Wednesday, November 29, 2006

My First Post On Birth Stuff

I haven't written much about birth on my blog yet. I have been unsure about where to start but I know that I want to include it in my blog. I love reading other blogs on birth and I have learned quite a bit from other midwives and doulas. I also know that many of my friends have had such different experiences in birth and have chosen things differently than I would have and I don't ever want my friends to think I am judging them or cause any tension in my friendships. So with that said, I do want to speak freely about my thoughts and opinions AND I want to honor and protect my friendships with you all. If something comes up I promise to leave out names and specifics so no one else will know who I am referring to (unless you are good friends with other readers of this blog in which case that can't be helped).

I was just telling a friend yesterday that I don't think I will ever go back to the Obstetric/medical model form of prenatal care. The OB that caught Ewan was a fabulous doctor who preferred low intervention birth, didn't try scare tactics to get me to do what HE wanted, and trusted that birth was a normal event and not a disaster waiting to happen. OB's like this are hard to find--but when the word gets out on the street about them women who value the same things come running. For my pregnancy with Isaac I really wanted to try midwifery prenatal care. The midwives I went to were absolutely FABULOUS and I liked all of them. Not all midwives practice the midwifery model of care--some are "med-wives" and are very interventionist oriented as well. In fact there is a midwife in the Dallas area that frequently uses cytotec/misoprostol to induce labor. I would never go to her practice because of that. Cytotec is an off-label use of a drug that has caused uterine rupture, maternal and fetal death.

I am currently getting my well-woman care from the Allen Birthing Center midwives. I was hoping to have our next baby there but since we aren't pregnant yet and will be moving to Pittsburgh this summer it isn't possible.

The first OB I had with Ewan fit the typical model of medical care I have come to expect from most OBs. As Jon and I began to learn about birth and what options we had during labor we started asking our OB questions. We didn't like the answers. Conversations went something like this:

Me: I would prefer not to have an IV during labor so I can move around freely.
Dr. Castellanos: That is not an option.
Me: Is it okay if I eat and drink during labor?
Dr. Castellanos: No.
Me: Why?
Dr. Castellanos: Because you will just throw it all up.
Me internally: That is not an answer and isn't it a sign of transition when women throw up anyway? That just means the baby will be here soon.
Me: What about episiotomies? How often do you perform them?
Dr. Castellanos: It is better to have an episiotomy than a tear---wouldn't you rather have a straight cut than a jagged tear? Women with episiotomies don't have bladder problems later in life.
Me: Mmhmm. (Internally-has this guy read ANY research?)
Jon and I on the way home: He's fired!

That was just the tip of the iceberg--after several conversations with him we realized that he was not going to provide an environment where we could be left alone to labor and do what we wanted. I was beginning to feel anxious about going into labor with him as my doctor and I knew that that could effect my labor so I wanted out. We switched to Dr. Kuhl and never looked back. Sure, I worried that Dr. C. would be offended and I felt guilty about leaving. Looking back I think it was silly for me to feel guilty about leaving. I hired him to work for ME--and he wasn't meeting my standard of care. I don't think he ever blinked an eye about it. I didn't want to go into my labor kicking and screaming about how I wanted to do things.

As a Bradley teacher, I want my students to have doctors who are supportive of their needs and values during labor. I want my friends to experience the same thing too!

I was talking to a friend from church a few weeks ago who shared she was expecting her 3rd baby. Several of us were sitting at a table and I asked her who her OB was. I like to ask around so I know good referrals for students. She proceded to tell our table that her OB was a long drive away--she started going to him pregnant with #1 and working next door to his office. She mentioned that he had made her cry about her weight gain, was kind of mean, and didn't even remember her when she came in pregnant with #2 (I think less than 2 years later). I looked at her shocked and said, "So why don't you switch?". Well, he is nice most of the time and now he does remember me. I asked her how far she lives from the hospital in Allen. "5 minutes", she said. "I know of a great doctor group at Allen Prespy--why don't you try them out? The convenience of being close to home will surely make you think about it--you don't want to have to drive 40 minutes to every appointment, do you?", I said. Okay, I was forthcoming in my opinion about her switching--but it makes sense, right? Being close to home will be great for her other kiddos to come see the new baby, her husband to go back and forth if he needs to and also, she would be getting great care from people who actually like and remember their patients! I don't know if she will make the switch or not but I hope she does. Her hesitancy was that she would feel bad about leaving him. You know what I said--actually a few other women said the same thing at the table--"What?! He works for you honey--if you don't like his care then move on!"

So, my hope is that women don't settle for second best when they can have the kind of prenatal care they desire. Whether or not that is from an OB or a midwife is up to each individual person. I think that women should not have to bargain or beg their doctors for how they want to give birth. This is their birth--your birth--and it will be remembered by each mommy and daddy forever. The doctor/midwife will only remember it for a short time. Women should be able to labor and birth their babies how they want to and receive care from providers who are there to support them through their pregnancy, labor, and birth.


DarWonder said...

You have such a writing gift! I, a very uneducated birthing chickie, would NEVER realize all the birth "options" out there. My OB said it, I believed it. Thank you for your thoughts:) Yeah, I never even thought...the doctor works for ME!!duh

amelia said...

darwonder: thanks for the compliment about writing! I want to start including more information about birth in my blog for readers who are interested. I'm glad you enjoyed it.

Melissa said...

Please do (keep writing about birthing).

Not that I'm planning on being a mom in the near future, but I'd like to know more about my options before that time comes. :)

thelins said...

i think after having my first baby, i feel better about my next (whenever that will be)... it can't be worse than my first. haha.

Dawn said...

um, did i read that right? pittsburgh this summer? what the heck??