If you used a midwife ...

Nechie122

... was there ever a time when you needed to be referred to an OB? And was that person a "stranger?"

I met with a new midwife practice today and generally had a good feeling about it. However, if any problems arose, my physician would be some random resident or attending at the academic medical center where the midwives deliver. Not sure how I feel about that.

We just relocated from New York where I had a FANTASTIC setup of an OB who basically practiced like a midwife. She even delivered in a birthing center and I had the no intervention birth I wanted, not even a heplock. However, if something had come up, she was fully able to admit me to the labor and delivery floor and perform any procedures.

Anyway, just curious about others' experiences using a midwife practice.

annabelle.27

Nope. I would have if I had developed certain pregnancy-related conditions or became high-risk, though. But as it was I only saw my midwife through my entire pregnancy and post-partum period.

eta: but if I did have to be referred it would have been to an unfamiliar OB.

littlemaybaby

This is always a possibility when using a MW.  I'm actually being referred to a MFM specialist right now to rule out some possible complications.  

As for problems that may arise in labor without warning, my MW practice is backed up by an OB group who they have worked with for years.  So while I may not know the particular OB if labor intervention was needed, I at least have some comfort that it wouldn't be whoever happens to be attending at the hospital at the time . . . it would be someone from the practice my MW teams with.   

Nechie122

littlemaybaby:

This is always a possibility when using a MW. nbsp;I'm actually being referred to a MFM specialist right now to rule out some possible complications. nbsp;As for problems that may arise in labor without warning, my MW practice is backed up by an OB group who they have worked with for years. nbsp;So while I may not know the particular OB if labor intervention was needed, I at least have some comfort that it wouldn't be whoever happens to be attending at the hospital at the time . . . it would be someone from the practice my MW teams with. nbsp;nbsp;

Yeah, this is what I'd prefer. I think I'm still better off with a midwife, given the other options here, but I wish there were more middle ground.

hutchjess

Obviously I am very lucky because I have the middle ground.  My OB and midwives all are in the same practice.  I gave birth with the midwives the first time around, and will do so again if all goes well.  But my own OB is part of the practice and will be there if I need him.  I would just say such practices do exist and seem to be becoming more common, so look around!

ncbelle

I was never referred to an OB but if the need had arisen it would have been an OB I hadn't met - but one who has backing arrangements with the midwifery practice.  My birth center midwives also have hospital privileges - so in the event you do have to transfer, they still attend your birth (the OB only steps in if a c-section is necessary).  My first birth was with a hospital based midwifery practice who had a similar arrangement with a backing OB practice in the event of a c-section or high risk complications developing during pregnancy.  In both cases, the midwives stayed on your care team even if you became high risk and needed specialist care.

pepomntpat

I ended up with the on call doc when I needed a c/s and it was terrible. I felt so scared and abandoned by my MW practice. The OB didn't give a crap about me. If we decide to have anymore LOs it will be with an OB/MW practice where I'll at least recognize the faces. 

Nechie122

pepomntpat:

I ended up with the on call doc when I needed a c/s and it was terrible. I felt so scared and abandoned by my MW practice. The OB didn't give a crap about me. If we decide to have anymore LOs it will be with an OB/MW practice where I'll at least recognize the faces.nbsp;

... And this is my biggest fear. The way it works down here is weird. There's only one midwifery group that delivers at the university hospital; the two private hospitals don't even allow midwives. I have yet to find a hybrid practice.

If I could guarantee that my second pregnancy would be as uneventful as my first, it would be an easy call. Anyway, at the very least, I have some good questions to ask. I still like the idea of a midwife group a lot.

RayRay007

I went by myself to the hospital for an NST at 41w1d. Results were to be sent to my MW and I was to see her the next day. Well the NST didn't go so well and they ran me down the hall to the OR. They called my MW and she made it before they cut, but after the spinal. The OB was a stranger, but that was fine. My c/s went pretty well and I was so glad they called my MW and she was able to be there, if only to put a hand on my shoulder. She took care of the baby after too, and the OB released me back to her right away. If you don't plan on seeing an OB for care during a pg, and don't 'plan' on needing one later, then I don't think you need to know them before hand.

celeste120

With our nurse midwife we also have a back up doctor, but we get to meet with her multiple times prior to giving birth so we will know who delivers the baby even if a doctor would be needed.

sbevmc09

Wanted to weigh in, but my experience is a little different.  I'm with a MW this time (it's a small, hospital-based midwifery practice with 3 CNMs and an OB.  I won't see the OB in normal rotation unless I specifically request it or if I develop complications).  BUT last time I was with a large OB/GYN practice with 8 OB/GYNs and 6 CNMs (that were really just extensions of the OB/GYNs, they didn't practice traditional midwifery) and I didn't get to know any of the people in the practice at all.  Any one of them could have delivered me.  My labor was monitored (by phone) by one of the CNMs who only came in at the very end to recommend a C/S.  One of the OBs then met me in an OR to perform the C/S and I didn't see him again afterwards until he breezed in a few days later to discharge me. 

My point is,you could be with an actual practice and not get to know the providers.  It's not that I would love my care being transferred to someone else when I formed a good relationship with my MW, but I just know that other practices can be impersonal anyway.  I guess I feel like you're lucky to get to bond with your MW even if you do end up having to transfer care to someone else.  

Hyaline

I moved midway through my pregnancy so had two midwives.  Both were in practices with OBs so that you met the OBs during your normal prenatal care--and if anything came up that required an OB you would know the person.  I do like that I've met the OB who would be called in if we have issues, but at the same time--I have a feeling that by that point I probably wouldn't care what physician I had, especially if the midwife stuck with me even though the physician was there.

pixieprincss

We paid for CMP care OOP but elected to use my HMO insurance for an anatomy scan and labwork which meant using a doctor to get an in-network referral for those things. I saw two drs I had never met before for them. It wasn't warm-and-fuzzy, but it got the job done. Had I needed a hospital transfer for our birth, I would've been delivered by the dr on call. That said, that it how it works with my insurance even if I'd done the whole PG with an OB. In the case of a transfer, our MW would've stayed with us as a doula at our request.

It sounds like you are looking at a CNM practice, right? Some CNMs are pretty mainstream, so that vs. the OB you met may not be all that different (or the OB may even be more of what you want).

xnbride

My midwife works in a practice with OBs so they wouldn't be complete strangers. However, in the circumstance that something were to require help from an OB, my midwife would put on her "doula" hat and be there for emotional support.

chronoptomist

OP, I'm almost positive that I saw you on my local board and that we live pretty close to each other. (You're in F and I'm in SH, just south of you?)  I'm going to PM you.  There is a doc that a few of my friends have used (and who I will use if I ever do a planned birth as opposed to home birth) that I think might be right down your alley.  He's done a lot of work in third world countries which really changes his views on natural childbirth, so while he's great with modern medicine, he's also very respectful of the human body and the things it can do on its own.  

LindseyJW

i've twice needed to be referred to an OB during a pregnancy. the first time it was while i was in labor and the midwifery practice I used referred to two OBs at different hospitals. i chose the hospital closest to my home (i knew if i was going to be transferred during labor, i'd be at home and wanted the shortest drive). that was a mistake, b/c my local hospital is NOT friendly to homebirth transfers. wish i'd known that. anyway, i digress. i was able to meet the OB before labor (around 39 weeks) so that we would have a relationship beforehand. 

the second time i was referred it was for a complication that arose mid-pregnancy. my care was never transferred, just a referral for that complication. had i needed to transfer during labor with my second MW (different practice than #1), i would have gone to the hospital and hopefully would be transferred to one OB in particular, but only if he was in that day. otherwise, i'd get who i'd get.

frankly, in retrospect, it wouldn't really matter. if you are being transferred in the middle of labor, something is wrong and what is most important at that time is that you get the medical assistance that you and/or your baby needs. it is hard to hear that when you are still pregnant and in the planning stages, and if you can control any of who that person is, best to do that. but if you can't, know that it will be fine and that in the moment and likely after the moment, you will just be glad that you had the option available to you (to transfer care during labor).