When to get a new OB? — The Bump
VBAC

When to get a new OB?

We're not ttc yet but I have a pretty strong feeling that my chances for a VBAC are lower with the practice I used for my first pregnancy. I don't believe my c/s was unnecessary. However, my doula said that she thinks my vbac chances are not good where I was before. She gave me recommendations of some other practices.

If you were in my shoes would you a) go back to the original ob practice and feel them out about a vbac before moving on or b) not bother with them and find a new practice?

Also, when would you do this? I would think it's better to do before getting pregnant rather than switching after I'm pg.

The practice I was at before, I really liked a few of the doctors. I feel like those doctors would be good with a vbac. But it's a big practice and you get whoever you get. The jerk doctor who ignored my HELLP symptoms is gone so I'm happy about that. But I can see what my doula is saying about the practice. It specializes in high risk pregnancies and has a pretty high c/s rate. But again, my c/s was not one that anyone could have avoided. The bonus to that hospital is that it is literally 5 minutes from where we live. The others are at least 25 minutes away. I liked that we lived so close to the hospital the last time.

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Re: When to get a new OB?

  • If you're in agreement that you don't think a VBAC is likely at your current practice, I'd go ahead and make the switch now.  If you have significant doubts, perhaps contact your local ICAN chapter and see if they have input on the practice and/or any suggestions for other practitioners. 

    I switched at 20 weeks, and I'll admit, while I like my current doctor, I don't have a huge connection with her.  I wish I had switched earlier and even had time before the pg.  

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  • There are two things that jump out at me in your post.  1. You say you have a strong feeling that you won't have the best chance for VBAC at that practice. I think listening to your gut can be the best thing sometimes 2. It's a big group and you don't know who you're going to get.  I think when you want a VBAC, it's important to be in a practice where you know everyone will be on board with your VBAC.  

    So I'd at least start looking.  You don't have to make any decisions right now.  Some practices, especially more NB-minded ones, will let you come in for a meet and greet type thing so you can ask them questions and see if they are a good fit.

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  • imageiris427:

    There are two things that jump out at me in your post.  1. You say you have a strong feeling that you won't have the best chance for VBAC at that practice. I think listening to your gut can be the best thing sometimes 2. It's a big group and you don't know who you're going to get.  I think when you want a VBAC, it's important to be in a practice where you know everyone will be on board with your VBAC.  

    So I'd at least start looking.  You don't have to make any decisions right now.  Some practices, especially more NB-minded ones, will let you come in for a meet and greet type thing so you can ask them questions and see if they are a good fit.

    Yeah, the big practice worries me. I had run-ins with 2 doctors while pregnant that I knew I wouldn't want to deliver me. The OB I went to regularly was fantastic. Totally on board with NB and I feel like he would be pro-vbac. I got lucky that the dr on call when I gave birth was another one I liked. But it could have easily gone the other way.

    For me to know my vbac chances there, I feel like I'd have to meet with all 8 of them. I trust my doula a lot. She's currently in school to be a midwife and before that was a midwife apprentice so I consider her more than a doula. I think I'll probably start with her suggestions.

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  • it sounds likes your mama voice is telling you this is not the best place for you.  I also think that doulas know a lot about difference birthing places since they sort of get an inside look so I would put a lot of weight on what the doula says.  I also agree that if they are used to doing high risk births, they sort of look for things to fix.  I don't feel like pregnant women are broken so I don't want them trying to fix me.

    I don't think it would hurt anything to go talk to the old practice, but like you said, if you get unlucky and get an unsupportive OB, you are stuck.

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  • Trust your gut. I think you already know the answer. I switched to my new Ob (and yes, I consider him mine even though I'm not seeing him for this pregnancy b/c I will go back for well woman care) when it was time for my annual when DS was 7 months old. At the time, I intended on going this pregnancy with him, and if I ever have to leave my MWs I probably will.
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  • Ditto to it sounding like you know the answer to this one already.  I just switched practices last week, even though I was told that my old midwife was pro-VBAC there were still too many restrictions for my comfort (only up to 41w, CFM with no telemetry, etc.).  I actually really liked my old midwife and cried when I realized it wouldn't work, plus the hospital was a 7 min. drive from my house.  Now I'm traveling an hour to my new practice, but feel so much better about my decision.  GL!
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  • I'd check out your doula's suggestions.  They probably have the connections & lowdown on the OB's & hospitals in the area that are VBAC friendly.
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