intro // OB or MW

CANDEE43 · August 2014

Hello

new to this board. FTM here. Been TTC for a year and just got our bfp. Yay! (I'm about 5wks along.)
I started thinking and I know I'm supposed to call my ob now and go in between 8-10 weeks, but my OB is not very supportive of natural birth - i know this from previous talks with her - and I want a natural birth.
I want to deliver at a natural birth friendly hospital and have the option of water birth there. My question is what now? Do i call my OB anyway and go in for now? Do i find a new OB or find a midwife and how do i find a midwife? Does the midwife have to be contracted with the hospital or does the midwife follow me to any hospital?
Sorry for all the questions, but I went back and searched and couldn't find any answers. Also, if you could refer me to a link that maybe answers these questions, that'd be helpful too.
thanks!

painttheair14 · August 2014

Congratulations on your bfp! If you plan on a hospital birth, I think you would have to use a ob or midwife who works in that hospital (right?). So, you could look at the hospital's website to see if any midwives work there.

I would personally make an appointment with a hospital sooner than later knowing that you can switch down the road.

painttheair14 · August 2014

Have you considered birth center or home birth?

JCWhitey · August 2014

Yes, as PP mentioned, you don't need to go in right away. Many caregivers won't even see you until 8 weeks and if you have a busy office you may not even be able to be seen until 12 weeks or so anyway. So I wouldn't call your OB if she's not the person you see yourself delivering with.

Take a week or two to research your options. There can be many in your area or very few depending on where you live, but knowing what's out there is a start.

For midwifes you have a couple of "varieties". There are midwifes who work exclusively with homebirths, ones who work exclusively with stand-alone birth centers (sometimes they offer home birth as well), and then midwifes who work in hospitals alongside OBs. Typically a midwife who works at a birth center or home birth is not allowed to help you deliver in a hospital, so if that is what you want you'll want to do your research on the hospitals in your area to find the most NB-friendly option.

The best place to start is to ask friends and family who have had babies in your area in the past couple of years, preferably those who had a natural birth. When I started asking around I had a ton of "I don't know who you should go with, but you should NOT go with Dr. (whatever)". It's good to know who to avoid just as much as who is good.

In my area at the time my son was born my best option was actually NOT the hospital that had midwifes. I was told they were basically under the control of the OBs and had very little power in the hospital, pretty much just doing prenatal appointments and not much else. That hospital had a very high c-section rate and a lot of regulations I wasn't comfortable with. I ended up selecting a small community hospital where you were actually treated by Family Doctors, not midwifes or OBs. I loved it and had a great experience.

jennypolkadots · August 2014

I just went though all of this myself, and it is tough figuring out the best option for you when everything is so new.

The first thing you have to do is tour all of the hospitals in your area. We have 4, but two are essentially the same. I toured 3 and asked questions like "how does your labor bed accomodate different positions?" or "do you allow birthing tubs?" or "do you have any natural birth friendly doctors or midwives who deliver here?" Usually the tour is given by a maternity ward nurse and she can answer all of your questions.

Once you choose the right facility, you only have the option of choosing a practitioner that delivers there. This is usually listed on their website or you can call and ask. Then decide between these. Independent midwives that are not listed as registered to deliver with the hospital usually work at birthing centers or in home birth settings. If you have to transfer to a hospital, or you have a complication that requires an OB, they usually have a collaborating OB to refer you to. If you go into a hospital, your midwife may assist you but likely the doctor on call will be making any ultimate decisions about your care.

We live in a state where it is illegal for midwives to deliver outside of a hospital or without the supervision of a physician in a hospital. So basically there are no midwives in our area because they have no autonomy over care. After touring hospitals, talking to doctors, and meeting a lot of different people we have decided our best option is with a midwife practice that delivers in a home birth setting 30 minutes from our house. Insurance won't cover it, so we will end up paying about $3K more than we would have for a hospital birth... plus it is due by 36 weeks... but if there is one thing I am willing to pay money for it is our child's birth. I feel better now that we have a birth plan in place and care providers I really trust. I hope you are able to figure out the best option for you!

If you go with a hospital, do yourself a favor and get a great doula. They usually cost around $500. She will come to your home and help you labor until you need to go to the hospital. You don't want to wind up at the hospital too early if you truly want a natural birth. A doula will also be a great resource for which hospitals and doctors are NB friendly, and how to go about having a water birth in one of those hospitals. Good luck!

jennypolkadots · August 2014

Also a note about water birth - as PP said, it is pretty rare to find a hospital who does water birth. Like I said we have 4 hospitals in our area and only one permits water births. But then the midwife that delivered there retired so I am not sure. The OB she practiced under would not permit water births for first time moms because you aren't sure how they will labor. I have heard of this being a pretty common policy in hospital water births.

Maybe you could start with making a consultation appointment with an experienced doula. She will likely have all sorts of valuable info about which doctors, hospitals, etc. are NB friendly. I would start there if you are overwhelmed.

MsMacual · August 2014

Congrats! I agree with everything that has been said. I would spend some time now researching your options so you can be prepared to switch to a provider who will be supportive of your desire for a drug free/low intervention birth. I have experience with two MW groups- both are clinic/hospital based and deliver at hospitals that are supportive of drug free birthing including water birth so it can be found depending on where you live, etc. For us, this was the best fit (DH isn't 100% on board with a home birth and the two free standing birthing centers in my area are pretty far from our house). I think that having a supportive care provider is a key factor in successfully delivering drug free and low intervention. There are OBs that are super supportive of natural births and you might be able to get a recommendation from another mom or two in your local LLL group or even on your local bump board.

I agre with PaintTheAir that a homebirth or using a birthing center are great options to explore, too.

CANDEE43 · August 2014

Thanks guys. All your input has been so helpful and given me a lot to think about. Unfortunately, all that has been put on hold because I started bleeding over the weekend. Went to the doc today and am doing that whole thing now. Gotta go back Wednesday for more blood work and next Monday for another ultrasound to see if baby is still there or if I've lost it.

shellybean3788 · August 2014

I went to an OB for the first three months until I had all of my prenatal testing done, and billed off to insurance.

Afterward, I left the practice and hired a midwife, and handed her the records from the testing. Technically, she could've had these tests done for me too, but my insurance wouldn't have covered diddly squat.

We are planning a water birth.

shellybean3788 · August 2014

Also, just saw your latest update. Hope all goes well. Let us know.

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