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11-28-2012 at 8:16 PM
BunnyBites
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BunnyBites is not online. Last active: 12-16-2012, 5:06 PMNewbie

OB/MD practice vs Midwives

I'm 24 weeks along with my first and not loving my OB practice for a variety of reasons I won't bore you with. My mom and a handful of friends with kids have encouraged me to look into moving to a midwifery practice. I am having a hard time making the decision.

Both rotate through 24 'on call' shifts for all doctors/midwives, which I can't seem to escape in my city. Both deliver at the same hospital birthing center. OB office has a c-section rate of 28% for FTM, midwives are at 11%. As a FTM, I like that the midwives stay with you your entire labor; they don't just 'catch the baby.' On the other hand, I worry I'm a bit too type A/old fashioned/traditional for the midwifery experience. I'm also ridiculously nervous about 'quitting' my OB's office, as I do like ~one~ of the five doctors and would like to retain her as a GYN. I need to decide in the next week or so.

 Has anyone else been faced with this choice? What mattered to you? What did you end up doing? How did you/do you feel about your choice? Is there another board I should be posting this on?

 Thanks in advance! 
 
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11-28-2012 at 8:43 PM
nycnola
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I had a midwife with DD and loved the whole experience, and I ended up with an unplanned section. We then moved to a new city and I had to see an OB for this pregnancy to try for a VBAC (laws are different in this state or something). The OB experience is totally different and I really miss the midwives. I felt like they really knew me, and took care of me. It was great having them with me the whole time, and I felt like the whole philosophy of the office was more patient centered than my new OB. Also, even though the midwives were way more open and supportive of natural methods and were slow to suggest interventions, I felt my midwives were very attune to interventions when necessary and it makes me feel better about my c-section, because I knew I needed it because we had exhausted all other options. I am completely biased but I think you should go with the midwives. Good luck!
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11-28-2012 at 8:58 PM
MrsWindyCi...
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MrsWindyCity is not online. Last active: 05-17-2013, 10:30 PMPlatinum

IMO, if you are really happy with your OB practice, I would probably stay there. No reason to risk a good thing. Do you meet the other doctors in the practice throughout your pregnancy? I go to a small office (4 OBs) and they make sure to schedule at least 1 prenatal appointment with each doctor so you know them as well as your primary doc.

FWIW, one of the reasons I really love my OB is because she is almost midwife-y. :) She was very on board with my birth plan and I felt really comfortable with her. I was able to have a med-free labor at the hospital, which is what I wanted. Unfortunately she wasn't the one on call the night I went into labor, but everyone else in the practice was great, so I was okay with that. 
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11-28-2012 at 9:52 PM
sucrets4
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I had an abnormal situation with DD (6 weeks early and a section since she was breech), but I always was under the impression that the nurses are the ones that you really bond with during labor, not so much the doctors.  

Have you met with any midwives?  Maybe schedule an appt and chat with one to see how you feel after speaking with one. 

I wish I had more advice, but I haven't had to consider this.  I feel much better staying with an ob after everything that happened with DD.  GL with your decision, though! 
BFP(1) DD1 born 4.17.10 @ 33w5d due to pPROM
BFP(4) DD2 born 2.14.13 @ 35w5d due to pPROM


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11-28-2012 at 10:55 PM
lisa5201
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I use a midwife and love it so much better than the OB. If the midwife is on board with your birth plan then I don't know why it would matter if you are type A/old fashioned/traditional. In my experience midwifes tend to be MUCH more flexible about the mother's desires for her birth experience than any Dr. If you want things a certain way, I would def say the midwife would probably be more flexible. 

If the OB you like is a decent person/Dr. then she won't take it personally that you switched to another care provider for your birth. If she gets upset, or she makes you feel uncomfortable then she's honestly prob not a very good dr.

 If you are giving birth in the same place no matter what you can expect the same level of care if something goes wrong. You will be in a hospital environment either way. For me switching practices/dr.'s/midwifes whatever is a no brainer. If your not happy with who you are with, explore your options. 
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11-28-2012 at 11:01 PM
RussianMom...
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i went with a midwife - it was an easy decision for me, hands down. I can't really explain why other than they just let you do it your way. No one pushing C-section on you if if it's taking too long, you can choose your labour positions. when i go in for my appts, it's very personal - im comfortable, i can ask questions, i dont feel rushed. it just works for me so far.
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11-29-2012 at 7:15 AM
hugmonkey
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I have been going to a midwife practice and as far as being type A, I would say a midwife would be perfect for you.  I find them to have all the professionalism of a regular ob/gyn.  But, they are much more responsive to questions/concerns.  At the office I go to, it isn't like some sort of new-agey place with incense and long flowing skirts or anything.  They look like doctors, they talk like doctors.  Except, they really take their time with you, answer all your questions, and are more open to allowing you to help decide how you want to give birth (standing up, kneeling, in water, etc).  The midwives I go to don't push you for a c-section, but they also aren't totally against medication if you need it.  They are there to listen and respect the decisions you make about your birth process.

All in all, I love the office I go to.  



Me: 35 DH: 30 TTC since 1/2010 DX: 6/15/2011: MFI IVF with ICSI

IVF #1: Sept 2011: Beta 10/10- BFP!! 1st u/s 10/31/11 1 blighted ovum, 1 embryo 2nd u/s 11/14/11 stopped growing, no h/b D/C 11/17/11

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11-29-2012 at 7:29 AM
KrisM86
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I've been so happy with my midwifery practice. There are 5 midwives, so I will get whoever is on call when I go into labor, but since I have appointments with all of them, I have a chance to get comfortable with each. Also, unlike most OBs, my MW spends the entire 20-30 minute appointment with me. She takes my vitals, feels the belly, listens for the HB, and gives me plenty of time to ask questions and talk about how I'm feeling, any concerns, etc. Each one is just as professional and knowledgeable as any OB but much more attentive.  

Also, in your case the much lower C-section rate with the midwives is a huge plus. I feel much more comfortable knowing I have a provider who will do everything possible to avoid a c-section.

You can always retain the OB you like as your GYN, although after meeting with the midwives, you might find you'd like one of them just as much.

I would strongly recommend meeting with some of the midwives in the practice and see what you think. It sounds like they would probably be a better fit for you. 
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11-29-2012 at 8:35 AM
wren444
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I think the c-sec rate speaks volumes about your OB practice vs the midwives. If you haven't explored the midwife option through a "meet & greet" type appointment, I would at least go in and check them out, then follow your intuition. I know changing mid-game is hard to do, but if you are having doubts about the OB situation then you need to explore your options so that you can rest assured later that you made the best possible choice for you. Personally I love the midwifery model, but I have a doctor who is so much like a midwife (she birthed her kids at home even) that I decided to go with her...If you are not comfortable with some of the OBs though, that is a very legitimate reason to be exploring other practices.
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11-29-2012 at 9:46 AM
candreco
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candreco is not online. Last active: 05-16-2013, 11:11 AMGold

Do any of your options offer both OBs and MWs?  My practice is a collaborative one, so as an uncomplicated pregnancy I primarily see the MWs in the practice, but do occasionally see an OB.  They also always have one of each on call at the hospital, so I can start labor w/ a MW and the OB is right there if needed. 

When DD was born, I actually ended up with the OB since the MW was overseeing a long labor, and she was very supportive and encouraging, so a lot of it depends on the individual OB as well.

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11-29-2012 at 2:20 PM
evelyntayl...
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So with my son, I was with an OB and I had issues with 3 of the 4 docs. The only reason I didn't switch to a midwife is because my ins would not cover a switch in coverage at the time.

This time, I am going with a midwife. I work in L&D with both OBs and midwives and I love them all, but a midwife will spend a lot more time with you and if your goal is something more hands off, relaxed with little interventions and possibly med-free, then go with the midwife. But before you switch, do a consultation with a midwife practice and see how you like it. I love my midwives. 
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11-29-2012 at 6:02 PM
BunnyBites
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BunnyBites is not online. Last active: 12-16-2012, 5:06 PMNewbie

Thanks, everyone, for sharing! I had a meet and greet with a midwife from the practice I am considering. After reading your comments/experiences, I think I'm going to call my insurance and double check a switch doesn't create issues (thanks, evelyntaylor!). If it doesn't, will get appt. with the one OB I really like at my current practice to talk to her about remaining a gyn client while moving to the midwives for prenatal/delivery. 

Thanks again! 
 
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11-29-2012 at 6:46 PM
YellowLili...
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I had an OB for the first 24 weeks of my pregnancy with DD and wasn't thrilled with the experience. I switched to a MW practice (has 9 midwives) and I think it was one of the best decisions I have made. I absolutely love the practice and all but 2 of the midwives.

I wanted to mention too that a MW can do your GYN care as well.  So if you form a good relationship with your MW you can stay with her after the baby is born for all your GYN care.  I've had all of my annual visits with my midwives since DD was born.
DD September 6, 2007 DS November 26, 2009 DS March 21, 2013 Our little Sammy- 5 days old. 
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