Would You Have Switched Obgyns If You Were Me?

My mom is probably the least crunchy woman on the face of the earth, but all 5 of her kids were delivered by midwives from 1978-1988. No problems.

Here's the thing. Doctors are there to help you. They CAN'T help you if you don't talk to them. If they don't know what you need or want, you won't get the care that you need or want. You HAVE to communicate.

If you can't talk to them "off the cuff", write it all down before you go and READ it when you are there. That way, you don't have to feel the pressure of "speaking up" when you are stressed. I'm assuming you are able to talk to the nurses, so let them know about your communiation problem. Then they can let the doc know and maybe you can work together.

You are a TEAM - they are not gods, they are people who want to help people. They just know a lot of stuff and worked really hard to learn it. Try to approach it in a way that they are your team mate to helping you get well, stay well, have the baby, etc. You are working together. Keep that in mind and maybe it will help you communicate more.

I would have fired him as soon as I found out what had happened.
You're seven months in, and haven't discussed any of this with him yet? TELL him what YOU want. It's YOUR body, and YOUR decision, and if he gets pissed because you're "questioning his judgement," he can just get un-pissed.

Doctors don't give episiotomies because they're fun... they do them because they think it's a necessary medical procedure. If you had an unplanned one, it's because your doctor thought you needed it to prevent tearing. Another doctor or midwife might have made a different decision, but you know what? You might have a fourth degree tear like my cousin... who could barely walk for two weeks after the birth of her daughter.

This next time - no matter who you choose, speak up!! You say you don't have any guts... but if you want to be in charge, you need to have guts. Take responsibility for your life and your choices and recognize that a doctor is just a service provider. So talk to your doctor or midwife and discuss what you want for your birth. Just remember, you can say no drugs, no induction, no episiotomy, or no C-section, but if it's medically necessary... your wishes will not be honored.

You can insist all you want, but the Doctor most likely won't listen to you.

You don't have to be crunchy to use a midwife. Midwives are great because THEY LISTEN. They also don't do outdated procedures like epistiotomies.

I switched when I was 6.5 months pregnant with my first. As soon as I figured out that who you have is the most important component to a good experience, I fired "a top rated" OB practice and found a midwife.

I would highly suggest that you find someone else, someone who WILL LISTEN to you.

Please do what is truly best for yourself and find yourself someone who won't go cutting you open because it's best for them, not you.

Is there any reason to believe that he will NOT blatantly disregard your wishes and your health again for his own convenience?
I would either find a new doctor or even a CNM who delivers at your hospital... I would not EVER let a guy like that touch me again.
People like that are who give their profession a bad reputation ( as in inducing or giving C/S so they can make their tee time).
Good luck.

And just to add to the episiotomy is "better" than tearing naturally: study after study show that the incidence for SERIOUS birth injury is much greater if you have an episiotomy than if you tear naturally. The incidence of 3rd and 4th degree tears is higher (because the episiotomy tends to "tear out" beyond the initial cut) and the healing time is longer than with natural tears. Most OB/Gyns will NO LONGER perform "routine" episiotomies and only cut you when they need to apply suction or forceps to help the baby come out. They are no longer recommended to "save" the vagina from a tear, but rather to facilitate a necessary intervention. This approach is based on scientific evidence, rather than convenience or anecdotal hearsay.

Well, if it's difficult to speak up on your own behalf, hire a doula that will meet you at the hospital and help you fulfill your birth plan. That's what my husband and I did. And in the end, I did need her and she was wonderful.

She helped negotiate w/ the nurses/doctors to 1. have a larger room with a shower that helped me in the labor process (btw, I didn't do an epidural), 2. she helped negotiate me being able to get up and out of bed (they wanted me attached to monitors the entire time 3. She helped ward off the C-section that the hospital kept trying to get me to have 4. She was there in my post-birth stupor, helping my daughter latch onto the breast immediately. 5. Ultimately, she helped me realize the natural birth that I had laid out in my birth plan. I labored for 36 hours total, 24 in the hospital. When you are in labor for so long and your husband is watching you (what he would say) 'suffer' ... sometimes your good intentions go out the door. Our doula helped us stay on track.

Good luck!

Even if you do not want a midwife, consider a doula. It may be late in the game to get one, but ask around. Our hospital routinely works with doulas and she may be the advocate you need in your birth experience. Remember that if he is not on call, you may end up with a different doctor.

Or, you might see if you can switch to another doctor. It's business - you don't need to stay with a doctor you don't like. You should also start asking around for friends and family who might help get your DH where he needs to go or pick up the toddler if you need him at the hospital instead. I stayed with my aunt and grandparents when my sister was born.

I think it depends on how much you like the doc. I loved my first ob. I let him give me pitocin even though I knew damn well that it didn't need to be done. But, my wish was to get my epidural when I wanted, and he let me have it at 2 cm. yes, he did do an episiotomy. But here is the thing about episiotomies, sometimes if you don't get one, you will tear to smithereens, and an episiotomy is so much better than tearing. His philosophy was if you need one you will get one. Baby was face up. He said if I didn't get one I would be sorry. Baby #2 was late and I begged for an induction. He didnt hesitate. No episiotomy because baby came too fast. And I tore, and it was so much worse than the episiotomy. He stopped delivering and I was heart broken. Baby #3 was with a doc he recommended and I did not like him. If there was going to be another (and there will not) I would not go back to that doc. He was creepy when he delivered me and basically cut me off when I had post partum problems. If you do decide to switch, tell friends and family what you are looking for and go from there. Word from others is the best way to find the right one.

AT 7 months many doctors won't take you as a new patient. Is your doc a single practitioner? YOu can certainly call around to find a new doc at this point - you might find one that will take you at this late date. But ultimately, you need to speak up for yourself. YOu're a grown up now. Or if you feel awkward talk to the nurse at the hospital. Also consider that you might not have had many options for the episiotomy. I didn't have one but ended up with a tear instead which my doc stitched up. Not sure which is worse though as my second child was a c-section.

Although there are exceptions, most docs follow protocol and don't go out of their way to induce. He may have recognized at your last appt that your fluid was low. Who knows.

For future reference, I always like working with a doctor group - the different opinions of the different doctors are good for you and the docs. They keep eachother in check and they know that they'll have to review the charts with eachother weekly. And you never know who will deliver your baby. I went to a group with 5 doctors and strangely enough the same doc was on call and delivered both of my kids.

If you are not that crazy about him then I would change. Heck I would have switched back when I found out I was pregnant. Having a baby is the most unbelievable experience but anything can happen at any time and you need to know that you can trust your doctor. My second pregnancy I considered inducing because due date was over a holiday but then I cancelled. I had read of risk of c-section and wasn't willing to take the risk even though doc told me she wouldn't do it unless my body was ready. Fast forward to labor and as my baby and I are in a stressful situation, she says I know you really don't want to do a C-section but as your doctor I think it is the best for you and your baby right now that we get him out. I totally trusted my doctor because she knew what I wanted but did what was best for me and my baby. If you don't get that feeling....move on! Ask friends who they go to...that's how I found mine after my other OB decided to be a SAH mom!

I think the time to change doctors was before your first visit with this pregnancy. Not many doctors will take on a new patient this far in to the pregnancy. If you do not like how things went last time, then you need to speak up. He deals with many patients and deliveries. Your specifics are not etched in his brain like they are in yours. During your next visit, you NEED to talk to him. Hand him a copy of your plan, and make him read it in front of you. Tell him how you didn't like the recover last time. Talk to him about what can be done differently this time.

For me, my two deliveries were night and day. The first one was induced, strong, intense labor from the moment they sent me home (15 hours total). When I got back I was barely dialated, but contractions were every 3-5 mins.
The second was the completely different. I didn't feel any contractions all night, sent hubby to work, when I got to the hospital, they said I was already 4 cm. I still hadn't really felt a contraction.

I'm not sure what you should do but I'll share a couple stories. My sister in a different city than I was told her fluids were low and they induced her. Later to find out that her fluid levels were not low. And I did NOT have an episiotomy but tore and was in pain for almost the full 6 weeks so you can still be in pain either way.

I guess what I'm trying to say is things like what happened to you can happen anywhere and if you go the different route you can still be in pain too. Would I jump ship, probably not at this point. But I also don't think your doctor should get angry with you about not wanting an episiotomy. I would go ahead and have a talk with him right now, if you do stay with him. If he's a good doctor he will hear you and accommodate you. But of course no one should be worried, scared or uncomfortable with their dr.

It sounds like you do not trust this doctor....is there no other doctor that is close that works with this hospital? A lot of OB's have other doctors in the same practice - is yours not like this? My OB did not even deliver me...I had the oncall doctor deliver me...could you just do this and not even ask them to call him? As far as your birth 'plan' - I have heard that many docs/nurses hate these. (Just being honest). I had one, too....but I heard that many women want things done a certain way even when the doctors feel something else is NECESSARY. I asked before hand about doing an episotomy because I, too, am against them. Did you ask him before about this? If you know now he does this ROUTINELY, yes I would switch. As far as him suggesting an induction, I would ASSUME it was done out of necessity and not just 'because'. Bottom line - you do not want him to deliver you. If you are comfortable enough having him examine you, then keep up with that and then have the oncall doctor(s) deliver you when the time comes.

If you have any doubts, switch. It is never too late! I switched at 35 weeks with my first because after reviewing my birth plan with my OB I realized she did not care about my preferences. If your insurance covers maternity, it should cover a switch the same as it covered the first doctor. Try finding a Certified Nurse Midwife (CNM) that works at your hospital of choice. Midwives are much better at listening and are much less interventive and better at discussing things before they do it. Most of them also work in practice with OBs so if you really NEED something more help is there. You should be able to call the hospital and ask what midwife groups practice there.

Call your insurance and ask for list of OBs that handle births (not all do) that are covered. Then, ask your friends who have had babies in the past 3 years or so if they would recommend the doctor that delivered their baby, and ask if they had any special concerns (like the episiotomy, c-section) and how those were addressed. Cross reference any "yes I liked him/her" with your list to find one that is covered by your insurance.

Also, check the ICAN (International Cesarean Awareness Network) has the c-section rates of hospitals on their website. So it is also very worth it to research that, because some hospitals really push c-sections.
http://www.ican-online.org/
You can also check with the local chapter for doctors that are not pro c-section.

There is a time and place for c-sections and episiotomies, but some docs/hospitals tend to do them as a matter of course or more often then necessary. Good for you for looking out for yourself! You are your best advocate.

When you do find a doc you like, ask them to review the records of your last birth w/ you. Go over your concerns and what you want to avoid if you can.

You are in control of your body and before anyone does anything to you, you have the right to ask what is being done and to discuss your concerns unless it is an emergency situation. Since you are so far along and cannot go to another hospital due to all your circumstances you should look online for another OB who is covered under your plan and hospital and switch immediately as sometimes they can only make the change at the beginning of the month depending your insurance and HMO vs PPO. You will need to speak up and be more proactive on your needs and know it is your right.

They should of told you they were going to need to do an episiotomy and why prior to doing it unless it was emergent and they saw you tearing.

Get a new doctor and go with your instincts never let anyone including doctors and nurses bully you into things.

Wow. Uh, yes, switch doctors. But it's sort of late... so I don't know how that would work with your insurance and stuff. I switched after my first, and LOVED my second. I would never switch from him. He is fantastic and did everything I wanted, even when the first said "no". I found out that it was a combination of the hosptial rules and philosophies as much as the doctor, so I switched both. I don't care much for convenience, I prefer to have a good birth experience.

Yes, I would change!

I changed OBs after my first birth, and it went better than yours did. I just didn't feel the OB was supportive enough of me, especially during the birth itself, and I didn't feel she properly "protected" me from some of the hospital policies that she later told me she disagreed with. My second OB was wonderful - exactly what I wanted. If you're not sure how to find a good OB, ask your insurance, get online and search, etc. I WOULD SWITCH.

wow you';re late to the game to swtich now,. i;d be calling all of my friends in the area to find a doctor they raved about and get in asap

I agree with getting a doula, but honestly, I don't think you're going to feel right about this unless you get another doctor. If some of this happens again, you'll know it's because you really needed it and your doctor just didn't communicate it to you well.

One way to find a good doctor is to talk to nurses and people whom you know who work at hospitals. When you hear the same name a couple of times from these people, then you know you have the right doctor.

Who are you saying will be angry about questioning the episiotomy? The doctor? Why would he be angry? Is he a hothead?

You really need to learn how to talk to doctors. You have the idea that if you speak up, that you'll make them angry. That really doesn't make sense. What you need to do is ask him WHY he did an episiotomy. Preface it by telling him that your birth plan asked not to have one. Tell him that you really want to know why. Listen to him.

With that said, if you tear, he has to stitch you up anyway. You cannot prevent yourself from tearing. You don't know what it's like to NOT give birth without having stitches. You need to allow for that in your thinking, and you need to understand that it may happen again. Instead of blaming all your healing time on one thing, giving birth is a big job and just having a torn or cut episiotomy is not the entire reason it took you a month to recouperate.

When we get pregnant, whether we are planning a pregnancy or not, we have to accept that there are risks associated with it. Those include the risk of having to have a c-section. Most of us ARE afraid of having one, though some women know right off the bat that they will have to. So you have to accept the possibility of it. We can look at statistics all we want, but induction is not the only reason women end up with c-sections. Sometimes it is what it is, and then you have to have alternatives to regular life at home for a while.

Cross that bridge when you come to it and try to make contingency plans, rather than worry yourself over it. Sometimes being under too much stress about NOT wanting to have a c-section can cause you to have to have one.

Good luck!
Dawn

First of all I'm not a doctor or work in the medical field. My sister however, was a labor and delivery nurse for over 10 years before she became a director at a college teaching nursing. I do agree you need to speak up more on what you want and expect. My sister said doctors tend to have their own agenda especially if you go into labor on the weekends. They usually have a "golfing game" to get to. They may want to induce sooner than let things happen naturally. However, when it comes to a episiotomy, that is sometimes better to have done than letting you tear open. Some doctors do it on a regular she said and then explained how scaring with a rip vagina is worse. The scaring is better when they do it that way because it's a straight line. She's made many comments about that.
I don't think you need to change doctors but speak up. That's it. Some of the stories my sister has told me are horrible. I'm not just talking about the doctor either, she just told me a few stories about women going into labor on the weekend, and doctor's pushing inducing or c-sections. However, she's had patients that insist on doing their birthing plan, instead of having c-sections, and the baby dies. I'm done having children, but I would never encourage a women having a vaginal birth if she had a c-section already. After the stories my sister said of watching a mother lose her child all because she wanted to have natural birth instead of a c-section and the scar tissue ripped open and a healthy baby died, was one of the saddest stories she told.
Congrats on #2!

YES - and I did! I had a similiar story to yours but mine ended in a very traumatic c-section as the pitocin caused my son to have heart problems!

It sounds to me like a homebirth with a midwife would be perfect for you. No need to drive and no need to worry about your husband and toddler. I would highly suggest that you contact a local birth center and ask about homebirth or about birthing at a birth center. You don't need to be crunchy to chose one but you do need to be educated. The OBs are in most cases more interested in making things easier for them than for you - that is why many of them want you on your back - a terrible birthing position by the way!! You don't induce unless there is a good reason for it and a 7 is not medically indicated! Your OB induced you because you allowed it and it meant he didn't get called in the middle of the night or another "unscheduled" time.

If you don't want to change at least get a super good doula to help you along your path. C.

It's been a long time since I had my DD. I don't have trouble speaking up to doctors, but I understand that a lot of people do. Try to remember that the doctor works FOR YOU. Now, there are a lot of things that can happen during a delivery and sometimes things are unavoidable. However, you should speak up during your next several appointments with the doctor. Simply tell him how you were disappointed, upset, whatever with your last delivery and you're hoping for a better experience this time. See how he reacts. You'll know if he's really listening or just patronizing you.

I don't think changing doctor's is going to solve your problem. If you don't speak up and say what you want, then no doctor is ever going to make you happy.
As far as the episiotomy goes, you really need to trust the doctors. Without one, you could tear really badly and that is WAY worse.
If he suggests an induction, just say "If you don't mind, I'd rather wait and let things progress naturally".
I would make 3 post it notes:
1) I do not want to be induced unless it is absolutely necessary.
2) I do not want an episiotomy
3) I do not want a c-section unless it is absolutely necessary.
Take all three with you to the hospital and ask them to put them somewhere prominent in your chart where everyone knows your wishes.

I'm like you, I'm bad at speaking up to doctors. I got better at it with my 3rd. You're familiar with your OB and you're already seven months, so I say don't switch, just let your OB know your wishes and make sure he adheres to them. They won't know what you want if you don't speak up.

I probably would have switched OBs (because I did -- I went with a certified nurse midwife in a hospital; I switched at 36 weeks pregnant, btw!). I also agree that you won't feel comfortable with this doctor for future births.

A CNM for a hospital birth could be a great option -- CNMs are like nurse practitionners, and they probably do more vaginal deliveries than most OBs. In my experience, they are a little more natural than most OBs, but you don't have to be crunchy to go to them -- in fact, most of people I know who do aren't particularly crunchy. They do all the testing that an OB would do, you can still get an epidural, and mine only deliver in the hospital anyway. But I've found they're much more willing to listen, less intimidating and more willing to let you labor how you want to labor.

If you don't want to or can't find a CNM, however, I would look for other OBs. Sometimes you can call your local hospital and talk to one of the nurses and see "off the record" whom they would choose for their births. Otherwise, look up reviews online, talk to friends, etc. Good luck!