I used a midwife clinic for my first pregnancy that was attached to a university hospital in California because they had a birth center inside of the hospital which made us more comfortable however we didn't have a great experience. We spent most of the pregnancy feeling like we were being made to jump through hoop after hoop. Almost every time we went in there for an appointment, there would be something else we needed to do. Another scan, another blood panel, another "oh your blood pressure is one point too high so you have to go to L&D to be checked". Our daughter was born with perfectly healthy and we were glad to be done with them. I'm 28 weeks pregnant with my son and we are now living in Virginia and seeing midwives in a similar set up except this is just a regular hospital with a birth center rather than a University hospital. And I'm starting to feel the same way I did with my first and I'm just wondering if this is normal and I need to just suck it up or say something about it. I got diagnosed with Group B at 11 weeks via a urine test and told I had to do a round of oral antibiotics. Didn't like it but I did and after that they said great now all we need to do is have you do antibiotics in labor. Wouldn't hear of retesting or explain why I needed 2 rounds of antibiotics. I didn't even know they tested for this until 36 weeks with the swab. Then one midwife didn't like my heartbeat. I have a little heart flutter that I've had for most of my life and have been seen for before and I usually go years without feeling it. But it does seem to come back up a little more when Im pregnant. So I got refereed to a cardiologist who ran all these tests (that I've already had done before) only to tell me "oh well this sort of thing is perfectly normal for pregnant woman" but I must come back at 30 weeks to see how I'm doing. Then I got a huge bill from that because my insurance didn't think it qualified as prenatal care. Then the ultrasound tech noticed that there was some measurement in his head that she felt was too high so we got refereed to a specialist. We sat there for over 2 hours to be told that he is just on the higher end of normal and its perfectly fine again. THEN I get diagnosed with gestational diabetes and they want to make yet another appointment to go over how that works with them then also go sit through hours of classes in diabetes at the local hospital even though they said the Midwife will teach me to manage it. I am just getting so tired of appointment after appointment that I walk of feeling either that my time was wasted or having something else to worry about until the next appointment. I an on edge every time I go into an appointment.
Hey mama! You are a consumer of healthcare and owner of your body. It's totally okay to ask questions and challenge your caregivers. I'm sorry you've had such a rough time with it but a lot of this sounds like the interventions and appointments are based on abnormal findings like GD or a heart issue.
I have MW as well but not part of a hospital. I've had two normal ultrasounds, normal prenatal bloodwork, lots of belly measuring, but that's it. Nothing crazy or abnormal came up so I'm in the low-risk pool for now. Had it, I'd likely be in the same boat!
I can see both sides in this. It can be frustrating to have all these tests done and not have an explanation. I would suggest each time they present a new set of tests you ask for the reason why along with the risks for refusal.
I can tell you as a microbiologist, that having the antibiotics for group B is HIGHLY important for delivery of your child. Group B is the number one cause of infant meningitis and it is very fatal.
It does sound like a lot of the tests they are ordering on you are pretty standard (I.E.: gestational diabetes). Would you rather have a midwife who isn't cautious at all? It sounds to me like you are receiving great medical care.
*TW Spoiler*
DD: Aug '16
10/2017: Twins confirmed with TTTS at 22 weeks. 10/10/17 Twin B passed after in utero placenta surgery 11/2/17 Twin A & B born 11/26/17: Twin A passed after 24 days fighting in the NICU Benched 6 months BFP: 6/28/18 MC:7/16/18 BO BFP: 10/2/18 EDD 6/15/18
Hi there. I'm also in Virginia seeing nurse midwives associated with the hospital (they deliver at a birthing center attached to the hospital). Kinda wondering if we're seeing the same ones, honestly lol.
I don't really see anything in your care that raises a red flag of being anything different than what I'd expect nurse-midwives to request. They are still part of the medical system and will be following certain medical standards. I'd expect the same response from my nurse midwives.
Ha, I think I'm also giving birth at the same place @saladflambe and @cposey1988! There are only 5 birthing centers attached to hospitals in the country (or so I've heard), so I'm pretty sure we're all at the same one. If we end up there at the same time, we'll have to say hi
Because they actually work under OBs since they are in a hospital, there are usually more regulations and test requirements than at a stand alone birth center and they are more cautious. If you aren't happy, try out another midwife practice; I've switched practices twice now this pregnancy because I wasn't happy with the care I was getting. I was also on edge at my old MW practice, and am so happy I switched.
I am confused. You are having warning signs of issues, that could cause serious harm or something that, and your CNM is following protocol to rule out/confirm something and all turns out well, and you are complaining? Do you know how many people are referred to L/D for 'doppler issues' that have issues, or don't have a take home baby. Or how many patients see a cardiologist and get the most horrible new of their life? Pregnancy can andbhas causes heart failure, strokes, cardiac arrest smd fetal death. What if next time, your CNM sees a red flags, and refers you to the appropriate level again and there is something seriously wrong, or your child dies because you assume it's nothing or 'a normal pregnancy thing'? Could you live with your self?
As for the group B strep, many many research studies show that if you have it at all during your pregnancy, you are 99.99% going to have it at birth. And ACOG recommends the antibiotics during labor. This is there stance, and is backed by researchers and science, and called evidence based practice.
I am confused. You are having warning signs of issues, that could cause serious harm or something that, and your CNM is following protocol to rule out/confirm something and all turns out well, and you are complaining? Do you know how many people are referred to L/D for 'doppler issues' that have issues, or don't have a take home baby. Or how many patients see a cardiologist and get the most horrible new of their life? Pregnancy can andbhas causes heart failure, strokes, cardiac arrest smd fetal death. What if next time, your CNM sees a red flags, and refers you to the appropriate level again and there is something seriously wrong, or your child dies because you assume it's nothing or 'a normal pregnancy thing'? Could you live with your self?
As for the group B strep, many many research studies show that if you have it at all during your pregnancy, you are 99.99% going to have it at birth. And ACOG recommends the antibiotics during labor. This is there stance, and is backed by researchers and science, and called evidence based practice.
It sounds like you are receiving excellent care.
----stuck in quote box----
this, 100%. I'm sure it is a little frustrating constantly getting tested for things, but i don't think you should be complaining. they're only trying to make sure you & baby are healthy & doing okay. everything they're doing sounds pretty standard. i wouldn't consider that a waste of time..
This sounds like normal and great medical care. It's not jumping through hoops, it's responses to valid medical concerns by your chosen medical team. GD can have serious effects on you and your child, unfortunately that's a fact. Getting education on managing it is a large part of preventing things that can go wrong. Group B strep is a standard test that can prevent serious infection to your baby during birth and prophylactic antibiotics are standard for those who test positive, even if they've taken antibiotics before.
I'm wondering if you're feeling like you're jumping through hoops because you feel that these measures are "interventions"? Midwives are medically trained and while their focus is on intervention free or low intervention birth, a good midwife will step in as they need to. This is a good thing and you can, of course, at any point question or refuse things. So far, I haven't seen anything that would warrant refusal though.
You appointments and experience sounds just like mine at my regular obgyn practice. Maybe it's a regional thing. Next time you may want to try a birth center not attached? I'm not sure where you are in Virginia but I'm in the Nova area. I checked out a few but felt with my current risk factors I should stick with my current practice because I was afraid I'd risk out of a birth center late in pregnancy. Which definitely would have happened.
I agree with PPs that it sounds like you're receiving routine and excellent medical care. If your heart has a flutter, it makes sense that you would be sent to a cardiologist. If you have GD, this is something that needs to be addressed. High blood pressure (there is a line between normal and high for a reason) being checked on is a good thing. Antibiotics for Group B are necessary. It stinks and sounds frustrating that you're having so many issues, but all of these seem like legitimate medical concerns that any health care provider would want to follow up on. If you dislike your provider, I definitely think you should shop around and find a provider you're comfortable with though. You are 100% in the driver's seat and should be working with someone you trust. I would try to keep expectations in check though- a different health care provider wouldn't change any of the medical red flags or diagnoses described here.
America, the only country where someone will complain about excellent preventative care because they believe it's not needed. Women the world over wish they were in your shoes. I say appreciate the care you are being given and enjoy your healthy pregnancy and baby.
Hey mama! You are a consumer of healthcare and owner of your body. It's totally okay to ask questions and challenge your caregivers. I'm sorry you've had such a rough time with it but a lot of this sounds like the interventions and appointments are based on abnormal findings like GD or a heart issue.
I have MW as well but not part of a hospital. I've had two normal ultrasounds, normal prenatal bloodwork, lots of belly measuring, but that's it. Nothing crazy or abnormal came up so I'm in the low-risk pool for now. Had it, I'd likely be in the same boat!
Your midwife is protecting you and your unborn baby. I'm so confused about how this is an issue. I'm also confused about how a patient with a pre existing heart problem wouldn't be considered high risk, given the potential for heart related issues with otherwise healthy patients.
Wow do I understand how you feel! I was diagnosed with GD as well and had to take classes and start seeing an internal med doc to manage my sugars and the high risk OB and I'm doing non-stress tests twice weekly, every 2wk sizing ultrasounds....it's been CRAZY!! And some things have seems super unnecessary to me, so I've asked lots of questions in terms of "dont tell me what the research says, tell me why, for ME in MY pregnancy and for MY baby, you're saying this needs to be done". That seems to have gotten me a lot better answers, or at least answers that I can reconcile with and feel okay.
The only part of your story that seems odd to me is the part about getting tested for Group B at 11wks and them saying that you'll still have to have antibiotics during labor. I was told that they test for it at 36wks because testing for it earlier than that is literally pointless as the diagnosis is very likely to change over the course of pregnancy. Even if you test positive at 36wks, they don't make you take antibiotics then, only during labor. So, yeah, that part is odd to me and I'd request a GBS swab at 36wks regardless.
Wow do I understand how you feel! I was diagnosed with GD as well and had to take classes and start seeing an internal med doc to manage my sugars and the high risk OB and I'm doing non-stress tests twice weekly, every 2wk sizing ultrasounds....it's been CRAZY!! And some things have seems super unnecessary to me, so I've asked lots of questions in terms of "dont tell me what the research says, tell me why, for ME in MY pregnancy and for MY baby, you're saying this needs to be done". That seems to have gotten me a lot better answers, or at least answers that I can reconcile with and feel okay.
The only part of your story that seems odd to me is the part about getting tested for Group B at 11wks and them saying that you'll still have to have antibiotics during labor. I was told that they test for it at 36wks because testing for it earlier than that is literally pointless as the diagnosis is very likely to change over the course of pregnancy. Even if you test positive at 36wks, they don't make you take antibiotics then, only during labor. So, yeah, that part is odd to me and I'd request a GBS swab at 36wks regardless.
Wow do I understand how you feel! I was diagnosed with GD as well and had to take classes and start seeing an internal med doc to manage my sugars and the high risk OB and I'm doing non-stress tests twice weekly, every 2wk sizing ultrasounds....it's been CRAZY!! And some things have seems super unnecessary to me, so I've asked lots of questions in terms of "dont tell me what the research says, tell me why, for ME in MY pregnancy and for MY baby, you're saying this needs to be done". That seems to have gotten me a lot better answers, or at least answers that I can reconcile with and feel okay.
The only part of your story that seems odd to me is the part about getting tested for Group B at 11wks and them saying that you'll still have to have antibiotics during labor. I was told that they test for it at 36wks because testing for it earlier than that is literally pointless as the diagnosis is very likely to change over the course of pregnancy. Even if you test positive at 36wks, they don't make you take antibiotics then, only during labor. So, yeah, that part is odd to me and I'd request a GBS swab at 36wks regardless.
Hope things smooth out for you!
GBS was found in my urine in my 2nd trimester so I never got the swab done at 36 weeks. They told me I had to have the antibiotic during labor.
Re: Midwives
I have MW as well but not part of a hospital. I've had two normal ultrasounds, normal prenatal bloodwork, lots of belly measuring, but that's it. Nothing crazy or abnormal came up so I'm in the low-risk pool for now. Had it, I'd likely be in the same boat!
FX for a healthy rest of your pregnancy!
I can tell you as a microbiologist, that having the antibiotics for group B is HIGHLY important for delivery of your child. Group B is the number one cause of infant meningitis and it is very fatal.
It does sound like a lot of the tests they are ordering on you are pretty standard (I.E.: gestational diabetes). Would you rather have a midwife who isn't cautious at all? It sounds to me like you are receiving great medical care.
DD: Aug '16
10/2017: Twins confirmed with TTTS at 22 weeks.
10/10/17 Twin B passed after in utero placenta surgery
11/2/17 Twin A & B born
11/26/17: Twin A passed after 24 days fighting in the NICU
Benched 6 months
BFP: 6/28/18 MC:7/16/18 BO
BFP: 10/2/18 EDD 6/15/18
I don't really see anything in your care that raises a red flag of being anything different than what I'd expect nurse-midwives to request. They are still part of the medical system and will be following certain medical standards. I'd expect the same response from my nurse midwives.
Married: Oct 20, 2013
BFP 1: Aug 31, 2015
EDD 1: May 12, 2016
DD1 Emma born May 12, 2016
An Honest Account of New Motherhood (with Postpartum Anxiety, Depression, and OCD)
BFP 2: October 07, 2019
EDD 2: June 20, 2020
Because they actually work under OBs since they are in a hospital, there are usually more regulations and test requirements than at a stand alone birth center and they are more cautious. If you aren't happy, try out another midwife practice; I've switched practices twice now this pregnancy because I wasn't happy with the care I was getting. I was also on edge at my old MW practice, and am so happy I switched.
Married: Oct 20, 2013
BFP 1: Aug 31, 2015
EDD 1: May 12, 2016
DD1 Emma born May 12, 2016
An Honest Account of New Motherhood (with Postpartum Anxiety, Depression, and OCD)
BFP 2: October 07, 2019
EDD 2: June 20, 2020
As for the group B strep, many many research studies show that if you have it at all during your pregnancy, you are 99.99% going to have it at birth. And ACOG recommends the antibiotics during labor. This is there stance, and is backed by researchers and science, and called evidence based practice.
It sounds like you are receiving excellent care.
I'm wondering if you're feeling like you're jumping through hoops because you feel that these measures are "interventions"? Midwives are medically trained and while their focus is on intervention free or low intervention birth, a good midwife will step in as they need to. This is a good thing and you can, of course, at any point question or refuse things. So far, I haven't seen anything that would warrant refusal though.
Expecting Double Trouble, April 2016
The only part of your story that seems odd to me is the part about getting tested for Group B at 11wks and them saying that you'll still have to have antibiotics during labor. I was told that they test for it at 36wks because testing for it earlier than that is literally pointless as the diagnosis is very likely to change over the course of pregnancy. Even if you test positive at 36wks, they don't make you take antibiotics then, only during labor. So, yeah, that part is odd to me and I'd request a GBS swab at 36wks regardless.
Hope things smooth out for you!