[bean's mama]

My last pg went fine until the birth part. I had step B and my water broke days before active labor begun. Because of the + strep B, I had to go into the hospital and get hooked up to antibiotics. Then they gave cervadil and pitocin. After 56 hours of bs, I had an emergency c-section.

I feel that all the tests and "interventions" where way too much. I feel like I should trust my body and my own ability. This being said, I have no desire at the moment to go to my ob/gyn (BTW, they are the only one's willing to do a vbac). I'm not interested in any of the early testing, since there is no way I would terminate this pregnancy. I was thinking that maybe I would go closer to the second trimester and even then, not every month. After my last experience, I just feel that pregnancy and birth has become far too medicalized. I'm pregnant, not sick or diseased. Also, having gone through it once already, I feel more secure in trusting my body.

However, when I tell people that I haven'y gone to the dr yet and am not planning to for a while, they kind of look at me as though I am being irresponsible. Am I or am I just not buying into the medicalized culture of today?

 

[KariM]

Quote:

Originally Posted by bean's mama However, when I tell people that I haven'y gone to the dr yet and am not planning to for a while, they kind of look at me as though I am being irresponsible. Am I or am I just not buying into the medicalized culture of today?

I think most mainstream Americans would probably have that reaction. There are, however, plenty of mamas who do their own prenatal care and many, many who receive minimal prenatal care (whether using a lay midwife, a CNM, or physician of some designation).

It's my personal belief that women who are healthy and engage in healthy habits don't *need* prenatal care.

Also, most OBs don't provide what I consider to be the most important care and advice (regarding diet, exercise, fetal positioning, etc).

To "meet" more mamas who don't use routine prenatal care, you might visit the Unassisted Childbirth forum here on MDC.

http://www.mothering.com/discussions...play.php?f=306

 

[DistractedMind]

Prenatal care is good, but prenatal care done by a physician is only as good as the physician doing it. My last pregnancy I had a rather horrible OB who advised nearly every intervention under the sun, including induction with Cytotec (which I was informed enough to refuse). This time I'm going with a GP who is much more easy going, more informed, and a heck of a lot more human than the previously mentioned OB. Of course, a lot of the difference between my first pregnancy and my current one is that I educated myself and gathered up the ovaries and make my own decisions about what would and wouldn't happen during my pregnancy and birthing experience.

Having seen many women who are about as informed on the processes of birth and pregnancy as they are on quantum physics (and they weren't exactly reading Stephen Hawking), I think the right physician's care can be extremely beneficial. Too many women are uninformed and blindly trust that physicians and medical professionals will always have the right answer instead of realizing that these professionals should be working with them to find the right solution for their individual situations.

I think prenatal care is good for women with existing conditions, so I work with my doctor to figure out how to have the best pregnancy and birthing experience for my situation. My GP helps me out with health issues related to pregnancy and depression, but we have an understanding: no unnecessary interventions, examinations or tests (I didn't do a lot of the early tests because I wouldn't terminate the pregnancy if they predicted the "wrong" outcome). My doctor is more than supportive of my decisions to avoid most of these tests and interventions, but she's also a rabid researcher. Of course, from some of the stories I've heard and things I've read, I'm beginning to think that my GP is a deviation from the norm.

If you're uncomfortable with your current OB, keep looking. I second the suggestion to look at the UC forum as well, but if you're not comfortable with the idea of UC, voice your concerns to OB, ask questions, and keep looking.

 

[DBZ]

I kind of question the need for so much prenatal care too, especially in the first and second trimesters.

As far as people's comments and such. Why bother giving them so much info? Most people don't get seen by a doctor till they are 8-12 weeks anyway.

 

[zoeyzoo]

I see your point. Many of the prenatal tests don't offer much information for a normal pregnancy if you do not care about sceening out babies with complications, conditions, etc. I will have them done because I want to be aware of potential issues ahead of time (i.e., protein in urine, placenta position, etc.) and be able to adjust my plans ahead of time.

 

[Jenlaana]

A midwife once told me that there is no point in going before 12 weeks, because until that point, there is nothing they can do for you. Meaning, if you were to miscarry, you would miscarry and they would just sit by and sit on their hands. At 12 weeks the fetus becomes much more viable and probable to 'make it' and so it is only then that it starts to make sense to keep an eye on things.

That being said, I waited until about 16 wks to see a CNM. I got an ultrasound at 20 wks or so (my 2nd visit, long enough along to see the sex of the baby). I tried to keep my appointments at 1 every 6 wks and they freaked out. I got letters about their "concern for me" etc. It was nuts. And then we went to every 2 weeks and I made them every 3 weeks and they freaked again, and then they said every week and I made them every 2 weeks and they fired me, lol.

I don't think they are necessary. I think that some of the tests are good, and having a doppler check is reassuring. I like having an u/s to check baby grown and placenta placement about half way through. I dont like the weight checks and the blood pressure checks, the vaginal exams, the STD checks, or the general feeling of going to an OB.

I would get much more out of seeing a homebirth midwife with a doctor back up than seeing a medical professional so often. The last time I was pregnant I asked my CNM about nutritional changes during pregnancy/what specific vitamins and minerals I should get more of and she told me to "get a book" (and not any specific book, just basically saying not my job)

*just wanted to say that I did get the screenings for downs syndrome etc and am glad I did. It came back abnormal and we went and saw a specialist and got a level 2 U/S which put our concerns to rest, on that as well as pretty much any other thing we could have a concern about regarding her physical development. I don't blame those who wont get it done, but while we would not have aborted, we would not have persued our UC if it came back with a heart defect etc

 

[Banana731]

You can do most of your prenatal care yourself if you really want to. Check out the self-assisted prenatal care sticky on the Unassisted Birth forum, even if you don't intend to UC, it's got a ton of info. Also if you have a HB your prenatal care would be minimal.

 

[Adasmommy]

I am pregnant for the second time also and while I was super happy with the first birth, I have definitely been thinking about the unnecessary-ness of all that prenatal care!

I am 15 weeks and going to see the midwife for our first appointment this week (I'll be 16 weeks). I plan to request very little care

but will probably go to all of the appointments because it's kind of exciting and makes it feel like I'm getting closer to baby-having time! It turns out we are not going to have to pay for any of our own prenatal costs, btw.

I don't remember much of anything they did during my last pregnancy being very important or making any difference to either of our health or happiness!

:

 

[amberskyfire]

I am pregnant with my first and I do all of my own prenatal care. It's pretty easy as not much needs to be done. It's more about preventing anything from happening than seeing what may have already gone wrong. If you are taking very good care of yourself and you FEEL good, then there really isn't anything to worry about in my opinion. Sure, there are freak occurrances, but I don't fret about something that is unlikely to happen any more than I don't get into my car because I might get into an accident.

If you are wanting a hospital birth, however, you will probably be required by your OB to see him if you want him to deliver your baby. This is for insurance reasons, not because the OB is being difficult.

With my OB, I tried playing the religious card, saying that I could not have sonograms/dopplers or testing for birth defects because it is against my religion (not really true, but hey, I can make up my own religion in a pinch) and he said that for insurance reasons, he could not see me or treat me unless every single intervention and test under the sun was done. I just quit going and took over care for myself. I did have an iron test done which was just a simple finger prick at the clinic.

 

[lilkat]

There is a huge range of prenatal care choices between all and nothing

I'm very happy with my prenatal care. Every 4-5 weeks, my mw comes to my house; she and DH and I talk for 1-2 hours (this is our first, so we always have a lot of questions!); we listen via doppler for the baby' hb; then she checks my bp, and has me do my own urine-test for protein/sugar. That's it! All the advice and support and empathy we need, but no weigh-ins or bloodtests or icky sugar-solution tests or fear-mongering. We're planning a home birth, either at our home or at mw's family farmhouse in the country

The *only* glitch is that since she is a direct-entry mw, our insurance doesn't cover it. But her price is all-inclusive an very reasonable, and DH and I are lucky enough to have the savings to cover it.

I feel like the most important part of the prenatal care for me is having the emotional and spiritual support from someone who has attended and studied childbirth. It's nice to know we'd catch any developing medical conditions, too. I feel like I've got the best of both worlds!

 

[nolonger]

I do my own prenatal care too. This is my fifth pregnancy (the first was a 10 week loss) and I had midwife attended home births with the others, so people just assume that I am doing the same with this one.

I feel much closer to this babe and it kind of shocks me how much I missed out on by just turning responsibility over to the midwife. I always allowed internal (vaginal) exams, but this pregnancy is the first time I've felt my own baby's head through my own vaginal wall at 16 weeks.

 

[Lizzie9984]

I'm 35 weeks this week, and haven't so much as given half a thought to considering mainstream prenatal "care". I don't do much aside from sporadically checking my BP, and to be honest, I feel totally confident in trusting my body's cues and my instincts. If letting nature take it's unhindered course (and trusting in it) makes me "evil" or "uneducated" in the eyes of the mainstream, then so be it. I'm happy, comfortable and content, and that's what matters the most. If the mind isn't at blissful ease, the body won't be either. It's a simple philosophy, but it works for a lot of people.

 

[ColwynsMommy]

I just called to make my first appointment, figuring calling this early would help me get a great appointment time when I'm 8-12 weeks (I forget when my first appointment was last time). They want me to come in next week when I'm 6 weeks to fill out a questionnaire and do a Q&A session with an 'intake nurse'. I was like.. huh? I've been pregnant before, don't have any questions really, so I'm anticipating a 10 minute visit. It's not invasive in any way, so I don't have a real problem with it, other than being a waste of time.

Anyway. As far as regular screening tests, I agree to most of it because I feel in control of my care. My OB and I have talked about how just because I do the AFP doesn't mean I have to do an amnio. We would never terminate the pregnancy, but now that I have two children, I can see the value in knowing ahead of time that there might be a problem. There are also some problems that can be caught and treated while still pregnant.. if having an ultrasound or blood test means I'll have a healthy baby, I'll do it. I feel 100% comfortable that if my OB wanted me to do a test that I wasn't okay with, that I could say no and have my wishes respected.

I do think that the frequent weight checks are pointless, as well as the frequency of BP and urine screening, but it's only a few minutes out of my day. Like I said.. I've educated myself well enough that if they were to say something was wrong, I'd be able to properly question and judge which interventions were necessary, rather than going along with whatever they recommend.

If your OB/MW doesn't listen to you, then you need to find a new practitioner. I don't think there's anything wrong with regular prenatal care so long as you're an active participant and are free to decline something if you feel it's unnecessary.

 

[patchynurse]

I also think it has a lot to do with who is giving you the care. I see a group of docs and midwives ands am very happy with their care. The only do a few births a week. They spend a huge amount of time and have always listened to me when I talk. I have never been pressured into doing anything. I have refused several tests and they don't bat an eyelash. They are also very low intervention. Do not do routine IV's in labor. Do not regularly induce. don't use constant fetal monitoring. All the rooms at the hospitals have pools and you are encouraged to birth in the position that best works for you. They also have all the nurses who work there complete doula training. So I am feeeling very good with them. I feel like it's a partnership and not a dictatorship.

 

[Jenlaana]

Quote:

Originally Posted by ColwynsMommy If your OB/MW doesn't listen to you, then you need to find a new practitioner. I don't think there's anything wrong with regular prenatal care so long as you're an active participant and are free to decline something if you feel it's unnecessary.

The problem being that the idea of being able to decline tests and interventions is, in my experience, more of an illusion than a reality. Of course they will let you take the AFP and skip the amnio because of the abortion component, and the right to lifers would eat them alive if they went overboard on pushing it. But other things, particularly towards the end of pregnancy when you are most vulnerable and least able to replace them, they can do a complete about face.

In TWO pregnancies in a row now I have been kicked out for wanting a say in my birth. The first, all I wanted to do was discuss attempting a VBAC trial of labor. I wasn't asking for a natural birth or no interventions or out of hospital, or ANYTHING other than to just be given the chance to VBAC or a good reason not to. Instead of talking about statistics and realities, they told me that if I did not do what they wanted I was risking killing myself and my baby. Then when that didnt work they asked
my husband if he was willing to "let me risk killing his child". I count my blessings that he and I had enough conversations about it before hand (and came to the conclusion to ask to discuss the VBAC further) that he was on the same page with me when they started doing that.

My second attempt to involve myself in my pregnancy went fantastically. I had a great midwife at an OB office that was simply amazing and allowed me to have the final say in pretty much every intervention. The problem being, during my pregnancy they hired a second midwife and there was also an OB that did not share her views. I accidentally ended up seeing the other midwife, who freaked out and got the OB involved over my BP (I have white coat anxiety to the most extreme but nobody would listen to me other than my midwife, who was w/ another patient). I tell the "new" midwife that I am concerned about taking BP meds and don't want to take them unless absolutely necessary because of the side effects, and somehow between that comment and the doctor's involvement it becomes "you will take these meds or you are going to have a stroke and a siezure and die and if you do not take them and get these x,y,z tests done immediately I am giving you your records and you can go elsewhere". This was at the one doctor's office in the entire part of SC that I had a good reccomendation about (VBACs cannot homebirth in SC). So now I am 2 wks out from my birth and have no OB. I just thank my lucky stars that I am comfortable with UC because I would be majorly screwed in both this and my last pregnancy if that was not the case.

Perhaps its not like this in other parts of the country, but where I am, saying no just isnt an option. They look at you like you have 3 heads and freak out if its anything they deem important.

As for the BP issue I have... I would rather take mine every day at home and bring in the results than have it taken there because its simply not accurate there due to the anxiety and the weight they put on it. And in regards to weight... mainstream medical care is so focused on weight that its ridiculous. The same doctors and CNMs that freak out about weight are the ones who could not have a 5 minute conversation about nutrition to save their lives. I would much rather pay a homebirth midwife to come chat about my over all body health for a half hour and discuss the reasons for weight gain during pregnancy and even analyze my diet and adjust it to her reccomendations than be weighed every single appointment and eyed for not weighing the "right amount" (regardless of starting weight) where the numbers echo in my head for weeks and are added to my "chart" and never mentioned again.

 

[ColwynsMommy]

I guess it does really depend on who you're seeing, then. Even at the end of my pregnancies, my OB was perfectly okay with what I wanted done. I'm not sure if it was due in part to me talking about the birth right off the bat or just her personality.

Even in the hospital, during and after the birth, I've always been able to say no to the OBs and nursing staff and never had a problem with it. They've also listened to me when I felt things were happening differently than they did.

I'm at least 100 lbs overweight, and have never heard a truly negative comment about it. Due to bad morning sickness with both of my other pregnancies, I lost/didn't gain weight until I was at least 30 weeks, and only ended up gaining a few pounds total. She neither congratulated me nor made me feel bad, she said so long as the baby was growing fine, that I should listen to my body.

So, clearly it depends on who you see. I still say that being upfront from the beginning about the whole picture is a good bet, as is being firm about what you want. If you truly believe you're right, you can refuse treatment, even if they do claim that you're putting your life or your baby's life at risk. On that point, a thorough knowledge of your health/circumstances/pregnancy is vital in making a good decision. In the case of last minute staffing changes.. I guess there isn't much you can do about it. That sort of bad luck can happen in the best of circumstances. Obviously things change, and with my births (without going into details), being able to roll with the punches and understand that helped keep my experience positive rather than scary.

 

[rootzdawta]

Just my $0.02. If you don't want the comments, weird looks, and general vibe people have when you say you are not getting conventional prenatal stuff . . . either don't say anything or say you're doing it all unless it's a person you think might benefit from knowing there are alternatives. To me, while pregnant, other people's crap can't get to me. I know what I'm doing. My body knows what it's doing. When I need help, advice, or guidance I'll ask for it, thank you very much.

P.S. I am right with you O.P. and couldn't agree more with the post. Our stories are identical except for the c/s which I believe I missed by a hair's breadth.

 

[gcgirl]

Quote:

Originally Posted by DistractedMind Prenatal care is good, but prenatal care done by a physician is only as good as the physician doing it.

I think you could substitute "practitioner" for physician, because I've heard some horror stories about midwives, GPs, AND OBs. There are good and bad in every profession, and I agree with you that informing yourself makes a huge difference. Some midwives are intervention-happy, while some OBs are content to just wait and see. Choosing a practitioner who fits *your* needs and expectations is probably more important than what license they have (insurance reasons excepted

).

 

[nascarbebe]

With my first about half of those appts. seemed pointless. I cancelled one and the next mo. my ob/gyn lectured me about skipping it. I didn't think he cared but he asked me if I was out of town or something. For this second one I switched OBs and he's so much more attentive. He stays in the room to talk to me for quite a while and never acts like he's in a hurry got get to the next patient. I almost always have questions for him so it's more about just getting personal care. And we've talked about what kind of delivery I want so I feel so much better this time. I just hope something weird doesn't happen and he's not able to deliver this baby. I guess the worse that could happen is getting my regular ob/gyn.

 

[DiannaK]

Quote:

Originally Posted by ColwynsMommy If your OB/MW doesn't listen to you, then you need to find a new practitioner. I don't think there's anything wrong with regular prenatal care so long as you're an active participant and are free to decline something if you feel it's unnecessary.

I agree ...
I'm not looking forward to the majority of my prenatal visits, but I know I'm not going to do everything carte blanche. I like the reassurance of checking up on myself and the baby.