Update on talk with OB *Another update at top*

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kvo
kvo's picture
Joined: 12/18/06
Posts: 902
Update on talk with OB *Another update at top*

I did it!!!!! I took the last spot for a June birth at the midwifery clinic. Woo-hoo....I feel better already!

I suppose it could have gone worse. I've had to continually remind myself that by sticking it out with her and the hospital I am saving over $4000. If we weren't sinking a TON of money into our house in hopes of selling it in the next 5 years, I'd be making the switch.

She asked if anything was new since our last appt. I said I had decided to do NCB this time and had hired a doula to help me manage the discomfort without the epi. She gave me a "you're weird" look and said "why do you want to do that?" I explained that I always envisioned myself giving birth naturally and wanted to do a water birth and the only reason I didn't with Zoe was b/c my anxiety was out of control at the time and I chose induction at 41 weeks due to having to start a new job only 3 weeks later. She asked if I was doing any sort of class to prepare for NCB and I said hypnobabies. She did seem to know what it was and thought hiring the doula was a good idea too if I was committed to NCB.

She then said "most people that want that give birth at home with a midwife." I explained that I really didn't want to give birth at my home, not for safety reasons, but b/c my home is very cramped and full of animals--not a relaxing place. I made it clear that the only reason I am going to the hospital is because my insurance won't cover a birthing center. I also asked her about how many of her patients do NCB and she said about 10-15%, which is considerably higher than the hospital's stats which are 3%. So I know she is at least familiar with delivering babies in that manner.

As for the IV--she said it is not "standard" to do an IV. I had one b/c Zoe's heart-rate was unstable and they were trying to stabilize her with fast fluids. I'm going to have to look into that a bit more since I don't really know if it was "necessary." If it was and actually helped keep me from getting an emergency c-section then I guess the IV was the right thing to do. I did agree to the hep-lock since the idea doesn't really bother me that much.

Movement during labor will not be restricted and I can choose to push in whatever position I want to. She does not do episiotomies and she will not break my water if I don't want her to. I asked about when the cord is typically cut and she said she usually clamps it once the baby begins crying. I asked if that meant it stopped pulsing and she said there is no way to tell when it's stopped for sure and that if the baby is not wrapped up well he could go into shock (not sure how that relates to cord-cutting). So that's an issue I need to look into more as well. She had no problem with DH going with Liam to get circ'ed and that it is done the day after he is born, which we are okay with.

I then asked her about how my induction may have altered my birth experience (making it more intense and difficult). She said since I was not given pitocin, that it probably was not much different that if I had not been induced. Since I had a very fast labor the first time, I can expect it to be similarly fast this time. When I asked her how long I will be allowed to labor before they try to augment, she said that it was going to most likely be a non-issue given how fast things went with Zoe.

So, yeah...not great, but not terrible either. Especially since she has always been respectful of my decisions regarding birth, pg, and my m/c.

krazykat's picture
Joined: 08/11/07
Posts: 1143

If I remember correctly from my Bradley instructor, the cord can contain as much as 1/3 of the baby's blood volume. If it is clamped, that blood will not make it through the cord and into baby. Just in my own case, if we are going to delay cutting of the cord, we will also not want it clamped in any form either. Receiving the blood can increase baby's iron as well as decrease the risk for anemia for the first 6 months (I believe). But that is totally a personal decision Smile

Her responses would definitely make me feel a little uneasy, but I do understand your reasons for staying with her. And honestly, she won't be there the whole time you are laboring anyways. I would be more worried about the nurses and hospital policies. Is she going to sign your birth plan for you so that the nurses know she is on board with your decisions? That would be great, so that hopefully you won't meet much resistance once you are in the hospital.

Also, just curious, you may have said this before and I missed it, but how were you induced with DD? I know there are many other things than pitocin that can lead to a more intense labor/birth experience. Heck, even nipple stimulation can cause VERY intense contractions.

I'm glad you are ok with what she said, and that you are secure in the fact that even if she doesn't agree she will honor your decisions. Go with your gut Mama, and if you are happy and healthy, and so is baby, then hopefully you won't have any issues Biggrin

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

I can understand why you stay with her, and if you trust her to let you make the right decisions (even if she doesn't agree with them) and will sign off on your birth plan, then you should feel ok. Hopefully the hospital and nurses will be able to be on board!

jooniper's picture
Joined: 08/27/07
Posts: 780

I tihnk it actually sounds pretty good for an OB0 but then I haven't coime to expect much of them. Good for you for sticking to your plan.

kvo
kvo's picture
Joined: 12/18/06
Posts: 902

"jooniper" wrote:

I tihnk it actually sounds pretty good for an OB0 but then I haven't coime to expect much of them. Good for you for sticking to your plan.

Yes, this is how I feel about it as well. She's a medical doctor and she is very knowledgeable and experienced. She is not a midwife and her belief is one of "better safe than sorry" and I can understand and respect that. I'm not totally anti modern medicine myself.

I can't say it's my ideal birth situation, but I do believe that the doula will be able to assist me in resisting the epi and I will be able to collect on my AFLAC hospitalization policy thereby getting $2800 and have about 98% of my total costs covered by my dual health insurance policies as well. So in total, I save nearly $7000 by going this route (which coincidentally will allow us to have energy efficient windows installed in our house).

klmj's picture
Joined: 11/24/06
Posts: 535

I'm glad the talk went well and you're feeling okay about things! Like someone else said, I would make sure she signs off on it and have a copy (or two) of it with you when you go to hospital. When I was with the OB she scanned a copy of mine to go into my electronic file and they sent one to the maternity center. I also planned to have two copies in my hospital bag -- one for the nurse and one for back-up.

Are you wanting to delay cord clamping/cutting then? Sounded like it from your post, but I wasn't positive.

kvo
kvo's picture
Joined: 12/18/06
Posts: 902

"klmj" wrote:

I'm glad the talk went well and you're feeling okay about things! Like someone else said, I would make sure she signs off on it and have a copy (or two) of it with you when you go to hospital. When I was with the OB she scanned a copy of mine to go into my electronic file and they sent one to the maternity center. I also planned to have two copies in my hospital bag -- one for the nurse and one for back-up.

Are you wanting to delay cord clamping/cutting then? Sounded like it from your post, but I wasn't positive.

Yes, I do, but it did not sounds like something she would do. I am still going to contact a midwifery practice that my insurance does cover just to see if 1) they would take me on at 32 weeks, and 2) they support the delayed clamping, etc. I don't feel like I "need" to get rid of my OB, but I can't say I feel totally comfortable. It would be great if I could have someone who was totally on-board with all my decisions and was covered by my insurance.

I feel pretty embarrassed that I waited so long to change my mind about my birth plans. I just didn't have the confidence before and then all of a sudden, I did. I appreciate that no one here has judged me on my flip-flopping.

gardenbug's picture
Joined: 03/12/07
Posts: 2025

Flip-flopping happens...nothing to be embarrassed about. I'm just glad that you are less anxious and more confident and that Chris is supportive.!

Also, I think it is exciting to hear about your home improvements. By the time you get it completed you'll want to stay there! Smile

rainymama's picture
Joined: 08/24/07
Posts: 409

Thanks for posting this. I am gearing up for a conversation with my OB next week, whom I have never met. I see the midwife for my appts. I appreciate hearing how your talk went, and what you said, and hopefully my talk will go as well as yours. I needed that idea about getting the birth plan signed.

cactuswren's picture
Joined: 10/19/09
Posts: 4658

You switched!! That's great! Post more details?

BTW the other stuff with the OB sounded okay, but I would be really concerned about the cord clamping. That's a huge one for me--the benefits of waiting are enormous for both mother and baby, and the downsides of doing it early are pretty scary. Gentle Birth, Gentle Mothering has a whole chapter on all the studies about it, and even suggest ways to have it delayed with a C-section. And "there's no way to tell" is a RIDICULOUS response. If you can't tell, just wait until the placenta is delivered, that's a pretty clear sign! (That's my mw's policy). :rolleyes:

I don't think you're flip flopping at all...I think you're changing your mind as you learn more and taking the steps to get what you need, rather than sticking with a system you're no longer comfortable with just because it's easier than switching. That's nothing but admirable!

jooniper's picture
Joined: 08/27/07
Posts: 780

That's AWESOME! Fabulous news! IT can make a world of difference to have a team you trust.

krazykat's picture
Joined: 08/11/07
Posts: 1143

I agree with Leigh... MORE DETAILS!! That is fantastic!! So I am assuming that the birth center made you feel much more comfortable? Do tell!

And flip-flopping is a part of my everyday life haha!! We all understand. Things change when you really start to gain perspective on them.

kvo
kvo's picture
Joined: 12/18/06
Posts: 902

"krazykat" wrote:

I agree with Leigh... MORE DETAILS!! That is fantastic!! So I am assuming that the birth center made you feel much more comfortable? Do tell!

And flip-flopping is a part of my everyday life haha!! We all understand. Things change when you really start to gain perspective on them.

It's not the birthing center. It's a midwifery practice affiliated with the hospital, so I will still deliver in the hospital and my insurance will cover it completely. It's totally win-win.

krazykat's picture
Joined: 08/11/07
Posts: 1143

"kvo" wrote:

It's not the birthing center. It's a midwifery practice affiliated with the hospital, so I will still deliver in the hospital and my insurance will cover it completely. It's totally win-win.

Oops!! That's what I meant, totally Wink LOL. So they were totally cool with everything? Yeah, definitely a win-win!!

MommyHopeful3's picture
Joined: 02/11/07
Posts: 108

that is WONDERFUL!

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

I'm glad to hear you decided to switch to the midwife group, and that you feel they'll support your choices and it works out for you financially.

What your OB said about cord clamping didn't sound right to me. I'm pretty sure you can tell if it has stopped pulsing by feeling it. Usually, if you haven't cut the cord, the baby stays on your chest and can't be taken to the warmer and be diapered, dressed, and swaddled (you can't really swaddle a baby who's still connected to it's mom by the cord(, but if the baby is held skin-to-skin with you under a blanket, he/she will stay warm and adjust better than if he/she is taken from you.

The cord hadn't stopped pulsing when it was cut for either of my births, because they wanted to take them and deep suction them, since they weren't set up to do that with the baby on me. My midwife felt DD's cord and said it had slowed, but not stopped when she cut it, and DS's was cut almost immedately (but I was holding him when they cut it). The nurse brought DS back to me before dressing/wrapping him so he could be skin-to-skin for his first BFing. DD was brought to me swaddled. DS did a better job BFing his first time, but I think that is also because his birth was not medicated, and DD's was.

krazykat's picture
Joined: 08/11/07
Posts: 1143

"MrsMangoBabe" wrote:

I'm glad to hear you decided to switch to the midwife group, and that you feel they'll support your choices and it works out for you financially.

What your OB said about cord clamping didn't sound right to me. I'm pretty sure you can tell if it has stopped pulsing by feeling it. Usually, if you haven't cut the cord, the baby stays on your chest and can't be taken to the warmer and be diapered, dressed, and swaddled (you can't really swaddle a baby who's still connected to it's mom by the cord(, but if the baby is held skin-to-skin with you under a blanket, he/she will stay warm and adjust better than if he/she is taken from you.

The cord hadn't stopped pulsing when it was cut for either of my births, because they wanted to take them and deep suction them, since they weren't set up to do that with the baby on me. My midwife felt DD's cord and said it had slowed, but not stopped when she cut it, and DS's was cut almost immedately (but I was holding him when they cut it). The nurse brought DS back to me before dressing/wrapping him so he could be skin-to-skin for his first BFing. DD was brought to me swaddled. DS did a better job BFing his first time, but I think that is also because his birth was not medicated, and DD's was.

Exactly! We watched videos in our class that showed the cord being cut once it had stopped pulsing. At that point it becomes white and limp... almost looks deflated. If it hasn't stopped pulsing it will have color (blue if I remember correctly) and will be full like a water hose is the best way I can think to describe it. And I have also read that skin-to-skin contact is even more effective at regulating the babe's body temperature than a warmer.

cactuswren's picture
Joined: 10/19/09
Posts: 4658

I have read that too--about mom's body heat being better at regulating baby's temp than a warmer. Studies have shown your body heat actually adjusts to fit baby's temp needs! Plus all the other benefits of having him cuddled up on you rather than taken away, of course Smile

klmj's picture
Joined: 11/24/06
Posts: 535

nak

so glad to hear it! that's the route i did too. i'm sure you won't regret it. it really did change everything for me; i was much less stressed & i found most all my what-if worries completely disappeared. i knew things could still happen/go wrong/etc but i felt much more confident having a team i knew was going to support me in what i wanted.

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

I'm so glad you switched! I think it wil lbe the best thing for you - youwill have a team that respects you and your choices so you can relax and have a much better birth!

Joined: 03/16/15
Posts: 53852

I'm SOOOO Happy you switched!!!

cmljll's picture
Joined: 11/28/06
Posts: 1409

Yeah! WTG!

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

This is the first I’ve heard about your dilemma. I’m so glad that you made a decision that you feel comfortable with, and I hope your birth ends up exactly how you want it to be.

Congrats on doing your research and feeling confident!