Breaking up with OB?

So, if you read this blog at all or know me, you know that I had an unnecessarian in 2004 for “CPD.”  (Umm, I’m 5’10” and only had an 8lb baby.)  I suffered three consecutive first trimester losses.  I had a repeat cesarean in 2009 for double footling breech twins.  And now I am pregnant again with a singleton and planning to HBA2C in June or July.

So, my childbirth years have been heavily governed by the medical model of care.  I’ve been wanting a homebirth since 2007, but the opportunity evaded me until now.  I need to break up with my OB, and if you have any suggestions for when and how, I’d love to hear from you.

Should I wait until after the 20 week ultrasound?  (I want this ultrasound to confirm where the placenta has attached.  I already know that it is anterior, so I am concerned about accreta.)

Or should I do it now that I’m out of the 1st trimester?  I already have a relationship with a midwife and will be seeing her in the next couple of weeks.

I see benefits for doing it now and for waiting.  If I do it now, I have more time to trust my body, my baby, and my midwife without the temptation of ultrasound machines and other interventions.  I’ve become somewhat dependent on the “bells and whistles” of obstetric care, and I don’t think they help me build that internal trust I still lack. 

These are just the 8am Saturday morning musings of the over-thinking fence sitter!

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6 responses to “Breaking up with OB?

  1. See if your potential midwife can determine accreta or if she has access to usound, and if so, skate on the OB. If the OB is unsupportive of vbac noe, they’re not going to do a 180 if an usound declares you free of accreta. Trust your instinct.

    • Kiki, it was interesting. My OB noted that my placenta is anterior and said that they don’t like to see anterior placenta with planned RCS. So, there is reason to be concerned if someone has an anterior placenta and knows they’re headed toward a cesarean. I didn’t ask him more about it, but it was a curious comment.

      I’m not planning on staying with an OB past the 20 week u/s if that long.

  2. Do you have to “break up with your OB”? Can you have dual care, “shadow” care? That way if anything comes up later in pregnancy that risks you out, you are already covered. If you just don’t like your OB and want to “see other doctors” ;-) then that’s different; but if your OB is pretty good, but just not a supporter of home birth, then why not keep him/her as a backup?

    • Unless I schedule a RCS, there is no guarantee that he’d be the OB there to deliver the baby should a transfer be necessary. Plus, since this is a summer baby, he’s even LESS likely to be around. The guy takes a week vaca every month of the summer. I happened to find that out last time around with him. :\

  3. I don’t have advice as I don’t know enough of the US system of antenatal care. Here in the UK you don’t get seen by an OB at all (the first I saw was when she monitored progress after 23 hours of labour, when it became likely that a c-section may be the way to go – same for my SIL who tried a VBAC. Antenatal care is done by midwifes almost exclusively, and a homebirth can be requested very early or very late)

    However I missed your last post and just wanted to say congratulations on your pregnancy!!!

    • Thanks Cartside! Well, no docs here in town attend VBA2C, so the point is moot. But, the OB is required to be in the hospital for the duration of a VBAC labor and delivery, which of course ties them up and screws with their schedules. It’s all a big nuissance . . . both for mother/family and for the doc.

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