July 2016 Moms

Midwife vs Doctor

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Re: Midwife vs Doctor

  • benten24 said:
    Doctors don't do things just to be dicks, they do things and push for things because it is safest for the mother and baby.
    I don't think anyone is saying this. I'm simply asking what the deciding factors were for each woman when making a choice of practitioners. I hear all of these good things about midwives, but feel safest with a doctor at this point. So, I'm curious where everyone's head is.
    I think the tone of this thread is that doctors push people into medical interventions that they don't want. And I don't think that is true. The goal of a doctor is to do no harm and deliver baby as safe as possible. Sorry I get a little defensive on this topic, I will tone it down :)
    I understand where you're coming from, and imagine it hits close to home with DH being a doc. I totally agree that docs tend to get a bad/pushy rep when it comes to L&D, which is why I'm curious about the reasons for everyone's decision. Personally, I want a natural labor and would LOVE to have that with a doctor while in the hospital. I'm petrified of being urged into an induction/epidural/caesarean if I'm not ready for those interventions. I understand that I can say "no", but since I've never done this before I'm not sure how my mental alertness and ability to stand my ground will be during labor. And my DH is basically content knowing nothing, and questioning nada about the whole pregnancy/L&D process. Basically, I'm scared.
    @benten24 just to reassure you - I agree with @Taymiller from experience that doctors get a bad rap in regards to medical interventions, and it's not really a fair stereotype for the majority of doctors.

    My experience with DD, I ended up wanting/needing all medical interventions. An induction, all meds available, epidural, and ultimately a c-section. I saw a variety of doctors in the practice and a variety of doctors and nurses through the 2 days of labour, as shifts changed, and not one of them ever pushed an intervention on me. They mentioned options, and then dropped it until I brought it up again. Even my induction was pushed as far as possible until I was almost 2 weeks overdue and they were concerned about DD's size (rightly so - she got stuck). My c-section was mentioned as a possibility when my stalled labour finally progressed but I still wasn't able to move DD hardly at all with each push, and her heart rate started to fluctuate more than they were comfortable with. Even then they told me it was up to me if I wanted to go now or wait and keep trying. They discussed the pros and cons and I truly felt it was 100% my choice. My current doctor is also really awesome with giving me information and letting me make my own decision - to the point where she's decline to give me her personal opinion when asked because she said she didn't want to sway me, and either decision was safe and valid. 

    Not trying to change anyone's opinion, like I said in my previous post I think the individual medical provider's demeanor and bedside manor is more important than whether they are a doctor or a midwife (midwives can be judgmental and push their views, too). Just want to reassure those that are nervous about a doctor because they don't want medical interventions pushed on them that in my experience with quite a few doctors and nurses and two separate practices it has never happened to me during pregnancy/labour/delivery/post-partum period.
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  • This is a legitamate post no snark I state that because I think this could be taken as snark but I'm so exhausted and my body so sore and hurting from MS that I don't want to make a birth plan I have no care who delivers the baby at this point I just want an epidural and to get the kid out as healthy and safe as possible is that wrong. Should I be having more opinions? I keep hearing about birth plans and the midwife dr debate and I didn't know any midwives so went to the dr my friend and her dad a top dr reccomended. She had her little guy a month early and they did amazing care and he is functioning and developing right on target. I guess I am feeling so disconnected right now and not sure if that that is wrong or normal. Also this is my first.

    There is nothing wrong with not having a major birth plan. I didn't take any classes and went in there with the plan "heathy mom, pain management, healthy baby." I knew what the medical terms meant, and decided to call the shots as I went. I didn't feel unprepared.

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  • Do doulas help, in terms of keeping drs from "pushing" drugs on you? For instance, I do NOT want pitocin. I don't want any bit of it. Give me a c/s if this baby won't come out, but I've just personally seen too many horrible things happen when pitocin comes into play. I understand this does not happen with every case, but it's enough and close enough to my heart to make me not want it. However, I do not want a doula to side eye if I decide to get an epidural.
    A doula's job is to support you in your choices and to help you advocate for the birth you want. So if you tell her that you don't want pitocin she can remind you if the medical team is recommending it that you didn't want it, so that you can be firm about what you want. A good doula should be as open to a medicated birth as she is to a non medicated birth, a c-section,or a mom who decides after a laboring that she wants to change her mind on some aspect of the birth plan. 

    From my friend, who is a doula:

    "doulas provide mental, emotional and physical support during pregnancy, birth, and postpartum. doulas attend births in all settings. doulas are not like midwives because doulas do not do any medical tasks, like checking fetal heart tones or cervical dilation (which midwives, both those who work in and out of the hospital, do). doulas are trained professionals who have knowledge and experience in the emotional/mental aspects of birth, they're personal birth coaches, they're individualized mini birth encyclopedias available whenever you need them, they're non-judgmental companions whom you build a relationship with and who stay throughout your labor to help you have the birth you want to have"

    My SIL is a doula and while I'm excited to have her at the birth I'm REALLY excited to have her support in the postpartum period. My hope is that she can help me adjust and help me manage my mother, which is the part of having a baby that I am most anxious about. 


  • benten24 said:

    Taymiller said:

    benten24 said:

    Taymiller said:

    Doctors don't do things just to be dicks, they do things and push for things because it is safest for the mother and baby.

    I don't think anyone is saying this. I'm simply asking what the deciding factors were for each woman when making a choice of practitioners. I hear all of these good things about midwives, but feel safest with a doctor at this point. So, I'm curious where everyone's head is.

    I think the tone of this thread is that doctors push people into medical interventions that they don't want. And I don't think that is true. The goal of a doctor is to do no harm and deliver baby as safe as possible. Sorry I get a little defensive on this topic, I will tone it down :)
    I understand where you're coming from, and imagine it hits close to home with DH being a doc. I totally agree that docs tend to get a bad/pushy rep when it comes to L&D, which is why I'm curious about the reasons for everyone's decision.
    Personally, I want a natural labor and would LOVE to have that with a doctor while in the hospital. I'm petrified of being urged into an induction/epidural/caesarean if I'm not ready for those interventions. I understand that I can say "no", but since I've never done this before I'm not sure how my mental alertness and ability to stand my ground will be during labor. And my DH is basically content knowing nothing, and questioning nada about the whole pregnancy/L&D process. Basically, I'm scared.

    @benten24 just to reassure you - I agree with @Taymiller from experience that doctors get a bad rap in regards to medical interventions, and it's not really a fair stereotype for the majority of doctors.

    My experience with DD, I ended up wanting/needing all medical interventions. An induction, all meds available, epidural, and ultimately a c-section. I saw a variety of doctors in the practice and a variety of doctors and nurses through the 2 days of labour, as shifts changed, and not one of them ever pushed an intervention on me. They mentioned options, and then dropped it until I brought it up again. Even my induction was pushed as far as possible until I was almost 2 weeks overdue and they were concerned about DD's size (rightly so - she got stuck). My c-section was mentioned as a possibility when my stalled labour finally progressed but I still wasn't able to move DD hardly at all with each push, and her heart rate started to fluctuate more than they were comfortable with. Even then they told me it was up to me if I wanted to go now or wait and keep trying. They discussed the pros and cons and I truly felt it was 100% my choice. My current doctor is also really awesome with giving me information and letting me make my own decision - to the point where she's decline to give me her personal opinion when asked because she said she didn't want to sway me, and either decision was safe and valid. 

    Not trying to change anyone's opinion, like I said in my previous post I think the individual medical provider's demeanor and bedside manor is more important than whether they are a doctor or a midwife (midwives can be judgmental and push their views, too). Just want to reassure those that are nervous about a doctor because they don't want medical interventions pushed on them that in my experience with quite a few doctors and nurses and two separate practices it has never happened to me during pregnancy/labour/delivery/post-partum period.


    @DobbysSock thank you for this. I think last night I was starting to freak out about feeling alone in this thing, and you ladies have really helped. My docs are all wonderful and haven't pushed anything on me yet, so I'm feeling more confident that they won't when the time comes. Sticking with the doctors I have already been using and am comfortable with. I need to shut it down when everyone at work starts talking to me about needing to see a midwife.

    @Taymiller thank you for the pep talk, I really need it right now! I hope you're right and he does jump into action, but normally he just gets this deer in the headlights look and waits for me to take charge. It's going to be interesting to see what happens when I don't haha.
  • DobbysSockDobbysSock member
    edited January 2016
    @benten24 I forgot to mention - another good option if you want a doctor/hospital birth but are worried about how you and DH will deal with any possible pressure from medical staff, is to hire a doula. The doula could be your advocate and support. You could share your birth plan and wishes with them, and part of their job is to be your spokesperson and help you stick to your plan as much as is possible/safe for you and the baby. I think they also do home visits post-partum and assist with breastfeeding, if needed. I've never used one but might be a good middle ground.
  • I went with a midwife and I love her. She's amazing. I want a natural water birth and I want the freedom to move around as much as possible and do what my body wants. This is something my midwife is completely on board with and experienced with. As far as doctors go, I understand what previous posters are saying about doctors getting a bad rap and it's true, not all doctors are going to push meds on you and rush you through the process. Maybe not even most. If you have a relationship with a doctor that you already trust to listen to your needs, then there's absolutely nothing wrong with that. I've had issues in the past with doctors not listening to me or my concerns and had serious consequences, so that's my own trust issue. But also, from what I've read (which is a fairly extensive amount even before becoming pregnant because I was a health major with a focus on women's reproductive health in college), doctors are far more likely to induce and/or "speed things up" with pitocin which increases your likelihood of getting an emergency c-section. If you want that, that's okay. I am avoiding all intervention if possible, that's just the birth experience I want. Things may change, who knows. If there was an emergency situation I would of course let them do anything they need to do to deliver my baby.

    I don't judge anyone's decision either way, just to be clear. That was just my personal reasoning for electing to have a midwife. I think the most important thing is that you find someone you connect with and trust, regardless of their "title". But again, that's just me.
  • DobbysSockDobbysSock member
    edited January 2016

    Do doulas help, in terms of keeping drs from "pushing" drugs on you? For instance, I do NOT want pitocin. I don't want any bit of it. Give me a c/s if this baby won't come out, but I've just personally seen too many horrible things happen when pitocin comes into play. I understand this does not happen with every case, but it's enough and close enough to my heart to make me not want it. However, I do not want a doula to side eye if I decide to get an epidural.
    @dolewhipper there are a lot of midwives who are fine with medical interventions too! My sister has decided to go with a midwife and part of her interview/selection process was to make sure that whichever medical professional she went with was going to support her in her medical choices.

    ETA: in particular my sister plans to have an epidural as soon as she is allowed, unless in the moment she feels like she can handle continuing without one. This was discussed with her midwife before she confirmed she would go forward with her

    My understanding of doulas, having never hired one but doing research about them during DD's pregnancy, is that they are your support person and advocate during birth. So I don't think they have any decision making power in the hospital but they can support and encourage you and advocate for you as a support person.
  • rakel88 said:
    @PhoebeJune1984 I have Kaiser too (this is my first) and I haven't really talked to anyone about how it'll actually be come baby time so this is good to hear! Thanks for sharing :)
    @rakel88 When I first had Kaiser, I was really bummed that they did things that way. But come to find out, I actually preferred it. If there are no complications during labor and delivery, there usually isn't a need to have an OB, if the MW can do your delivery. Because the doctors have specific days that they are in the hospital working shifts, you don't call your OB when you go into labor, you just go into the hospital. And after their shift, they leave....they aren't exhausted and trying to still deliver babies or do c-sections, the patient is just moved to the next doctor working his/her shift....and you get a fresh OB. They also wont tell you not to push, while waiting for the OB to arrive, like two of my friends had to do while they were in labor. I was in labor for 28 hours, and I would say for the first 23 hours, I had a MW. She was there for checking my stats, checking my dilation, having me rotate when the heart rate dropped, etc. Then I started having complications and I had the OB on shift for the rest of the time. During the 23 hours of having a midwife, the OB working his shift came in twice (once to start the induction process, and once just to check on me after I had been there for 18 or so hours). So the OB was still present a couple of times, even during my MW timeframe.......
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  • Taymiller said:
    @Taymiller I definitely agree about feeling safest in the hospital. I know things can go downhill real quick, and I'm far too nervous to be anywhere else at such a crucial time. I just wish my husband was more in charge of things like yours! He's got me really down lately with his comments about not wanting to even talk about life after baby comes, and not wanting to know anything about L&D. It's making me feel so alone and like this will not be a good experience for me at all simply because he's being a jerk. I think it's worse because I have no one else I would want in the delivery room with me, so it's just me with my husband who knows nothing and I can't even talk to him about anything because he refuses to learn. End rant. I'm gonna go cry into my milkshake now.
    He is probably just scared and won't admit it. I tend to shut down and not want to talk about things when I am scared. Life is going to change a lot and that is scary. I bet he will snap into action once you are there. I am better when I am just flung into things rather than plan and think about it. Chin up, you got this!
    I agree. My husband was the same way with my first pregnancy, and I felt like....this is supposed to be a happy time, and we are suppose to be enjoying this whole experience together. My friends that were pregnant at the same time, were talking about how they would read the baby books together and blah, blah, blah. I felt very alone in the whole thing. It wasn't until our DD was born, that it hit me that he was acting that way due to fear of the unknown. He was in such control of his life for so many years, and he had no control over this (the pregnancy, labor/delivery, having something to take care of 24/7, etc)....so he was scared. As soon as she was born, it all stopped. He was changing diapers, asking the nurse lots of questions, and very hands on.  Months later, when he would talk about the L&D experience, he would admit that he had no idea what to do, because he hated seeing me like that and knew there was nothing he could do to help lessen the pain, and how nervous he was during the c-section. Now we are on our second pregnancy, and he is acting the same way. If you asked him right now, he wouldn't even be able to tell you my due date. For four years, we have only had DD and it has been easy when it is two parents against one. He is worried about what it is going to be like with two kids. He is focusing on getting his business started, he knows that in the next few months we need to get a new vehicle, and I know he is nervous about the fact that I am doing a RCS. With him, nothing is real until there is a baby in his arms. And your husband could be the same way. It sucks big time, and I feel like I am missing out on those bonding moments when it comes to pregnancy, but for him, this is how he deals with being scared and stressed.

    Maybe when the time comes, sign him up for labor and delivery classes with you and he can kind of be forced into at least learning the terms and what is going to happen during the process. My SIL had to do that with her husband, he said he didn't want to take a class, and she knew he needed to, so she told him it was a requirement of the hospital, and then he went. HAHA  
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  • I think it really just depends on the individual. With my first, I was naive and uneducated about the whole process and went with the flow of my OB that I had been seeing for several years. She's an incredible Dr., but not very personable. And I was a little bummed that when I told her I wanted an unmedicated birth she told me I don't get a trophy for doing it that way. I understand she probably didn't want me overly attached to that plan, but a more supportive response would've been appreciated. It didn't really matter that much to me bc I knew she would take care of me and baby and I trusted her. Anyway, she wasn't on call when I delivered and the OB I had was amazing. She let me do my thing and never once rushed me. I did have a couple of pushy nurses, but DH took care of them for me. I had an unmedicated birth with no interventions. I don't know if anything would have been different with my OB, but the one who delivered my baby seemed more supportive.

    The only reason I'm going with a midwife this time is bc I want a water birth and the hospitals in my area don't have that option. The birthing center is right next door to the hospital and they have an OB on call. I'm confident I'm in good hands with them, but if I had any doubt at any point, I would switch caregivers.
  • I see a group of OBs and I love them. With my VBAC I went to the hospital and since it was the weekend, none of my doctors were there. I was disappointed but it comes with the territory. I was assigned a midwife. I had no problem with this but she had terrible bedside manner and I wish I could have had the on staff OB instead, who has a great reputation.

    Now reread that and switch OB with midwife and you'll get what could have also been the story. 

    I don't believe OBs are any pushier than midwives, but I do believe they know quite a bit more in terms of preventative care, whereas midwives have the reputation for going with the flow. I could be wrong about that, but I do also prefer the preventative care in labor and birth. I'll take a "better safe than sorry" "intervention" over waiting something out that could turn deadly.

    All that said, each woman simply needs to find a provider they are comfortable with, and an amount of risk they are comfortable with. For me that is hospital with and OB, or the midwife who may be there instead. Just get my baby out safely!! 
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  • While I agree that both want what's best for you and baby, a lot of times the philosophy behind the two jobs is very different. For someone who wants a natural birth (since you're asking he question, I assume you do), a doctor is more likely to recommend interventions rather than a wait and see approach because of their training and expertise. My doctor told me after I was induced (11 days overdue) that there was no way she would allow me to still be laboring when she ended her shift in 18 hours or so. Obviously women can labor for longer than that without there always being inherent danger. Thankfully my labor was only 8.5 hours. I was also advised strongly to be induced before I wanted or before medical research suggests is necessary. We pushed back and delayed until as late as I felt comfortable. They estimated my baby would be 9 pounds and was 7 pounds 1 ounce, so I was glad I didn't waver. (I am tall and weighed almost 9 pounds myself at birth.) Also, the nurses at my hospital told me a few times that "everyone" gets an epidural. They were actually very supportive, but it means they aren't as familiar with dealing with the type of labor that I chose. My doctor went into a whole speech about pain management as well despite discussing my birth plan a few times beforehand. I really think that my doctor did mean well and I really like her. We chose a doctor because we wanted an expert working closely with us in case of emergency. Also, midwives don't work in the hospitals nearest to us. If we were not well researched and fairly strong willed people though, I'm sure we would have been persuaded away from our birth plan. Of course the important thing is that everyone is healthy and happy, but why not choose where you feel you will be most comfortable? We are still going to go with the same doctor's group this time around for the record.
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  • NerdchildNerdchild member
    edited January 2016
    Watching one of my best friends and her son nearly die under the care of an absolutely awful midwife (refused to call an ambulance for nearly 24 hours on a what was already a 2 day long labor, having her push at 8cm dilated, infection in her uterus that her baby swallowed and inhaled, nicu, antibiotics, and having her uterus nearly rupture before an emergency c-section and the APGAR score immediately after birth being a 2, barely breathing and a almost nonexistent pulse).

    I trust and like my o.b., I am of the mindset of letting him and his years of education and practice take the lead. Vaginal birth, c-section, whatever it takes. It's all personal preference, do what makes you comfortable.

    Edit:words
  • Omg @Nerdchild! Holy freaking crap, I would freak the f out on that midwife. Someone would be getting a malpractice lawsuit against them. Ugh! Awful!
  • Yeah, I've known women who had wonderful experiences with midwives/doulas, but my friend's birth turned me completely off to the whole thing.
  • I want add, because there seems to be somewhat of an assumption: midwife =\= home birth. I will be in the hospital with a midwife. Obs all over the place in case things go in a direction a midwife does not.
    Same here. I wouldn't be comfortable delivering knowing there wasn't a doctor around if needed.
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  • With my first I had an OB. I was induced at 39 weeks due to pregnancy induced hypertension and had an epidural. Once I saw the bill for the epidural, I decided I would not be doing that any more, and chose to go med-free with my second child. Because of that, I felt more comfortable having a midwife. I LOVE my midwives office, and after delivering two kids with them and having another, they know me very well now.
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  • @Nerdchild that is terrifying. This is an excellent example of why it is SO important to have a direct conversation with your midwife about what she plans to do in the case of different emergencies if you are planning a home birth. Also making sure you're working with a Certified Nurse Midwife, though training is no guarantee with doctors or midwives that things will go as planned. 

    I judge any one who uses a lay midwife. Please use a CNM, a OB or a PCP that is trained in obstetrics.
    Those aren't your only options for properly trained and licensed. And here in WA we actually have extra licensing requirements. But my midwife is a CPM/LM. And she's wonderful. She can't deliver in the hospital, but every time I've had to, she's come along for support anyway. My last labor was 40 hours. I spent 19 of that dilated to 7cm and the last 4 hours at the hospital, and she never left my side. I don't know how she did it.
  • born2run911born2run911 member
    edited January 2016
    Lancy1269 said:

    With my first I had an OB. I was induced at 39 weeks due to pregnancy induced hypertension and had an epidural. Once I saw the bill for the epidural, I decided I would not be doing that any more, and chose to go med-free with my second child. Because of that, I felt more comfortable having a midwife. I LOVE my midwives office, and after delivering two kids with them and having another, they know me very well now.

    IMHO that doesn't really matter--I don't feel that one should have to choose a med-free labour based on finances, not choice. You are all welcome in Canada.

    image
  • @Lancy1269 how much are we talking about?? I think I can manage pain better myself if I know an epidural is going to cost an arm and leg
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