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July 2013 Moms
mslmk11
member
CNM vs OB/GYN
mslmk11
member
My husband joined me at our first doctor's appointment with a CNM. Ever since I saw some women's psychology video in college, I've leaned more towards midwives than OB's or doctors as pregnancy aides. Anyway, my husband doesn't really seem on board with someone not being "properly trained" (even though I've tried to explain to him that they are) compared to someone who went to school specifically for maternity and pregnancy, etc.
We scheduled our next appt with an actual OB (same care facility) 1)so I can be familiar with the doctors, 2)so my husband will hopefully be able to shush about the differences between the two and see there is no reason to choose the MD over the CNM.
Anyway, my question for you women is, if your husband shares the same sentiments as my husband, how are you dealing with it, convincing him that a CNM is just as qualified for the pregnancy as an OB, except that OB's are trained and medically capable of handling high risk pregnancy situations? I mean, I wouldn't have an issue with using an OB (though I'd prefer it to be a female and the next appt is with a male) I'd prefer using a CNM.
Also, what was your experience using either one, or both if you experienced both?
Also, also. The CNM I saw today said that I wouldn't be getting an u/s until 19 weeks, as there is 'no need' for one. If you used a CNM, is that the experience you've had, or is it probably just mine?
Lisa
This discussion has been closed.
Re: CNM vs OB/GYN
I have seen CNMs for all of my pregnancies (and births). CNMs are nurses with a master's degree in midwifery (essentially specialized nurse practitioners). They specialize in normal low risk births. OBs are trained in the pathology of pregnancy and birth and are surgeons by trade. If you are like 90% of women and have a normal low-risk pregnancy, there is no reason for you to see an OB over a CNM. If you are aiming for a natural or low intervention labor and birth, your best bet at achieving that is to see a midwife in the stead of an OB. CNMs have OBs who back them up so in the case that you were to become high-risk your care would be transferred to the OB.
I am not sure how to handle the husband getting on board issue, because mine is pro-midwife (I am pretty sure that he would object to an OB unless I were high-risk).
BFP #2 03/08/11 EDD 11/16/11 DD Born on 11/04/11
BFP #3 08/29/12 EDD 05/06/13 M/C on 08/30/12
BFP #4 11/01/12 EDD 07/09/2013 M/C on 12/28/12
BFP #5 04/30/13 EDD 01/03/14 DS Born on 01/02/14
BFP #6 01/11/15 EDD 09/22/15 M/C 03/09/15
It's definitely not the case with all midwives. I go to a practice that is exclusively midwives and all of the midwives there are wonderful and take the time to answer questions and address my concerns. It really stinks that the midwife you saw was so insensitive.
BFP #2 03/08/11 EDD 11/16/11 DD Born on 11/04/11
BFP #3 08/29/12 EDD 05/06/13 M/C on 08/30/12
BFP #4 11/01/12 EDD 07/09/2013 M/C on 12/28/12
BFP #5 04/30/13 EDD 01/03/14 DS Born on 01/02/14
BFP #6 01/11/15 EDD 09/22/15 M/C 03/09/15
Frankly, it's my care provider and I'd be very annoyed if DH didn't trust my judgment. I wouldn't mind him asking questions, but I'd expect him to be satisfied with my answers. He knows I am an intelligent person.
And in general CNM is better trained in normal pregnancy and birth than an OB who is specially trained to handle high risk pregnancy and birth as well as surgical birth.
Thanks for differentiating them for me LittleMomma, that was what I had read and found out too. And I do anticipate just a low risk pregnancy, but the practice I'm going to also partners with doctors, so I know if I needed one, it'd be easy access to them.
It's weird that my husband is so adamant about at least visiting with an OB is that my husband doesn't really care for doctors. The few instances he's ever had to rely on them (he NEVER gets sick - so jealous!) he has not had good experiences because they don't take into account what he has to say about his body, or his experiences, etc, they just do their doctor thing right over him. And that bothers him. Which I can understand. But it's like..he doesn't like them, but is so set on me wanting to use one. Just frustrating and stressful because I want him to be comfortable with the pregnancy aide, but at the same time, I know it's about my comfort as I'm the one going through everything.
So funny you say that because he had said that exact statement about "trusting my judgement" and yet...he doesn't. Just frustrating.
Well, he has to give you specific reasons for his concerns so that you can address them. I find that reasonable. If you address them and then he still doesn't like it, then he's just going to have to deal.
This provider is going to be touching your body and YOU have to be the most comfortable.
And he doesn't have any issue or concerns with the fact that he's demanding that you be "handled" by another man? If I chose a male doctor/cnm I don't think my husband would mind, but if I don't want a male, and he's saying I'd have to just because they're the only OB, well I don't know what I'd say to that.
I had a drug.free birth with DD and funny enough the help of our hospital nurse was the most supportive thank goodness. We knew that a more specially trained higher degreed nurse would be a perfect provider for us as long as I remain very low risk.
We like the casual atmosphere of our midwife practice and the fact that they deliver at one of the best hospitals in our city. I can't wait to try for a water birth this time!!
NEW PEANUT DUE 7.2017
I'm seeing a practice of midwife nurse practitioners, and my husband is definitely more of the "go to the person with more education, always" bent. I got him on board by:
1. Making him read "Pushed,"
2. Explaining the difference between lay midwives and CNMs/Nurse Practitioners, and
3. Explaining that OB's "extra" training is designed to help in surgical settings - and if it were the case that we needed surgery, we'd be in a hospital, and therefore transferred to one.
Before doing the above, I also, frankly, got frustrated, and said something along the lines of, "Gee, it sounds like you WANT me to have trouble. What gives, dude?" and then had a lovely argument about it, but I don't recommend that route.
It's unfortunate that YH is not completely supportive of your preference for a CNM. Maybe I'm biased (my ultimate career goal is to be a CNM), but I think that nurse-midwives are extraordinarily caring, competent providers. The nurse-midwifery program is a focused, intensive program designed to train CNMs in how to deal with all types of low-risk pregnancy and delivery. Most people don't know this, but in order to earn a master's degree in nurse-midwifery, the CNM must complete a minimum amount of clinical hours. These clinicals cover scheduled well-women care, postmenopausal care, prenatal care, normal labor and delivery, and high-risk labor and delivery (including assisting an OB or DO with scheduled and emergent c-sections). Of course, nurse-midwives, like doctors, never stop learning. They are required to read and research in order to keep abreast of current standards of care, and they gain experience and expertise daily once in practice. In circumstances where something unexpected happens, CNMs practice alongside of OB's and DO's, whom they can collaborate with to ensure mom's and baby's safety. My last CNM was pursuing her doctorate when I was seeing her and had been in practice for many years. I absoultely trusted her implicitly.
Philosophically, I tend to align with a more traditional nurse-midwive's approach to patient care. That said, I am open to seeing either a doctor or midwife. This is my fourth baby and my fourth provider.
For my oldest, I was seen by an OB. She was amazing doctor, nurturing and competent. She supported my decision to deliver without pain medications. Later, her nurse told me that her view on pain management during labor was, "You wouldn't have a tooth extracted without pain management, why would you have a baby without it?" I never would have guessed that was her philosophy. She just asked me about my birth plan and supported my decision. Sadly, she relocated out of state shortly after I delivered.
My second provider was another OB within the same practice. She and I didn't really mesh the way my previous OB and I had. She was a very competent, intelligent clinician, and I would still trust her with my and my kids' lives anyday, but she didn't give me the "warm fuzzies." I think it was just a personality difference.
For my next baby, I finally got a CNM. She felt like a long-lost aunt. Personality and philosophy-wise, we were very like-minded, and I felt completely comfortable around her. I wish that I could see her for this pregnancy, but unfortunately my last delivery ended in a c-section, so I have to see an doctor this time around.
I have yet to meet my new doctor. She is a DO and I've heard wonderful things about her, and that she is very "nurse-like" in her approach to patient care.
I know this was a long narrative, but my point is that, OB, DO, or CNM, I don't think it's about the title of your provider, but rather how similar your personalities and philosophies are. You want someone who you are comfortable with. If YH is really firm on you seeing an OB, meet with all the OB's in the practice, see how each one feels, then make your decision. It's all about finding a good fit for your family, no matter what the title.
Both my deliveries and all of my pre and post natal care as well as my routine GYN care has been with CNMs. I adore them and their laid back, low key approach. They have answered all my questions with plenty of time and have often provided me with alternative/holistic options for managing symptoms. They are excellent bedside clinicians and many will go the extra mile to help you manage your comfort and prevent you from tearing etc. I had epidurals both times and they were fully supportive of that and actually encouraged me to keep my mind open when I was inititally dead set against meds.
As for the ultrasound, it is standard to only have one at 20 weeks. If it is necessary CNMs will order more just as an OB would. With my DD1, I had one for dating due to irregular periods, and 2 20 week scans because she would not cooperate position wise and they couldn't get the right measurements. For DD2, it was 1 @ 20 weeks and that is it.
My advice is to see the provider you feel most comfortable with. If you are low risk, they a CNM and an OB will provide you with the same level of care and are equally competent to do so. If complications develop, the CNM will refer you to an OB to manage it. Go with your gut.
DD1 7/10/08 DD2 8/11/10 DS 7/2/13
I used CNMs for my last pregnancy and will use them again this time. The practice that I use has both CNMs and OBs, so if something were to happen at the hospital, one of the OBs from the practice would handle it. I liked the idea that someone I was familiar with would be doing surgery if needed (it wasn't).
My CNMs were great. There were four CNMs and I had appointments with each throughout my pregnancy so that when I delivered, I would know whoever was on call. They were super easy going and even had me wait for 2 hours after I was fully dilated to let the contractions move the baby down further. It saved me a ton of work. I would highly recommend using a good CNM.
As for your husband, I would tell mine where to stick it. Dealing with pregnancy, I will ask his opinion, but ultimately, I'm the one who has to go through it, so I make the final choice. Luckily DH is really good about that. You really do need to make the choice that you are most comfortable with since you are having the baby.
9 IUIs = 9 BFNs
IVF October 2012: 22 eggs retrieved, 17 fertilized, 5 frozen
ET #1: 1 blast = BFP; Blighted ovum discovered at 7w5d; D&E
FET #1: 1 blast = BFP; Missed m/c discovered at 9w5d; D&E
Karyotyping: normal ~ RPL Testing: normal ~ Hysteroscopy: normal
FET #2: 1 blast transferred 10/25; BFP 10/31!
EDD 7/13/14 ~ Induced at 37w4d due to pre-eclampsia ~ Born on 6/28/14
*Everyone welcome*
Thanks for the tip to avoid that argument! but the rest does sound like a good way. I've already talked to him a bit more about 3, but I could probably expand more on 2 for him. That does help though, thanks.