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Our tech team has launched updates to The Nest today. As a result of these updates, members of the Nest Community will need to change their password in order to continue participating in the community. In addition, The Nest community member's avatars will be replaced with generic default avatars. If you wish to revert to your original avatar, you will need to re-upload it via The Nest.
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Thoughts/experience: Obstetrician vs. Nurse Midwife?
I was wondering if anyone was comfortable sharing their thoughts/experiences and reasoning behind choosing one or the other (or both!). I've done some research, but wanted to get some other folks' impressions and ideas on the subject. Especially if you intended/were able to have a natural childbirth without epidural/pain meds.
If you'd prefer to keep your thoughts between just the two of us, my email is: wdcote at gmail dot com and I'll keep it private.
Thanks, Ladies!
"Once the realization is accepted that even between the closest human beings infinite distances continue, a wonderful living side by side can grow, if they succeed in loving the distance between them which makes it possible for each to see the other whole against the sky." -- Ranier Maria Rilke
Me:37 MH:38
TTC since Oct 2011
BFP/Beta#1: 13 6/20/12; Beta#2: 20 6/22/12;
MC/Beta#3: 9 6/27/12 BFP#2/Beta#1: 9/21/12
S/PAIFW
Me:37 MH:38
TTC since Oct 2011
BFP/Beta#1: 13 6/20/12; Beta#2: 20 6/22/12;
MC/Beta#3: 9 6/27/12 BFP#2/Beta#1: 9/21/12
S/PAIFW
Re: Thoughts/experience: Obstetrician vs. Nurse Midwife?
I saw an OB through my WHOLE pregnancy with Josh and when it got to delivery day (not pain med free) I had the NMW for delivery because the doctor on call was the one doctor in the practice i didn't want touching me (heard horror stories from friends). I loved the NMW, she was great and never really pressed one thing over the other as far as getting things moving...The only time she said we had a decision to make was when I wasn't progressing on my own.
She said we have to think about this now we can let you go a little bit more on your own or we can start the pitocin and get things moving - if we can get things moving with the pitocin we won't have to think c-section unless baby is in harms way.
Now that we are thinking about #2 I've already had a bad episode with my new OB and will most likely be switching to a different one but I would have no trouble going to the NMW either.
I went for an OB because, well because I didn't really give it a whole lot of thought and the office I went with was convenient! I liked the location of the OB office, I liked that they had a lot of staff, and I liked that they delivered at Maine Med and Mercy since at 6 weeks I had no idea where I wanted to deliver!
I feel very lucky that my primary OB was a really awesome doc who felt a lot like a midwife. She was mellow (do you see a trend for what I look for in a health care professional from my eye doctor post today!?) and didn't push anything. She told me to have a drink at Christmas. She told me moderation on anything was generally best. She laughed when the ultrasound people estimated the baby big when she put her hands on me and said "No, there's no way there is that much baby in there."
When we got to the being overdue part, the office had a policy to not induce before 1 week over, much like a midwife. If I had wanted to go longer than 2 weeks (and if I hadn't had low fluid and a placenta that looked like it was crapping out) I think they would have let me. My doc swept my membranes upon my request, but never mentioned it prior.
When we got to the really overdue part, and I was admitted to the hospital, all of the pros I saw were good. They all reviewed my birthplan and were cool with it. Even when I had the older dude at the end, he very pleasantly talked with me about my options. He was obviously hoping we'd agree to the c/s since I was a full 2 weeks over, not making much progress after 36 hours, tired, and seemed to have a slightly stressed baby. But we did feel like it was in our hands to decide. We felt pressure, but not in a bad way.
So long story short, I might not have given it thought, but my positive experience came from having a good office. I think no matter where you go, you have to have a good connection and feel good about the choice, and like Jess said you've got to be your own best advocate. If that means switching things up 7 months in, so be it!
(I was also glad to have made friends with my primary nurse Pam who gave me the scoop that older dude doc had a preference for episiotamies and that if if came to that, she'd be on my side and try not to hear him the first few times. Having a good nursing staff that day is worth their weight in gold!)
LOL I think anyone who knows me for more than 5 minutes (if that) knows that I am not shy about making my wishes known and advocating for myself-- in fact, it's one thing I always make a point of educating my patients about, since it is easy to defer to those folks in the official-looking white coats.
I should probably also mention that for me, this decision is not only big because it's my body and my baby's well-being (like it is for all women and their babies), but also because I am planning on delivering in the same hospital where I work. Soooo.... I would hate to cause any professional wrinkles by telling a doctor or nurse-midwife where s/he could go stick "it" if I felt s/he wasn't respecting my wishes or failing to listen to me or was talking to me like I was an idiot. Or whatever-- I'm going to be hormonal, so how the heck do I know if I'll be reasonable?!?
This is all good input for me as I consider things. I have an idea of what I want to do, but you know what they say about the best-laid plans! I find it helpful, though, hearing others' perspectives (especially with hindsight being 20/20)....
I really debated between a MW and an OB... I have plenty of choices here in Boston but overall, I went with ease. The practice I chose (OB) was 5 minutes from work and the hospital it's associated at has been highly recommended by a lot of the doctors I work with.
The MW practice/ hospital was highly recommended by MM but it was harder for me to get to their appts.
I actually chose my OBs office because they offered ultrasounds at 8 weeks to check viability and I knew we weren't telling anyone until we saw a heartbeat.
I used an OB. Mostly because the practice that I went to has mostly OBs on staff but I also didn't feel any need to seek out a midwife. I knew I wanted an epidural. I prefer more hands-off, less touchy-feely care. I was not someone who worried a lot or wanted hand-holding. I never called my OBs office or my insurance nurse line; I like to get my information from reading books. My birth experience didn't matter much to me as long as I got a healthy baby as a result. The only thing that pissed me off was that I wasn't allowed to eat when I was being induced (with pitocin) so I was cranky hungry for a few hours before my contractions got strong enough that I didn't care about food anymore.
ETA: I was induced for ruptured membranes without contractions, not because I had some "induction happy" OB. We don't actually know how long I was ruptured because it was a slow leak and I thought it was just random pregnancy discharge. In retrospect it was probably about 5 days, so I believe it was prudent to go ahead with the induction.
As part of our maternity rotation in school, I got to watch a woman attempting to have a VBAC (her first pregnancy failed to progress so she had to have a c-section) but then failed to progress and had to have a c-section. So I actually got to see almost the entire process of both manners of delivery. I was VERY impressed with the docs who were there, but I never really got to see/spend any time with the midwives.
I'll have to check out the whole OB/GYN practice at CMMC and see how they handle things (i.e. can I have both an OB and a midwife or what?)...It's good to hear that someone else is having a good experience there, though, since that's where I've been leaning on going!
I guess it depends on the individual midwife and practice because the midwife I saw for the first few visits was awful. She didn't explain anything to me, rushed us out, barely even acknowledge my husband when he asked questions and seemed like she could care less about either one of us. I left there crying after my last visit with her. I was so happy I didn't have to see her again after the initial visits! The DR's at my practice have been so much more helpful, informative and caring. I really like them so much better! I really think no matter what choice you go with, it's still depends a lot on the individual person.
I second this.
I went with an OB just because I have had many "lady issues" (starting with abnormal paps and all the awesome stuff that goes along with that) since high school and was used to seeing an OB for my problems. I ended up really loving my OB, and was lucky enough that she was the doctor on-call when I went into labor so she got to deliver Nolan. She also let me take the reigns as far as putting off any Pitocin and letting me wait a little longer, even though she kept recommending it and I'm pretty sure I told her to "shove it" at one point.
We took the "Childbirth Without Fear" class and the 2 nurses who conducted our class also helped deliver Nolan. Since my labor/delivery was start-to-finish 12 hours, both nurses were with me through the whole thing. In fact, they stayed on an extra 30 min. past their shift to see me through until the end. Pretty much awesome motivation for getting N out of there so that they could meet him!
Both nurses were amazing and never left my side once active labor began. (although at one point, there were about 10 people in the room and I didn't even notice) I did go with a round of Nubain towards the end of labor before the pushing began just to take the edge off, but no Epi. The nurses really are the big stars behind the scenes!
Anyways, above all, it wouldn't have mattered that my OB delivered my son, or that 2 nurses whom I had gotten to know really well supported me through it all (and really, I felt quite lucky to have them all there) Joe was the most amazing, supportive husband I could ask for. That man only stepped out of the room when I yelled at him to get me more "damn Gatorade!!!" Otherwise, he was there holding my hand, rubbing my back, explaining what was happening in the movie "RoboCop" while I labored(ha, ha), putting cold compresses on my head, keeping me hydrated, cheering me on, and then telling me how beautiful our son was when he finally was born. He was my rock.
I will go back to the same OB for our next child, and love Midcoast Hospital - especially its nurses!
I can't express strongly enough how much I loved my midwifery experiences with both kids. I have fair to bad OB experiences attached to both pregnancies. (The OB who delivered Owen via c-section was a gigantic *** and the OB who sewed up my Frankencrotch with Ellie was just generally okay.) Like pps, I was all about the philosophy of care associated with the midwife practice. It's not that I wanted hand-holding or anything like that like Kimberly listed, I just wanted to work with medical professionals who supported my views on pregnancy and childbirth. They were true advocates for my role in creating my birth experience: if I wanted drugs, they were in, if I didn't, in again. If I wanted screening testing, they were in, but totally supported me when I declined all of it. I was made to feel (whether true or not) that I had a role in the decision making process in my birth experience, whereas the OBs in both experiences seemed to come with the attitude that they knew what should be done and what was best, and told rather than consulted. Also, unlike the OBs, the MWs seemed much more sensitive to the fact that the births of my children were very personal experiences unique to me (even if it didn't seem unique to them, since they do it every day). Does that make sense? I would choose midwife care again and again and again.
Oh, and Owen's c-section came 9 days past due after 30 hours of non-productive induction drugs and a declining baby heart rate. Ellie was born VBAC after several hours of pitocin but no pain meds. We did the Pitocin only because my water broke on Thursday afternoon and by late Friday morning I still didn't have regular contractions.
I could have written this exact thing! I went with an OB office with 6 drs and ended up loving the first one I was scheduled with. She is so mellow, down to earth and caring. The only thing I don't like is you don't know who will be on call when you deliver. I did meet all of the doctors last time during my pregnancy and liked them all enough. I was lucky last time that my primary dr was on call when I went into labor, but she had to leave before I had Eli. The doctor that came on was very nice and after 20 hours of labor I didn't really care who was there- I just wanted my baby out!
I had a MW all the way through and I adored her (and I liked the few others I met too). I had a natural birth plan and she was with me 100% on everything.
Then we found out Abe was a porker and had to be cut out. You may remember how upset I was, I cried and cried and cried. I met the OB and thought she was fantastic. She is the same one Jess W. had.
To be honest, I would do everything the same next time. I would see my midwife and then have the c-section (I think).
I was already seeing my GYN for other issues so when it came time to see an OB I just stuck with him. His office has a few Midwives and I met them and I felt like all of the people in the office were on the same wave lengths. From the beginning I was against induction, but felt that pain meds may just need to happen
Obviously, I had a lot of problems and at the end I needed all sorts of intervention. I was very glad at that point that I had an OB. There was no way of knowing that would happen. I think the biggest thing is find the hospital you want to deliver at, find someone who you feel comfortable with and who will respect your wishes. Doesn't matter if they are an MD, DO, or MW, that's what is most important. Like you said, you've got to be your own advocate