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Iffy OB appt


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  #1  
November 4th, 2009, 08:03 AM
stlgirl's Avatar Platinum Supermommy
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So, we went to my 30 week OB appt. yesterday and it was pretty uneventful as far as baby goes: My BP was 100/64, baby's HB was 135, weight gain is pretty much right on track, fundus was 30 cm (so baby measures right on schedule), and baby was heads-down. So all is well there, and thanks to perfect health, my shot at an un-medicated hospital birth remains quite high.

But...

Saw the actual OB this time, not the nurse-midwife, and she was sort of harried and even though she smiled the whole time I could tell she was kinda annoyed by some of the questions I was asking her, and that really bugged me. Telling me "the only thing that matters is keeping mom and baby safe" is an insult to me when I'm asking about her C-section rates, whether she still uses vacuum or forceps on occasion, and whether I can go without continuous fetal monitoring and use a hep-lock rather than an attached IV. Those are valid questions and I'm not just trying to have a natural birth because I think it is cool, I'm doing it precisely BECAUSE I think it is safer for me and my child! I know she has a great reputation, and is one of the few OBs who is pretty NCB friendly at the hospital where I am delivering, but I saw a side of her today that was more 'establishment' and less holistic, and that irked me. I wish wish wish I could have a midwife-assisted birth-center or home birth! Stupid Missouri.

Some of her actual answers bothered me too. She thinks forceps are better than vacuum extraction if baby is 'stuck', even though they can sometimes cause more damage. Seriously?! Forceps are like a torture tool! And her average C-section and epi rates are on-par with the hospital averages, which are like 30% and 98% respectively. That's pretty awful. So even though I sought her out specifically because she is known for respecting the mom's wishes, and even though she reassured me that she's not going to push meds or other intervention as long as I am healthy, I am now starting to get really worried. Thank god I hired a doula, especially one who's had experience in this hospital before, but is that going to be enough???

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  #2  
November 4th, 2009, 08:29 AM
NutMeg76's Avatar Platinum Supermommy
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Are you against going 'underground'? There are travelling midwives that would most liekly be willing to come and deliver your baby at home. You keep your OB for shadow care and they take care of the birth.

If you join the ICAN yahoo group you can ask questions on there and I am sure will get a good answer. There are a few traveling midwives that belong to the list. You do not need to have had a c-section to join ICAN. It is not only about support for women who have had a c-section, but also for preventing a c-section in the first place.
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  #3  
November 4th, 2009, 09:05 AM
moon~maiden's Avatar Cheryl~ birth truster
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I would switch, although if you use an OB you won't find anyone who could be described at "holistic". You can't have a midwife at the hospital?
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  #4  
November 4th, 2009, 09:56 AM
mgm78's Avatar Zoe's mom Meredith
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so sorry your appt did not go as wished. that sounds awful. i would make sure your doula and you have a good game plan for game day. ((hugs))
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  #5  
November 4th, 2009, 10:18 AM
**Jenn**'s Avatar Platinum Supermommy
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I'm sorry things didn't go like you would have liked with the OB. I'm glad for you that you have a doula though, she should be a tremendous help!
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  #6  
November 4th, 2009, 11:02 AM
stlgirl's Avatar Platinum Supermommy
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My state is so backwards. Up until this summer, midwife-assisted births were ILLEGAL. Now, it is legal to have them, but midwives are not granted hospital admitting privileges, so I can't have a midwife deliver me in the hospital, and if I choose to have a home birth, I'm cut off from bringing my provider with me if something were to go wrong. As a first-timer, even though I am healthy, it makes me nervous to be so cut-off. So yeah...I basically have to choose between going it alone or taking my chances with an OB.
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  #7  
November 4th, 2009, 11:54 AM
catherineclare's Avatar Mega Super Mommy
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Note to self....dont move to Missouri! I'm so sorry your appt didn't go well. I honestly have no advice to offer. I know it's your first time and the whole homebirth idea is scary, but honestly it's probably the route I would go and have the doula as backup if you were to need a transfer (I hope I am understanding your homebirthing law right). After her responses at your appt I don't think I would be comfortable with her...of course now that I've had a homebirth I'm terrified of hospitals and OBs. OUr c-section rate here is about 40% from what I have heard!! Anyway, sorry I have no good advice, but good luck..will be thinking about ya!
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  #8  
November 4th, 2009, 01:11 PM
NutMeg76's Avatar Platinum Supermommy
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If midwives are legal, then they would have a doctor for the back-up provider. You transfer to the hospital, you get their back-up. Generally, back-up doctors for midwives are more like minded. Sometimes a midwife that is not given privledges in a hospital will still be able to go with you to the hospital as a doula, so you wouldn't be left alone to go into the hospital and face a doctor you brely know.

The other thought though is at what point and for what reason would you transfer? More than likely you will be transferring because the midwife feels there is a reason to be in the hospital. At that point does it really matter who the OB is? Not really as long as they are competent and can perform a surgery, which the majority of them can do a fabulous job.

If i were to do a homebirth I would only leave my home if there was a problem with me or the baby and I needed a surgical intervention.
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  #9  
November 4th, 2009, 01:17 PM
moon~maiden's Avatar Cheryl~ birth truster
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well I meant nurse-midwives, like the ones at your office. They don't deliver?
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  #10  
November 4th, 2009, 02:27 PM
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You might have to fight the whole way but I believe you can still have your natural childbirth. Just keep in mind what you want. Know all of your options. If she says "we need to do ___" always ask what your options are. Your doula should be great help in that area also. You can do it!
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  #11  
November 4th, 2009, 02:48 PM
~ Christine ~'s Avatar Platinum Supermommy
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I'm sorry the appt didn't go as you had hoped. Even if your OB isn't 100% on board, it's still possible to have a NCB in the hospital. Glad you have a doula and find your motivation.... you can do it!!
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  #12  
November 4th, 2009, 03:34 PM
stlgirl's Avatar Platinum Supermommy
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Quote:
Originally Posted by Cheryl33 View Post
well I meant nurse-midwives, like the ones at your office. They don't deliver?
Nope. The CNM at my practice is WONDERFUL and I love love love her, but she isn't even allowed with me in the delivery room. Sheesh! As for the midwife Dr. back-up thing, I'm not really sure how that works in MO so I'll have to do some research. I just assumed that if your midwife felt you needed to go to the hospital, you had to leave her behind and take your chances with whatever OB was on staff at the time. This law is pretty new so I don't know the ins and outs of it yet. Seriously, before July, a midwife being 'caught' providing homebirths could be charged with a FELONY. Oy vey.
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  #13  
November 4th, 2009, 05:29 PM
moon~maiden's Avatar Cheryl~ birth truster
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well, just make a good plan of action with your doula and husband. Make sure they know up and down what you want because you might not be able to communicate your needs when the time comes. Request a nurse who has experience and knowledge in NCB. If you are determined, you will do it!

are you staying in shape at all? Physical stamina plays a big part in labor.
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  #14  
November 4th, 2009, 06:09 PM
flitabout's Avatar Platinum Supermommy
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Also remember you have the right to refuse treatment. They can never do anything to you that you don't allow. If they do, by law it is considered assault and battery. While I would never want a mother to have to play that card, it is there for a reason.
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  #15  
November 4th, 2009, 07:58 PM
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Well maybe 98% of her patients want a epidural...I guess to me if I had to use an OB I would choose one that was okay with me having a natural birth even if he or she didn't encourage it. I think as long as you have a DR that will let you do your own thing (hep lock, no continuous monitoring) all the other stuff (forceps, episiotomy, medications) you can refuse.
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  #16  
November 5th, 2009, 04:26 AM
DoulaMama's Avatar Platinum Supermommy
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many states the midwives back up is just the on call OB or CNM at the hospital- that s how we do it as well. If you're nervous about that then a homebirth really isn't the best option.

It sounds like you have a pretty good plan, and if you do plenty of laboring at home and ask lots of questions to assure yourself you aren't having unnecessary things done, then you should be good. As for the forceps vs vaccume- I'd prefer, if they were truely needed (less then 2% of the time) that the doctor used whichever she was more skilled in. Either can be harmful, and care provider skill is a huge factor in that.
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  #17  
November 5th, 2009, 08:18 AM
NutMeg76's Avatar Platinum Supermommy
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Quote:
Originally Posted by Snow Mami View Post
Well maybe 98% of her patients want a epidural...I guess to me if I had to use an OB I would choose one that was okay with me having a natural birth even if he or she didn't encourage it. I think as long as you have a DR that will let you do your own thing (hep lock, no continuous monitoring) all the other stuff (forceps, episiotomy, medications) you can refuse.

The problem with this is the vulnerability that women have when in labor. It is a time where you should not have to fight, and refusing medical procedures is not an easy thing to do. On an almost daily basis I second guess my choices with Evie's birth. No, I didn't get the epidural, but I allowed myself to be bullied into things I didn't want or need. I consider myself a strong person, but when you are in labor your defenses are down. I wish that I had a doula with her for sure.
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  #18  
November 5th, 2009, 08:45 AM
stlgirl's Avatar Platinum Supermommy
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I think I am just going to rely on DH and Doula. They are both FULLY aware of everything I want. I told DH to fight for me, and he is no shrinking violet, so I know if some pushy nurse starts giving me trouble about 'slow progress' he will make her get the h**l out of my face

I am a very strong willed individual, but as Meghan said, during birth I know I probably won't have the same power of mind and strength because I'll be so inwardly focused and worn out. I am taking prenatal yoga and go for walks to stay in shape, so hopefully my body will be up to the task when the time comes. Fingers crossed!!
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  #19  
November 5th, 2009, 11:53 AM
moon~maiden's Avatar Cheryl~ birth truster
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I feel that is a really important part and it sounds like you are doing everything you can!
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  #20  
November 5th, 2009, 10:00 PM
kmac's Avatar Platinum Supermommy
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i think its great that you have a hubby that will advocate for you and a doula as well. that will help you to have the best ncb you can have at the hospital. however......how relaxing and nice of an experience is it going to be if your doula and hubby have to duke it out with doctors and nurses all the time?

the reason i point that out is because although i had to have a scheduled c section with emerson, there were certain things that i really wanted. i had to duke it out with my midwife, doctor who the midwife worked in conjunction with, and the nurses as well...both before the c-section, during and after the c-section. i won a lot of battles (having them provide a mirror so i can watch the c-section, warmer for baby placed in my recovery room, etc) but i also lost some (delayed cord clamping, immediate skin to skin, immediate breastfeeding, ect).

although i couldnt have had a c-section at home, i am kind of upset that i had to fight for the birth that i wanted, even though it had to be a c-section. i shouldnt have had to fight.

i guess if i were you, in your situation, i would lean more towards the homebirth option. if you are going to have to go to the hospital anyway, it will be because there is a serious medical complication, in which case all the ncb stuff is kinda out the window at that point. but if you can have a nice ncb at home, with supportive people who know what they are doing (doula, midwife), more than likely things are going to go fine. this is what our bodies were DESIGNED to do. if we allow our bodies to go with the process, then most of the time, we will birth without issue. the human race wouldnt have continued as long as it has if there really was as much a need for medical intervention as medical professionals are making it seem.

anyway, i wish you the best. its a shame that you have to fight for what should be a "normal" healthy birth.

another thought for doing a homebirth....hospitals are full of sick people..especially with flu and *gasp* h1n1 flu. if you are healthy and baby is healthy, why put yourselves at risk in a building full of sick people?

i wish i had your opportunity. i had no choice because my first was footling breech and now that this pregnancy is sooo close to my first (got pregnant 6 months post partum), it puts me in a slightly higher risk category for uterine rupture. i would love to do a homebirth someday if i ever have another baby, but until then, i am going to settle for hoping for my all natural vbac, supported by my awesome doulas, midwife and the doctor she works with (midwives cant be alone in ny state either). my doctors c-section rate is only 8%, whereas the state's is around 30% as well. he also has a 90% vbac success rate, so i feel really confident in him.

anyway, good luck!!!
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