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Natural Birth
PineApple85
member
Reviewed Birth Plan w/ OB ... didn't go great (a little long)
PineApple85
member
So I went over my birth plan with my OB yesterday and it didn't go great. I wouldn't say it was a total loss; honestly on the technicalities it was about as good as I was hoping from an OB. She's fine letting me go 41 weeks and then 42 is her max with close monitoring after 41 weeks; she's fine with med-free and I didn't get any "don't be a hero" comments or anything like that. Really the only areas of concern I had are fetal monitoring: I would like intermittent monitoring (unless there is a medical reason for constant monitoring, of course) but she wants constant monitoring. It isn't really too awful because the hospital I'll be delivering at has wireless, waterproof monitors so I wouldn't be limited on mobility and I can still labor in the tub but ultimately my biggest reason to avoid constant monitoring was to avoid the ultrasound on the baby.
Really, the only part that left me with a bit of a sour taste in my mouth was her tone when we were asking questions. My BF wanted to know more specifically why I can't go past 42 weeks and had some various other "technical" questions and we got a lot of "well because" in a rather combative and defensive tone.
Honestly, and I know it's not a science, but with my family and personal history I don't forsee that I will likely have many or any complications or even that I will go far past my due date so I don't think these discrepencies will necessarily come up but my BFs concern is well, what if it does and then we've got to deal with it then.
What are y'all's opinions? Do you think it's worth the trouble of trying to switch to a midwife at this point? I'm assuming that my prenatal appointments to date would be rebilled as OVs and I would "lose" that money there (I have an HSA policy with a relatively high deductible)? What were the experiences of other moms that switched providers this late (I'm 27 weeks on Thursday)? Thanks!
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Re: Reviewed Birth Plan w/ OB ... didn't go great (a little long)
I think you can at least go and interview some MW's in your area to see if it might be a better fit for you. Some MW practices won't take you after a certain point or don't have any openings so you may have to call around to find one that's available.
If you're uncomfortable staying with your current OB, then it's worth it to switch, no matter how far along you are (my neighbor fired her OB when she was in labor).
I just switched at 28 wks and it was the bast descision ever. My DH even commented that since we switched and I've had a couple appts now, that he has seen my stress level go down dramatically.
The CNM's we found are in-network for our insurance, so changing providers didn't screw anything up with billing or insurance.
GL with whatever you decide!
By all means switch if you'd like!
FWIW, I had a midwife who worked for a Dr that insisted on constant fetal monitoring (but without all those bells and whistles) and she nearly got fired over my birth experience. She knew I didn't want to be tied down to the bed and he wouldn't have it any other way. She told me at my 6 week PP check up that I should have refused and gotten out of bed anyway. It would have meant that after delivery, I would be banned from that clinic, but it would have gotten a better labor experience for me. You can say no to nearly anything they tell you they "need" to do.
I agree with this. Go talk to some MWs and see what you think about them.
And like a PP said, you can refuse any procedure. They might give you a hard time, or ask you to sign an AMA, but you have the right to refuse. Good luck!
DS2 - Oct 2010 (my VBAC baby!)
I dunno, she doesn't sound that bad... she's probably not used to being questioned on this stuff. And the answer to many questions is "well, because." Like I know my old (very natural birth friendly) hospital had a policy of inducing at 42 weeks. Why? Well, because.
That said, if you're not comfortable with her, I'd encourage you to switch.
I switched at 36 weeks with DS. I was never billed for my prenatal visits with my old provider. From talking with a friend who used them all the way through, what they do is bill one BIG charge after delivery, which covers all the prenatal visits. I guess since I never delivered with them, they "forgot" to bill me.
On the other side, my new provider gave me a discount because I had had so much of my prenatal care with my previous provider. I also found that it wasn't a hassle at all, because my new provider was totally on the same page with me when it came to, well, everything. So there wasn't a lot of "well, this is what I want" "well, this is how I do things" type negotiations -- how she did things WAS what I wanted.
At a minimum, I would chat with some other providers. If you decide your current OB is your best option, great -- you'll probably feel more comfortable sticking with her knowing that. If you find someone who is a better fit, you can ask about the money/insurance stuf. If it doesn't work out, at least you'll know you explored your options, and you won't wonder "what if."
Mommy to DD1 (June 2007), DS (January 2010), DD2 (July 2012), and The Next One (EDD 3/31/2015)
If your main issues are continuous fetal monitoring and your provider not wanting you to go past 42 weeks, I'd honestly not bother switching. Many providers insist on inductions after 41 weeks (even those on the progressive end of the spectrum), so you are actually quite fortunate. It's extremely unlikely you would go past 42 weeks anyway.
Regarding CFM...I had it during my L&D (full disclosure - I arrived to the hospital 90 minutes before DD was born, so it wasn't for very long) and it was really not a big deal. I think it would have been more annoying to have someone touching me to do intermittent monitoring.
That said, if you're truly uncomfortable with your provider, definitely switch. Or, does your OB work in a practice with other OBs or MWs (the practice I went to had both and you could pick who you wanted to see)? If that's the case, book your next appointment with another clinician in the same practice to see if that is a better fit. That way you would likely avoid the insurance issues.
No, sorry for the confusion. I totally expected to hear 42 weeks so I don't have an issue with that at all, and like you said, the odds of me going past 42 weeks are slim. CFM was really the only discrepency between what I want and what she wants. And honestly if she had openly answered our questions without giving the impression that she didn't want to, CFM wouldn't be deal breaker, either.
It really was just her tone when we asked for more information. Neither my BF nor I are passive about any part of the pregnancy and we're very inquisitive. We were merely asking "why" she pushes for CFM instead of intermittent? What is her medical reasoning? Or what is the difference between 42 weeks and 43, why is "42" the magic number (honestly that's my BF's question, not mine
)? Most of our questions were just good old fashioned curiousity and wanting to understand the process, not necessarily doubting her judgement and it really felt like she just didn't want to answer - "just because".
And to everyone, thank you for your feedback and input. There is a local midwife that has been highly recommended so I am going to try and get in touch with her and then make a decision about possibly switching after I speak with her.
I really am torn, because there isn't a hard and tangible "disagreement" here. Just a concern that if I feel like this now just talking about the birth plan. What's going to happen during labor when she wants to push for one decision and we want another? When we ask questions "in the moment" is she going to be this unwilling to offer a full explanation so we can make an informed decision with the added benefit of her professional opinion?
My OB sounds similar to yours. Mine was surprisingly fine with a number of things, but CFM was one she was adamant about. She claimed that it's because "it's the only way [she] can know what's going on in there" (which I found lame... but she is a newer OB, and probably less confident without it). She doesn't like intermittent monitoring because "something could be going wrong during the 40 minutes you're not being monitored". Fortunately, my hospital also has the wireless monitors, and if that's what it comes down to, I'll use it.
However, I'm planning to have another discussion with her about it. The ACOG actually does not recommend CFM for low-risk situations. I may try bringing that up to her, and see if she might be willing to negotiate for intermittent monitoring as long as there are no signs of complications/I don't become high risk in the next few months, in line with the ACOG's recommendations.
But, in any case, I plan to labor at home for as long as possible. Hopefully, by the time I get to the hospital I'll be close enough to actually delivering that the CFM, if that's what ends up happening, won't be for very long.
Mama's Clone - 07/18/12
My OB sounds a lot like yours, we switched because I felt personally that yes maybe she would be ok with certain things but in the heat of the moment her mind may change and she would want things done differently and honestly I didn't trust the practice. You have to trust who you have.. switching to mw's was such a great choice for me.
Most of the questions I asked her were "well...generally we try ....." and I just don't trust that. I want a straight answer. not a half hearted answer of maybe we can do that. I felt so anxious and nervous for my delivery after having a talk with her. Also I felt that maybe she would be alright, but 80% of your labor the nurses are the ones I would be getting "support from" ..the nurses are not used to that kind of delivery so they won't be the support system I would need either.
My friend goes to the same practice and loves it. She is primarily seeing a different ob though.
Go with your gut/heart you know what will be best and if you are having anxiety about it now you don't want to have to deal with it during labor!