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My dilemma-OB vs. Midwife? updated with birthplan for anyone interested

Posted by on May. 31, 2013 at 9:36 AM
  • 26 Replies

Ideally, I would choose the midwife (in a birth center) in half an instant. Water birth, no IVs, intermittiant monitoring, etc, etc. HOWEVER, if there should happen to be any kind of complication, like baby is breech, they send you to one specific hospital and I don't like that hospital. I did my L&D rotation there for nursing school. They are a "high risk" hospital, so they use every intervention in the book. The doctors are jerks, as are the nurses. OR, I currently have an OB who I love at a different hospital. So my dilemma is this: go with the midwife and risk the (small) chance that I may have to go to the horrible hospital? Or stay with my OB and go to the "good" hospital (which is still a hospital, and I'll still have to fight for no interventions, but not nearly as much). What would you do?

Birthplan

1.     I do not want an epidural, spinal, or any other form of pharmacologic pain relief offered. I know what my options are, how they work and that they are available. I will ask for them if I please.

2.     I do not want pitocin to induce or quicken labor as long as I am safely progressing (no matter how slowly!)

3.     I am happy to have a vaginal examination on arrival at the hospital and after that every four hours or on my request 

4.     I am happy to have 20 minutes of electronic monitoring and if all is well then intermittent monitoring every hour for five minutes after that 

5.     I do not want an internal monitoring system

6.     I want to be able to sit up, squat, walk, stand, or use the birthing ball at any point in my labor

7.     I want to be able to change positions as frequently as I desire

8.     I want to be able to push and deliver in the position I choose

9.     I want to be able to use hydrotherapy, if I please

10. I am willing to have an IV, should an emergency arise but it is to stay INT'd. I will stay hydrated through oral fluids, ice chips, popsicles, etc.

11. I want to wear my own clothes, even during delivery

12. I do not want an episiotomy, unless absolutely medically necessary. I plan to do squatting, Kegel exercises, and perineal massage ahead of time to prepare the perineum for stretching

13. I do not want my amniotic sack ruptured artificially

14. I do not want the physician to "help" remove the placenta by applying traction or pulling on the cord in any way, unless absolutely medically necessary

15. I want delayed cord cutting until the cord has stopped pulsating to allow all the blood and nutrients to be delivered to the baby.

16. I want my husband to cut the cord and announce the sex of the baby

17. I want immediate skin to skin contact and for the nurse to complete the baby's assessment while on my chest

28. I want to immediately try to nurse

19. I do not want the baby removed from my room at any time, unless accompanied by myself or my husband

20. We will not be administering the eye ointment, vitamin K shot, or hepatitis B  to my baby

21. I do not want my baby given any formula, water, or other nutritional supplementation. If supplementation is absolutely necessary (blood sugar at or below 45, or whatever is hospital policy), I want my baby given SNS tube or syringe of formula, NOT a bottle

22. I do not want my baby given a bottle or pacifier


by on May. 31, 2013 at 9:36 AM
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Replies (1-10):
MacMamaof5
by on May. 31, 2013 at 9:39 AM
1 mom liked this

Boy that's a tough one.  I, myself, love a midwife and wouldn't mind an OB--as long as she was a female.  I just can't do male Doctors.  But no matter how the staff feels, how does this OB feel about what you want your birthplan?  Go with whomever does not give you funky looks or tries to get you to compromise your list of wants and needs for YOUR birth.  Either way--just remember--THEY work for you!

Azure
by Representative on May. 31, 2013 at 9:41 AM

Since most midwives will only transfer if there seems to be a real problem I would definitely go with the midwife/birthing center. But you have to do what makes you most comfortable. I'm sorry you have to fight for no interventions. That's never fun. :( 

LeapBaby123
by Kathleen on May. 31, 2013 at 9:45 AM


My OB right now is female and I just love her attitude. I haven't actually gone over my birthplan with her yet, maybe that will be a determining factor! With the other hospital, I'm not guaranteed any certain doctor, just whoever is there and will take me. So I won't know my doctor, and he (there's only one female OB there) won't know me. But I'm wondering if it's such a small chance that I would be transferred that I should just stick with the midwife? Ugh!

Quoting MacMamaof5:

Boy that's a tough one.  I, myself, love a midwife and wouldn't mind an OB--as long as she was a female.  I just can't do male Doctors.  But no matter how the staff feels, how does this OB feel about what you want your birthplan?  Go with whomever does not give you funky looks or tries to get you to compromise your list of wants and needs for YOUR birth.  Either way--just remember--THEY work for you!



LeapBaby123
by Kathleen on May. 31, 2013 at 9:46 AM


Yeah, that's what I'm thinking too. Because I know that if everything works out, the midwife is the absolute best option for me. I guess I'm just scard something will happen. 

Quoting Azure:

Since most midwives will only transfer if there seems to be a real problem I would definitely go with the midwife/birthing center. But you have to do what makes you most comfortable. I'm sorry you have to fight for no interventions. That's never fun. :( 



CLG122
by on May. 31, 2013 at 10:02 AM

I would go with the OB.  If the OB is worth their salt, you should not have to fight to have the birth you want, even if it is in the hospital.  I have had both an OB and a midwife and I MUCH prefer my OB.  She rocks and never tries to "make" me do anything, even when she disagrees with me.

LeapBaby123
by Kathleen on May. 31, 2013 at 10:06 AM


I'm glad to hear it! So my birthplan is intense...it's a full page, single spaced. I'm afraid any OB (no matter how wonderful) is going to laugh me out of their office...

Quoting CLG122:

I would go with the OB.  If the OB is worth their salt, you should not have to fight to have the birth you want, even if it is in the hospital.  I have had both an OB and a midwife and I MUCH prefer my OB.  She rocks and never tries to "make" me do anything, even when she disagrees with me.



Azure
by Representative on May. 31, 2013 at 10:07 AM



Quoting LeapBaby123:


I'm glad to hear it! So my birthplan is intense...it's a full page, single spaced. I'm afraid any OB (no matter how wonderful) is going to laugh me out of their office...

Quoting CLG122:

I would go with the OB.  If the OB is worth their salt, you should not have to fight to have the birth you want, even if it is in the hospital.  I have had both an OB and a midwife and I MUCH prefer my OB.  She rocks and never tries to "make" me do anything, even when she disagrees with me.



Do you mind sharing your birth plan?


LeapBaby123
by Kathleen on May. 31, 2013 at 10:09 AM
1 mom liked this

Absolutely! I'll edit it into the post. I actually made it before I got pregnant, while I was in my mother/baby class in nursing school. haha. Feel free to make suggestions! It's obviously tailored for a hospital birth. 


Quoting Azure:



Quoting LeapBaby123:


I'm glad to hear it! So my birthplan is intense...it's a full page, single spaced. I'm afraid any OB (no matter how wonderful) is going to laugh me out of their office...

Quoting CLG122:

I would go with the OB.  If the OB is worth their salt, you should not have to fight to have the birth you want, even if it is in the hospital.  I have had both an OB and a midwife and I MUCH prefer my OB.  She rocks and never tries to "make" me do anything, even when she disagrees with me.



Do you mind sharing your birth plan?




CLG122
by on May. 31, 2013 at 10:14 AM

It's a good idea to keep your birth plan simple for the hospital staff.  I want very specific things, but I don't write them all down because I think it comes off as irritating and pretentious to the nurses, which does not make them want to help me out.  You know?  I type out the important stuff: no circumcision, baby may not leave the room without me or my husband, no vitamin K shot or hep B, no eye ointment, etc. I don't type out that I'd like dim lighting and to play my music during labor.  That's what you have a husband/doula/friend there for-- to help you set stuff up if you want it.  Does that make sense?  If it's not something that the nurses will be doing (or NOT doing), I don't think they want to read through it.  Nor do I think they are going to sit and read through a 2 page birth plan.  Give them what's really important to you and vocalize your wishes during labor :)

Quoting LeapBaby123:


I'm glad to hear it! So my birthplan is intense...it's a full page, single spaced. I'm afraid any OB (no matter how wonderful) is going to laugh me out of their office...

Quoting CLG122:

I would go with the OB.  If the OB is worth their salt, you should not have to fight to have the birth you want, even if it is in the hospital.  I have had both an OB and a midwife and I MUCH prefer my OB.  She rocks and never tries to "make" me do anything, even when she disagrees with me.





LeapBaby123
by Kathleen on May. 31, 2013 at 10:16 AM


Yeah, I know :( The problem is I see everything on my list as really important. And it's not all for the nursing staff, but also for the physician as well.

Quoting CLG122:

It's a good idea to keep your birth plan simple for the hospital staff.  I want very specific things, but I don't write them all down because I think it comes off as irritating and pretentious to the nurses, which does not make them want to help me out.  You know?  I type out the important stuff: no circumcision, baby may not leave the room without me or my husband, no vitamin K shot or hep B, no eye ointment, etc. I don't type out that I'd like dim lighting and to play my music during labor.  That's what you have a husband/doula/friend there for-- to help you set stuff up if you want it.  Does that make sense?  If it's not something that the nurses will be doing (or NOT doing), I don't think they want to read through it.  Nor do I think they are going to sit and read through a 2 page birth plan.  Give them what's really important to you and vocalize your wishes during labor :)

Quoting LeapBaby123:


I'm glad to hear it! So my birthplan is intense...it's a full page, single spaced. I'm afraid any OB (no matter how wonderful) is going to laugh me out of their office...

Quoting CLG122:

I would go with the OB.  If the OB is worth their salt, you should not have to fight to have the birth you want, even if it is in the hospital.  I have had both an OB and a midwife and I MUCH prefer my OB.  She rocks and never tries to "make" me do anything, even when she disagrees with me.






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