Birth Plans? OB vs Midwife

ChattyKitty17

I know I'm very new here and please let me know if I'm stepping out of line to post a new topic on my own yet, I am struggling with this decision this time around and was just wondering if anyone else had debated this and possibly talk about what our thoughts are?  I made the very mainstream decision last time to go with an OBGYN and the hospital she was linked to simply because she accepted my insurance and had a quick appointment for my first visit. Overall I wasn't happy with her and some of the way things were done so I am opening myself up to different possibilities this time but also anxious to get my first appointment scheduled. Any thoughts or plans from you all?

elsieisamoocow

I'm high risk so I am sticking with an OBGYN, though I switched doctors this time because of my history, and because my old doctor was an ass. I'd love to have a doula on top of that but it's just not in the budget. 

pawcall

This has been on my mind.  I had a 90% great experience last time around, my only complaint was the hospital itself was very pushy about formula.  My husband at the time tends to agree with whoever seems the most impressive, so he backed them and left a sobbing me begging them not to feed him.  They just didn't seem to want to take the time to get things working (my son was smallish and had/has blood sugar problems).

That said, I am feeling more confident this time around as a STM.  I'm not worried that they'll bowl me over like they tried to do then.  My FI is completely supportive of me.  I like my OB/GYN and I like the other docs in the practice.  My only complaint now is that the hospital is NOT close to home.  Probably about an hour, longer in traffic.  So I'm trying to weigh how much I don't want to change doctors with how much I don't want to be so far from the hospital.

(Not trying to start any kind of feeding debate.  I breastfed, and then I formula fed, and now my 6 year old is 100% fed by an Rx formula through a feeding tube.  I'm big on kids getting fed.  I just didn't appreciate their scare tactics, making a hormonal FTM who had just given birth think she was hurting her baby.  I wasn't, he was just slow to wake to nurse and with questionable blood sugar, it just would have been more convenient for them if I would FF him and be done with it.)

captainfoxtrot

I'm going a bit inbetween - a Certified Nurse Midwife, at my hospital's midwifery program.  They still do epidurals, but I get more control and a birth plan which is nice.  If any complications happen, then they refer me to the partnering OB.  I feel like it's the best of both worlds for me!  I'm a bit controlling, but I like the safety of being in a hospital in case something does happen.

NYTino24

I am also high risk, like elsieisamoocow, so I am seeing a regular OB (8 in my practice) and a perinatologist. It isn't as personal at my office as with a midwife, but that's what I need. I may switch to a smaller practice.

BayCamp

I used a birth center with my first and loved every bit of the experience. I initially went to an OB but jumped to midwife care after my first OB appointment left a bad taste in my mouth. We're using the same midwife group again, and contemplating a home birth since I'm an ideal candidate with no real "risk factors".

The thing I love the most about the birth center we chose was that they were very honest about the fact that transfers to the hospital DO happen. I like that they didn't try to gloss over that and I knew they'd make the right judgement call when the time came. 

ArtificialRed

captainfoxtrot said:

I'm going a bit inbetween - a Certified Nurse Midwife, at my hospital's midwifery program.  They still do epidurals, but I get more control and a birth plan which is nice.  If any complications happen, then they refer me to the partnering OB.  I feel like it's the best of both worlds for me!  I'm a bit controlling, but I like the safety of being in a hospital in case something does happen.

I just had a small moment of panic wondering if my midwives offer epidurals. Then I remembered they post stats every month of vaginal/c-section, medicated/unmedicated, doulas, and so forth. Phew. Wouldn't have wanted to have to change practices AGAIN. (ETA: But I would not hesitate to do it again if I felt like I had to.)

I'm a big advocate for changing if you're unhappy. I moved at 28ish weeks with DS. I'm with someone new and a new hospital now than who delivered him. Finding a care provider that listens to you and seems to be willing to support what's important to you is what tops my list. I've seen OBs, my gp delivered DS, and now I'm with midwives (because they took my post-delivery developed thyroid situation seriously and gp did not). 

kissthesky32

For me, it really depends on the individual person. Both can be great and both can be terrible. My current group has both. As long as the options are all safe and properly credentialed, it really comes down to how comfortable you are with the person/group. 

Karrotelle

I have always had a Midwife and will again this time. With my first pregnancy I ended up needing a csection (baby was breech), so then my Midwife shared care with my OBGYN. Aside from the actual csection, the Midwife still did everything. My second pregnancy was a VBAC and my Midwife was a rockstar. (Same Midwife as the previous time too!) if it wasn't for her support I don't think I could have had a successful VBAC, let alone managed to do it naturally without any pain management. She was fantastic. I have already put the call in to request a Midwife again. 

The level of care I received was amazing. I don't know about Midwives in the US but here in Ontario, Canada they provide after care for 6 weeks. So for 6 weeks after baby arrives your Midwife will see you weekly to check on baby, check on you and answer your questions/address your concerns etc. For the first few weeks they actually come to your home, so you don't have to haul your newborn out and about and you can hopefully continue to rest/heal.

That was such a great thing for me. Not to mention, I loved how supportive they were (at time of labour there is always 3 Midwives present) and someone was always making sure I was as comfortable as possible, and that my husband wasn't freaking the hell out lol It was really a great support. Our Midwives in Ontario are very well trained to manage non-high risk pregnancies. I had gestational diabetes with both pregnancies and they still managed me just fine. Here, they are equipped with the ability to send you for the same testing/ultrasounds as an OBGYN can. I felt like I got more personal, me specific care versus generalized care, if that makes sense? I had more control.

Anyway, sorry for the novel lol I just really really love Midwives!!

Roliepoliecoley4

OB. My first was a c section. My insurance is through the hospital I work for, and the hospital itself refuses VBACs. I would prefer a midwife, but think it's silly to go to someone the entire pregnancy who wouldn't deliver me. Working in the ED (and I have shadowed in L&D), there is only one doctor I am 100% comfortable with performing a section on me, so that's who I'm going through.

sarahunderthesea

I am currently going thru the OB vs midwife debate too. I had DD by csection due to failure to progress after my water broke, 13 months ago. My OB said to try VBAC I would have to wait 2 years to get pregnant again and because I was "failure to progress" he most likely wouldn't let me waste the time trying to VBAC. Lol, typing this I am wondering why I am even debating. But I like the known, but I really want a VBAC so I will probably get brave try the midwife.

meatytugboat

This is my fourth pregnancy and I'm going to use a birthing center. I've used obs with all of my previous pregnancies and was happyish. However with my last I was told that I was not in labor and to go home and chug water. 5 hours later I arrived back at the hospital(45min drive) to find out I was fully dialated and baby was born literally ten minutes after I got in the bed. It was very scary. Cause 3 days prior I was told baby was still breech and the nurse that saw me earlier in the day said an ultrasound wasn't necessarily because I wasn't in labor. My ob was not on call that night and didn't have time to get there before delivery despite attempts to keep me from pushing. A midwife delivered my baby and despite the chaos and fear she was awesome. She helped me through my first completely unmedicated birth and then held me afterwards while I cried like baby because nothing went right. The small experience I had with her was incredible. 

heatherdubrow

I have had scary/complicated births in the past. My first had a placental abruption and had to be vacuumed out. My second had a shoulder dystocia (basically got stuck in my pelvis because she was 10lbs). So I'm definitely more comfortable delivering in. Hospital. Also my husband is a dr and just feels more comfortable with the idea.

DuchessOfCambridge

I'm a FTM but for now I'll be using an OB, though I don't see that changing. My PCP is at a hospital and my OB will be there too. I LOVE my PCP and like how the hospital handles things so as long as I have an OB similar to my PCP, I'm going to stay there. I personally am just more comfortable at a hospital.

av2323

I love my OB.  I would love to be besties if she would let me    I had really high blood pressure after giving birth to DS (like scary stroke level high) so I was thankful to be in a hospital setting.  

ArtificialRed

I also can't imagine not being in a hospital. I've always struggled to see the appeal of home births over hospital births.  As in, I know why it does appeal to people, but those benefits have never outweighed hospital benefits for me. 

jess0211

I always thought I would go with a midwife and birth center, I actually wanted to be a midwife for bit! But because I am AMA and have a heart condition I feel more comfortable with my OB in a hospital setting. I had to switch OBs though because I was seeing one where I work,but it's about an hour from my home and I felt uneasy giving birth where I worked.  So it's a new ob practice for me...I did have my annual there a few months ago and really liked all the doc I saw. 

kschref

My practice has 1 OB and 2 MW so they rotate your appointments through all 3 ladies so that you are familiar with whomever is on call when you deliver.  I love it.  We will go to the hospital again due to my heart condition.  I also had some issues from DS's birth that make me more comfortable in a hospital situation.  I have had no issues laboring and delivering there - they have always been super accommodating and awesome and I like that they have a level 3 NICU.  We always have a doula and will have her again - she is amazing and I already asked her to pencil us in for November in case that month fills up quickly due to Valentine's babies.  I'm a hobbyist photographer and love birth photography and so DH has agreed to hire a birth photographer this time assuming all goes well.  

adirat

Thanks for sharing all your thoughts. I'm really interested in hearing how people make this decision. 

When I graduate from the RE, I'll need to look for a doctor. I've seen a gynecologist for several years, but she doesn't do OB. I'd also like to go somewhere near our home, rather than near my office, so my husband can attend u/s and such. I find the midwife idea appealing but I think I'd want a nurse-midwife in a hospital. Can anyone recommend how to research options in my area?

MrsBunz

I went OB with my last, but I make a point of finding one that was a DO. In my personal experience, I've found DOs are more willing to take a more holistic and natural approach (again that is just my experience with DOs vs MDs). I loved her, she was crunchy friendly, she drives in to deliver all of her patients (even when she was not the on call OB), and she was my biggest advocate for skin-to-skin, breastfeeding, delayed cord clamping, etc. I'm going see her again and deliver in the hospital, partially because I had to have a vacuum assist and then I hemorrhaged, so I want to be at a hospital I like, just in case. 

ChattyKitty17

I love this! My decision right now is basically whether I go with a midwife assisted hospital birth or OB hospital birth. I tore pretty severely with my DD and lost a lot of blood so I was glad to be in the hospital, however I feel like I missed out on a lot of information that I should have had prior to her being born that could have improved my post birth experience a lot, like ways to help lessen the chances of tearing. The nurse who was with me that night delivered my daughter, the doctor was on her phone and barely got gloves on in time to stitch me up.

heatherdubrow

@adirat one thing that is important to me is that the hospital has a nicu on site. God forbid I needed it and they have to take my baby to another hospital.
I have found that the hospital is more important than the doctor. Chances are, in a big ob practice, your dr won't be delivering your baby. But a hospital with awesome nurses will mean everything to you. 

kissthesky32

heatherdubrow said:

@adirat one thing that is important to me is that the hospital has a nicu on site. God forbid I needed it and they have to take my baby to another hospital.
I have found that the hospital is more important than the doctor. Chances are, in a big ob practice, your dr won't be delivering your baby. But a hospital with awesome nurses will mean everything to you. 

So much this! I've delivered at two different hospitals. One was in a not great area and wasn't huge for L&D. The nurses were bossy and not warm in any way. They fought me for everything because they just wanted me in bed, with an epidural, not leaving them alone. The second was a hospital that does a TON of L&D. The nurses were awesome: friendly, helpful, and let me not be hooked up to everything so I could walk around the halls while in labor. It was a huge difference and I really appreciated not having to argue with them to be able to do what my body was telling me to do.

ChattyKitty17

adirat said:

Thanks for sharing all your thoughts. I'm really interested in hearing how people make this decision. 

When I graduate from the RE, I'll need to look for a doctor. I've seen a gynecologist for several years, but she doesn't do OB. I'd also like to go somewhere near our home, rather than near my office, so my husband can attend u/s and such. I find the midwife idea appealing but I think I'd want a nurse-midwife in a hospital. Can anyone recommend how to research options in my area?

I would recommend calling your insurance and seeing if they will send you a list of care providers they cover in your area, I have done this for other medical things and it saves the time of looking into places that aren't covered, then I look at reviews and try to "investigate" them as much as possible.  I usually like to ask people I know as well but as we are keeping this a secret it makes that hard initiall

slaven

@adirat I looked at my options for where I can deliver near our next duty station. There's really just one hospital on our current insurance plan but it just so happens to have 2 OBs and 5 midwives, 3 of which are only for military patients since the on base hospital doesn't do L&D (from what I understand). I found that out by looking at the hospital's OB page. I haven't seen the place so far but it's a nice balance of being in a hospital but also nice that it has midwives, tubs for laboring in (don't think you can deliver in them) and they let you walk around and using birthing balls as well. 

kalenp

We had a great OB for the first birth but there were many aspects of the hospital care that I didn't love. Initially with 2nd son we were going to go the same route but I couldn't deal with my OB's practice anymore (long wait times etc) and we switched to a birth center inside the hospital at around 30 weeks. My midwife was great. The care was way more personal, more thorough and felt less rushed. I'd love to have a home birth for #3 but my husband isn't on board so we'll likely stick with the birth center and use the same doula we've had for the other 2. 

MrsBunz

@slaven I'm assuming you are on TriCare Prime (though I think it applies to TriCare Standard as well), but a lot of the bases state side only have clinics and don't do OB or L&D (at least this has been my experience), so they send you to a local hospital that accepts it. I live in a large enough city that pretty much all 8 hospitals are available to me. Also, they do allow CNM and if you DH has to be deployed during delivery, TriCare should pay for a doula if you'd like one. 

slaven

@MrsBunz It is Prime but it's going to be a small area so only one hospital there. Here in Korea I had a choice of 4. We're going to Drum which I think has a small hospital and OB but no L&D. I could be completely wrong though. I'm pretty much just sticking with Prime because we're moving halfway through the pregnancy and I don't want to deal with more insurance problems/changes than necessary. If there was a natural birth center that I could only use with Standard then I'd switch but there's no center like that, as far as what I could find. 

NYTino24

Like @slaven my hospital has birthing tubs, but I think I'd like to labor in one and deliver in a bed. It has a level 3 NICU, not that I expect to need one... but you never know. This will hopefully be my first take home baby.

libfish825

@slaven @MrsBunz This is my first time going through the process with Tricare... care if I lean on you guys a little with questions sometimes? Incidentally, I know that down at Ft Campbell, they definitely have OB and L&D at Blanchfield Hospital on post. Maybe is because Clarksville is otherwise fairly small? The next closest major hospital is Vanderbilt in Nashville.

jess0211

@slaven can I ask what hospital up there you found? Was it Samaritan?

slaven

@jess0211 it was Samaritan 

@libfish825 If your MTF has OB and L&D that's most likely the only place that Tricare Prime covers you to deliver. There are exceptions though, for instance for high risk pregnancies or patient load. You can check on the Tricare website for any other places for Tricare Prime or Standard. Standard usually gives you more options but higher copays and such. I would only use it if I wasn't happy with what services/facility I could use on Prime. 

jess0211

@slaven I don't know if you would be interested or if it's worth it, but there are a few hospitals in the county over that some folks use. My nephew was born at Samaritan though and I don't talk to his mom but he was a happy & healthy baby

slaven

@jess0211 I figured I'll look into it more when we move. I'll have to take where ever we live into consideration and all that. I don't plan to go to Tricare Standard so I think Samaritan is the only option. I'll do a tour of it and if I really just don't like it then I'll switch but I've heard good things. 

KeHill08

I'm going with an OB again, although I will have a different one. Last time I was in Kansas until 37 weeks and was bounced from doctor to doctor because on post you just don't know who will be there when you go into labor so they want you to have at least seen them once. When I moved home at 37 weeks during the deployment I saw the OB that worked with me when we lost our first. We live 50 or so minutes from our home town so I'm definitely not driving that far, especially since we have a facility that offers more special care if need be.

Edited to add that I'll also need a c section again so OB it is. I don't want to try a VBAC when there's a good chance I would end up with a c section again.

Tourmalily

I have an OB, and while I am still not 100% certain I'm going to stay with her practice, I am going to wait until my first appointment and see if I have a good rapport with her. I also want to know about the other doctors that deliver at the hospital she uses - what if I have to have one of them bc she is unavailable, what are they like, etc. I will also be setting up a tour of the hospital. I've learned they have an attached birthing center that is separate from the other aspects of the hospital, they have labor tubs although I do not know if you can deliver in them, they have birthing balls and other non-traditional labor aids. The hospital claims the staff are "committed" to supporting laboring moms and respecting their wishes and birth plans. They're also designated a baby-friendly hospital. 

So right now, tentatively: OB, with hospital birthing center delivery. 

MaximumEffort

My last one I had a nice birth center all picked out, it was in Alaska and then at 27 weeks I moved back across country to CT. Found a practice with OB and midwives which sounded perfect except it was a draw who would deliver, my early labor Dr was an add, luckily DD held out a little longer and I had a water birth with a midwife at that hospital.  Those midwives all left the practice and I just found them last week.  My first appointment is with the one who delivered DD, all I have to do is get to 37 weeks again.  

MrsBunz

@libfish825 Feel free to ask anything you need (you can PM me if you need to). This will be my second time around with Tricare Prime, and it can be a bit confusing. Your MTF probably has OB and L&D because there aren't many civilian hospitals or there is a higher demand on your base. I'm in OKC, so there are so many different hospital options, it doesn't make sense to keep our MTF as a fully manned hospital.