I have a lot of conflicted emotions about medical care and for anyone that looks in through a window at my life, I’m sure they would be confused as well.
For starters, I work in the medical field as a registered nurse. I work with doctors, surgeons, case managers, social workers, physical, occupational, and speech therapists, dietitians, radiologists and so on and so forth. I seem to baffle a lot of my co-workers when I divulge the fact my first two children were planned to be born at home, in the care of midwives, given the fact that I should know what “could” happen and all that jazz.
If I’m being honest, I’m happy to be planning a hospital birth this time around. Two failed attempts is enough for me and while I support it wholeheartedly for other women, I’ve come to the conclusion that it’s just not for me. I wish it was.
This is the first pregnancy I’ve been followed by an OB, from the beginning. The OB that delivered Hooper was fantastic, fully knew and supported the midwives I was working with, and did a fantastic job navigating Hooper’s tumultuous birth (though I’m still against induction despite the fact I know it’s necessary at times — I blame much of the decline in Hooper’s birth experience on the pitocin I was given).
During my pregnancy with Van, I had to chose a different back-up OB (the previous OB suffered a sudden death heart attack, which hit many in the OB community like a ton of bricks). I met with the new OB one, maybe two times. Because Van’s birth involved an ambulance transfer to the closest hospital, the OB that actually delivered him had never met us before (and to-be-clear by delivered, what I actually mean is pushed on my belly until his 9.8 pound body literally popped out — it was, um, audible). Point being, I’ve had OBs that have had to intervene along the way, but this is my first pregnancy where I will have been seen by the same OB from beginning to end, and more-or-less, only by him (I can’t help but think as I type that how ironic it would be if he couldn’t make my birth for some unforeseen reason and baby #3 ended up being delivered by yet another, new-to-me, OB. Hashtag: funny not funny).
So in a sense, I’m merely jumping through the hoops this go-around. I’ve had more ultrasounds in the first half of this pregnancy than I had combined in my pregnancies with Hooper and Van. I’m taking my first ever glucose screening test (I opted not to with the midwives because I was checking my blood sugars regularly at work and knew that if anything, my sugars were running on the low side of normal — therefore ruling out gestational diabetes).
The one thing I did turn down was the genetic testing and that’s based on nothing other than the fact that finding out the results of the test would have no bearing my decision to go through with the pregnancy.
I had my first ever ‘comprehensive ultrasound / anatomical screening’, which I was surprised to learn is not performed by regular OBs but by perinatologists instead. The very definition of a perinatiologiat, by the way, is “a physician that works in conjunction with a patient’s obstetrician when pregnancy complications develop and is able to provide care for both the mom and unborn baby”. My eyes were already rolling before I even made the appointment because I understand the absurdity in involving a physician who deals with complications being involved in the care of an individual experiencing an uncomplicated pregnancy. But, alas, the hoops — I’ve agreed to jump through them (almost entirely for Willy’s sake; as he was rather traumatized from the first two births).
When I arrived at the perinatologists office, the receptionist pointed out where the bottles of water were; they sat on a fancy mirrored tray above the magazines that included none of the trashy stuff I only pick up in doctor’s office and in line at the grocery store, but instead “Travel & Leisure” and other sophisticated crap my burnt out brain cells didn’t feel like picking up. The sofa was oversized and included a large velvety blanket that I presume was there in the event anyone felt like cuddling. Point being, it felt very spa-like. Very pampered. And this experience continued as I was shown to my room, which was dimly lit with a desk at the window like you would find in a hotel room; a desk I’m sure no one has ever sat at with a small cup of pencils I’m sure no one has ever written with. At the sink were special soaps and lotions and a basket of hand towels. I sat back in the large chair, with my feet up, and watched the ultrasound on the big screen tv placed in front of me. I was a bit disappointed the chair didn’t have one of those massage mechanisms like they do at the manicurists. I’m being facetious.
It’s funny because sometimes I want to remind the very patients I care for in the hospital that they are in fact in the hospital, because of medical necessity no less, and not in a hotel. But I found myself on the flip side, wanting to remind the staff that they are indeed in a medical office and not some kind of massage pallor. It made me question further if any of this were necessary as I assume things that are necessary contain less fluff and more, I dunno, latex gloves.
In any event, all checked out fine. I closed my eyes while they checked out the baby’s goods and met with the doc at the end who summarized the findings; “My only concern”, he said, “is the baby’s size. You’re measuring a week ahead of where your dates put you”. He went on to suggest I have an additional test done to rule out gestational diabetes (because gestational diabetes accounts for larger babies). We then had a conversation about the birth weight of the boys (Hooper was 8.15 and Van was 9.8) and how neither of those involved any gestational diabetes. He also confirmed that birth weight has a genetic component (both Willy and I were 8+ at birth). And despite all the exchange of information, and this is the part that makes me hate the medical field, he wrote me script for the additional gestational diabetes testing and said he’d like to see me back, at 32 weeks, to “see how the baby is growing”.
Surely at 32 weeks the baby will be growing. It isn’t rocket science. It also doesn’t take rocket science to make the prediction that I will be carrying another large baby. The best indicator of the future is to look to the past, after all. I also know that ultrasounds later in pregnancy are less accurate due to the fact the baby is taking up more room. Sometimes they say weight can be plus or minus a pound, which is pretty substantial when you’re talking about a being that is only a handful of pounds anyway. And what’s it matter? It bothers me that women are not trusted to birth babies anymore; that so many are encouraged to go down the planned c-section path or the planned induction path (and while I have no judgements toward woman that chose this path, I do have judgments on practitioners that lead their patients to this path based on some kind of instilled fear). I have no doubt that this baby will be big. I also have no doubt in my ability to work with my doctor to get it out safely.
I could go on and on. I could even jump over to the other side of the coin and defend certain arguments from that side as well but all in all I think the take home message that I want to remind myself is this: Trust your gut. The care you receive is at times reflective of the larger population and fails to take the individual experience into account. Be your own advocate and ask questions that force your practitioner to see you as an individual.
And so, thus far I haven’t had many, if any, questions for my OB. I spend more time waiting for my food at the drive-thru window than I do in his office for an appointment. But when I did ask about the baby’s weight and his confidence level in delivering a big baby, he more or less shrugged off my concerns, boasted about the 9 pound baby he delivered that morning, and before-I-knew-it I was back in my car, on my way home.
I miss the care of midwives. I miss having my belly measured and touched. My OB appointments are exactly the same: pee in cup, stand on scale, check blood pressure, wait a minute for doc, doc comes in and asks “any bleeding, cramping, discharge, headaches?”, performs an ultrasound and listens to the heartbeat for maybe 7 seconds, asks if I have any questions, and I’m dismissed.
I remember listening to Kevin & Bean on the radio talk about that show ‘I didn’t know I was pregnant’, about women who actually go into labor and deliver a baby having never known they were even pregnant. They talked about how surprising it was that a lot of these women birthed healthy babies despite the fact they didn’t receive prenatal care. I’m not so surprised; prenatal care thus far has not impressed me. I feel like a cow being led through a corral.
Would love to hear from any mamas out there that also birthed big babies. I have a friend who birthed a thirteen pound baby at home and I always channel her in my pregnancies. Would also love to hear from any others about their prenatal care / OB experience.
This post resounded with me, as I too, am pregnant with my third baby and questioning prenatal care. I try to schedule my appointments a week or two later than they tell me because they feel sort of pointless when I am so low-risk. I do like my female OB, though. Anyway, my first two were on the small side compared to yours, but I know many, many women close to me that have delivered big, healthy babies vaginally. My sil had a 12 pounder, and my good friend just had a 10.10, 23.75″ baby last week. It is so doable, and I hate how some docs put so much fear in women.
I didn’t have big babies, but I can relate to your experience in prenatal care. With my first, I had been seeing a specialist because we were having trouble conceiving so there were many, many visits and lots of ultrasounds and it was actually towards the end of my pregnancy that I decided to switch to a midwife. The second time around I started with midwives and the overall experience was so different. There were no ultrasounds until 20 weeks and then one after to check on my low-lying placenta, but it was so much more personal. We’d chat and my belly would be measured. My midwifes treated like pregnancy like the normal, healthy thing that it is, but with the OB’s I felt more like pregnancy was something that I should be worried about.
My son was 9 lbs 10.5 oz, with an enormous head too (I forget the measurement, but they did tell me it was in the 99th percentile). I gave birth in a hospital with a midwife and an OB who was training with a program to facilitate greater cooperation between midwives & OBs who work in the same hospital. I had never met her before, but by the time I got to triage I was dilated to 7 cms and already in transition so I honestly would have said yes to anything if it meant they’d stop talking to me and leave me alone to cope with my contractions, ha. So basically I had a midwife birth in a birth center in a hospital.
I knew he might be big based on his measurements throughout my pregnancy, and because I was an 8.5 lb baby and my husband was over 10 lbs. The midwife & OB took it in turns to do perineal massage and warm compresses, as well as various hip-opening postures, and they kept me from pushing as long as I possibly good to give him a chance to come down slowly. I had a tiny labial tear that only required one stitch and I credit that in large part to their care.
But I also credit myself, because through my whole pregnancy I focused on not being afraid, and reading story after story of women who had successful, positive births, and talking to my friends & family who’d had good births. The female body is designed for birth, which is an almost cliched mantra nowadays, but it’s true! My body did what it was meant to do, with the help of some wonderful women who had more experience with birth than I did, and I was so grateful for their care.
I feel like I’ve seen you mention that you’re in the San Diego area—the UCSD birth center, within their hospital in La Jolla, is the facility I used and overall it was a positive experience. I don’t know if you’re at all interested in switching care or if La Jolla is close to you, but I’d recommend them as a sort of halfway point between home birth and hospital birth.
With my first, I had an OB until about 34 weeks when I switched over to a family doctor. I had been using that OB for years for my annual exams, so when I got pregnant, I was excited to have that relationship already in place with her. However, after I decided to go the natural birth route, it quickly became evident that wasn’t going to happen with her as my doctor. Starting at about 20 weeks, she began mentioning the baby’s size and talking about induction (even c-section) more and more. My grandma had 12 children (no meds) with several of them being over 8 lbs, so the whole scaring me about the size bit didn’t sit well with me. I researched until I found a natural birth friendly doctor in town, and was luckily able to move to her. She’s a family doctor and has had 5 children naturally herself. She is so laidback and open to any “crunchy” stuff you throw her way, but she’s able to talk you through any standard medical interventions at the same time. She definitely knows her stuff when it comes to women’s health, and we have continued to use her as our pediatrician/family doctor since. My son ended up being 8 lbs 12 oz, and I know without a doubt she saved us from me having to have a c-section. With that whole experience of changing doctor so late in my pregnancy, I learned to trust my gut.
I’m pregnant again and wanted to go the midwife/birthing center route, but I decided to stick with the same doctor. I know I can trust her fully. I never felt that kind of trust with the old OB — she could only see the “medical” side of things and didn’t seem to care that birth is, for most, a natural process without complication.
As long as your babe doesn’t have a bowling ball for a head or linebacker shoulders… Vaginal birth is happening. Keep on keeping on. Your medical background will always be helpful to navigate through the nonsense. I believe that if we stay accountable for our bodies and our knowledge, then that hospital and staff is there IF YOU NEED them; otherwise just swear a lot and maybe they’ll leave you alone!
Also, I’ve heard third trimester ultrasounds to determine weight, can be off by 2lbs each way!!
I didn’t have a big baby, but she decided to wait an extra 9 days to join our family. She was a tiny 7.6 at 41 weeks and 2 days. My OB was amazing though. I got long, personalized appointments. He measured and touched my belly and hung out for a few during my appointments. He was amazing when I was in labor and told the nurses that he wouldn’t be rushing to the OR to c-section me like they kept suggesting and asking. My labor wasn’t quite as dramatic as yours, but my lovely little daughter shelled out a fair share of drama in the 13 hours. In fact, I’m 100% on board for another baby because my experience with my OB was so great. If you ever decide to move to Jacksonville, FL I will be glad to point you in his direction. With that being said, he’s got TONS of patients and is super busy – so I’ve stopped recommending him because I’m tired of making my annual appointments 3 months out hahaha!
I had a CPM for all my pregnancies and I was fairly happy with her. She kind of let me do my own thing, like I didn’t have a bunch of ultrasounds, and she would check my belly like any other midwife would. But I gave birth in a hospital. I wish she had been a little more crunchy… I had to get an induction with my last one because I went over my due date and the hospital wouldn’t let me go more than a week. However, the minute home births are “legal” where I live, I’m getting pregnant again haha!
In my close circle of friends, five of us had our babies at a birthing center with midwives and three chose a hospital. All three hospital births ended with unplanned c-sections and/or other interventions like forceps and were overall very scary experiences. I know it doesn’t always work out that black and white but in our cases the five who chose midwives describe our babies’ births as the best days of our lives – and the three that went the hospital route cringe when they’re asked about birth. I almost wonder though about some sort of placebo/self-fulfilling-prophecy type of effect as well… Like the fact that my three friends who chose the hospital route did so because they were fearful of comlications… and went on to have complications… It’s all so complicated.
Man, I wish you could have a better fit! We have a great 5 person (all women) practice here (in Vermont) that has 3 OBs and 2 Midwives and you see them all at at least one appointment and then could get any on delivery day. The OBS and Midwives all are very similar except the Midwives cant do cesarians. Cant you see a hospital friendly Midwife? I think at a different practice or in a different city with a different OB I would have had a cesarian for sure ( I had long, slow, bumpy labors) but so thankful my OBS really trusted my body and my labor. I also had a doula so that helped, maybe get a doula!! Best of luck!!
I used an OB with my first. I realized about a quarter of the way in, I should have went with a midwife. I stuck it out though. I read a ton during my pregnancy and there were things I chose to do (like staying home when my water broke before contractions started) for fear of being forced into a birth I knew I didn’t want. Not that births go as planned, but that’s the point. A doctor can’t predict a birth and patients can’t be fit to a mold. Each woman and each birth experience is different and should be treated individually. I had a natural birth with the OB, but it was a fight the whole time. With my second I went with a midwife. I wanted a home birth but could not get my husband on board no matter how hard I tried. I had a water birth in the hospital with a very supportive, non invasive midwife. It was a hospital birthing experience I never thought possible.
For the record my babies weren’t huge by any means, but larger than average at 8.1 and 9.2. People and doctors need to realize that, in normal healthy pregnancies, women are meant to birth the babies they grow. It is very frustrating when specialists and doctors treat you like you have no idea what’s going on. Unfortunately there are so many uniformed women out there who have no interest in reading about birth and pregnancy and don’t know the difference. They go by whatever the doctor says. Doctors are meant to treat sick people and by nature are prepared for the worst situations. It’s almost in their nature to interfere. But birth isn’t a sickness and just because the woman is small and the baby is “big” or just because it’s taking her longer than they thought it should doesn’t necessarily mean they need to do something to “fix” it.
This is my story.
2 boys. 8.15, 9.8.
No genetical testing.
After the first birth: never again pitocin or an epidural.
3. baby a girl. 8.15 again.
I tried to love giving birth but it didn’t work out. Still I’m grateful everyone is fine!
Trust your guts.
As a doula, I believe in a woman’s ability to birth. The midwifery model of care is more aligned with this belief, but there are exceptions. I’ve seen women have unsatisfying birth experiences with midwives and have positive birth experiences with OB’s. I believe the most important thing is to choose a care provider who trusts the process and supports your birth preferences. When a woman and her partner are seen and heard; when they are included in the decision-making process and are given evidence-based information, they can give informed consent or refusal and are more likely to have a safe and satisfying birth experience. After a traumatic, but supported first hospital birth with Judah, I ultimately chose a naturalistic OB for my second pregnancy with Benjamin and we collaborated with a midwife so that I was able to birth at a birth center in LA. It was a precedent for an OB to catch at a birth center but it’s where I felt safest and most comfortable. I am grateful that we were able to make it happen. Ben had a big head (still measures in the 98th percentile) and was born in the water weighing in at 9.5 lbs and measuring 20.25 inches long. People assume because I’m a doula that I would naturally have this kind of experience which is not the case. I always looked at my clients and other doulas and thought this is the kind of birth that they would have. I hit some bumps in the road and had a great deal of anxiety in my pregnancy. It was a journey to overcome my fears and believe in myself! I am reminded as a doula that things don’t always go according to plan and each woman’s pregnancy, labor, birth and baby are unique. Both of my personal birth stories are shared more in depth on my site… links below.
http://naturealmom.com/judah-birth-story/
http://naturealmom.com/benjamin-birth-story/
I can really relate to your words. I loved the care of my midwife in my first pregnancy. In Germany we have the option to be seen by an OB and a midwife during pregnancy. When i was 19 weeks the OB found cysts in the brain of my baby so i had to see a perinatologist who insisted on taking more tests, because he thought the baby most likely had a gendefect and would be born death. I declined and just hoped it all would be a nightmare. My midwife safed me and carried me through the following 23 weeks full of anxiety. Well…I gave birth to a perfectly healthy girl (by the way…8.7lbs). The overmonitoring of pregnancies is just causing more insecurity and disables women to rely on their bodies and the good hope.
I can’t imagine that kind of fear and anxiety… and yet, I’ve heard similar accounts. It’s the very reason I decline as much as I feel comfortable declining… sometimes too much information can be harmful… Congrats on your healthy baby girl and thanks for sharing.