Friday, March 2, 2012

Guest post: Midwife vs. OBGYN

I am excited to be presenting several guest posts in the upcoming weeks. While I've been feeling lately like I might have temporarily run out of things to say, a lot of the wonderful women around me are going through experiences that have given them a lot to say - and I've been shamelessly recruiting them for guest posts.

The first comes from my cousin, Maggie. We lived far apart growing up, but were close in age and shared a lot of phone calls – mostly on the topic of American Girl dolls, if I remember correctly. Now we text about breastfeeding instead! (But yes, I do have Samantha and Felicity in a box somewhere.) Maggie is pregnant with her second baby (yay, more babies in the family!) and I asked her to share her thoughts on the difference in care between her first and second pregnancies. I was so happy to get this post and see what a more positive experience she is having this time around.

Guest post: Midwife vs. OBGYN

I just went to my 34 week doctor appointment today and the first thing I told my husband after I left the appointment was, “The closer I get to my due date, the more I realize how glad I am that I changed to the midwife group.”

To give you a little background, I am pregnant with my second baby and going to a midwife group that is associated with a hospital. This means they deliver at a hospital and still have to abide by hospital rules and regulations, but they are a lot different than a typical OBGYN group.

I went to an OBGYN group during my first pregnancy. They deliver at the same hospital I am delivering at now and overall, were a nice group of women (all the docs in the group were women), but I just never felt like they cared about me. Every time I met with them I felt like I was just a number. They took my blood pressure, listened for the heartbeat and I was out the door.

I didn’t do much research about labor, pregnancy, etc until I actually was pregnant with my first and had already started to go this practice. What I know now is that I could have switched, but then I was too nervous. I felt like it was the wrong thing to do and my care would somehow be compromised. Not that I didn’t get good care there, I did, but the biggest difference between them and the midwives is that there I felt like I was just a number. They had their way of doing things and overall, they were doing it no matter what their patients wanted. I feel like the midwives treat me like a person that has opinions and feelings about how her pregnancy and labor should go. To me, that is the most important thing you can ask for in a provider, no matter who they are.

I thought the best way to really portray the difference is to give you some examples of my care at both places.

Example 1: Birth Plan

The OBGYN office did not discuss birth plans with you. The midwife office does and requires each woman to fill one out around 34 weeks. My cousin (who writes this wonderful blog) helped me put together a birth plan for my first pregnancy. I brought it to my appointment with the OB and asked her to look at it just to make sure I was on the right page. I had something in the birth plan about the hospital staff not asking me if I wanted any pain medication. The doctor’s response to this was laughing and saying, “What are the nurses supposed to do when you are lying on the floor screaming in pain?” Needless to say I left the appointment completely shaken up, crying and even more nervous about the labor.

I discussed my birth plan today with one of the midwives at my 34 week appointment. This birth plan is a lot more simplified. One thing I learned after my last pregnancy is that everything will not go according to plan and I can’t get discouraged if it doesn’t. I basically stated that I would like to try to go naturally and use certain techniques that have always helped me relax. The midwife was wonderful when going over the plan and even gave me suggestions about things to add in.

Example 2: Extras

I am not sure what to call all of the additional things that happen after the labor such as cord cutting, skin to skin contact, nursing immediately etc, but I will just call them extras. These extra things were a cause of worry for me when my first was born. Waiting to cut the cord, not cleaning the baby right away, etc were not routine for the OB practice I went to. It was just one more thing I had to worry about getting included on my plan and making sure they would follow. (Luckily they did.)

I went to a “Meet the Midwives” open house when I was first pregnant with my second and trying to decide if I should go to their practice or not. Some of the women there asked questions about cord cutting, skin to skin, etc and midwives said these are not even things that need to be included in the plan because they are all routine at their practice. In fact, the midwife I met with today even told me about a study that the hospital is doing called “Kangaroo Care” and to make sure I tell the nurses I want to be a part of it. That way I am guaranteed that all the nurses follow these procedures from birth to discharge.

Example 3: Induction

I ended up getting induced with my first. Yes, completely different than what the plan was. I was 41 weeks and the doctors recommended I get a non-stress test. Of course, we failed! My daughter’s heart deceled one time during the test and the doctor told me that I needed to get induced. Actually she told me we needed to go straight to the hospital, not to eat anything, and that I couldn’t go home and get my bags. I was freaking out! After 30 hours of Cervidil, Pitocin and an epidural my wonderful daughter was born. In the end, the labor didn’t matter. I had her vaginally and I was blessed with a wonderful, healthy daughter. But, do I want to go through that again - no way!

I discussed my last labor with the midwife today and have discussed it with my new group in the past. They basically have told me that because they are associated with a hospital if a patient gets to 41 weeks they have to recommend a non-stress test for liability reasons. Would the OB docs have told me it was a liability issue, again, no way!

They have also told me that there are more false positives than positives in a non-stress test. In fact, when I met with the midwife today I told her that I think my daughter’s heart rate never decelled. I told her that the monitor moved while I was being monitored and I believe that is when it recorded the decel. In the next 30 hours of labor my daughter’s heart rate did not drop one time. She laughed at me when I told her that. Not because she thought I was uneducated or naive, but because she could tell how strongly I felt about the whole thing. She actually went on to tell me that if I get to 41 weeks this time and get a non-stress test that I need to make sure I drink plenty of water, eat a lot before the test and “watch the monitor like a hawk.” She said if the monitor moves at all I need to pull it off, call the nurse and tell her to come put it back on. That way no false decel is being recorded. I almost grabbed her out of her chair and started kissing her when she told me that! A medical professional that is listening to me – what a novel concept!

Overall, I have had a lot better experience at my midwife group. I feel like they listen to my concerns, answer my questions and most importantly want me to have a role in my pregnancy and labor instead of just sitting back and being a passenger. That is how I felt at the OB group.

My recommendation to any pregnant women thinking about what type of practice to choose is to educate yourself first. Maybe you are okay with being a passenger, maybe you want to be in the driver’s seat. Either way, decide how you want to approach your pregnancy and pick a provider that offers you that. It has made my second pregnancy such a better experience.

1 comment:

micky mayor said...

It may be you have few if any options in this area, depending on the institutions your OBGYN works with. oB/GYN South Florida