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Old 02-28-2011, 10:30 AM   #1
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OB Dr /Midwife question -switching back and forth

This maybe a weird question so bear with me. We do not have any midwives at the local hospital but we do have a home birth midwife 40 minutes from our house. We had a homebirth with our first with a different midwife that was farther away but since my last homebirth was only 6 hours long and my midwife was only here 45 minutes before she was born we are a bit concerned with her not making it next time perhaps and are going with the closer midwife. I have a new OB dr that I see for GYN exams and yearly appointments. I love her and she knows I had a homebirth with my first because I tore badly and told her all about it at my exam this past fall so she could tell me how it looked and if it healed ok. She didnt seem to upset that I had a honebirth but we didnt really talk about it much. I really like her as a GYN and Im sure she would be a great OB dr but my heart is at home for birthing. My question I guess is have you ever used a OB/GYN dr only for GYN stuff and use a home birth midwife for birthing? How do you switch back and forth. I mean the OB dr will know next time you go back and you had another baby. Is it awkward? Can they throw you out as a patient if you homebirth? How do you do that? I really dont want to lose her as my GYN but I really dont want to hospital birth unless necessary. I am going to schedule a app in april to have a pre conception exam and Im debating about asking her if she would be willing to see me for like 1 app each trimester during pregnancy just so I can have blood work and stuff. But I dont want her to kick me out all together ya know? So if I just say Im going to try to conceive and dont mention I want a homebirth then just dont go back til after the baby is born how do you handle that??

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Old 02-28-2011, 11:10 AM   #2
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Re: OB Dr /Midwife question -switching back and forth

Whew.

Well, I think you are over-thinking things a bit my dear.

First, not all GYNs practice as OBs. Many do, but certainly not all. Do you know for sure that she does practice as an OB?

Second, it's none of her business where/when/why/how you choose to deliver your baby and it would be VERY unprofessional of her to offer an unsolicited opinion on your choice.

Third, as far as kicking you out of her practice.... For what? I mean, what would be her reason? You aren't doing anything illegal. Or, anything WRONG. You're making a choice. Which, may be different than the choice she would make (or has made), but that in itself is certainly no reason to kick you out as a patient. That's bonkers.

People make choices that doctors disagree with on a personal level all the time - people smoke, or don't exercise, or eat crap food, or they don't take their meds as directed, or they refuse certain prcedures.... Doctors are people, too. They may DISAGREE with your choices, but that doesn't mean they will stop treating you b/c of that. And any doctor who WILL stop seeing you as a patient b/c they disagree with some of your choices is not a doctor that you want anyway.

I can understand being a little concerned over the akwardness that might come from your GYN finding out you had a HB. But, beyond that, I don't see a need to worry. There's not much she can do, really. Your body, your baby, your choice.

And as far as going to her for your bloodwork... why? Maybe things are different where I am, I don't know, but my HB MW does all my bloodwork for me.

I think you can absolutely keep your relationship with your MW - who is delivering your babies, completely separate from your relationship with your GYN - who is just checking to make sure your bits are healthy. Two separate ballgames here.

Last edited by Kiliki; 02-28-2011 at 11:22 AM.
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Old 02-28-2011, 11:21 AM   #3
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Re: OB Dr /Midwife question -switching back and forth

I wouldn't worry about the Drs opinion. However I see my hb midwife for all my girly needs whether I am pregnant or not. She is a CNM though so maybe all midwives aren't capable of this?
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Old 02-28-2011, 11:22 AM   #4
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Re: OB Dr /Midwife question -switching back and forth

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Originally Posted by Kiliki View Post
Whew.

Well, I think you are over-thinking things a bit my dear.

First, not all GYNs practice as OBs. Many do, but certainly not all. Do you know for sure that she does practice as an OB?
Yes she is a OB dr.

Second, it's none of her business where/when/why/how you choose to deliver your baby and it would be VERY unprofessional of her to offer an unsolicited opinion on your choice.

Third, as far as kicking you out of her practice.... For what? I mean, what would be her reason? You aren't doing anything illegal. Or, anything WRONG. You're making a choice. Which, may be different than the choice she would make (or has made), but that in itself is certainly no reason to kick you out as a patient. That's bonkers.
I know its not illegal but I just wondered if she could "fire" me from her practice if she doesnt agree with me. Its been done before I read it on here alot.

People make choices that doctors disagree with on a personal level all the time - people smoke, or don't exercise, or eat crap food, or they don't take their meds as directed, or they refuse certain prcedures.... Doctors are people, too. They may DISAGREE with your choices, but that doesn't mean they will stop treating you b/c of that. And any doctor who WILL stop seeing you as a patient b/c they disagree with some of your choices is not a doctor that you want anyway.

I can understand being a little concerned over the akwardness that might come from your GYN finding out you had a HB. But, beyond that, I don't see a need to worry. There's not much she can do, really. Your body, your baby, your choice.

And as far as going to her for your bloodwork... why? Maybe things are different where I am, I don't know, but my HB MW does all my bloodwork for me.
My midwife is NOT affiliated with any hospital, she is just a homebirth midwife. In my state midwives are not licensed.Therefore she can not do any blood work or labs or anything. My old midwife had a backup dr an hour and a half away from me that did my labs but I dont want to have to drive that far again.

I think you can absolutely keep your relationship with your MW - who is delivering your babies, completely separate from your relationship with your GYN - who is just checking to make sure your bits are healthy. Two separate ballgames here.
Thanks for the insight!
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Old 02-28-2011, 11:32 AM   #5
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Re: OB Dr /Midwife question -switching back and forth

I think technically she CAN dismiss you from her practice, but I don't see why she would. And, I am not familiar with all of the rules that GYNs/OBs have to work under, so I could be wrong.

I guess since your MW can't do blood draws, it could be a good idea than to see if she will do them for you. Can't hurt, right? Worst she could say is "no"....
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Old 02-28-2011, 11:35 AM   #6
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Re: OB Dr /Midwife question -switching back and forth

Well as far as her kicking you out of her practice the only way to know that for sure would be to ask her opinion of it. I'm using an ob that I love but have been clear from the beginning that I wasn't sure about my delivery options. I choose to start seeing the ob in the beginning because even though I was unsure of my decision on delivery I wanted to at least get certain tests and things done at the ob plus I wanted to be comfortable with an ob in case of transfer. If it was me since you are planning preconception counseling I'd mention it then. She already knows you've done a home birth before so I doubt she'd kick you out of her practice for wanting another. Personally my route would be during preconception counseling I'd discuss pregnancy testing and exams (what she requires and what she's comfortable letting you pass on or what you want to avoid having done) and birth options including home birth and what is allowed and what's she's comfortable with for hospital birth. I think that would be the best way to open an honest conversation to get her opinion.
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Old 02-28-2011, 11:37 AM   #7
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Re: OB Dr /Midwife question -switching back and forth

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Originally Posted by brittneyscott06 View Post
Well as far as her kicking you out of her practice the only way to know that for sure would be to ask her opinion of it. I'm using an ob that I love but have been clear from the beginning that I wasn't sure about my delivery options. I choose to start seeing the ob in the beginning because even though I was unsure of my decision on delivery I wanted to at least get certain tests and things done at the ob plus I wanted to be comfortable with an ob in case of transfer. If it was me since you are planning preconception counseling I'd mention it then. She already knows you've done a home birth before so I doubt she'd kick you out of her practice for wanting another. Personally my route would be during preconception counseling I'd discuss pregnancy testing and exams (what she requires and what she's comfortable letting you pass on or what you want to avoid having done) and birth options including home birth and what is allowed and what's she's comfortable with for hospital birth. I think that would be the best way to open an honest conversation to get her opinion.
(the bolded) EXACTLY what I am wanting!!! I definetly want to be able to have some of the first blood work done and I like to have a ultrasound done at the very beginning to check dates just because my cycles are weird so I usually THINK I know when I ovulated but i want to know for sure.
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Old 02-28-2011, 11:55 AM   #8
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Re: OB Dr /Midwife question -switching back and forth

That's why I did it too. The ob I have is actually pretty reasonable about things and didn't freak out about me not wanting certain things done. Even if I was planning a homebirth though or to birth at a birth center (considering it but only one is over hr away so not sure) I still wanted to be comfortable with an ob and know what to expect and what my options were at the local hospital. If I have a homebirth great he's run my tests I wanted and he's clued into my pregnancy so he'll be up to date and ready to go on my 6 wk and future gyn issues. If I decide to or need to transfer he's already got records on the pregnancy and can treat me better. He'll also already know my preferences to hopefully make the transfer easier (some things may not be possible if an emergency requires transfer but at least he'll know what I want as far as after birth if nothing else - ie rooming in, bfing, no pacis, etc.). That's just me though. It eases my mind to have a back up plan that I'm comfortable with ready to go. I'd be very anxious and freaked out if I had a homebirth planned and needed a transfer ending up with an unknown doc, no one at the hospital up on my choices, etc.
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Old 02-28-2011, 11:58 AM   #9
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Re: OB Dr /Midwife question -switching back and forth

thats what happened to me brittney- I had to transfer due to tearing to the hospital and my OB that saw me during the pregnancy was over an hour away so we had to go to the local hospital and had to have the OB dr on call. He was HORRIBLE. rude,rude, rude!! We couldnt tell him I had a midwife cause she isnt legal in our state cause she isnt a CNM so he thought we didnt have any prenatal care and yeah. It was horrible. I dont want to ever have to go through that again!!
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