WWYD...

BBhopes15

Hi ladies! Me again. (21 weeks pregnant) Again sorry about not fixing siggy yet! We had an appointment yesterday and my husband asked out OB about being on board with natural birth. I was a chicken and didn't want to ask but I am glad he did. After a few other questions about inductions, episiotomies, c-sections, epis and my low-lying placenta...I got the following responses: 1. I would suggest lamaze class. My wife and I liked that and I used those breathing techniques during pushing. But the people that teach those classes are very agains physicians so I suggest making your own opinions and not allowing them to influence you. 2. He's never heard about hypnobabies (perhaps because we are in Pittsburgh?!) 3. He doesn't do episiotomies 4. He likes epidurals but its my choice. He said he wants me to be educated and know its gonna be painful. 5. He is pro-inducing and that he would prefer a baby not go pass 41 weeks. However, the hospital rules are very restrictive about inducing and he essentially doesn't do these. 6. He then said: why are you worrying about worse case scenerios. Be positive and think that everything will work out. He didn't really answered much about c-sections. Except to say the following: 7. About your low lying placenta: chances are it will move and be no problem. We will check at 28 weeks. If it stays the same and its low lying this should be no problem you should be able to deliver vaginally. If its partially covered, there is a chance you can still deliver vaginally so long as there is no bleeding but its a bit risky or you may end up with a c-section. Placenta previa is always a c-section as the risks of bleeding are high and dangerous to you and the baby. Sorry this turned out so long. I am nervous about the response but I guess I feel it doesn't matter much....that so long as I labor at home till the last minute I can avoid an epi...Or am I being blind and is there enough information here for me to switch?! I feel lost....

pisceschik

Just wanted to comment on #2, my old OB and my current MW hadn't heard of Hypnobabies either, I think it's so new, that not everyone has.  I live in the Philly area.  I wouldn't hold that one against him. 

AmyRI

Nothing screams "run" to me, but I would ask a few more questions next time. (I will say, though, that I am not afraid of hospitals and in fact prefer to birth there - so this might taint my opinion.)

1. Sounds like his only NB education is from Lamaze. Which is fine, but it doesn't mean you have to use Lamaze. He's just suggesting it as a tool that he has seen as beneficial.

2. I'm not sure this would really worry me at all. The OB's job isn't to help you labor so much as it is to make sure you're progressing and catch the baby at the end, and intervene if complications arise. I would probably have a brief, few-sentence summary to talk about next time - "this is what I'm planning" sort of thing and see if he's ok with you trying it. But realistically, it's the nurses that will see you using it for the most part.

3. Yay.

4. Ask him what situations would warrant him telling a patient to get an epi. I asked my OB point blank if she had ever told a patient to take the meds, and she said once - when the mother was not progressing after many many hours and was facing a c-section if they couldn't get her moving again. The epi worked.

5. Ask if he will let you go past 41 weeks if you pass NSTs every day or two. If there's negotiating room, then I think it's fine. Also ask about how he induces - cervadil, cytotec, pitocin, AROM? Figure out how you would want an induction to go, if the need arises (say at any point you develop pre-e, what would you want to happen?) and see if he's ok with following your plan.

6. I don't think there's anything wrong with an OB trying to keep you in a positive frame of mind. He's saying your body can do this (without using those words, but still) and that you should focus on being healthy. Once you get through this initial "are we on the same page" period, I bet you'll appreciate this positive outlook. My OB is the same way, although she's a little crunchier so she will say that my body is made to do this.

7. I had partial previa with my first. It did move, but slowly. It was out of the way by 28 weeks. My OB's opinion was the same as yours, and I was ok with it. I did not want to risk any sort of bleeding issues. I am more afraid of out-of-control bleeding that could result in a transfusion for me and danger to the baby than I am of a c-section. I don't think anything he said is out of line.

I would not switch, at least not yet. But if you don't feel good about him, then you should find a different care provider who you ARE comfortable with.

robyn2201

BBhopes15:

Hi ladies! Me again. (21 weeks pregnant) Again sorry about not fixing siggy yet! We had an appointment yesterday and my husband asked out OB about being on board with natural birth. I was a chicken and didn't want to ask but I am glad he did. After a few other questions about inductions, episiotomies, c-sections, epis and my low-lying placenta...I got the following responses: 1. I would suggest lamaze class. My wife and I liked that and I used those breathing techniques during pushing. But the people that teach those classes are very agains physicians so I suggest making your own opinions and not allowing them to influence you.  His statement about the teachers being very against physicians worries me a little. I didn't do lamaze so I can't say what the classes/instructors are like though.

5. He is pro-inducing and that he would prefer a baby not go pass 41 weeks. However, the hospital rules are very restrictive about inducing and he essentially doesn't do these. Would he be willing to let you go past 41 weeks with additional monitoring? A due date is just a estimate and I don't think I could get on board with a OB who wouldn't let me go past 41 weeks.

Sorry this turned out so long. I am nervous about the response but I guess I feel it doesn't matter much....that so long as I labor at home till the last minute I can avoid an epi...Or am I being blind and is there enough information here for me to switch?! I feel lost....    I would ask him some more detailed questions next time you visit him. You could also in the mean time do a little research and see if there is anyone else in your area that is recommended to be NB friendly. That way if you decide to switch later down the road you aren't scrambling to get recommendations. 

runlong3

Where are you currently going to be having your baby? (Magee, West Penn, Forbes, etc) I am also in the Pittsburgh area.

I'm not surprised that your dr. wasn't familiar with Hypnobabies/birthing or Bradley as Pittsburgh is super medically oriented. I know Bradley classes exist around here, and I'm not positive about Hypnobirthing, but I know the lady who was doing Hypnobabies has stopped and the other girl who was supposed to take over hasn't started yet.

I would be a little leery when it comes to the the dr. saying he's a fan of the epidural, especially if that's not what you want. To me that means he's not going to encourage you at all from not getting it and may ask you several times if you want it.

I think you need to sit down and think about how his answers line up with what you feel is right for you. Do you feel that inducing at 41 weeks is rushing it, are you going to mind him encouraging you to get the epi, etc? I kind of got the feeling from his answers that he is more "oh you want a NB? How nice, we'll give you the epi when you realize it's too painful..."

Keep in mind depending on where you are, there is the Midwife Center in the Strip that's a freestanding birth center (which is where I'm going) or there are the Midwives at Magee if you prefer a hospital setting. Of course there are OBs out there that are NB friendly, but unless you already have recs for them, they can be hard to find. I will say if you're unsure of using a MW, the Midwife Center has an orientation tour every Tuesday night that you can go and get a feel for the place w/o an appt and ask them any questions you have regarding their approach to birth or things like "when do you transfer to the hospital", "what are your transfer rates?", which is great for a SO that may not be so sure about going that route.

BBhopes15

thanks for the advice. RUNLONG--I am planning to birth at Maggee. I agree with what you said. I would probably feel more confident going with the Midwives at Maggee but my husband doesn't like the idea of a midwife. I think I need to talk more with my doctor about this. I will include the questions suggested. I think I need a better idea of how he will act if I do go past 40 weeks and whether or not he would push an epi. He did say he likes women getting the epi because it makes it easier for them especially with all the internal exams during labor.