- Author
- Posted Forum topic
Tue Jul 06, 2010 9:56am
When you're pregnant, there are so many choices to be made - including whether to choose an obstetrician or midwife for your prenatal care. For example, in many provinces, midwive services are covered under our provincial healthcare.
If you're like me, you talk it over with some friends who've had kids in the past few years - conversations and the experiences of others can really help with planning.
I'm wondering what other people's experiences have been with either an ob/gyn or midwife, what the benefits and challenges are. If you have other questions, please add them too.
Looking forward to your comments!
In my case, I have opted for an OB for my prenatal care. While I know others who have gone with a midwife instead, and there are certainly benefits, I'll be honest... it just wasn't for me. When I became pregnant with my first child, I knew I was most confident with the OB referral from my family doctor, who I have gone to since I was 8 years old and used to deliver babies himself for years. I also wanted to be under the care of the full hospital staff, with no sudden transitions or communication issues in the event of complications. I also liked that the nursing station would always be up to date on our baby's and my status, which was also important for our own parents.
My OB is so friendly, skilled, thorough, calming, and has a great sense of humour. He takes the time to ensure you have all the answers to your questions and that you have all the information you need to make an informed decision.
I think this was the best choice during my delivery, as I began to have some complications and ultimately needed a vaccuum-assisted delivery. The care was consistent and seamless, the nurses wonderful. Although it was not my OB who actually delivered our daughter, I was very happy with the OB who did. Ironically, she was my good friend's OB - and conversely, my OB delivered my friend's baby!
After delivery, my obstetrician and family doctor provided fabulous care, even though it was not in our home... which would have been convenient! I had many complications breastfeeding, and without going into detail, we had to switch to formula. Contrary to popular belief these days, breastfeeding does not work for everyone!! Initially the hospital nurses, public health nurses, and all but one lactation consultant were adamant that it would work and I was taught nothing about formula feeding. This caused us a lot of undue stress and guilt in my early days as a mother. It was my family doctor who one day closed his office and took an extra 30 minutes to counsel me (I'm so grateful to this day), and one lactation consultant who admitted that she was not able to do it either... and her kids are perfectly healthy. I'm now very passionate about advocating for what works best for your own family - baby, mom and dad - and the professional care that supports your needs.
Now in my second pregnancy, I did not hesitate to go back to my OB. I know my baby is in good hands! While I know that all OBs are not perfect, I have also heard of some problematic midwife experiences. I agree with Nicole and Brianna that it's important to understand your options, and make the choice that you are most comfortable with. We are lucky to have options. Looking forward to reading what everyone else has to say!
I think this is a great topic to discuss in a Canadian health care forum because in Canada (at least in most provinces or territories) we have the option to choose an OB or a midwife and in some cases we get the best of both options.
When I first found out that I was pregnant, I was instructed to find an OB by my family doctor. So I did. I did not question the decision at first. However, the OB was not able to meet me until my fifth month of pregnancy so I entered into a "shared care" arrangement with my family doctor for the first five months. My family doctor would then connect with the OB and we would transition near the end of my second trimester.
Something about this arrangement did not feel right to me. I am a curious person at the best of times. My propensity to ask questions and look for "what ifs" was only magnified by the news that I was expecting our first child. I was not sure I was ready to have a "stranger" deliver the baby. I also wanted to ensure that there was some continuity of care for the baby and me.
In addition to my concerns listed above, I started talking to other parents. They shared stories of their OB being away for the delivery, of having the OB in the delivery room for only five minutes with the nurses doing the bulk of the work, of having very short appointments with the OB, and of OBs who did not seem to have time to answer their questions. I knew this was only a small sample of experiences and that there are excellent OBs practicing in my province. However, I also knew that this curious cat was going to need more than a few minutes at each appointment to ask questions and work through any concerns. I also knew that I would feel better knowing who was going to be doing the delivery work on the big day.
I should also note that my decision to work with a midwife had nothing to do with the excellent care of my family doctor. My decision was related to my strong desire to get to know the person that would deliver my baby and to feel comfortable asking questions - and lots of them. And I am lucky to have a husband who supported my decision of working with either an OB or a midwife (he felt that I was the "patient" and should make the call).
Like Brianna, I was reluctant at first to work with a midwife because of my fear of complications. I also had concerns about pressure to have the baby at home. Unlike Brianna, due to an experience with my nephew who may not have survived a delivered at home, I knew that I would be having my baby in the hospital regardless of who delivered her.
Upon my first meeting with the midwife I could tell that we had made the right choice. The system, in Ontario, is set up to allow for one hour visits. One hour?!?!? Could that be true? I couldn’t believe it. I have never in my fortunate and healthy life had the opportunity to meet with any health professional for one hour. Think about all the questions I could ask in an hour! And there was no pressure for me to have our baby at home. The delivery location was my choice and the midwife was there to support me. My experience with the midwife demonstrates, for me, how some health systems really can work when the compensation and scope of practice is set up to support quality and patient centered care. The midwives are compensated by the provincial government in such a way as to allow for this level of care.
I had our baby in the hospital with my midwife. Due to some complications I was also transferred into the care of the capable OBs at the hospital where I delivered. Our midwife was there with us every step of the way. I had the continuity of care I needed from her and benefited from the hospital resources to ensure both the baby and I were safe.
Upon discharge from the hospital, I received the in-home portion of care provided by midwives and am so grateful I had this opportunity. Of course I had more questions, being a first time mom comes with lots of worries and uncertainties, and there was the comfort of knowing that she would come to me. She would see us in our home, where the baby lives, to make sure that she was progressing and thriving for six postnatal visits.
And if I had any doubt that I made the right choice, the patient and client centered nature of care provided by the midwives was so outstanding that I am certain I would work with a midwife again if we have a second child. In addition to the hour long visits and the quality of care that I was receiving from the midwives, I have to highlight two situations that have made me a champion of the care that was provided.
First, I had some challenges that could have resulted in bed rest for a substantial portion of my pregnancy. On a good day I have a hard time sitting still…let alone for months at a time. Needless to say…I was worried. I had an ultrasound on a Friday afternoon. This was the test that would determine my need for bed rest. My midwife was concerned enough for me and my care that she called me after the ultrasound to tell me that she was trying to get the results as soon as possible so that I did not have to be concerned over the weekend. At 7:00 pm that night she called me back. She had called the hospital and was able to gather the findings that indicated I did not require bed rest. Now that is client centered care! She knew that I would feel better knowing and did what she could to ensure that we would have answers as quickly as possible.
The second situation occurred after I had arrived home with our daughter. She was premature and as a result had some minor issues to contend with at the start. On our second night home it appeared that there was blood in her diaper. You can imagine my horror. I was 1:00 am and I was out of my mind to understand what was the problem. I paged our midwife. Within minutes she called back to explained the reason and the ‘cause’ for the appearance of some red crystals in her diaper. I went to bed relieved and woke up the next day to find that the situation had resolved itself just as she had said it would. 1:00 am responses to my questions….now that is the dream of any new parent.
In the end, the midwife provided me with the type of experience I wanted. I celebrate that I had the choice and could benefit from the expertise of both professionals to ensure the happy and healthy arrival of our daughter. For me the combination of in-practice, in-hospital and in-home care was the perfect health care arrangement that allowed for a wonderful prenatal and delivery experience.
I am passionate about alternative health options and started out my pregnancy with a midwife and a plan to have my daughter at home.
That plan changed when my mother implanted horrible scenarios in my head about being out in the country without modern medical technology if something horrible happened. At the time our closest local hospital would allow our midwife in the hospital room with us but only as support (basically a Doula role) and was not able to deliver baby. Luckily this has since changed!
So after playing these frightening "what if" scenarios in my head I decided to go with my family practitioner to deliver our baby and now feel that I should have stayed with the midwife option. If we have any more children I will definately do the Midwife route, having my daughter in the hospital was completely "sterile" for lack of a better word. I was told what to do even when my body was telling me to do something different. My water was broken because the doctor was going on vacation and wanted to speed things along. I had the epidural but it did not take and medical staff argued with me telling me that I could not feel anything when in fact I could feel every single contraction at full force. It was not a pleasant experience feeling like another number instead of a human being giving new life!