NEED ADVICE! Cant decide between midwife or doc

beckstyle

Please bare with me through this explanation...kinda long but I if it impossible to make a decision! I live in guatemala where in the private hospitals its 70-80% c-section. I've found a doctor that I like, the private hospital where he works out of is very nice AND affordable. I met with my doc today had a great appt everything looks good, he even moved the due date a week earlier. I'm 12 weeks now! I explained my fears that I will be forced into a c-section and that I don't want any kind of intervention. He says his c-section rate is about 30%, and that if my labor goes okay and amnionic(sp?) Fluid and heartbeat looks okay, they won't intervene. He says he prefers "natural birth." My other option is going with a mid-wife who is very professional and well trained and has a lot of experience. She's the most well-known and well-respected mid-wife in the country. Her fee is almost double what I would pay for a c-section birth with my doctor. It involves a contract and includes almost all prenatal care. She says she's had two transfers to hospitals for c-sections in the past two years and averages about 4 births per month. If I end up having to do a c-section I still have to pay her full fee as well as a huge chunk for a c-section. I understand that cost shouldn't dictate my decision,but I can't deny its a factor. I feel so torn between the two options! My friend had her baby with the same doc and same hospital and she was extremely happy with both, even though she was against a c-section and ended up with one because she got to 40 weeks and things weren't moving along and the amniotic fluid was too low. What do you ladies think? Thanks so much!!

CurbsideProphet

If you can afford it, I think I would go with the midwife.

pepomntpat

I find it odd that the MW charges so much. They are usually cheaper than doctors.  The OB doesn't sound very NB friendly though.  Are there no other doctors or MWs in your area?

beckstyle

To give you and idea of the costs: midwife birth. $1700, but includes most prenatal care and 40 days of aftercare. With a :doctor in a private hospital $700 vaginal birth or $1000 c-section. I haven't found any other good mid-wifes here, she is seriously from what I hear the best in the country. Thanks for reading my post, I know its hard to read as one paragraph but I can't do paragraphs when I post from my blackberry!

nonoemily

I would go with the midwife, but it's good that you've connected with a doctor you like just in case.

30% c/s rate is still really high. That's my two cents.  

drpayne

This isn't really what you asked about but I found it kind of weird that he changed your due date at this point...

pepomntpat

beckstyle:

To give you and idea of the costs: midwife birth. $1700, but includes most prenatal care and 40 days of aftercare. With a :doctor in a private hospital $700 vaginal birth or $1000 c-section. I haven't found any other good mid-wifes here, she is seriously from what I hear the best in the country. Thanks for reading my post, I know its hard to read as one paragraph but I can't do paragraphs when I post from my blackberry!

I am pretty sure that is just your doctor's fee. I think you will find the entire cost of the birth at a hospital will be significantly more than that.   

flyer23

The following are red flags to me, with what you've said about your doctor:

1. Changing your due date at this point. Have you asked him about his induction policy for overdue moms? If he routinely induces at 42, or 41, or 40 weeks, he's just given you one less week for your baby to come out on his/her own.

2. 30% c-section rate. Better than 70-80%, for sure, but WHO recommends no higher than about 15%.

3. The fact that he is already talking about amniotic fluid levels when you're 12 weeks along AND you know that your friend got a c-section due to "low amniotic fluid." That sounds to me like it's a common "reason" he gives for inducing or sectioning moms who are close to/past their due date.

4. A possible red flag: Did you clarify what he meant by "natural birth," and whether it's in line with what YOU want for your birth? In an environment where 70-80% of moms get c-sections, he may mean "natural birth" to mean any non-surgical form of delivery.

All that said, I'm sure he'll give you a safe birth, so it's up to you to decide whether the experience you want is worth paying $700-$1000 more. I know I'd pay that in a heartbeat -- it's a once-in-a-lifetime experience, so I'll pay just about anything (within reason) to make it happen the way I want it to. But it's up to you to decide what's important to you, and there are no "wrong" answers.

LindseyJW

flyer23:

The following are red flags to me, with what you've said about your doctor:

1. Changing your due date at this point. Have you asked him about his induction policy for overdue moms? If he routinely induces at 42, or 41, or 40 weeks, he's just given you one less week for your baby to come out on his/her own.

2. 30% c-section rate. Better than 70-80%, for sure, but WHO recommends no higher than about 15%.

3. The fact that he is already talking about amniotic fluid levels when you're 12 weeks along AND you know that your friend got a c-section due to "low amniotic fluid." That sounds to me like it's a common "reason" he gives for inducing or sectioning moms who are close to/past their due date.

4. A possible red flag: Did you clarify what he meant by "natural birth," and whether it's in line with what YOU want for your birth? In an environment where 70-80% of moms get c-sections, he may mean "natural birth" to mean any non-surgical form of delivery.

All that said, I'm sure he'll give you a safe birth, so it's up to you to decide whether the experience you want is worth paying $700-$1000 more. I know I'd pay that in a heartbeat -- it's a once-in-a-lifetime experience, so I'll pay just about anything (within reason) to make it happen the way I want it to. But it's up to you to decide what's important to you, and there are no "wrong" answers.

all of this.  except the part in bold. this i'd be wary of saying, since it does seem that he is given to unnecessary interventions and that he's already setting you up for them. IMO, that's not helping to ensure a safe birth for you. that's increasing your risks of complications since unnecessary interventions cause unnecessary risks. 

FWIW, and i know this a different country and COL are drastically different, but i paid twice that for my MW and it was the best investment ever.  

drpayne

pepomntpat:

beckstyle:

To give you and idea of the costs: midwife birth. $1700, but includes most prenatal care and 40 days of aftercare. With a :doctor in a private hospital $700 vaginal birth or $1000 c-section. I haven't found any other good mid-wifes here, she is seriously from what I hear the best in the country. Thanks for reading my post, I know its hard to read as one paragraph but I can't do paragraphs when I post from my blackberry!

I am pretty sure that is just your doctor's fee. I think you will find the entire cost of the birth at a hospital will be significantly more than that.   

 

Um, yeah.  We are paying off our hospital bills right now (I had to be transferred) and it's WAY more than that (closer to $8000 and that was because we signed a waiver to be discharged after only one night). Our birthing center charges ~ $4,000. 

But again, I think the red flag is changing your due date this late in the game.  I don't want to jump to conclusions but this is setting you up to be "overdue" before you truly are...

beckstyle

Guys thanks so much for the responses! I know by american standards the costs seem low or a little wonky, but for us living and working here it is a big cost. I hear what everybody is saying, and I'm still on the fence but I really appreciate your replies! I think I know in my heart the midwife is the way to go but I'm just skerd! Gotta make my decision soon and commit! Yeah he's changed my due date three times: june 3, may 20 and now may 26. Basing it ultrasounds. My period was kinda wonky. I'm going with june 3rd and the midwife agreed with that. Thanks again!

drpayne

beckstyle:

Guys thanks so much for the responses! I know by american standards the costs seem low or a little wonky, but for us living and working here it is a big cost. I hear what everybody is saying, and I'm still on the fence but I really appreciate your replies! I think I know in my heart the midwife is the way to go but I'm just skerd! Gotta make my decision soon and commit! Yeah he's changed my due date three times: june 3, may 20 and now may 26. Basing it ultrasounds. My period was kinda wonky. I'm going with june 3rd and the midwife agreed with that. Thanks again!

 

Good luck!  Just FYI (and maybe standards are different there) but you can't really rely on ultrasounds for dating past about 8 weeks (if I recall correctly).  The fact that he doesn't know that would make me a little nervous.  

flyer23

LindseyJW:

all of this.  except the part in bold. this i'd be wary of saying, since it does seem that he is given to unnecessary interventions and that he's already setting you up for them. IMO, that's not helping to ensure a safe birth for you. that's increasing your risks of complications since unnecessary interventions cause unnecessary risks. 

Intervention-heavy births are generally safe, too -- increased risk, yes, but you're also in a hospital, equipped to deal with that risk if it becomes reality.

That said, I do think a midwife will give you a safer birth.

On the due date issue, definitely go with June 3rd, and INSIST on it, if you stay with the OB. Take this from someone who didn't haggle over her due date when he OB moved it up four days in the first trimester, and came to regret it when she was induced at 42 weeks (which was likely closer to 41 weeks...)