason, like WTF!! I thought we came down here because I wanted to be treated like an educated woman capable of making decisions about my own f-ing body!! He said, "You did great honey. Don't let them bully you!" I said, "Am I making too much of a big deal out of this?" and he said, "No! The state of Ohio has no right to tell you what to put up your vagina!" He was really great and at that moment I was so glad he was with me. I said, "If they really have a problem with it, I will happily sign a waiver releasing them of responsibility, and I know I have the right to refuse that particular test (or anything else I don't want to do)." We knew it would be a few minutes until Margie the midwife came in, so I picked up this book that the front desk receptionist had given me, called Pregnancy & Childbirth or something, by the Amercian Association of OBGYN, or some shit. Anyway, I flipped to the section about pap smears, and on the facing page (no kidding) was a list of patient's rights & responsibilities, and of course it said I had the right to refuse any procedure or treatment, but that I had a responsibility to release the care-giver of liability. So I dog-eared the page to show to Margie, if the need arose.<br><br>
She came in, and I could tell the nurse had told her that I am difficult (or something to that effect) so there was obvious tension, but I really didn't want things to start out on a bad noe with someone who may be at the birth of my baby. So she asked a few questions, and then we listened to the heart-beat (which, I will say, was great, especially since DH wasn't with me the last time), and I even recorded it onto my cell phone, so I can listen to it whenever I want!! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin"><br><br>
I realized eventually that she wasn't going to bring up the pap smear issue, so she was about to leave and I said, "Are you not going to try to convince me to get the pap smear?" and she said, "No, Kathy said you didn't want an exam, so I am not going to make you have one." I said, "No it's not that don't want an exam, I just feel strongly that I don't NEED a pap smear right now, first of all, because I had one less than a year ago. And second, what if it comes back saying I have abnormal cells? I wait three months for another test, and during that time I am worrying about it, which isn't good for me or the baby. And then let's say after a second test, it's still abnormal - there aren't any procedures that can be done during pregnancy anyway, so what's the point? And finally, it may not seem like a big deal, but I don't want my cervix scraped, and I don't want to see blood!" She nodded and said, "I understand. And you have had one in the past year, so that's fine. We can wait until after the baby is born." OK, so shit, finally someone is listening to me. She asked if I would consider the STD screen because it is a vaginal swab rather than a cell scrape from the cervix, so I said OK, because I mean that is fine, and hardly invasive. So she asked me to get undressed, and said she would be back.<br><br>
When she came back, I said, "Margie, I don't want this to be an uncomfortable relationship. I feel like things got off on the wrong foot, and I just want you to understand that I am much more active and educated about pregnancy and childbirth than perhaps the average woman. I even hope to become a doula after this baby is born. I just don't want to be bullied when it comes to my own body, and I feel that I have the right and the ability to make the decision about what's best for me and my baby." She thanked me for saying that, and told me that I had "flustered" Kathy (whatever!) but that she understands my feelings. I then went on to tell her what a bad experience I had had last year at the military hospital when I had the blighted ovum, and told her the reason we switched was so that I could have care that is in line with my own beliefs about my body, pregnancy, and birth. She was understanding, and I think that it sort-of changed her opinion about me and she realized (I guess) that I do know what I'm talking about. She even said, "We assume that everything is fine unless we have direct evidence to the contray." And then Jason told her I'm a PhD candidate and I am pretty damn adept at researching and educating myself. Well, OK, I hate to trot that one out, but this time it actually made a difference and she showed me more respect *immediately*. Which, I mean, that sucks that you have to tell someone you are almost a PhD for them to give you credit that you know a little something about your own fricking body. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/irked.gif" style="border:0px solid;" title="irked">:<br><br>
Aaaaaanyway, I guess things ended OK, but it certainly wasn't the love at first sight experience I was hoping for, and which I kind of had with my midwife at the military hospital. I'm hoping things improve with my next few visits, or that I will meet another midwife at that center with whom I have a better rapport. They way they do it is that you meet with each of the 3 midwives and the one OB during your pregnancy so that no matter who is on call during your delivery (or if you need the doc) they all know you, you know them, and they understand your needs. I think this is smart and I don't have a problem with it, but now I'm just a little worried that I will be <b>THAT</b> patient, and you know, my reputation will precede me. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"><br><br>
My biggest problem (and the basic point of this rant) is that I am SO DAMN SICK of care-givers making the assumption that I am a passive patient in need of their expertise and direction because I am too uniformed to know what the hell is going on with my own body. Granted, it is true that there are MANY people who fit this description, but I think what is in necessary is for the nurse or midwife or SOMEONE to take a couple of minutes prior to peering into my vagina to find out who I am, what I believe in, what I already know. I'm tired of people assuming that just because this is my first child, I don't know a damn thing about this whole process. And if they just can't spare 10 minutes to figure it out for themselves, give me a questionnaire to fill out, asking me what books I've read, what type of role I envision myself taking in the process of care-giving, etc. How hard would that be?!<br><br><img alt="" class="inlineimg" src="/img/vbsmilies/smilies/hopmad.gif" style="border:0px solid;" title="hopping mad"><img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/soapbox.gif" style="border:0px solid;" title="soapbox"><br><br>
After the appointment, I was wound up for a good 20 minutes, and DH really tried to calm me down by pointing out that the nurse was the disrespectful one and that I was being tactful in expressing my feelings, and that Margie ultimately deferred to my judgement. But I still just don't understand why it has to be a battle, and I told him, now I understand why women choose unassisted pregnancies! What good is this doing me?? UGHHHH!!!<br><br>
I really do hope that my next visit (with the OB) will go more smoothly. I really don't want to have to be an asshole, but dammit, I'm not going to lie back and let them treat me like I'm a child and that *they* know what's best!<br><br>
But I will end on a good note - we made our 20-week ultrasound appointment for June 30th, so hopefully we'll find out whether this little butterball is a boy or a girl!! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love"><br><br>
Thanks for letting me get that off my chest.
 

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I'm not in your expecting month, but I wanted to tell you that your husband seems like a terrific advocate for you!<br><br>
Yay! For your husband for encouraging you to stand up for yourself!<br><br>
Also, you did a stellar job! Way to go!
 

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Amy, I understand competely. So often, I leave a doctor's office in tears or feeling stupid. I try to express my opinions/beliefs, but feel like since they don't know me, they just assume I'm not educated about my body or can make my own choices about my care. And it is sad that you had to "prove" your intelligence in order to get respect. bleh.<br><br>
Lots of times I beat myself up for having high expectations of these people to begin with. <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/greensad.gif" style="border:0px solid;" title="greensad"><br><br>
Sounds like you (and your husband; love his comment, btw! :LOL ) handled it well. Good for you for standing up for yourself and your baby.
 

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Oh yeah, I gave up on it in about 1999. I do believe in some aspects of healthcare but as a RN for a long time it kinda burnt me out. The straw that broke the camel's back (if you will) for me was dealing with the healthcare system during my mom's final 2 years. It was exhausting, frustrating, overwhleming and sad. Gosh there were so many medical mistakes during her care. I am now 50/50 traditional medicine and alternative medicine (which is more traditional in my mind).<br><br>
With my DS I started in a local Ob/gyn practice and hated the way I was treated. I remember at 17 weeks the ob berating me for gaining 5 lbs (my first weight gain in 17 weeks) yet almost blew me off entirely when I questioned her on the results of my u/s-- the one that was performed because I had 24 hours of bleeding out of the blue. I looked at her like "ok, so where are the priorities here?" She was more concerned about the 5lbs (I'm average size btw) than she was about the bleeding.<br><br>
I'm always afraid for people who can't advocate for themselves in healthcare.<br>
It's scary. I saw it with my mom who had aphasia and now with my dad who has some mild dementia.<br><br>
Good for you!!!
 

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Amy, I wish there was more that I could say than just you did a great job! If you didn't have to potentially work with that nurse again I would have suggested writing a letter but I understand that probably wouldn't "help" right now. It sounds like a very difficult experience. Hopefully things will work out with your midwife, remember you have lots of time to get to know her. Take care of yourself!<br><br>
Kelli
 

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I totally know what you mean about the healthcare system. If I weren't so chicken I would have a home birth. My first OB didn't explain a damn thing about what happened to me. I had to read it in a report that I ordered from the hospital. She spoke in medical terms... way over my head and rushed through everything. I felt like I was a number more than a person. When I asked her about VBAC she said "why would you want to put yourself through that? You should just schedule a cesarean". Why? Because the 20 hours of labor was nothing compared to my recovery from a c-section and if I had to do it over again in the hope that I might be able to have a VBAC I would do it in a heartbeat! So this time I did my research and taught myself about HELLP and Pre-eclampsia and VBAC. I chose a different OB that has a Midwife in her office. I figured that she would be more in line with my beliefs. Everyone there is so nice and respectful. Hopefully it will continue to be that way. I did agree to the pap smear though... and it was misearable because I have a really high cervix. I felt like I was being pried open with a crow bar.
 

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I can totally understand your frustration. I've had the same experience when I've NOT been pregnant, even! There is something that bothers my personal boundaries when people are being bossy with my reproductive tract, in any way.<br><br>
I just read, there is this approach that people are on a "clinical pathway," sort of like the vaccination schedule for infants. So at x month of pregnancy, you should have all these tests done or else you are somehow not conforming to the pathway. And when someone like you waltzes in the door and says, thanks so much, not too interested in your pathway, I've got my own - that messes with their whole mindset/paradigm for How Things Work. Just think of it as something akin to ignorance, or your great-grandma learning that boy-girl dances are prevalent nowadays, and maybe it will be easier to deal with next time.<br><br>
On the other hand, based on my experience with schools, medical bureaucracy, and other institutional settings, it's not so bad to thought of as "that troublesome person." They try to avoid setting you off, they usually respect you even if they don't agree, and they tend to get things done for you - particularly if you maintain your own decorum and rationality when they get all bent out of shape. Being calm and using the "I understand that you feel xx" has worked a million times for us, even as we bitch about something that isn't right. Your birth is YOURS, not theirs, and sometimes they need to be reminded of that. I also would not be so shy about mentioning the current Master's Degree - I always tell physicians that I'm a MLIS librarian and enjoy using medline, so I expect to be a partner in my healthcare.
 

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Good for you. I've been "that" patient before -- when I went to student care after being sick for a long weekend (since student care was closed couldn't go sooner) and told the doctor I had taken some antibiotics that I had left over, since I was so sick. They helped me a lot, but boy did she freak out on me, lecturing me about how much she "cared" about me when I was 80 and that I could be infected with all sorts of bacteria that couldn't be treated because of my prior "indiscriminate" use of antibiotiocs. I tired to emphasize the point to her that I was being honest with her telling her what I did so she didn't prescribe something that would be contraindcated, plus giving her the info that the meds really helped. If some one comes in and and says they are a heroine addict to you start giving them a sermon, come on! She had to bring another doctor in to evaluate me because I was being so "difficult." BTW I am also a PhD candidate! Oh, and wouldn't the fact that I have antibiotics "left over" indicate that I am not someone who overuses drug, in fact I have a whole pharmacy of drugs I have been precribed and not taken. And, to show how hypocritical they are, another time when I went in for a UTI they gave me these giant horsepill antibiotics, don't rememeber the name but I found out they are super strong, and as a 100-lb person I was on a huge dose. After the second pill I had a bad reaction and stopped taking them. Guess they weren't so "concerned about me" when I was 80 then, they didn't mention cranberry extract which I have since learned works great. (It was my first one when I went in to them, so I didn't really know what to do then.)
 

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ITA with what everyone else has said!! SO pathetic that someone who actually has researched things and is educated on how they want their birth to go and what they want done with their body is 'difficult' and cause for consternation! You'd think they would be so pleased to have a patient like you!<br><br>
I work in healthcare and I am the biggest anti-doctor and anti-mainstream medicine person imaginable. I absolutely can't stand how patients are treated. And patients and family members who want to take an active role in their care, ask questions about thier medications, etc, are definitely considered difficult and annoying- like why can't they just be quiet and let us do our thing?<br><br>
I hate it when I hear friends and co-workers being told they 'the doctor said I have to do so and so' and they don't want to do it but they do, because the all-knowing OB said so- like my friend whose OB 'made' her quit being a vegetarian (which she had been for 15 yrs) because it was supposedly incompatible with pregnancy, and made her have an induction, because her first birth was quick and problem-free, and the OB didn't want it to go 'too quickly' so she (the OB) could have more control over the birth. DUH!! That makes me so mad. I always think, they are forgetting that it's YOUR birth and YOUR baby, you should be able to do it YOUR way! In fact, that is the motto of the birth center we use: 'Your baby, your way'.<br><br>
And don't even get me started on how many of my friends' peds have 'made' them do CIO because it was time the baby get out of their bed and sleep through the night (usually by 6 mos.)<br><br>
I could go on and on and on! But, it does sound like the midwife was decent and ok with your views and what you wanted. I hope it was just that one nurse who was ill informed and you'll have a good experience from here on out.
 

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THAT'S EXACTLY WHY I CHOOSE HOMEBIRTH! and I don't mind being "that" patient. I let my midwife know at the very first visit that I pretty much don't care what she thinks... it's my body, my story, my birth. She should feel honored to attend and to serve my and my baby's best interests as determined by myself and backed up by countless hours of research. And if she has a problem with that she knows that I'll just find someone else to take her place. No problem, no feelings are hurt. I try to be up front like that because I am a freakin b**** when I am in labor.... get too close and I'll chew your head off and gnaw on the stump while you watch... sorry... those pregnancy confrontation hormones are WAY outta control!!!! I don't feel the need to have to explain myself to anyone if they treat me like an ignoramous in the first place and try to demean my sense of... what's the word? I don't know, I'm pregnant mush brain right now. Anyway. Kudos to you for standing up for yourself and for having the ammunition (knowledge) to back yourself up... I'm sure the only word that will be spread around about you is that you DO know what's going on with your body and you DO choose to be a conscientious consumer (... well, in a perfect world...) . It really doesn't matter what they think. You have way more education than your midwife (not to make light of her experience) and that nurse... don't feel bad about letting them know it.<br><br><br>
And in reference to all the negativity about the medical establishment...<br>
That's exactly why I chose the profession I did. I am not your average "crack-your-back-when-it-hurts" chiropractor... I'm more of the holistic type. I believe in the body's ability to achieve optimal health when all interferences are removed (structural, physical, emotional, psychological, etc)I really feel a calling to help people get more in tune with their bodies. But to get the average person to that point I need to first show them why it's so wrong to just hand over the power of your health to a virtual stranger. You never win in the end if you let someone else make your decisions for you.<br>
Kudos to you again!
 

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<div>Originally Posted by <strong>itsybitsy25</strong></div>
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I always think, they are forgetting that it's YOUR birth and YOUR baby, you should be able to do it YOUR way! In fact, that is the motto of the birth center we use: 'Your baby, your way'.</div>
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Uh, you're sure that's a birth center and not a Burger King, right? :LOL (You know, their slogan is "Have it Your Way.")<br><br>
Okay, enough of my attempts at being funny!<br><br>
I totally agree that the medical system is a pain. I've worked in it, and also on the fringe as a licensed homebirth midwife. I am planning on having my baby at home, and try to avoid the medical model and its practicioners as much as possible, not only in birthing matters but in general.<br><br>
I don't want to defend practicioners too much, but I do want to make a point, which is that there is a tremendous amount of pressure to conform to the "standard of care." Everything we do, we have to consider, "Is this going to come back and bite me on the you-know-what?" It's very liability driven, even for midwives, because we're always considering how something is going to look in court if something goes wrong. Even if we don't believe in certain procedures, we may be legally obligated to offer or recommend them. Just to take your case as an example, if you weren't offered the pap smear or informed as to the possible risks to the baby of an STD, you might (legitimately) blame the midwife and her staff if you ended up with cervical cancer and didn't find out, or if the baby had an STD related problem. Also, we all have our little biases and beliefs, and sometimes the practicioner's beliefs will conflict with the patient/clients. It can get sticky. I always want to make sure that if I'm offering something that is the "standard of care" or that is legally mandated I am darn sure that the client knows what the risks of refusing are. Not because I think it's necessarily "risky" not to get that particular procedure, but because if something happens later as a result of that choice I don't want to be accused of not adequately informing her. That's the whole principle of informed consent--it also applies to informed refusal! Sometimes it looks like "I'm required to recommend that you have a blah-blah-blah test/ procedure . . . here are the potential risks and benefits . . . and if you don't want that I'll have to get that documentation in writing with your signature."<br><br>
Anyway, it sounds like you are doing well communicating with the midwife, and SHE'S not the major problem. Her nurse isn't going to be there at the birth, and if "Kathy" freaks out too much between now and then maybe you can request to not have her involved in your care. Once the midwife gets to know you a little I'm sure things will resolve and relax a little. Otherwise, you should find someone else if you're uneasy with her.<br><br>
I also don't want to be pushy, but you seem like you'd be a great candidate for a homebirth!! Is that something you're considering at all? (Not a plug for myself as the midwife, 'cause obviously I live all the way across the country and am due at the same time anyway! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/smile.gif" style="border:0px solid;" title="smile"> )
 

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Ah, yes Kavita, standard of care. It sucks. It's like the government wants us to "treat" everyone as if they are all textbooks and not human beings. You raise a very important point.
 

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My midwife actually gave me a form that she uses that explains the tests that are available, with checkboxes for whether I want them or not, and a signature line for me to sign off on. I appreciated that, although she never seems to remember which tests I wanted or didn't want. It's not intentional (I don't think) on her part however, and my choices probably do seem a little inconsistent - I'm into selective testing, but not for things I KNOW I don't have a problem with (i.e. STDs).<br><br>
Maybe your midwives office could think about using a form like this? It protects both the midwife and the patient, as far as personal rights and responsibilities, and avoids a nasty inoffice fight.
 

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<div>Originally Posted by <strong>*Amy*</strong></div>
<div style="font-style:italic;">Anyway, I flipped to the section about pap smears, and on the facing page (no kidding) was a list of patient's rights & responsibilities, and of course it said I had the right to refuse any procedure or treatment, but that I had a responsibility to release the care-giver of liability.</div>
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If you are that flustered at this point, keep in mind that this is only the beginning.<br><br>
What are you going to do about doctors/specialists/know-it-alls who -<br>
- tell you not to breastfeed,<br>
- tell you to vaccinate on the APP schedule,<br>
- tell you to start solid foods when you know your child is not ready,<br>
- tell you how to diaper your child<br>
- tell you when to start potty-training,<br>
- tell you when to send your DC to pre-school, kindergarten, etc.,<br>
- tell you where to send your DC to pre-school, kindergarten, etc.,<br>
- tell you what sports your DC should be in,<br>
- tell you when and where to get orthodonic braces or not,<br>
- tell you what diet to follow,<br>
- tell you your child has ADD, ADHD, is a genius, is too slow, etc, and needs medication, or a special program...<br><br>
OY VEY!<br><br>
This is the beginning. I am happy to see you impassioned and intelligent. Remember that not all doctors will appreciate that. Choose your battles carefully.<br><br>
And happy baby to you ...these are the very happiest years of your life.<br><img alt="" class="inlineimg" src="/img/vbsmilies/smilies/happytears.gif" style="border:0px solid;" title="happytears">:
 

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Discussion Starter · #15 ·
Thank you all SO MUCH for your support and wisdom. I really mean it; I just came here to vent and wasn't expecting so much empathy. I love MDC!! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/love.gif" style="border:0px solid;" title="love"><br><br>
Kavita, you raise an important point.<br><br><div style="margin:20px;margin-top:5px;">
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<table border="0" cellpadding="6" cellspacing="0" width="99%"><tr><td class="alt2" style="border:1px inset;">Sometimes it looks like "I'm required to recommend that you have a blah-blah-blah test/ procedure . . . here are the potential risks and benefits . . . and if you don't want that I'll have to get that documentation in writing with your signature."</td>
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And I don't even have a problem with that at all - I think it is a good idea even if it seems a little legally-driven, and I do understand that people sue practitioners at the drop of a hat here in the US. So I don't begrudge them telling me that this is standard procedure or why something is recommended. As for homebirth...God...I wish I could say I have enough courage to do it! I told DH though that if everything goes well with this baby, I will definitely consider it if we have another child.<br><br>
I think I may have perhaps avoided this situation if I had interviewed with the midwife prior to making my first "official" appointment, but I just assumed that since this is the clinic associated with the birth center, they would be just like the people I'd met there! Well, now I know not to assume. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"><br><br>
Like I said in my first post, I have my next appointment with the OB in about 4 weeks, and I'm kind of toying with the idea of writing a letter to give to him and for my file (so the other midwives will see it), explaining my beliefs and such. Do y'all think this might be a good idea, or would talking in person suffice?<br><br>
And yeah, I know that it's not necessarily a bad thing to be "that" patient, and DH even asked me if he thought it would be different anywhere else. I said, if it wasn't, I would advocate for myself just as I'm doing now. The medical establishment DOES need to be shaken up! I'm a pioneer, dammit! (Which is kind of funny because I grew up in rural Oregon - gold mining area - and our elementary school mascot was the Pioneers. Hee!)<br><br>
One great thing that did come of this is that I know DH is going to back me up if push comes to shove, and that he will be awesome during our birth experience. He rocks.<br><br>
I've also decided to follow up with the two pediatricians who I've spoken to on the phone (and who have said they will support delayed/selective vaccination). I think this week I will make appointments with both of them and start that whole process.<br><br>
Thanks again, y'all.
 

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I would like to add that I am happy to see a PhD candidate who does not necessarily believe in all of the so-called experts out there who are supposed to know more than all of us.<br><br>
I am happy to see a PhD candidate who still believes in plain old common sense...Dr. Mendelsohn used to say that persons with a graduate degree (me included) are crippled by our "higher" or, as he said, "longer" education and lose the ability to think on the basis of common sense.<br><br>
Congratulations on overcoming that one.<br><br>
My own SIL has a PhD, and one would think she was the Second Coming, but that is another thread....<img alt="" class="inlineimg" src="/img/vbsmilies/smilies/rolleyes.gif" style="border:0px solid;" title="rolleyes">
 

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Like I said in my first post, I have my next appointment with the OB in about 4 weeks, and I'm kind of toying with the idea of writing a letter to give to him and for my file (so the other midwives will see it), explaining my beliefs and such. Do y'all think this might be a good idea, or would talking in person suffice?<br></div>
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Personally, I wouldn't take this approach, only because it really raises the stakes and intensity of communication. If you are stuck with these people (and sounds like you are) then it might be better to take the "catch more flies with honey" even while clearly stating what you are interested in firmly. Be positive and open (not defensive) and sound like a stuck record if you have to, "I understand that it is normal protocol to have xx test done, but I choose to decline for personal reasons. Would you like to hear my reasons?" The OB might be cool, or s/he might not be with that. But you staying rational and communicative is half the battle and helps you to leave feeling in control of the situation, maybe?<br><br>
My daughter once had a ped who wanted to know why I didn't want to vax my daughter for certain vaccines - I provided calm, common sense reasons (i.e. she wasn't having sex or sharing needles yet, I'm not too worried about Hep B). He was like, "cool. sounds like good reasons to me. but will you reconsider it before she becomes sexually active?" and I said yes. It's that sort of dialogue that can take me far, even while both parties are holding on to their own personal issues.
 

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About writing the letter...<br><br>
I agree with the last post (sorry to post again, I'm not a november person!). You might consider offering to write a letter for clarity during your visit with the OB if you find you're not getting what you want? Although I suspect they would say it wasn't necessary. Also, I think it would be better for you to meet a few people first and have them form their own opinions of you based on personal contact. I can't tell you how many times (unfortunately) I've seen medical staff look in someone's chart see a birth plan or something and say out loud "oh, they're that kind of person" and then act according (ie having labelled you) during their visit with you. The flip side of that is I have also seen staff gossip about a client (ie she is so difficult wait 'til you meet her) and then had people say after meeting that person for themselves "wow, I don't know what so-and-so was talking about, she seemed so nice/reasonable to me"...<br><br>
so I'd wait and see what you're next encounter is like and go from there. You may also want to consider having a doula at your birth if you haven't thought of that already. Your partner sounds wonderful but who wants the fights with the nurses, midwives and doctors during labour as part of the birth memories? You both deserve to experience your birth as the most emotionally involved people in the room...a doula is able to be an objective advocate for you and your family.<br><br>
You probably knew all of this already...<br><br>
Good luck!
 

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Discussion Starter · #19 ·
Oh yes, I am *definitely* having a doula. I had planned to prior to this visit, and now I'm 100% committed to the idea!<br><br>
You're right loraeileen & Turtlemum; I don't want to come of completely defensive right out of the gate. I will try the catching more flies with honey approach with the OB (but I am so bad at that!!), or will at least not go in *expecting* the worst. LOL!<br><br>
Thanks for the compliment, applejuice! If going through the PhD program has taught me anything, it's that research is imperfect, and two people could look at the exact same piece of evidence and claim that it supports THEIR theory and discounts the other person's. <img alt="" class="inlineimg" src="/img/vbsmilies/smilies/eyesroll.gif" style="border:0px solid;" title="roll"> I am soooo not impressed with academia, let me tell you (or academics, for that matter!). I did learn how to do my own investigative research though, and how to read every article with a critical eye. I certainly don't consider myself better than anyone else, but perhaps more well-read than the average Joe.<br><br>
PS: Turtlemum, don't apologize! You are welcome here whether you are due in November or not! <img alt="" class="inlineimg" src="http://www.mothering.com/discussions/images/smilies/orngbiggrin.gif" style="border:0px solid;" title="orange big grin">
 

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I just wanted to respond to the issue of DH advocating for you--I think that it's great that he supports you, but I definitely think that it's good that you are planning to have a doula with you. Nobody is telling you that your baby is at risk AT THIS MOMENT if you don't have the pap smear, and you yourself have already had time to think this out and are also not in pain or concerned for your self or your baby. I am telling you, if you tell a laboring woman that she needs to hang upside down from the chandelier for the safety of her baby, she'll do it!! All this plus an altered state of consciousness in general make it very, very hard for a laboring woman to advocate for herself. Also, even in a homebirth situation or in the best of possible scenarios, it is totally impossible for you, your DH or your caregivers to predict the situations which will come up in labor. (That's partly why being a midwife is so exciting--it's never exactly the same thing twice!) Which leaves DH making a lot of decisions for you, on the spot, under pressure. Let me tell you, even husbands who have already been at their wives births sometimes get pretty scared or nervous even in normal labor, even when they are surrounded by caregivers that they know well and trust. It's very easy to just scare the pants off the best husband, when they see you in a way that they've never seen you before! (In my experience that is what I think of as what they call "transition"--when the woman says she can't take this anymore and can't do it, whatever has been working before in terms of the husband supporting the wife stops working, and the husband gets nervous and scared and looks to the birth professionals for guidance or reassurance or to see if this is within the realm of normal. I think that this is probably when most people cave and get the epidural that they were sure that they didn't want before!)<br><br>
On the Dads page there is a post by a dad who writes about being totally traumatized by the birth process. I haven't read it lately but I know the thread is still going, and it seemed to me that a lot of dads who were really troubled/traumatized by the birth process mostly had a lot of guilt because something didn't go as planned and they didn't feel like they were able to protect or advocate for their wife and child, and felt like things were happenning fast and they didn't know what to do and things didn't go as they planned.<br><br>
So I am very leery about feeling that a husband should be the primary advocate for the woman. I also feel that theories of childbirth preparation which stress the husband being a "coach" (like Bradley, for one) are missing the point with the sports metaphor of a coach. You wouldn't have a tennis coach who's never even seen a game of tennis, much less played one or coached one before! Also, you wouldn't have a coach who is on the field or court playing with the team--the coach is on the sidelines watching the action, and outside the situation and with some degree or measure of objectivity. A husband is not on the sidelines of the birth experience, it's his experience too, and he is emotionally involved as much as the woman is only in a different way. (Especially good, kind, sweet, loving ones like yours and mine!) I also believe that if you feel that you have to have someone to advocate for you and defend you from your care providers, there's something wrong and that you may have the wrong type of provider, which is why I asked if you'd considered homebirth. BUT, you have to feel safe and comfortable with your birth environment, which kind of puts you in a pickle if you don't totally feel comfortable with the medical environment you're birthing in and their policies, procedures and practices but also don't feel safe about birthing at home. So, just keep that in mind as you go on with this care team. If you feel safe and comfortable and that you and your wishes will be respected, then it will probably all be fine. And it is good to have a doula, because they CAN be that objective, somewhat on-the-sidelines coach, and can help advocate somewhat or help you to consider issues that may come up in labor and ask the right questions. (Like if they are recommending pitocin b/c the labor isn't going very fast, you could ask if the baby is in immediate danger due to the current condition, or if you could wait another hour and then reassess--stuff like that!)<br><br>
Oh, I wouldn't write the letter now, but I WOULD write out a little something for yourself, just a little index card or something that you can refer to if you need to, just to clarify your intentions. Before I started interviewing midwives, I thought a little bit and wrote down what I absolutely did or didn't want, what I could compromise on, and what didn't really matter to me. (Like, not cutting the cord for a long time after the birth is really important to me, I will consider some sort of blood glucose testing if the midwife thinks it's important, and I am totally fine with getting the standard prenatal bloodwork.) Clarifying how important things are to you can sort of help you prioritize and pick your battles!
 
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