OB vs Midwife: Your Experience

[MissMusic]

So this might be 3 yrs too late, but oh well!  I need your input.

I've done the googling about midwife vs OB.  I had an OB with Lillian and I was very happy with that practice, but new we live in another state and I don't like the new practice I'm at.  I'm switching to an office that was both MWs and OBs, but I need to choose which care I would like to receive.

I'm having trouble deciding because I like the MW idea for unmedicated births, support, and avoidance of c-section.  The hospital here has the highest c-section rate in the nation I believe, and that scares the shit out of me.  I've heard a LOT of bad things about it being a baby factory, with people laboring in the halls because there's not enough rooms.  So NO THANKS.  The new office works with a different hospital.

OBs might be best because:
-I will be 35 any day now, which puts me at a higher risk
-I had a c-section previously
-I'm worried about emergency situations
-I'm not considering a home or water birth
-MWs can't perform emergency services like c-sections

MWs might be best because:
-I'm not a number or "another preggly lady"
-someone to advocate for me
-they make their best efforts to avoid c-sections
-they aren't going to push pain meds or other meds on me
-an OB will be on call in case they are needed

If you had the choice, which did you choose, and why?

[cbear]

So our hospital had a midwife practice. There are 5 midwives and you see them all basically, which is nice because by the time delivery came around you were comfortable with all of them, so you didn't have to worry about your specific doctor being off and not knowing who was going to deliver.

They also worked with whatever birth plan you want- not just for home/unmedicated. Because I definitely wanted alllll the drugs lol!

They were also honest and if I would have needed a csection they were going to tell me- they just wanted the baby here safely. I almost had to have one with Elise and she was very upfront and honest about that. Literally she said if we can't get here here by 9pm we are going to have to call in a csection - elise was born at 8:54pm lol! But I trusted her to make that call 100%

I went with the same midwife group with Vera and I would go with them 1000x over!

[aimeefarrahfowler]

So I had an OB and c-section with my first. I wanted to try for a VBAC with my second and was seeing a different OB who was very supportive of that, but because of office policies (idk, insurance or something?), I wasn't allowed to go past my due date, and had a RCS at 39w6. I loved my OB and trusted her, but I still wish I had seen a midwife instead to decrease my odds of another C/S.

If I ever have another baby, I will really consider going to a midwife instead.

[versed]

I would absolutely choose a midwife if I had to the option to make the choice. Like you, I love the philosophy of most midwives.

I was somewhat high-risk, but I luckily had an OB practice where I felt very comfortable with each of the OBs.

In your position, I would definitely interview/meet the midwives and talk through any qualms. Ask about the VBAC and what situations would lead to a CS.

Good luck!

[sarahandeddie]

I had an OB and c/s with both my girls, but they were both breech. When discussing a Vbac with my OB she said she would support my choice but she had to be at the hospital the whole time I labored just in case something went wrong. She said if I were to rupture (which is only like a 1% risk) she'd have mere minutes to save the baby and me. It ended up not being an issue since Avery was also breech, but something that stuck with me.

For that reason alone I'd probably stick with an OB who is supportive of your desire for a Vbac.

[britbratjf]

I would probably opt for the OB but I'm always so nervous about worst case scenarios. Then maybe hire a doula to help? Maybe have the best of both worlds that way.

[MissMusic]

Great input, lots to think about. I'm really only asking now because I need to schedule appointments in advance up to 16w so I can plan my work, etc. I can't do that until I pick which care I'll be getting.

Love the stories, love the insight. Thank you!

Keep 'em coming!

[heatherbee]

I switched to a practice for my last delivery that had both OB and midwives, however I didn't have to choose. Most of my visits until the very end were with the midwives and the actual delivery was done by a widwife. The OBs really only became involved in deliveries if a complication arose.

Personally, I would feel it was most important to find someone in the practice who is vbac friendly if that's your goal. My whole practice was and that was so incredibly helpful. My gut would say midwives would be more helpful with this goal, however my personal OB is awesome and was a huge advocate for my vbac so maybe ask around some?Not sure how your practice is run, but if the midwives do most deliveries, it might make the most sense to have them provide your care. I would guess you can always switch if anything comes up throughout the pregnancy and you feel more comfortable seeing an OB?

Good luck!

[heatherbee]

Aug 10, 2015 18:15:22 GMT -5 heatherbee said:

I switched to a practice for my last delivery that had both OB and midwives, however I didn't have to choose. Most of my visits until the very end were with the midwives and the actual delivery was done by a widwife. The OBs really only became involved in deliveries if a complication arose.

Personally, I would feel it was most important to find someone in the practice who is vbac friendly if that's your goal. My whole practice was and that was so incredibly helpful. My gut would say midwives would be more helpful with this goal, however my personal OB is awesome and was a huge advocate for my vbac so maybe ask around some?Not sure how your practice is run, but if the midwives do most deliveries, it might make the most sense to have them provide your care. I would guess you can always switch if anything comes up throughout the pregnancy and you feel more comfortable seeing an OB?

Good luck!

Also - I had a doula and that was really helpful!

[bantyrooster]

I love love love my OB. From stories from others Gage would have been a csection with their doc. I would interview/ see both if you could. I feel like ob's get a bad rap sometimes. You are a good bullshit reader. In your situation I would want an OB just in case of a RCS.

[sarasansh]

I went to midwives with Robin and loved them, but I did not like the hospital they delivered at at all, and the relationship between them and the OB practice there was very strained. After Robin was born there seemed to be a lot of hospital politics that went down that changed how the midwives were allowed to practice and all my favorite ones retired. If that hadn't happened, I would've sucked it up being at an older hospital to stay with them.

I'm with an OB for this pregnancy and it's been great, but I did a LOT of research beforehand to find one that met my needs. (For me that was having a low csection rate & being natural birth friendly.) So far it's been great, but it's definitely a different experience. My face to face time with the midwives averaged about 30 minutes per visit. With the doctor it's more like 5.

My main concern is/was that my doctor only delivers from 7am-7pm, M-F, so if I give birth outside that window it's just whoever is on call, and he was honest when we talked to him that the other OBs range greatly in terms of their views on birth. For that reason we decided to go with a doula, because it's important to me to have an objective third party that's not emotionally invested in the birth process.

I think whether you go OB or midwife it's most important to find someone to aligns with your hopes for your birth experience (VBAC, no drugs, whale songs, whatever), and then to surround yourself with as many people as you think you need to make that happen for you (as much as you can control.)

[mightybee]

I was in an OB only practice with D and switched to a midwife group within a large hospital at 28 weeks. I felt like just another number with the OB practice, but once I made the switch, even so late in the game, I felt immediate comfort and support.

If any major complications came up or if I went past 42 weeks, then the OB staff would have been called in. It was a nice blend for me: the midwife did all routine PNC and my low risk delivery, and an OB was called in when I had a more severe tear that needed to be stitched up.

With P I was with the midwife practice from the start and loved it.

You can switch care at any point in your pregnancy (barring any complications), so if you make one choice now and feel it doesn't fit, you can find the provider that you mesh with the best. I think that plays a big factor in having the kind of birth you desire. Good luck!

[MissMusic]

Aug 10, 2015 22:22:35 GMT -5 sarasansh said:

I think whether you go OB or midwife it's most important to find someone to aligns with your hopes for your birth experience (VBAC, no drugs, whale songs, whatever), and then to surround yourself with as many people as you think you need to make that happen for you (as much as you can control.)

I think this sums it up--LOL whale songs!

I picked this practice because they have one of the lowest c-section rates around, even lower than the country's average!  They are all very pro-vaginal birth, but of course will accommodate if thats not how its going to go.

I think I need to ask if the MWs do all the same ultrasounds and testing that OBs do.  If so, I'm leaning towards MW.  I know I'm higher risk, but if the OB is on call and is available for consultation, I'm ok with it.

I have an appt with a NP on Aug 23.  I can ask her what she thinks. I wanted to choose before then so I could plan appts in advance due to my insane schedule, DH working and now me working more, but an informed decision is better than winging it.  I could also change if I needed to so I don't know why I'm sitting on this!