Did anyone switch doctors or practices around their 3rd trimester? I've been seeing the same doctor for my annuals for 5-6 years now so I just assumed she'd be my OB. We just finished our 3rd Bradley Method class (of 8) and I'm having second thoughts now. I had an OB checkup on Friday and asked my doctor her thoughts on unmedicated births. She was supportive in the "more power to ya" way (her words) but sorta dismissive when I mentioned the class we were taking. The practice is very firm on only allowing for one week over due date and that concerns me because that puts me up against July 4 weekend. I know so much can change but if it were to come to that, I'm concerned they'll try and push for an earlier induction. The hospital and practice I would be considering is completely different. Not as convenient to work for appointments but it's a practice of all midwives and they deliver at a hospital with birthing rooms and tubs. That hospitals C-section rate is also only 15% compared to almost 30% elsewhere. Their episiotomy rate is 5%. In some ways this seems like a complete no brainer but I don't know. If you switched practices "later," why? How did you go about it? I haven't toured current hospital yet (or prospective one obviously). Should I do that first? Maybe have a consultation with the new practice first? Any input would help. 
You might also enjoy...
-
I'm not a huge fan of switching. There is knowledge that will be lost in the transfer, and honestly there are no guarantees for any particular type of birth.
If she was mildly supportive, I'd stick with her.
-
I would switch if I were in your position, no question about it. That OB's response doesn't seem supportive at all and if you are going for unmedicated birth, the place you choose is the most important thing. The place you're considering sounds perfect. Go for it.
-
@Mrs. Jacks: I don't think there's much knowledge that'll be lost. I've only had monthly appointments at my OB's office so far and have only met 2 out of the 4 doctors (need to see all 4 eventually). They didn't do my NT scan and it's been a completely easy pregnancy this far with little involvement or help needed on their part. My concern is more so how mild the support was and how they handle inductions.
@PawPrints: She came across supportive about the unmedicated part but I didn't even ask about their induction timeline. And that concerns me too.
-
I would definitely switch in your position! I don't have any experience with switching mid pregnancy but I've known people who have for reasons like moving out of state and it's fine, things happen. As long as the new practice is able to take you on as a patient and you can make it work with getting to appts from work it should be fine.
-
We've moved a lot the past couple years so I haven't had any sort of regular doctor. Both places I delivered at were big hospitals where even if you had a regular doctor you might not have ever seen the dr delivering you, which was the case with both my babies. Id stll be a bit cautious about switching so late just to make sure insurance stuff was OK and you really did like the place though.
-
I don't know if I would switch; however, as for the c-section rate, is it possible that hospital 1 has a higher level NICU? That might account for it, if they then have more high risk pregnancies/babies. Also, I would take in to account the csection rate for your OB rather than the hospital.
-
@LindsayInNY: one thing to keep in mind is that your OB isn't around for most of your labor (at least that has always been my understanding). It is just whatever nurses happen to be working that shift at the hospital. And the OB is just there for the very end. So really, her thoughts on your labor plans don't mean much.
-
Absolutely do what you feel comfortable with, but my OB ended up being out of town and I just got an on call doctor that I had never met before. And the nurses were the ones who really mattered. That and I would deliver at a hospital with a great NICU just in case.
-
@LindsayInNY: if you've been seeing them for 5-6 years, there's a lot more knowledge base than just this pregnancy. Health outcomes are less good in patients who doctor switch overall.
Don't get me wrong, there are legit reasons to switch, but I rarely suggest it unless it is something egregious. Despite what I say, though, it is your baby, your body, so do what feels right for you.
-
Choosing to deliver in a place that wholeheartedly supports unmedicated birth is really important if that's what you hope for. It's the difference in what they default to - are they inclined to offer interventions as a matter of course or only when medically necessary? Is it routine and normal for them to suggest natural pain management etc or is that not something they think much about? I'm extrapolating your OB's lack of enthusiasm into assumptions about the whole practice (nurses, other docs) which may not be true, but, it sounds like the other place you're considering is much more likely to support your desires in a pinch. If you are a healthy low-risk pregnancy then there's no reason to approach birth with the mindset that you're a patient, or that there's any advantage in sticking with a doctor because she knows your history.
-
Does your insurance cover midwives? I am pretty sure mine doesn't. So that's something to look into if you haven't yet.
I probably wouldn't switch if I were in your shoes. I'd just hate the idea of starting over so late in the game. And the OB won't really play a role in whether you get an epidural or not (that's more the nurses). And I think I remember that you'll have a doula? So your doula should advocate for you. I don't really think the holiday matters either as one of the OBs is going to be on call regardless so I don't see why they'd push to induce you sooner.
-
I switched late into my 2nd trimester. I wasn't comfortable with the dismissive attitude of my doctor and didn't appreciate some of the comments. I switched to midwives and part of the reason I was with the other doctor was convenience to work.
I would switch if you are having doubts. This whole process is so much better if you feel comfortable with your health care provider.
I really liked my midwives. It was hard to get an initial appt but well worth it.
Good luck and go with your gut! -
I switched in my third trimester bc we moved. My OB didn't end up being on call when I dekivered. I met the OB on call when I was pushing. Not exactly ideal, but it all worked out and I had the in medicated birth I wanted.
-
@LindsayInNY: You please go and do what is totally right for you, or at least look into it. This is your very important experience, no one else's. My doula switched when she was pregnant at 38 weeks. Do what feels right, go check it out if you want to. Nothing wrong with switching or looking into the possibility.
I almost switched because I wanted to know who would be delivering but ended up staying and had a good experience with the doc on call.
-
I would only switch if I was VERY uncomfortable with the doctor in every regard. I think her response sounds totally normal, but she is clearly being realistic and has done this before. My OB (in NYC) also told me about the 30% c-section rate which is totally normal in the area and I had a vaginal delivery. They didn't push me to do an epidural either. It was totally up to me the entire time, but the upside was they were FAST and organized once I said I wanted drugs.
-
I would definitely at least check it out. My experience was a tad different but I ended up switching super late because I was looking for a VBAC and wanted to give myself the best possible chance to make that happen. I asked my doc a lot of questions- about vbacs but also things like if I could labor in the tub, experience with doulas, etc and his replies did not leave me feeling comfortable that I would get the experience I was hoping for. So I switched the last few weeks and I think it made a huge difference!
ETA: One other thing- once you're in labor you're not in a position to really advocate for yourself, or at least I certainly wasn't, so I think it's important that you and your provider are on the same page ahead of time. -
If you feel uncomfortable in any way, I say look into it now while you stilll have time.
I didn't LOVE my ob, but I don't really have any attachments to docs in general. So I went with it even though we didn't "click." Come to find out the morning of my delivery that he's known as the 'csection doc'....! I had a break down when he came to see me when I was at 9cm saying "okay if you don't get to 10cm in an hour, we'll c-section!"... :O talk about shock. Luckily, he ended up being stuck in a scheduled c-section when I reached 10cm and was pushing, his partner (my OB now) is now my new OB and I'm so glad things worked out the way they did. He's been an absolute pleasure this second pregnancy and there are 7 other partners that I will (fx) likely see at delivery over my first OB.
-
I moved between 32 and 34 weeks across the states. I never even met an OB at my new practice, just certified midwifes. I don't even know the name of the doctor who delivered my son. I had a very uncomplicated pregnancy, labor, and delivery.
-
It wouldn't hurt to talk to the new practice. I'm a bit biased because I had a hospital birth with a midwife at a hospital with a much lower c-section rate than the rest in our area.
-
I switched at 30 weeks. My original OB was closing the office I went to and I would've had a long commute by subway to my appointments thru the rest of my pregnancy. It also coincided with getting better insurance so I was able to switch to an OB who didn't take my previous insurance and thus deliver at a more desirable hospital. Getting the paperwork and charts moved over was a bit of a pain but it was totally worth it. you meet with them so much more in the third trimester. If. You can find an OB who is on board I say do it.
-
My OB was kind of like that for my first, but I knew the hospital was open to natural even if not their norm. That practice has like 40 doctors so I didn't know the person who delivered. I did however do a birth plan (later in Bradley you will) and talked through it point by point with her and asked if she thought others in practice would feel the same. In the end, the nurses were totally ok with it and really went with the plan despite a longer labor. And the fact that my ob talked it through made me feel better. So maybe that's an option to explore, but I totally say go with your gut and if you want to switch, do it. However with Bradley training and a doula you may be able to make it work regardless.
-
I recommend checking out the hospitals and the nurses. In my experience, the nursed were the ones that really had the control of labor. The doctor was there to catch and stitch (and my ob missed the catch). Of course, the doctor makes decisions if things aren't going exactly as planned so there is some coordination there.
-
As has been mentioned before, the OB isn't even there the majority of your labor. I only saw an OB when I started pushing. And even if they were to be there, they aren't going to be hand holding you through it.. IMO that's not really their job, that's the job of a doula, a bit the nurses, and your partner/support person/people. If the hospital is your major reason for wanting to change, then I would do more investigating, but I wouldn't change based on your OB's response.
-
I switched at the end if my second tri, and I'm really glad I did. I would ignore the hospital's overall c-section and episiotomy rates and only consider the rates of the specific practices you are comparing.
Btw I heard a lot of conflicting things about that NYC hospital's birthing center. There is a very high transfer rate out of the birthing center to the main delivery ward. And I have also heard unpleasant stories about the triage process there, though I think that might be an issue at all NYC hospitals. I was supposed to deliver there with an OB and switched to an OB in NJ. (I live in Hoboken.)
My labor started ten days after my due date, and I was stalled at 9.5 for several hours. So I would not have been admitted to the birthing center in the first place, and even so I probably would have transferred due to "failure to progress".
-
I should've probably noted that I know it won't necessarily be "my" OB when I deliver, but any of the 4 at the practice which is why I'm concerned about all of their opinions.
@hilsy85: The lower c-section rate is for the midwife practice. I don't know what it is for my OB practice and I doubt they would openly reveal it either...
@lawbee11: I didn't think of that so I'll have to look into it for sure. I know there's some sort of NY requirement that if there isn't an in-network option for a midwife, insurance companies have to cover out-of-network at that in price?
@bhbee: I'm interviewing our first doula tonight so that might help things if I stay with my OB/hospital. And I think I might want to tour the hospital sooner rather than later so I can ask all of the birthing questions and see the responses.
@ElbieKay: It's a birthing center in Westchester, not NYC. So that's a big difference in things too. I work in NYC but live in Westchester.
-
@LindsayInNY: one thing to think about as to why the midwife practice has lower rate of c- section is that they can only take the most low risk patients, anyone higher risk is filtered out to the OBs. So it's more of what their population looks like.
-
@LindsayInNY: why do you think your practice wouldn't tell you their C-section rate? My doctor was really open about his rate -which was about 15 percent if I remember correctly - compared to the hospital's 30 percent rate (which I think is standard for all NYC hospitals). I think you have to do whatever will make you the most comfortable - but I wouldn't switch from a long term provider without at least having a conversation about your concerns.
-
@Madison43: I just don't foresee them being entirely open with it, unless it's a good/lower number. The problem is, I have limited time to have these conversations. My next appointment will be at 28 weeks.
-
@LindsayInNY: Great then disregard! There is only one hospital in NYC with a birthing center (St. Luke's Roosevelt). Glad to hear this doesn't apply to you
-
@LindsayInNY: there's no reason for them not t be open about it, I would be surprised if they didn't tell you. I would ask for sure. Again, if the hospital with your ob has a higher csection rate look at whether they have higher risk patients.
-
@MenagerieMama: also a great point
-
@ElbieKay: It sounds like a lot of changes have been made to policies at the birth center since hospital ownership changed last year. They now allow women to labor there up until 41+6. (Used to be 40+6) Also I think transfers out due to failure to progress would be driven by your provider, so I think it's mostly critical that each women chooses a provider she trusts explicitly---- what makes me feel most comfortable is knowing that if my provider recommends a c-section, I will feel confident that is 100% the best and safest way for baby to arrive and will be at peace with it (I hope!). ANYWAY, sorry for the novel---- you may be right, I'll know and report back within a few weeks
Sorry @LindsayInNY: for threadjacking! Know I'm pulling for whatever decision ends up being right for you.
-
@MrsBucky: Cool, my son just turned a year old so my reasearch is almost a year and a half old. I didn't know the hospital management has changed since then. I agree that your specific provider matters most, and when I voiced some of my concerns about the birthing center my OB was very dismissive of them and tried to scare me out of switching to a hospital in NJ. So, her response factored into my decision to switch as well.
I'm glad to hear that things are changing at SLR!
-
I certainly would. The support you get from your OB is enormous in terms of the birth you want, and if you've already felt like she isn't overly supportive in terms of natural birth, you're probably right. During my very long labor, a surgeon was called in. I was so tired and over it and wanted any excuse to throw in the towel - instead, he told me that there was no reason to do a section at that point, and that we had a lot more options. I ended up with a vaginal birth.
Had that surgeon told me otherwise, I'd have ended up with a csection - I was totally at his mercy. I'm so glad that he didn't push it and instead guided me towards less invasive options. The doctor/midwife matters A LOT - no matter what people say. It's really important to have one who matches your birth desires really closely.
-
@ElbieKay: it's now Mount Sinai - Roosevelt! other than that, i have nothing to add, i've just seen the signs
@LindsayInNY: Just wanted to wish you good luck! I'm sorry you're not happy with your doctor. I personally wouldn't get too caught up in the statistics, because c sections happen for all kinds of reasons that have nothing to do with a doctor/hospital, but I would trust your gut, and if you're not comfortable with your doctor, it's certainly worth at least exploring another option if it's available to you. hey, at least if you deliver in westchester, you solve your hospital bag issue, right?
-
personal preference, I would not unless absolutely necessary. You can't choose a practice on "what ifs" as in "what if they induce before 4th weekend" these are professionals, they know that babies will come when babies come, she sounded supportive of your all natural. I think it's first time jitters personally. As for the C-section rate, midwives usually transfer all higher risk to a OB, so generally they do have a lower rate because they have only low-risk patiences.
-
It wouldn't be my preference (I'm a big supporter of continuity of care) but unfortunately this will be my reality with this pregnancy as we are moving provinces when I am 30 weeks.
If you do switch, ask for copies of all your records and be prepared to fill in knowledge gaps (about your history) on the care provider side.
-
@hilsy85: Good point. I think I'm just having anxiety of all the uncertainty and "what if's" and making something out of nothing
@sarac: She's supportive in the sense that she knows me and my personality and likely will not stand in the way of what I want. I haven't asked the other 3 OBs though... I think DH knowing my desires and having a doula there might help things as well.
@Pirouette: So true! I'm slowly backing off the ledge, LOL. I would like to make it work with my current OB and practice so hopefully it will!
@LuLu Mom: I think you're right about the jitters... So much can happen (or not happen!) and it's hard for me not to have a rough plan for every scenario. I need to just let things be, I think!
-
@LindsayInNY: just want to say that I also thought about switching OBs (much earlier on, around 10 weeks). I went so far as to meet with another OB who had a better reputation for being warmer and more natural birth friendly. Ultimately, I stayed with my OB because it was SO hard to get an appt time with the 2nd one, and when you're going every 4 weeks, then every 2, then every week, that makes a difference. Plus, I realized that I didn't really need my OB to hold my hand--that was my DH's job. And in labor, my OB was AWESOME, and I now adore her.
Sorry @LindsayInNY: for threadjacking! Know I'm pulling for whatever decision ends up being right for you.
- Google Plus
- Stumbleupon
- Twitter
- Facebook
- Pinterest
- Favorite0
41 comments