Lukewarm response on going natural from my OB — The Bump
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Lukewarm response on going natural from my OB

Hello,

I mostly lurk on here, but I am 29 weeks and hoping for a natural birth.  When I asked my OB yesterday about inductions she said they will induce if I go past 41 weeks.  When I asked if I could push that out if I wanted, she said it depends on if everything is okay with the baby.  I took that to mean that I could probably delay it with an ultrasound or NST.  She seemed lukewarm on my hopes to go natural, but indicated that the hospital is very good with natural births.  I asked if I could go without an IV and she said yes, unless I have group B strep.  She went on to assure me that I can change my mind and have anesthesia anytime until it gets to be "too late" which she defined as time to push.  

 

Anyway, the OB group I go to has a midwife on staff, and my hubby thinks we should look into transferring care to the midwife due to the lukewarm reception to my birth plan from the OB.  I'm not too keen on transferring care this late in the pregnancy, and I've actually been seeing this doctor for about six years so I'm nervous about switching.  I am not planning to have a doula, and I have heard good things about the hospital in general.  My questions are:

 1. What do you think of her response?

2. Would you consider trying to switch?  


Re: Lukewarm response on going natural from my OB

  • 1. I'd say her response is typical of a doctor that doesn't see many natural births and won't go out of her way to encourage you to have one. She may not push the drugs, but she won't understand why you don't want them.

    2. 29 weeks is early and I would have no problem switching. I'd interview the midwife first, though, and make sure you like her more.

    And I'd get a doula, if you can. Seriously. It's the best thing you can do for a positive birthing experience.

  • Switch.  Having a supportive care provider is #1 on my lists of things you need for a successful natural birth.  So many people settle because they are afraid to switch and then regret it after they have a bad birth experience.  

    Do everything you can now to set yourself up for a good birth experience.   

    GL  


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  • imagepinksweetpea2:

    Switch.  Having a supportive care provider is #1 on my lists of things you need for a successful natural birth.  So many people settle because they are afraid to switch and then regret it after they have a bad birth experience.  

    This! Just because she's a good GYN doesn't mean she's what you're looking for in OB care. Can you at least interview the MW and go from there? It's definitely worth a talk, especially if you're having second thoughts. You don't want to have to battle your OB for more time if you go past 41 weeks. 

    DS1 - Feb 2008

    DS2 - Oct 2010 (my VBAC baby!)

  • if the mw is a CNM then she has to practice under the supervision of a dr and probably has the same ideals/protocols.  i could be wrong about that, so you might ask to find out for sure. 
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  • kxp004kxp004 member
    I second (a million times over) PP suggestion about hiring a doula (aka life savers)
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  • I'd switch to the midwife, or at least meet with her. My first OB had all her kids with no epi  and was still a damn pit pusher and absolutely didn't support my desire- she tolerated it somewhat. I was scared to switch doctors with my next pregnancy until I was over 20w, and I expressed my concern about how much pitocin I had the first time- she said, "you're lucky I didn't section you". Beeotch was replaced.It's not too late to get a new provider, and if it means having a positive birth experience and knowing that if any interventions occur they are absoultely necessary, it's totally worth it. Good luck!

  • I'd meet with the midwife first before switching & make sure you like her. I switched from an OB at a hospital to a MW in a birthing center inside a hospital at 28 weeks and was happy with my decision. I was supposed to alternate my care between 2 MWs in the practice and ended up loving one and hating the other. Luckily I was able to see the one I liked for most appointments and she came for my delivery, but if I'd been stuck with the other MW I would've probably been missing my OB.

    I did have a doula and would recommend it if there's any way you can get one. I did most of my labor at home (arrived at the BC 2 1/2 hours before DD was born) and it was great having my doula there to keep me focused on having a natural birth. Hiring her was probably the best money I spent through my pregnancy. 

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  • I had an induction at 37weeks due to pre-e, but the rest of my labor was as natural as possible....no meds or epidural.  I did have an IV b/c of group-b strep.  My doctor is all about the epidural, even questioning me as I was pushing.  However, she only showed up to check on me in the am when she started the induction and came back to deliver that night.  The nurses and other staff (residents and others docs) are the ones you have to worry about.  My first nurse said she was so happy that I was trying to keep it as natural as possible, but at the end of her shift she was telling me I NEEDED an epidural.  I labored quietly, calmy, and asked others for very little.....she had no reason to push an epidural.  My mother stepped in and handled her pushy suggestions.  So, my point.....other than the induction factor, your doctor probably won't have much to do with the rest of your labor.  Like pp stated, get a doula, or someone who is very familiar with natural births and keep your OB.....IMO. 
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  • I have a midwife and would never use an OB in delivery. She is fully supportive of my desire to not only delivery naturally but at home as well. I'm really lucky that she is so supportive of any decision I make.
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  • 1.  I'd say her response is pretty typical of most OB's in America.  They don't see many people go natural, some have never seen a natural birth.  They don't understand why people want to go natural. 

    2.  Absolutely I'd find a different provider.  Who cares that you've been seeing her for 6 years?  She's no longer meeting your needs.  You are the consumer here, you should get a provider who is on the same page as you.  That all said as I understand it lots of times midwives who work in offices with doctors tend to act more like doctors than midwives so you might want to consider finding a completely different practice.

    My doctor told me that I could skip the IV and just get a heplock and that I didn't have to push on my back with knees to my chest.  The hospital birth class said the same thing.  All lies.  They forced the IV in me and told me the only way my doctor would deliver my baby was if I was on my back.  I was furious when I walked out of the hospital because I had spoken at length with my doctor about what I wanted and was assured that would be fine.  I went back for my 6 week PP visit and for a pap at 6 months PP where I again spoke to her about the birth experience that I had had and whether there was any chance it could be different the next time.  And I fired her because I could see there was no chance.  She didn't understand why you would want to skip the epidural and why you would want freedom of motion and why you might not want to push on your back (my third degree tear sealed that one for me).  So she just didn't get it.  What she understood was an epidural birth, a C-section, an induction.  That's not what I wanted.  I found a great birth center where they actually listened and cared and didn't lie to me.  And I cut off ties with my OB who I'd been seeing for years.  Guess what?  I doubt she even noticed that I wasn't a patient anymore you know?  I was just a number to her.  To the midwives I'm a person to them.  They actually care about having not only a healthy baby at the end, but a healthy mother.  OB's only seem to care about a healthy baby as the end result, and a healthy enough mother even if she is cut open and gets a little infection and all that.  She's healthy enough. 

    Mama to Lucy (7/06), Lexi (5/09), and Max (11/11) M/C 12/17/10
  • I am probably in the minority, but I would not switch based on the conversation you had.  I was in labor for 10 hours and my doctor was only there for about an hour of it, she checked on me a few times during the day and was there while I pushed (for 20 minutes) and put me back together.  It was the amazing nurses at the hospital that really got me through the day and if you have a pro natural birth hospital that is a plus. I am not having a doula either, but I feel very confident that I will be able to advocate for myself, but if you feel nervous to respectfully decline any intervention you feel is unnecessary, a doula is awesome.  I would make sure to find out what is hospital policy too so you are not "fighting" something you have no control over. Today I made sure to find out that a hep trap is ok, so no mandatory IV, but I did find out that intermittent monitoring is not ok, (unless the baby is "perfect") but they have telemetry units available.

    I agree with others, her response it typical of an OB.  You have to remember though, clinically, that's what she sees, mostly medically managed births.  I read the stats for my hospital, the rate of epidurals is 85%. 

    Good luck! 

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  • 1. I think that response is pretty typical.

    2. I switched practices at 29 weeks.  No reason not to.

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  • romiguromigu member
    imageMrs.Greeko:

    1.  I'd say her response is pretty typical of most OB's in America.  They don't see many people go natural, some have never seen a natural birth.  They don't understand why people want to go natural. 

    2.  Absolutely I'd find a different provider.  Who cares that you've been seeing her for 6 years?  She's no longer meeting your needs.  You are the consumer here, you should get a provider who is on the same page as you.  That all said as I understand it lots of times midwives who work in offices with doctors tend to act more like doctors than midwives so you might want to consider finding a completely different practice.

    My doctor told me that I could skip the IV and just get a heplock and that I didn't have to push on my back with knees to my chest.  The hospital birth class said the same thing.  All lies.  They forced the IV in me and told me the only way my doctor would deliver my baby was if I was on my back.  I was furious when I walked out of the hospital because I had spoken at length with my doctor about what I wanted and was assured that would be fine.  I went back for my 6 week PP visit and for a pap at 6 months PP where I again spoke to her about the birth experience that I had had and whether there was any chance it could be different the next time.  And I fired her because I could see there was no chance.  She didn't understand why you would want to skip the epidural and why you would want freedom of motion and why you might not want to push on your back (my third degree tear sealed that one for me).  So she just didn't get it.  What she understood was an epidural birth, a C-section, an induction.  That's not what I wanted.  I found a great birth center where they actually listened and cared and didn't lie to me.  And I cut off ties with my OB who I'd been seeing for years.  Guess what?  I doubt she even noticed that I wasn't a patient anymore you know?  I was just a number to her.  To the midwives I'm a person to them.  They actually care about having not only a healthy baby at the end, but a healthy mother.  OB's only seem to care about a healthy baby as the end result, and a healthy enough mother even if she is cut open and gets a little infection and all that.  She's healthy enough. 

    wow...are you kidding?  could you possibly make any more broad generalizations?  Do you have any idea how many patients an Ob delivers just during residency?  About 1200.   That's just during the 4 years of training.  Do you really think that its possible not to have seen a natural birth with natural childbirth being as prevalent as it is now? 

    It sounds like you had a negative child birth experience but don't sit there and impose your stereotypes on everyone else before they've had a chance to form their own opinions.  Doctors are not the enemy...

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  • I think you need to keep in mind that some women change their mind when the pain gets to intense and she was probably just trying to tell you that you will still have options up until the last minute and there is no failure in getting some help if you need it. Some people find that comforting.

    If you like the care she's been providing and you trust her with your health, I wouldn't switch. Simply mentioning that you will need IV antibiotics if you're GBS+ and that pain management is available to you at any time, doesn't necessary mean she won't be supportive of your natural birth. And the 41 week induction caveat is standard medical liability talk. Mine said "at 41 weeks we'll assess where we're at and determine whether we should induce or wait a few more days", he also gave me a list of doulas and said "great!" when I told him I'd prefer to have a natural birth.

    BFP #1 05/11/10 Natural m/c 05/17/10 BFP #2 12/07/10 Natural m/c 12/12/10 BFP #3 01/21/11 Taking Prometrium, Baby Aspirin, and two injections of heparin a day Lightning Bug was born a healthy and happy 7lbs 14oz on 9/20/211
  • I'm pretty sure almost every OB in the country has delivered a natural birth baby. There is a birth story every other day about a woman who went natural when she had no plans to do so.

    OP- The only concern I would have would be with your doctor inducing or pushing ptiocin on you. Most doctors don't tell their patients to get pain medications. They don't really benefit from you getting pain meds. Since your husband wants to try to switch to the midwife, maybe meet with her and see if you like her. I would also hire a doula who can really encourage you to go natural and will help in "fighting off" any nurses who suggest an epidural or pain medication. A doula will also help with your birth plan and making sure people stick to it. Good luck!!!!
  • I'd say her response sounds pretty balanced to me...but if the overall vibe and gut feeling you have with this care provider isn't good, consider switching for that reason alone.

    I found the nurses had much more to do with me getting my natural birth without epi and getting through transition. The doc just comes in at the end when you are in/near the pushing phase (when it actually feels kind of good). No doula for me...

    You could at least meet with the MW.
    We met with one of the other docs at our family practice...really liked him...and were secretly gleeful when he ended up being the one to deliver us instead of my reg. doc (who was great...but newer). 

     

     

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