Denied Prenatal Care?

[jaelynsmommy61607]

Hugs mama! I know how hard it is to.fight for a vbac. I had a hba2c in June and u wouldn't change it. You said your midwife is far away...how often are you seeing her? It's.important you have a good relationship with her also. Have you checked into her qualifications? There are different types of midwives and not all require a lot of training. Have you been in contact with your local ICAN? they are often a huge source of knowledge for vbac moms. They may be able to give you info.about Drs that will support you. Or even a midwife that can see you regularly.

[Kiliki]

I'm really sorry. I'm angry FOR you.

It's really REALLY unfair how "stuck" moms are who want to labor/birth naturally. Ridiculous, actually.

I would totally call bologna on his "10%" thing.

Babies who are sunny side up can be delivered successfully and do not always result in a c/s. I'm betting an arm and a leg that thanks to all your wonderful interventions, you were stuck on your back in a hospital bed. If that is the case, it is really no wonder you wound up with a c/s. Kind of hard to help a baby turn if you can't move. oy.

I HATE American maternal/fetal medicine and protocols. It is just not evidence based in so many cases.

I'm so sorry.

[canadianbakers]

Originally Posted by luvsviola Its a business. Follow their protocols, or find another provider. They get to pick their patients just like you get to pick your doctor. If it hits them in the pocketbook, they'll change their policy.

And people want private care?

Originally Posted by Kiliki Babies who are sunny side up can be delivered successfully and do not always result in a c/s. I'm betting an arm and a leg that thanks to all your wonderful interventions, you were stuck on your back in a hospital bed. If that is the case, it is really no wonder you wound up with a c/s. Kind of hard to help a baby turn if you can't move.

All of my full term vag birth babies (DD, DS1, DS3) were born sunny-side up... and they never turned before birth at all.
Just the way my pelvis/hips are shaped and hold them, I guess. But it works out fine in the end (just a LOT of back labor for me!) and no c-secs needed for that issue.

[trying4more]

My first was sunny side up. I was told I'd end up in a c/s. The doc said she' be back at 6am to start pit, then at 4:53am my sunny side up girly was born, after 20min of pushing! It CAN be done!

I'd look for another doctor. If you still can't find one that doesn't agree with your plan, then just go with the midwife!

[evasimone]

Originally Posted by holly6737 The Dr could be sued very easily. By allowing you in his practice, he's accepting you in a patient-provider relationship. That comes with certain responsibilities on his part. If you go through with your HBAC and transfer to him in an emergency in labor and that emergency has an adverse outcome, you would have very strong grounds to sue, especially considering you had an established patient-provider relationship. Honestly, I wouldnt' accept you as a patient either. It's too much of a liability on my part. Further, I really think it's disrespectful. Like you trust him enough to have him provide you with prenatal care but you don't trust him enough to deliver your baby? Not only that, but by establishing that you are a homebirth patient, you're basically coming right out and saying you're going to be difficult- refusing all sorts of testing that he medically recommends, again putting him at liability. Another reason not to accept you into the practice. I"m not saying it's fun for YOU, but he's doing what he has to do to protect his practice and stay true to his principles.

I have to wonder if you find it equally disrespectful that this doctor basically poo-pooed this mother's desire for a VBAC? Why would she want a provider who tells her on the first visit "you can't do it."?

I think maybe if the doctor had came off as supportive and willing to work to get this mama her desired outcome (not a csection) maybe just maybe she'd want him to deliver her baby. Anyone who told me that I had a 90% failure rate wouldn't be trusted to deliver me, they've already accepted that I'll fail. And that "trial of labor" he offered her sounds like a chance for him to show her that she's part of the 90%. Just my two cents.

OP another poster brought up a good point about how it is important to have a good relationship with your midwife. I've paid several thousand out of pocket for delivery, prenatal care, tub rental etc. And it sucks because I have great insurance from the hospital i work at. My out of pocket with them for everything would have been between $150-300 for hospitalization and doctors visits. But the csection rate is crazy high (probably 35% or higher, its unusual for one of my coworkers to manage a vaginal birth even the ones that really wanted them) in the hospitals that I'd have to go to. And they are routinely pushing people to induce at 38 and 39 weeks for "big babies" etc. and i knew I didn't want that.

But anyways what I am getting at is that i am glad that all of my prenatal care is being done through my midwife; that I have 9 months to get to know her and trust her. When the time comes I implicitly trust in her ability to help me birth my baby safely. I also completely trust her advice, if she was to tell me that I needed to deliver in a hospital for some reason or go through additional testing I'd trust her because I know she wouldn't recommend that unless she felt it was necessary. I can't say I'd feel the same level of trust if I had an OB for all of my prenatal care. I think developing a relationship with your midwife is invaluable.

[7 for now]

Originally Posted by trying4more My first was sunny side up. I was told I'd end up in a c/s. The doc said she' be back at 6am to start pit, then at 4:53am my sunny side up girly was born, after 20min of pushing! It CAN be done! I'd look for another doctor. If you still can't find one that doesn't agree with your plan, then just go with the midwife!

My 7th was born vaginally sunny side up AND weighing 10-5. No problems at all.

Sent from my iPhone using DS Forum

[JennTheMomma]

Many hospitals do not work with independent Midwives. It's just how it is at the moment. However, you can use a OB for back up care, you do not need to tell them you're attempting a HBAC (I don't always agree with lying, but if you need/want back up care sometimes you need to to get it). You can also just schedule with a nurse to get blood drawn, etc for testing, that's what I normally do with my homebirths (had a back up OB with ds2 who knew I was homebirthing, and odn't have a back up this time but the nearest hosptal and OBs know I'm homebirthing and are totally fine with that).

[holly6737]

Originally Posted by evasimone I have to wonder if you find it equally disrespectful that this doctor basically poo-pooed this mother's desire for a VBAC? Why would she want a provider who tells her on the first visit "you can't do it."?

I disagree with his assessment of her VBAC chances, personally. Yes, it is true that if you get to complete and there is "failure to descend" then your chances of VBAC are slim. That's because that kind of scenario is indicative of a poorly shaped pelvis (ex/ possibly platypelloid). However, the position of the passenger (baby) matters as well as the passageway (shape of the pelvis). If the baby was malpositioned (which it sounds like he/she was- as it was OP), then it very well could have been a problem with the position of the passenger, not the passageway. The only way to know for sure is to have a TOL with another baby (hopefully in another position) and see what happens.

So, to answer your question- I dont' think it's disrespectful for a provider to accurately convey to the woman her chances of VBAC success. I think it would be more disrespectful for a provider to tell a woman she was a great candidate when in fact she wasn't. There are several different VBAC success calculators out there- perhaps he was looking at one of those. However, given the extenuating circumstances of the OP presentation, I'm not sure the number he quoted was accurate.

And I say all of that as a VBAC mom myself. I've had 2 VBACs (the first even being an HBAC, which I wouldn't do again) and am attempting another VBAC with this baby. I know how hard it is to get a TOL, but I'm also a realist.

[Mamatoabunch]

Well of course I entirely disagree w/ the dr and his assessments. I have had 9 VBACs all at home. My 9th was born face up and 10lbs 3oz.

[Leiiki]

Thanks for all the responses! I had my first midwife appointment today and I am feeling better about things. She was very sympathetic and also had a lot of helpful insight on my situation. I am not going to pursue another OB, though I will still try to get my testing covered by having my PCP order it.

On the even better side, I finally got to hear the heartbeat (140) - and I got confirmation that I'm carrying high and forward: I measured 15-16 weeks at 13 weeks 5 days.