Birthing in Birth Center, but had to get signed off as "low risk"

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AmberC727's picture
Joined: 06/05/06
Posts: 226
Birthing in Birth Center, but had to get signed off as "low risk"

I'm having this baby at a new birth center in the area and have known for a while that sometime in my last 6 weeks of pregnancy, I would have to go for a MD visit to get signed off as low risk. I think it's a joke, but it's their regulation so I went. Has anyone ever heard of this? It was such a waste of time!

That appointment was a MESS! I got there 10 minutes early and ended up waiting an hour and 15 minutes just to get called back to the room. The nurse took my blood pressure in this busy hallway that was loud, chaotic and crowded. She didn't give me time to sit and relax to calm down or anything. My bp was 150/80. I told her that couldn't be right, I took it before I left home and it was 126/74. She didn't have anything to say to that.

She put me in a room where I waited for another 30 minutes to see the doctor. He was supposed to be very natural minded and supportive of MW's and all that. What a joke. I told him that the ONLY time I have high bp is in an actual doctors office. I don't have high bp at home, or at the birth center, or at my chiropractors office. ONLY in doctors offices. He retook it after I had time to sit in quietness and relax and he got 124/85 or something like that. Better, but not as good as what I got at home. He didn't fuss about my bp though, so that was good.

Then he wanted to measure my fundus. I told him that was fine, but that I had a full bladder (and thus would push the baby up) and that I could already tell him I would be measuring 2-3 weeks ahead. I always did with Evan and I always have with this baby. Plus, I'm fluffy. What do you expect? LOL Sure enough, I measure 38 weeks. That got him started...

He apparently is concerned that I am carrying an elephant or something because he started talking about how big this baby could be and yada yada yada. Now mind you, we had just had the discussion that Evan was 9 lb 12 oz, and I was only in labor with him for 9 hours, and only pushed for 45 minutes of that time, AND his big ol' head was trying to come out tilted to the side. I would say that my body is capable of birthing big babies, wouldn't you? Even with all that, the rest of the visit was like a commercial advertisment of him telling me how wonderful his hospital is, how family friendly and blah blah blah. I happen to know it is not, and it has one of the higher c/s rates in this area! Nice try doc.

He also asked me if I would be willing to come back at 38 weeks for an ultrasound so he could check the size of the baby, and if she was big perhaps we could discuss membrane sweeping or something like that. I asked him if that would influence whether or not he signed the paper. He said it might. I explained to him that the form simply said that as of TODAY, he doesn't find any high-risk signs. That's it. I told him it's as of TODAY, not tomorrow and not 38 weeks, and that if I end up with a huge baby, he's not liable because it was as of Today, not any day after that. He said fine, he would sign the paper. I thanked him and told him I would not be having an ultrasound as they are not reliable anyway.

Aside from that, he went on and on about how sometimes things just happen and if you have your baby in a birth center and don't have an OR nearby that it's not a good thing. I should have told him that many times the reason they need an OR in the first place is because doctors mess too much and have to put their 2 cents worth of interventions in the mix when they're uncalled for. I should have said that. Hind sight is 20/20.

So, my paper is signed and he failed at scaring the living daylights out of me. So I wasted the second half of my day, $15 plus the gas it took me to get up there, and missed out on working yesterday just for all that. Uggh.

Joined: 08/22/06
Posts: 621

How frustrating! But I am so glad he finally signed off! Your sons' birth sounds sooo similar to mine. Total labor/delivery time was 10.5 hours. 42 minutes of pushing and the poor child's head was so cocked back and to the side it was ridiculous! My son was 9 lbs., 4 oz.

I'm surprised the birth center is the one who examined/questioned you to see if you were low/high risk. I guess they'll probably do their own assessment though once this dr signed off.

Glad everything worked out though!!! Yay for getting into the birth center Smile

Joined: 08/22/06
Posts: 621

How frustrating! But I am so glad he finally signed off! Your sons' birth sounds sooo similar to mine. Total labor/delivery time was 10.5 hours. 42 minutes of pushing and the poor child's head was so cocked back and to the side it was ridiculous! My son was 9 lbs., 4 oz.

I'm surprised the birth center is the one who examined/questioned you to see if you were low/high risk. I guess they'll probably do their own assessment though once this dr signed off.

Glad everything worked out though!!! Yay for getting into the birth center Smile

AmberC727's picture
Joined: 06/05/06
Posts: 226

Well see that's the thing, I've had my care at this birth center since I was 14 weeks pregnant, so they should know if I'm low or high risk or not. They just have a doctor do this to cover their butts I guess, but I don't think it's a state rule or anything like that. Homebirth midwives certainly don't have to have a MD sign off their patients! And my MW is a CPM not a CNM so it's the same thing basically, just not at my house, and covered by insurance.

sarahsunshine's picture
Joined: 11/29/06
Posts: 1462

It sounds to me that as annoying as your appointment was, it was great to get full signoff so you don’t have to see this doc again! Too bad about missing work, but would you rather not miss work and go to the hospital, or go to the birth centre and miss 1 day of work. I know my answer!

Congrats on being knowledgeable. I would have loved to add my 2 cents to the doctor, though sometimes keeping your mouth shut gets you further where you want to go… Some docs don't like patients who know more than they do!

MrsMangoBabe's picture
Joined: 04/09/07
Posts: 2276

maybe the physician consultations are necessary for their birth center license? I'm sorry the appointment was so terrible. The "big baby" paranoia is so silly. And I hate how little respect midwives get in the U.S.--like the OBs have all the power and midwives get permission to work from them. I noticed this when I had my DD with a hosptial CNM group.

jolly11sd's picture
Joined: 02/02/05
Posts: 3327

I'm so glad you got your paper signed and don't have to go back there. I would have probably given him a piece of my mind as I was walking out the door with the signed paper tucked away safe! Then again maybe I'd be running out of there and away from him and his big baby scare tactics!

faeriecurls's picture
Joined: 06/04/08
Posts: 790

I'm sorry you had to go through all of that, but I am glad you got your papers signed. I think Brittany may be right - it may be part of their license that requires a physician sign off. I HATE the whole "big baby" thing - it's ridiculous.

My birth center (which is an in-hospital center) requires the back-up OB to sign off on all birth center clients/patients around 36 weeks. My m/w group assesses risk throughout though. I waited over 2 hours for my appointment and was ready to strangle him when I finally got in the exam room. He was really great though - he is super supportive of m/w etc - his two kids were actually delivered by one of the MW's from the group I see.

TyrantOfTheWeek's picture
Joined: 12/26/05
Posts: 1147

In a way, I am glad my homebirth midwife isn't licensed (No such thing as a CPM certification here in GA. Basically, she is practicing illegally). Alphabet soup behind someones' name doesn't make them "all knowing" or automatically qualified. Also, she doesn't have anyone to answer to, or stupid legal CYA crap.

I am glad your doctor signed off on your papers though.

Joined: 11/12/09
Posts: 19

I'm betting that you're at the same birth center that I recently delivered at (saw that you're in NC!). there's only 1 new one in the region! The MD sign-off is required by law for the state that the birth center is in. Bummer but at least we have the birth center option now! I would have loved to have had my daughter there.

Good luck with your birth!! I had an amazing experience there.

CaBlondie918's picture
Joined: 01/27/07
Posts: 260

Sounds like a frustrating appointment but glad to hear that he did sign the paper. Biggrin

Illiana's picture
Joined: 09/29/05
Posts: 338

thats how it is here.. you have to see the MD for first appt. and then again at 36 or 37 weeks (MW can't deliver before 37 though) and if doc says no (only one doc is known to say yes in the city) then your SOL. No birth center or homebirth for you. They're VERY restrictive on MWs here. NO VBACs, no high risk of any kind (no GD for example), must be between 37 and 40 weeks. before or after must be directed to hospital. Etc.

ANyway, it's probably a state regulation. I'm just glad that it wasn't too much of a problem for you to get it. Yay for a birth center birth!