My name is Beth Anderson. I'm a nurse, and I like to make websites. I'm also 
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Switching Teams
By Beth | February 26, 2007
It’s kind of late in the game, I know. But I’ve switched teams. I’ve gone from an OB practice to a nurse midwife practice.
At around 30 weeks I started to thing about taking a birthing class. I procrastinated because (a) I don’t have much spare time and (b) I’m just not a classroom kind of a learner. So I decided to start doing some research on the labor process, in order to come up with some sort of birthing plan.
First stop, the bookstore. Not too many books on labor, but most of the books that I did find recommended another book: “Ina May Gaskin’s Guide to Childbirth.” So I bought it and started to read it. Ina May Gaskin is, from what I can gather, one of the US’s leading mid-wives. She has a place in Tennessee called “The Farm Midwifery Center,” that has been in operation since the seventies. The first one-third of this book was composed of Gaskin’s clients telling anecdotes of how the birthing process went. I was hooked from the beginning…I love a good birth story.
In her book she talks about the midwifery model of care vs. the medical model of care, which, in a nutshell is this:
Midwife = birth is a natural, instictive process. Your body already knows how to do it.
Medical = birth should be in a controlled environment (the hospital), supplemented by medical interventions.
For some reason the midwife model rang true to me. I remember not too long ago, visiting a birthing center in nursing school. I though it was the coolest thing. It was like someone’s house. You could get up walk around while laboring. You can eat and drink while in labor. After the birth the woman was given a chance to recover, the family shared a nice meal, and were on their way home within hours of the birth. I found this very appealing, but unfortunately the flip side of the coin - What if something goes wrong and they can’t get you/the baby to the hospital on time - got the best of me and I forgot all about birthing centers and midwives.
So why the change of heart?
For one, I wasn’t quite satisfied with my OB practice. It consisted of 7 practitioners, and at that point I had only met about half of them. So it was becoming quite possible that a complete stranger would been have attending my birth. Also, this practice was very over-crowded. The waiting room was always like a zoo. The phone number was always busy. Not busy as in, leave a message busy, busy as in an actual busy signal. Haven’t heard one of them since the 1990’s.
And the “get em in, get em out” feel to it - “Ready?? Go! Pee on a stick! Blood Pressure! Weight! Doc listens to fetal heart tones, and YOUR DONE! Who’s next?”
After a few visits I was like, “Man. I could be doing this over the phone.”
Don’t get me wrong - I really liked the physicians there, at least the ones that I had met. But there was one in particular that just kind of rubbed me the wrong way. I can’t say anything really that bad about him except this: At 25 weeks he said to me, “I see that you’ve gained 4 pounds in two weeks. You should be careful about that.”
I said, “”Really? So your telling me I’ve gained too much weight this week?” Then he glanced over my chart and saw that I had gained very little weight in my first trimester. “Um, well, it’s probably not a problem.”
I didn’t think it was a problem. At 25 weeks, some of my colleagues couldn’t even tell I was pregnant yet.
Then a friend of a friend told me about her recent experience of delivering with this doctor. He would come in to the room, check her cervix and say, “You’re going to have to do better than that. I need you to get 4cm more dilated by 12 o’clock.” And so on and so until finally he did a C-section because she wasn’t dilating fast enough.
To me that’s kind of like being constipated, sitting on the toilet, and someone coming in and saying, “C’mon. You’re going to have to poop faster. Please produce two turds within the next 20 minutes, or were going in after them…”
So I knew that I couldn’t leave things up to chance.
I did some research and found a midwife practice with a birthing center that was on the hospital campus where I am to deliver. This, to me is the best possible scenario. If any thing goes wrong - there you are, just a stone’s throw away from the actual hospital. So I called them at 31 weeks, and they had me in by 32 weeks. Now I’m 35 weeks pregnant and so far I’m very satisfied with the care I’m receiving there.
Except for one thing: At the last visit the midwife told me that the OB practice still hadn’t sent over my medical records (even though they are in the same building). I offered to go get them myself but it was late in the afternoon and the office was closed.
“You’re might have to start calling them and bugging them to send over the records,” she said.
I told her about the busy signals, and how it’s one of the reasons I left the practice.
And besides, I’m not in that much of a hurry to get the records over. What if they find out that I gained 4 pounds at week 25? I’m hoping it won’t change the course of my care.
Topics: Blog |
February 26th, 2007 at 6:35 am
Right on. I’m a doctor, and knowing how doctors are trained, when I was pregnant my attitude was “Keep the hell away from me.” I went with a midwife group for my first pregnancy (twins, 40 weeks, induced) and a solo for my second (41 1/2 weeks, all natural.) Never looked back.
February 26th, 2007 at 6:26 pm
I haven’t done OB in a long time, so I didn’t even know about the birthing centers working with/near a hospital. Best of both worlds, because if there’s no complications, I would prefer a midwife too.
I worked OB back when natural was the way to go for most drs, except for complications of course. I only recall one dr that seemed to have a LOT more C/S after 5p than the others.
But if what I’ve read online lately is true, it seems that drs and hospitals are pushing C/S a LOT. And it seems many first time patients are actually opting for C/S — I can’t believe it! I’ve done it twice myself, and cared for both natural and C/S afterwards. I would nag a family member to pieces if I heard she was choosing a first time C/S with no medical justification! I better stop now, because I could go on and on LOL
If it’s not too much to ask, perhaps you could do a post about what insurance covers as far as the birthing center, and whether one costs more out-of-pocket compared to the other.
February 27th, 2007 at 12:07 am
I had high aspirations to be a midwife once. At that time CNM’s had a less than 10 percent C/S rate and the average for MD’s was over 30 percent. Why the difference? The argument can be made that midwives are not able to care for complicated deliveries but in reality the fact is that they do approach the whole thing as natural, allowing the birthing mother to do what is comforting including eating and drinking, moving around, baths. The ‘hurry up’ medical model stresses the mother and baby - for the mot part a uterus knows what to do, millions of mothers gave birth before pitocin so I don’t think our uteruses forgot the job since then. I’ve had both ways and the midwife was far superior than the doc who rushed in, caught the baby said congratulations and left. For God’s sake, I could have had one of the L & D nurses do that and saved several thousand dollars.
Good luck and enjoy your baby.
February 27th, 2007 at 9:58 am
Wonderful! I switched OB’s at 7 months with my last pregnancy because my first OB did not take me seriously when I discussed avoiding a c-section by having a natural birth. I found an OB who did take me seriously and I am SO HAPPY that I switched. I had to have an OB because I’ve had a myomectomy that scarred my uterus much like a c-section does. I was treated as if I were a VBAC.
Now that my first daughter is 9 months old, I am 22 weeks pregnant and due in July. I’m with the OB who assisted with my first delivery, which was natural. It was long and difficult because bebe was sunny-side up. I needed forceps in the end, but I would do it all again. Anyway, I’m babbling . . .
Best of luck with your midwife and with enjoying the last part of your pregnancy. It should be enjoyed, truly. Not rushed.
February 27th, 2007 at 3:01 pm
[...] I have been asked to review a product, “Concierge Medicine” offered at MDVIP.com. This is rather timely given my last post, expressing my less than satisfying experience with my OB practice. [...]
February 27th, 2007 at 3:52 pm
Good for you.
I moved when I was 7 months pregnant with my first and in the process switched from an OB to midwife. What a difference. In the end I did need lots of interventions, but because of the midwives I knew that they were necessary and I was part of the process.
I had my 2nd with the midwives (a sunny-side up delivery yet), WONDERFUL!!
My 3rd & 4th were twins and my midwifes didn’t do twins. So I had to switch back to an OB. I ended up with healthy twins via C-section (which probably was necessary) but the communication and care pre-birth weren’t nearly as good. The doctor(s) missed some things they wouldn’t have if they had listened to me and what I noticed about my body.
February 28th, 2007 at 7:33 pm
Yay for midwifery! Another good book to read is Henci Goer’s “The thinking woman’s guide to a better birth” It really goes over the different interventions you may encounter and the real research behind them as well as why they may be necessary and when they aren’t necessary.
And it is terribly unfortunate but there are a lot of docs like the one who “managed” your friend right into what sounds like an unncessary c-section.
~Alyson
(passionate about birthing choices!)
April 1st, 2007 at 2:31 pm
[...] Remember Switching Teams? [...]