ob decisions

Monday  around evening time  Mystie

I thought I’d post a follow-up to my initial series from October about making prenatal care decisions. In October I wrote:

So, I look around. Who do I want to be like? Who thinks the same way I do? Go-with-the-flow-types. They don’t swallow everything the doctor tells them, but they just go through the hoops and deal with it all and are patient. So, that’s what I’m trying this time. I don’t want to excert time and effort and energy to find some new midwife to form a relationship with. I just want someone to find the baby’s heartbeat, tell me everything is fine, and let me go my merry way.

[...]

I also want to go to a doctor, as an experienced mother, have a natural birth and not be interfered with by the doctors just to prove it’s possible. I know it is. I have friends who have done it. I am curious to see what my friends’ experience is going to the doctor. I am curious how much doctors really do push you, if they do. I want to make that comparison myself.

Yet, as you have probably noticed by now, I am going to a midwife this time. So, I just wanted to clarify myself. No, it is not because a tragedy occurred while I happened to be seeing a doctor. No, it is not because I hated the doctor. It’s actually simply because the midwife I had with Hans and Jaeger is practicing again. She took a sabbatical for health reasons and is back. It was a no-brainer as soon as I became pregnant again that I would go see her — actually, I went to go see her beforehand to give her the update.

There were a few things I was discontented about with the doctors’ office I went to, though. I only had one actual appointment with a doctor, and I was going to give them two shots and compare what the two doctors had to say, but I was not pleased with the answers I got from the doctor I saw. Here are the things I didn’t like about my experience with the practice:

* I have had two previous births, and yet they never inquired about them or sought to get my medical history from my midwife. I did have to fill out an extensive medical history report at my first appointment, but for the births it only had blanks for provider, location, and ‘complications?’

* When I made mention of any of my past experience (at 10 weeks: “We never got a heartbeat before 12 my other times, I’m not worried.”), my remarks were at best shrugged off and at worse rudely ignored. My sister-in-law blamed it on the fact that it was a PA and she said all the PAs were bad. My doctor as well, even on my commenting on particular symptoms or asking questions about L&D never asked about or referred to the fact that I had birthed before. After learning a bit more after the fact about some hospital politics going on, I think they discounted any experience had with a midwife. When my midwife had me fill out the paperwork so she could get their records of my health care, she said that she would try faxing it, but she usually had problems getting information from them, in which case I would have to take the paper down in person and get it myself and then bring it to her. They did send it to her without hassle, though.

* The doctor I saw was very friendly and very open, honest, and straightforward. He gave me straight answers and I was very grateful for that. However, making statements such as “I’d rather induce 2 weeks early than have anyone go ONE DAY overdue” made me think we were not such a good fit. He also made a comment about how he thought if the technology was there it was best to use it — i.e. he would rather interfere than not; he would rather keep things under his own control than be waiting on nature at all. I asked if big babies were a worry, since mine were both over 8 pounds and I wouldn’t be surprised to get a nine-pound baby. His eyes did get big and he did say he didn’t think it’d be good to let the babies get that big, 6 pounds was about the average for their practice. Moreover, when making the ONE DAY overdue comment, he said the reason was because “the chances of SUDDEN DEATH greatly increase once the due date is past.” “Great,” I thought, “you’re going to try to scare me into going along with you.” So, he would prefer having a baby in NICU to having any patience at all. This was not a “let’s wait and see; let’s keep an eye on that and check back in a few days” doctor. I don’t think all the doctors in the practice are like that and he did admit to being into medical intervention the most, but the thing is, you cannot choose the doctor you get — if you make it to delivering naturally that is. It appeared as though I’d have to fight to not be induced (with my history of going late and having “big” babies) and I don’t want to be at a place where I have to fight, especially not when there are other options.

I do want to say again, though, that I was pleased with the experience I did have there, though. I had a different doctor for the birth and saw him postpartum and he was very nice. God guided us there for a reason. Kadlec was the right place to be for the situation. But I also realized it was not the place for me for a normal birth.

Now, here are my reasons for loving my midwife that I appreciate even more:

* Routine visits take 15 minutes from walking in the front door to walking out.

* My midwife does every part of my care, and she doesn’t have to spend 10 minutes looking at my file to do it.

* I can call my midwife directly at any time of the day or night. If something happens on a Saturday I can be talking to her in 5 minutes and she doesn’t need my file to know me and what’s going on.

* A doctor can be compassionate and gentle, but that’s not the same as being near tears after a miscarriage. I know she’s committed to doing her best to take care of me because she knows *me*.

* I don’t care what art you hang on the wall, an examine room is nothing but cold and unfriendly. And a couch in the living room makes a cozy waiting area.

* My midwife’s office is very laid back. She might not immediately look up from her computer when I come in, and her receptionists are clueless, but I know the ropes and so it’s just comfortable. I know what to do and no one will tell me what to do unless I just sit there doing nothing. I go use the bathroom and get my weight, then come back and wait for Fran to pick up my file, then we’re off to the back room.

* My midwife consults with the most reputable doctor in town and has gotten his opinion on my case several times over the past few months. Personal care and the assurance, if you needed it, that an excellent doctor approves of what she’s doing (and disapproves of what the other doctor recommended for my next pregnancy, incidentally)

As I see it, I have the best of all the worlds. The opinion of a good doctor, a practitioner who knows me and is always available, and the option to birth at a hospital or at home.

And, yes, there is no question about it, as long as I get the “go” (i.e. no strep and no high blood pressure in the last few weeks), I’m doing it at home. After the other questions I had already asked the doctor, I gave up on the last one on my list, which was “Will I be able to not birth on the hospital bed?” No one’s gonna get me birthing an over-eight-pound baby in any sort of reclining position ever again. I have had the aid of gravity and I ain’t going back.

This entry was posted on Monday, July 16th, 2007 at 9:11 pm and is filed under Mother. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.