Natural Birth

Disappointed by discussion with OB

I have a "great" OB - he is very well respected, Harvard educated (for whatever that is worth!), and really does have a good bedside manner. When I asked him recently about labor and delivery, he said that they would do their very best to accommodate what I want (which is hopefully intervention-free birth). He also said, though, "you may not know what you want". Which is certainly true. He said only about 5% of the women he sees end up med free during delivery.

I asked about his thoughts on a doula, and he said he thought it was a waste of money, that it would marginalize my husband in the process, and if I end up not needing her I would have to pay anyway.

 So I said OK, what are your thoughts on the Bradley method. He said "ooh, that's militant", and proceeded to go on about a patient that was screaming at her husband for an epidural, and he had been taught to help her through it, but she "clearly just was in too much pain". 

This all added up to me to say that he feels either threatened or bothered by these notions. I'm sure he would go along with it if it's what I chose, but I would hate to create a situation where we have two parties at odds (eg my husband versus the OB). Right now I am thinking that ultimately I would like to have a midwife or someone else with experience for support through the labor process and the OB to deliver the baby, but it's sounding iffy.

Any thoughts or similar experiences? I am obviously new at this and don't know what to expect. Feeling very confused...

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Re: Disappointed by discussion with OB

  • I bet only 5% of the women he see's have a med free delivery in part because of his attitude.

    It sounds like he's already pushing you to do things in a pretty medicated fashion. If you're confident that you want to go med-free then a midwife might be a great option for you. I'm surprised he called a Doula a waste of money. One comment on it's own isn't alarming, but the way that all of his comments adds up would make me nervous.

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  • Your OB doesn't sound natural birth friendly.  If you want a NB, I think you should look into switching.

    And a good doula would never marginalize your husband.

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  • Why not just go with a midwife both labor and delivery?  Ours deliver at a hospital so if there are any issues that require intervention there are a staff of OBs available but if everything is normal the midwives do a totally med free experience (or an epi if you wanted it). 
  • As a supplemental care provider (I'm a clinical massage therapist) and a birth doula... I hear this way too often.

     I'm sorry that your experience with your OB was negative.  Its a difficult conversation to have in the first place, even more so when someone you are taught to trust responds in a negative fashion.

     I will tell you from a doula perspective that there is NEVER a time when I have gotten in between dad and mom during labor.  Its absolutely NOT my job to replace him, but to support him AND mom at the same time.  I might firmly insist that he stand up so I can put a cushion under his knees, or put food in front of him and be adamant that he eat, but labor and birth should be a joyful and intimate experience.

     I will tell you I have absolutely NEVER heard of a midwife supporting labor and an OB doing the delivery unless there is a complication that requires significant intervention.  If you want something along those lines, look into getting a monitrice.  

    While as a doula, I have to remain impartial and supportive regardless, I will say personally if an OB said those things to me, I'd fire him in a heartbeat.  On the plus side, at least you know he's not blowing smoke at you.  Too many OB's give women a "bait and switch" - telling them what they want to hear and then railroading them during labor.  Remember, he's there to serve YOU.  He may have a body of knowledge you don't have, and an amazing amount of experience - but he's a person with biases and preferences just like the rest of us.  You have every right to fire him and change care providers.

    My best recommendation (as someone who has seen many many different types of birth) - go interview some midwives and ask around your local community for the names of NB friendly OB's.  They ARE out there.  (Hint - if you're taking Bradley classes ask the instructor if they know of any OB's who are "Bradley friendly".  Childbirth educators are a wealth of knowledge when it comes to providers.)

    Also, tour some birth center facilities - both in and OUT of hospitals.  Trust your instincts and go with what  makes you feel most comfortable.  I have seen some absolutely gorgeous husband coached births in a hospital - med free.  It CAN be done.  

  • Even if he's theoretically supportive of natural birth, he rarely sees it and doesn't know what's normal so if you experience a normal variation in labor, he may not know what to do with it. My thinking on picking a provider is that I want some one who is familiar, ie - sees it at least 1/3 of the time, with my general approach. I wanted a natural labor so I picked a midwifery practice that frequently sees patients like myself.

    If you provider is dealing with patients unlike you 95% of the time and isn't a fan of the birth method you've chosen, then he simply may not have the practical experience necessary to support your plan. You're 20 weeks along? You still have time to switch - I did around the same time.

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  • imagevszapp:

     When I asked him recently about labor and delivery, he said that they would do their very best to accommodate what I want (which is hopefully intervention-free birth). He also said, though, "you may not know what you want". Which is certainly true. He said only about 5% of the women he sees end up med free during delivery.

    I asked about his thoughts on a doula, and he said he thought it was a waste of money, that it would marginalize my husband in the process, and if I end up not needing her I would have to pay anyway.

    Yeah, this is a big sign that you need to find a different provider. Take the time to do it now, rather than having to be stressed with battling him for whatever reason at the end of your pregnancy or during labor.

    And in regards to his feelings about doulas - a doula is there to support the mom, but she can also give the mom's partner a break. What if your labor is for 24 hours straight? Your DH is going to want to take pee breaks now and again, hee hee. My DH really liked having a doula, especially the first time around, bc she was able to assure him that I was laboring normally, she was with us most of the time (bc the MW just checked in on me), etc etc.

    Good luck!

    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

  • Thanks all for the input and support!! I guess part of my fear of "breaking up" with my OB (how do you even do that?? lol) is that if something *does* go wrong and I need a c-section or whatever, it will just end up being some random person. My OB has yet to miss a birth, allegedly.

    I definitely want to be in a hospital, but I think a midwife sounds really good. My OB did say (I guess sort of in his defense) that they would never do anything to me that I didn't consent to, of course, but I still just don't think he'll give me the support I need to give natural birth a go. It's a shame, because he was really great when I had a giant abnormal ovarian cyst shortly before I got pregnant. 

    Is there any reason *not* to get a midwife?? I don't think I'm high risk, other than being a first timer, and apparently my LO is measuring in the 99th percentile so far (and I'm tiny)...

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  • I think he was just letting you know his experience with all those things. Being honest. If he says he's ok with the type of birth you want, he most likely is. It would be good if you knew some one that went to him. Just remember what happens during labor is mostly out of anybody's control.
  • imageKitttkattt:
    I think he was just letting you know his experience with all those things. Being honest. If he says he's ok with the type of birth you want, he most likely is. It would be good if you knew some one that went to him. Just remember what happens during labor is mostly out of anybody's control.
    I agree to a point.  I'm sure he's being honest that he's OK with some of it, but it doesn't sound like he's very experienced with med-free births either if he is marginalizing doulas like that.  I bet he's a great doctor and I would go to him if I had a high risk pregnancy or other problem, but for a low intervention birth probably not.  OBs truly are trained to look for pathology for the most part, which is great when you need it.  I had a c/s with a midwife for my first birth and for my second birth switched to a different midwife practice at 24w and had a doula.  My DH raves about having a doula and how he was able to relax and really support me since our doula was so experienced. 
    DS born via c/s 11/08 and med-free GD VBAC DD 3/11! Baby Birthday Ticker Ticker Baby Birthday Ticker Ticker
  • imageiris427:

    Your OB doesn't sound natural birth friendly.  If you want a NB, I think you should look into switching.

    And a good doula would never marginalize your husband.

    I could not agree more with both of these statements.  

    Also, I am sure your OB is a fabulous OB-in other words he is probably wonderful at identifying issues and problems and wonderful at surgery.  Most OB's are not trained in understanding and supporting normal/natural birth.   if you were high risk or wanted a high-intervention level he would probably be perfect.

    Lilypie - (vGZN)

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  • In a follow up to your original post you asked about how to break up with your OB. I did this (though I'm going back to her post birth for my annual care). I found that what worked for me was to keep my appointments with her but to also look for a great birthcenter and midwife group at the same time. I found a wonderful midwife team and signed up with them. Then I contacted my GYN/OB and asked for copies of my medical records with her office and explained to her how thankful I'd been for her care up to that time and that I planned on returning to her post-birth. She wished me luck and wants to know how it turns out.

    I also agree with the pp who said that your doctor may be a great doctor/surgeon. If you're not high risk though it would be great to have someone who is experienced with natural births- sounds like he is not if only 5% of his patients get that results- that's way lower than even some of the hospitals I visited and would be a good reason to look around IMO.

    Best of luck with your birth and keep coming back here for help!

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  • I could have written this post almost word-for-word about five years ago, when I was pregnant with DD. Well-respected OB, great bedside manner, but when asked about natural birth, his response was, "Well, about 85% of my patients go into labor knowing they want an epidural, and most of the rest of them end up with one anyway. But if you don't want one, sure, that's fine." On taking natural birth specific childbirth prep classes, e.g. Bradley: "I don't think those are really necessary." I didn't ask him about doulas because I didn't know about them at the time (I learned about them later, in Bradley classes Wink) but I wouldn't be surprised if he were similarly dismissive.

    I stuck with him. And long story short, we clashed more and more over the course of my pregnancy, culminating in an absolutely disastrous appointment at 41 weeks, when he scheduled me for induction. Not that it came as a shock that it was time to do that, but the way he handled it was AWFUL and really upset me.

    By that point, it had gotten so bad that I had the on-call schedule memorized and prayed every day that he was on call that I would NOT go into labor. "Luckily," I did go to 42 weeks and had to be induced, and I was able to schedule the induction with his partner, who I "clicked" with much more and who totally understood my desire for a natural birth. She was fantastic.

    If your OB has yet to miss a birth, personally, I would run far, far away.

    As for breaking up, I obviously didn't do it with that OB, but I did have to do it in my next pregnancy when I decided to switch to homebirth. My new provider gave me a records transfer request form to fax over to my old one. I did it, and that was that. Very easy.

    Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)

  • I don't think there's any reason to *not* have a midwife in your case since you're low risk.  I'd honestly be more worried about unnecessary interventions and being unsupported in natural birth than ending up with a random OB if you needed a c-section.  Chances are good if you have support that you'll be able to go med free no problem and having a doula actually improves your odds. 

    With my first, I saw a midwife practice at a natural-birth friendly hospital and they had about 85% of their Moms go med free!  Pretty good odds.  For my second, we had a homebirth and hired a doula for extra support and it was a great decision.  DH was still very much a part of the birth, but it was awesome to have an extra set of hands to help me through.

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