Friday, February 5, 2010
Why I Switched to a Midwife
After a few interviews and facility tours, I decided that I would be much more comfortable with both the hospital and the pediatrician there, which left the biggie - the midwife or doctor that will be delivering my baby. I met with a midwife who came highly recommended both by local women I talked to in person and online, and by reviews on mothering.com by women who'd seen here at a previous practice in a much larger city. Long story short, I will be transferring my care.
I'm sure some people would like to know why I'd "change everything" this close to my due date, so I'll go through a few of the reasons. The main thing though, was just following my heart - I was becoming increasingly uncomfortable with the way my care was going and just had a gut feeling that something wasn't quite right with the path I was on. The last straw was when my OB mentioned starting cervical checks at my next appointment [35 weeks], and said something about "loosening the membranes" while he was doing that. I asked if he meant sweeping/stripping, and reminded him I wouldn't even be full term, and he said something along the lines of "well, sometimes things take time to work, and big women have big babies, so you'll want him out as soon as possible". I'm not sure if I was more pissed about the fact that he'd strip without explaining what it was and getting my consent first, or that he was all about an early induction just because I'm a fat chick [which I could just see leading into another one of those "necessary c-sections" for obese mothers], but I know it was time to get the heck out of there before that appointment came.
He also basically told me 2/3 of my birth plan was too difficult and unrealistic, and I should just listen to the nurses and "plan on having a healthy baby". He said I could ask for whatever I wanted, but he would not sign anything, and they would probably just follow hospital policy to "be on the safe side". Even though another doctor in his practice had verbally OK'd several things in my birth plan, he pretty much said it would depend on which doctor out of the 4 was on call as to what they'd "allow", and he didn't want to make any waves. He even told me with the waterbirth, which was one of the first things I'd asked about, that one provider allowed labor in water but was not "going to get down on the floor", so I'd have to get out during transition and get on the bed, and one of the others would want me in the bed and in stirrups as soon as he showed up because he didn't deliver in "non-standard" positions. So much for all the things we'd discussed, and that I had been assured were OK over the past few months. Of course, he was in such a hurry, I practically had to block the door just to get straight answers to these few questions before he left the room.
When I met the midwife, it was such a huge difference. For one, our first conversation took place in a private office with chairs, not while I was half naked in a paper gown. Also, she didn't seem rushed, and took time to ask about me, why I wanted that type of birth, and what my expectations and experiences were. I feel like if my OB had done that, we'd have known straight off that it wasn't going to work out. When I mentioned the birth plan issue, she asked if I had a copy, and said everything looked fine to her, and would be OK at the local hospital, which she said was much more laid back about birth and following the mother's wishes. She has done a lot of waterbirths and natural/unmedicated births, and the the backup OB at the practice is also very hands-off and is fine with both. She encouraged me to meet him just in case he is on-call and she's gone when I deliver, but also said to have the hospital call her cell phone if she's not there when I do go into labor, because she does try to make an effort to be there at least in time for the birth. She also said the the cervical checks are up to me, as long as they find the position of the baby [if he stays the way he's been, you can tell from the outside], and that there is no real reason to do them before labor, and only during labor if there's a decision to be made [ie, if I decide I want an epidural or augmentation - if I'm at 8+cm, there's no point], and that she will try to explain everything she's doing and to ask questions if I have any. Again though, the main reason I'm switching is just instinct and the overall vibe I got from her, like birth is just natural and something we're working together on, not some big procedure where I'm expected to be scared and give up all control.
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