XP: Would u switch from OB to Midwife at 31 wks?

Re: XP: Would u switch from OB to Midwife at 31 wks?

• iris427 member

  April 2011

  Hmm.  First I think that switching at 31 weeks is fine, especially if you are having doubts about your current provider.  I kept thinking about switching during my first pregnancy but never went through with it or even looked into my options thoroughly--and I ended up really regretting that.  I ignored my gut instincts that were telling me something.

  Midwives generally have lower c/s rates than OBs, even when you control for low-risk pregnancies, so I think you may have a better shot at VBAC with a midwife.  You'd have to compare this individual midwife's stats with your OB's stats though, because this is just a generalization. 

  That said, I really dislike that this midwife wants you to commit ahead of time to no epidural.  That really infringes on patient autonomy IMO.  It's one thing to be delivering at home or in a birth center where an epidural is not available; but even then, you have the option of transferring to a hospital should you decide you want one.  It strikes me as unethical of her to request this.  I also don't like that she requires you to have a doula.  I would be hesitant to sign on with any care provider who pressures me to give birth a certain way, whether they are a midwife or physician, whether they are pressuring me to have an epidural or not have one.  There are ladies on here who had great VBACs with epidurals and I don't like the idea that you would feel pressured not to have one during labor because your care provider made you give her a "commitment."  What would she do if you got one anyway?  Would she treat you badly, etc.?

  
  

  
  

  Big sister {September 2008} Sweet boy {April 2011} Fuzzy Bundle {ETA July 2014}
  

  
  

  
  

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• ryemo member

  April 2011

  I saw your post on DCUM. Are you considering switching to WISDOM and Whitney Pinger? Just asking because of the requirements you listed. If so, I am planning a VBAC with them next month and could share my experience so far.

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• mrsbookworm member

  April 2011

  Hi! Yes, I'm referring to WISDOM! Please share your experience!

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• MAprincess member

  April 2011

  I think you should switch if you are not comfortable.  That said, I don't really like that you are forced to "commit" to certain things ahead of time.  My first baby was with midwives at a free standing birth center, so I had to sign that I understood that I would not get an  epidural there because it was not in a hospital.  But if you are IN a hospital, I don't see why you have to commit to that.  I think a doula is a great thing and could only be positive.

  But do I think you should switch providers if you are uncomdfortable?  Yes.  But switch to a provider that you are comfortable with.  The midwife that delivered my VBAC baby was extremely supportive.

  

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• ryemo member

  April 2011

  Well I chose WISDOM because Whitney has probably the highest hospital VBAC rate in the area. She has some rigid ideas, but they are all in support of a successful VBAC. For example, a doula and a commitment to natural labor...your chances are much better. And she or another MW will be there helping make that happen. That said, if you can't have a natural labor I believe they will support you in whatever you need. I also think I want that hardcore commitment in my provider. They have been so kind and really understand my grief over my CS. I can't say that for many people I have met, especially not medical providers. During labor, your MW will not say CS unless it is true. I had position issues with my DD, and Whitney told me it can be 12 hours between full dilation and time to push with an issue like that. Doesn't sound fun but it means she will be patient with me in labor in a way an OB would not. That said, this babe doesn't want to get in a good position either...so we will see how it goes!

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• lorryfach

  April 2011

  Do you actually have issues with your OB, or are you just considering the switch because your OB is an OB and not a midwife? I agree that it's not too late, but I wouldn't do it without reason. There is value in having a provider with you the entire time. It's not everything, far from it, but it's one consideration.

  
  

  There's also value in a provider who supports your mindset, including on issues like doulas and epidurals. I disagree that a doula can 'only be a good thing.' If you don't want one, a doula might not be a good thing at all. It's another person in the room and if you don't want her there, if her personality and yours just don't mesh, whatever, then that's not a good thing. If you don't want to spent the last weeks of your pregnancy interviewing a doula and stressing about it, then that's a bad thing.

   

  If you have a problem with your OB, by all means, switch. But if it's just a general 'midwives are better than OBs' thing, I wouldn't. OBs can be fantastic, amazing, totally supportive providers too. 

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• ryemo member

  April 2011

  I do think wonderful OBs exist. Unfortunately, I think they are few in this area. For example, I know of an OB who does a great VBAC or breech birth, but is part of a practice where other OBs know little or disagree with VBACs. My old OB was wonderful and supportive but I was delivered by his backup, who has one of the highest CS rates in DC. So it's hard to find a practice where you're really comfortable. I forgot to mention that WISDOM has no cut off date. You go until baby is ready.

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• mrsbookworm member

  April 2011

  Thanks so much for all the feedback, ladies.  It is great to hear someone's experience with WISDOM. 

  I think my fear is that, although my current OB is very supportive of the VBAC and thinks I'm a good candidate, there is a high likelihood that he won't be on call when I deliver.  Then, I'll end up with one of his partners who I'm not sure support VBAC as much as he does; this is the same practice that gave me my first C-section which my current OB has called 'unnecessary based on [my] records'.

  I had already planned to try to go natural without an Epidural, but part of me just wants the option even if I don't take it.  My DH is also a little nervous about there being push back on the Epidural if I want it since he hates seeing me in pain. 

  In terms of the doula, I had planned to hire one early on and had already started the interviewing process, but then decided that I didn't want to shell out the $1100 that the doula I wanted was requiring.

   

   

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• drakee

  April 2011

  On the one hand, I think that choosing to go with a midwife practice and switching to a very supportive hospital made all the difference for me.  I had the odds stacked against me, and having the full support of my hospital, nursing staff, doula, and CNMs was priceless.  I switched fairly early on (around 12 weeks). 

  However, I would be very concerned about the "natural birth" commitment.  I had prepared for and planned on a natural birth, but I ended up needing to be induced for my VBAC due to low fluid.  Because of this, my labor was extremely slow (induction started Tuesday night, and DS was born Friday morning).  Eventually, on Thursday morning, there was a point where I was about to give up and I started asking for a repeat C.  It was my dear midwives that convinced me to get an Epidural.  There is no way I could have been successful without my Epi (and my boluses); the pain and duration of my back labor just became too much to handle.
  

  And by the way, doulas are fantastic.  I loved mine.
  

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