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Dealing with the "who will be on call" question
I talked with my OB about my interest in a med-/intervention-free birth this morning. I was satisfied and comfortable with his responses; he was very encouraging and I didn't come up against a single thing where he seemed like he'd be rigid or whatever. I was glad about this, because I really like this provider and I don't really want to have to switch. But still there were two things that worry me:
* He might not be the one on call when I go into labor. There are basically five providers in the practice--4 OBs and 1 midwife--and it could be any of them. I haven't really been organizing my care such that I get to know all of these people during my pregnancy, and honestly I don't really want to, because, really, what's the point? Even if I develop a preference, I still won't be able to control who I get. Plus, I already really like my OB and feel we have a good relationship, and I like the consistency of care. (With my last pregnancy I met with each doctor in the practice [a different, high-risk practice], and it was a bummer during the pregnancy plus also when it came time to deliver I got who I got anyway...)
* Water birth is unlikely, even though the hospital I'll deliver at does offer water birthing facilities. My OB is in the middle of completing the necessary certification to assist a water birth, but he's the only one of the 5 in the practice who will even potentially be certified.
I guess what I'm wondering is whether there are any positive stories from people who planned for a med-free experience but didn't know who would be there to deliver? Or if you think that I should be wary of this situation, please tell me. My thought is that if I do stick with this provider, this hospital, I definitely want and need a doula--and I'm ready to start working on that. But would you worry even then? My other option is a birth center, and though I like that option, like I said, I'd really rather not start over with a new provider relationship...
Sorry for the rambling post!
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Re: Dealing with the "who will be on call" question
I'd look into what is standard at the hospital. What kind of monitoring, do they allow you to drink / eat in labour, do women deliver in non-traditional positions, etc. Find out what the hospital culture is so you know what you're up against. A doula will help you know what is normal and what is a special request, and your OB can help with that too obviously.
I'd also plan to labour at home for as long as is practical.
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Agreed!
Even if you get the OB you like there is still the question of who your L & D nurse will be and you will see him/her most of the time. So if you are in a hospital that is natural birth friendly and the staff is familiar with med-free births then it shouldn't be much of a problem.
Could you ask your OB about the other docs in the practice? That might shed some light on things. I wouldn't expect him to bad mouth his colleagues, but he might say something in a round about way, to give you a general idea of what to expect from everyone else.
I did ask him about this and he said I can expect to have no problem with any of the providers from the practice, but also acknowledged the nurse issue. He said that it's a little bit of a crapshoot with the L&D nurses, and some will be friendlier than others. I actually delivered my twins at this hospital and had a great experience with the L&D nurses--but my priorities were completely different then. At that birth I basically had every intervention in the book aside from a c-section, and I left the experience delighted, because my only real priority/hope was to avoid a c-section...
Because I delivered there before I know that they will totally let me eat, they just won't feed me. I'm not sure about the labor positions because last time I just didn't ask; I have a tour scheduled soon, though, so I'll ask then.
That is how it works at the hospital that I go to. It is a team of midwives that I work with. With DS, I tried to meet a few of the midwives, but when I went into labor a midwife that I hadnt met was on call. She was absolutely wonderful.
I have the same fears this time around with not knowing who the midwife will be for sure. I plan to do what I did last time- stay home as long as possible! I arrived at the hospital with DS in the middle of transition and he was born 2.5 hours later- it was perfect. I am hoping to do the same this time around.
The hospital that I had DD (and actually also the hospital where I will have DD2) at was this same way, but I didn't have the option of bouncing around between Drs for my pre-natal care. I had to stick with one. With DD, my OB was in a rotation with like 7 other Dr's. I was a little nervous about this prior to DD's birth, but I didn't really have any other options. If I went to the other hospital it would have been the same way. Insurance didn't cover home births or a birth center. I felt a little stuck, so I hired a doula and she really was wonderful.
Come the day that DD was born, my Ob was actually on rotation. She basically came in and just caught DD and left. I had a really good nurse though who basically left me alone to do my thing when she learned that I wanted a natural birth.
Like previously mentioned, do another tour and ask lots of questions. For example, ask about intermittent monitoring, if that's something you are considering. Ask if they have a squat bar or birthing balls. Their answers to these types of question will give you a better feeling as to how natural birth friendly the hospital staff is.
I had never met the OB who delivered dd until about an hour before she was born. It wasn't a problem. She came in to verify that I was at 10, and then helped me push. I remember her name, but that's about it. It was not a big deal at all.
IVF #1 ET 1 d3 embryo 10/30/11 BFP
3 Embryos frozen (1 d5, 2 d6)
DS born 07/29/12
FET #1 ET 1 d5 embryo 02/10/15 BFN
FET #2 1 d6 embryo didn't survive thaw, transferred last d6. CP
I was in a similar situation. I went to a large practice with 8 OBs. During your visits you see 1-2 of the OBs but they rotate who is on-call at the hospital. So when you go into labor you get the OB who happens to be on-call that day. For me it worked out great! I went into labor, got to the hospital at 6 cm, and my water broke in triage. The OB who was on call came in and introduced himself, as I had never met him before. My regular OB had made a note in my file it said I wanted a natural birth with no intervention, so he told me that he would try his absolute best to do that for me. He was the best OB I could have asked for!! I labored in the tub and started to push for a few contractions before I transitioned to the bed (my hospital does not allow water births). He let me deliver in the position I wanted, massaged my perineum while I pushed since my LO had a nuchal hand. He was better than my regular OB!!
The big thing I did was ask about how the practice as a whole felt about natural births. That will give you a good gauge of how the majority of the OBs feel. Also ask other people you have used the practice. I new several couples who used my practice who had natural births! So the OBs in that practice were very supportive as long as I was low- risk!
GL!!
I delivered at a major hospital with 11 OBs, I'd met 3 of them during the course of my pregnancy (my OB and then 2 appointments I had with other drs when she was on vacation). I only know who delivered LO because it's on the medical record. It turned out to be one of the other 2 OBs I'd met, but that was really just luck of the draw. I remember being told that it was ok to push and then realizing that we'd gone from the L&D nurse, my husband and doula to suddenly 7 or 8 people in the room. I don't think the OB id'ed herself, but I'm a little fuzzy on the details (I was only in the hospital 2 hours before I delivered).
When I toured my hospital, I asked a lot of questions of the L&D team to see if my goal of an intervention free birth and it turned out that standard hospital policies were actually very supportive, so I wasn't too worried that my OB wasn't likely to be in the delivery room. I had a very basic birth plan outlining my wishes for as intervention free birth as possible. The L&D nurses were great and I'm also really glad I had a doula as well.
I had an ER doc attend my second delivery. Nice enough guy. I remember him sitting on the edge of the bed while I pushed. He was nice. The on-call doc arrived after babe was born. He was nice nice and chatty while he stitched me up, toured the placenta with me and made a most excellent suggestion for an anti-inflammatory.
I missed my GP who delivered my first baby. A mom of 4 herself she gave me a great measure of calm and pragmatic. But the ER dude and the on-call dude were very good as well.
My point is: there just aren't any guarantees when it comes to this. The first of many things that you just cannot plan with certainty.
Try not to worry too much.