How much settling is too much? (LONG)

fyziksgirl

I just had my third midwife appointment and met the third midwife and am trying to decide if I should stick with the practice or go looking for another one. I noted what is "background" below so you can skip it if you want to just get to my question...

Background

This practice is at an out-of-hospital birth center and has three midwives. I interviewed them and one other birth center (which has two practices at it), and kind of chose this one in spite of the personality of midwife 1. They were much more focused on not transferring you to the hospital, not breaking your water, not doing interventions, etc. than the other place. Not that they wouldn't do it (their transfer rate is 10-15%, for example), but just that they viewed such things as not insignificant and requiring careful consideration, like me, as opposed to no big deal, as the other place seemed to. However, the midwife was very stuffy and I just wasn't relaxing with her. I figured I was nervous, and that outcomes mattered more, and went with them. There's one other main birth center group in town, but I've heard they're very pushy and domineering which is not what I want, so I didn't interview them.

I had midwife 1 at my first appointment, and it was pretty awful. She was not respectful of me (I didn't feel), had lots of snark (things like answering my question about running saying it was OK but muttering under her breath it would ruin my knees), and refused to accept my conception date from extensive charting as a way of calculating due date (which I also had), etc. I just felt belittled and not included as a partner, but more as a potential problem. I almost left the practice after this appointment because it was so bad, but decided to give them another chance.

Next appointment was with midwife 2 and was FABULOUS. She put me and my husband at ease, answered questions with her opinion and official stance, making clear which was which, and telling me I should make my own decision, calmed me when it was hard to find the heartbeat immediately and sat there savoring the moment of us first hearing it with us, allowing me to relax and really enjoy it. It was great. She is somewhat pushy about some things later, but if it was just her I'd be willing to put up with that because I like her.

Next appointment was with midwife 3 and was just this morning. It was underwhelming. As my DH said, she felt scattered and unprofessional. She spent almost our whole appointment on a mini-rant about clients not preparing in answer to a question. After that we had no time, so I hopped on the table, she quickly found the heartbeat but was distracted and out of it (as she was the whole time), so it was completely not-special, and just generally the appointment was not great. I wasn't uncomfortable around her...I was just definitely unimpressed.

Question

So in summary, 3 midwives, one awful, one good, and one meh. I was on the fence about staying with them after the first bad appointment, and today didn't help. But I don't know if my standards are just too high. Maybe it's not possible to find a medical provider and/or midwife whose philosophy aligns with mine and who I'm comfortable with, who treats me with respect and as individual and involves me in decision-making. Maybe I'm wanting too much in wanting to "click" with someone who I also trust and respect to work with me as she guides me in this process. Maybe I would go looking around at other midwives and end up with the same level of overall meh a few appointments in, because this is really what's out there and as good as it gets.

But then I get frustrated that I feel like I have to settle. Is it really true this is as good as it gets? I mean, things have been way better than with my OB so far...but couldn't they be better still? If I only had to deal with one midwife would that be better, because I'd just have to find one I clicked with instead of trying to get along with a whole group? That is probably my other option at this point, there aren't really other groups I'd consider around here...but then are there downsides to only having one midwife instead of a group I'm not thinking of that would disappoint me?

I just don't know if I should lower my expectations and be happy I've found someplace that is likely to help me get the birth I want even if I'm somewhat uncomfortable with the people helping me get there, or if it's worth looking around because better exists and I can find someone with whom I'm really comfortable. Any advice?

JLG95

I'd tour the other practice.  You have plenty of time to switch.

julyjennifer

I feel like you have answered your own question. 

Keep looking around.  If you don't find anyone you like better, at least you won't be wondering whether there is something better out there.

On the question of a single MW vs a group, my expectation is that most single MWs would at least have an apprentice that they work with, or MWs that they partner with if they need backup.  I would want to have two trained people available at the birth, in case both you and your just born baby simultaneously have issues and need the full attention of one trained person.  That is something I would inquire about when interviewing solo MWs. 

I guess one advantage with a group is that if something prevents one MW from attending your birth (illness, family emergency, other birth), you'll have already met the backup.

I had a solo MW with her apprentice (who was very experienced so basically almost a full MW herself) for my DS.  They manage their client load such that it is unlikely that they'd have to be at a different birth when you go into labor.  However, if that were to happen they had a plan for what backup MW they would call in, so I would have had the apprentice that I knew well and the backup MW attend my birth.  They were both local MWs that I happened to have interviewed in a previous pg, so I had met them.  In the end they were both there for the birth (and by "there" I mean arrived 5 and 15 minutes afterward because DS came very quickly, but that's another story). 

Here's my math:

(a) find a solo MW who you click with, and have a 97% chance of someone you really like at the birth, and a 3% chance of someone you have not met.

or

(b) use your current practice and have 100% chance of having someone you've met, and a 33% chance of it being someone you really like.

You can decide what is more important to you and how you want to play the odds.

FWIW, with my first birth, it was at a hospital with a large MW practice and I hadn't met the attending MW before, and I could have cared less.  I had my doula and my DH with me and that's who I noticed. 

That said, one of the reasons I chose a homebirth was to up my odds of having someone I both knew AND liked attend the birth.

KateLouise

I would definitely look at my other options.

Even if you ultimately stick with this practice, you will at least know what the other options out there are.

I never felt the need to, "connect" with my midwives. I do need to feel I can trust the, to be knowledgeable and skilled, and to have a manner that will gel with me when I'm in labour. ie I don't need a drill seargent barking orders, and I don't need someone being all, "nicey nice, and cooing at me." I just want someone to calmly tell me what the state of play is and where things are at. 

My first midwife, I considered her to be a bit scattered at times, and seemed a bit vague, but I came to really trust her knowledge and opinion. I had a great birth and post-birth care experience with her and I was guttered when she retired.

The midwife I'm currently working with, is professional, friendly and seems to know her stuff. As does her partner. So I'm happy.

So I guess you need to decide what is most important to you in a midwife, and decide if any or all of these midwives meet that

FWIW I think feeling relaxed is a big part of having a successful natural birth. If I felt on edge with a midwife, I would shop around.

pc150805

I just recently posted about a similar experience. My concern was more about switching back to my OB, but I totally understand how you feel. I can honestly say that I feel 100% better now that I've switched. The midwife and I just weren't on the same page and I didn't feel comfortable with her. All I kept thinking is that if she showed up to deliver my baby I would be devastated (and scared/anxious). You have a 2/3 chance of getting someone you aren't comfortable with at your delivery. That was the deciding factor for me. Now I know that when the doctor walks in to deliver my baby, I'll be comfortable and relaxed (well as relaxed as I can be). You absolutely should have the highest standards for your healthcare provider. In the end, they work for you and you have the right to be happy with the care they are giving you. Good Luck!