Looking for Midwife/Perinatologist Combo (Wishful Thinking?)

Updated on October 21, 2009
S.E. asks from Portland, OR
7 answers

I am looking for a strange combination of care for my second pregnancy. I had a midwife for my first, but ended up with an emergency C-section (baby was breach, placenta rupturing, 3 weeks early). Now I am pregnant with twins and not sure what my options are. My ultimate preference is for all-natural, home birth, but with my history and the fact that I've got twins in there, I suspect that home birth is not an option. Regardless, I would rather have a natural-birth-supporting midwife for my delivery, but I'm also fairly certain I will need a perinatologist on-call for the potential worst-case scenario. I would love to find a midwife and perinatologist who can work together or be backup for each other. Is that wishful thinking?

I know the midwives and Dr.s at Women's Healthcare Associates, but I don't want to deliver at St. Vincents, so I'm looking for something else. Good Sam or OHSU?

If you know of a great home-birth midwife who can also deliver at a hospital, or a great perinatologist who is supportive of natural birth, please send along info. Thanks!!

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So What Happened?

Thanks so much everyone for your thoughts. I called a lot of your recommendations. It turns out that midwives are not allowed to take me because of their certification (unless I get a lay home-birth midwife. I'm totally down with lay home-birth midwives, but I have had 2 surgeries on my uterus recently, and my first child's birth was very complicated and problematic, so even though I'd love to be at home, I feel like I should play it safe and be in a hospital just in case something goes awry). Even regular OB's can't take me, unless they just schedule a C-Section.

I ended up trying to get midwives' recommendations for a perinatologist and am seeing Dr. Periera at OHSU. He is totally supportive of my desire to have an all-natural, vaginal birth. I am welcome to have a mid-wife or doula present if I want. The OHSU practice is the only one I can find where I can do a vaginal twin VBAC no matter who is on call (all other practices it depends who is on call when you go into labor). They are very busy and have been a bit of a frustrating office to work with, but I can't find anywhere else that will accommodate my birthing wishes without me needing to have a C-section if my doctor doesn't happen to be on-call.

Now I will try and find a doula to accompany me. Thanks!

More Answers



answers from Portland on

You might want to look at OHSU; I think they have labor tubs for everyone, and they have doulas on staff (pdx doulas) that are complimentary. THese might help you reduce the chance of medical intervention with the birth. Best wishes to you for a happy birth experience!



answers from Portland on

I would recommend checking with any one of the amazing midwives at Andeluz Waterbirth Center in Portland/Tualatin. They are capable of providing at-home-birthing services. As well, they have two birthing centers to choose from, both with waterbirth options in each and every room. They have ample experience in multiple births as well as breach births. The Portland location is in close proximity to OHSU for your safety and peace of mind. The main phone number is ###-###-####. There are seven midwives to choose from. I am currently working with Tracy Lawson-Allen as my primary and Jessica Dolin as my secondary. They are both phenomenal. I would suggest calling and giving your background to see if they can match you up with the best option. If you have any questions please feel free to ask me. I am due with my third on Halloween and looking forward to a great experience with these women. Good luck!

by the way, my second delivery was a VBAC, at home, so don't let anyone tell you it isn't possible or that no one will do it. it's just not true. it's what your body was meant to do. it knows how to. be assured. :o)



answers from Portland on

Linda Glen is an amazing midwife who works at OHSU. She is incredibly well respected, and probably knows whatever perinatologist you would be working with there. I think you will be very happy with her!



answers from Portland on

I would check out the midwives at OHSU. I was going to them until I decided to have a homebirth. I think they are going to be the closest thing to what you are looking for. They are very respectful, and truly seem to want to help you have a natural birth. A couple of them actually do homebirths in their own practices and were (surprisingly) very supportive of my decision to have my baby at home. My only thought is they may have rules about who they can treat in the midwife section of the practice, but you should at least check them out.
I delivered my first child at Good Sam, and while it is a really nice hospital (with wonderful nurses), I would consider it fairly "medicalized." I felt a little pushed to get an epidural, and were not terribly supportive of some of our choices regarding the baby after the birth.



answers from Portland on

Most people will not offer VBAC to someone with a twin pregnancy. It is not considered very safe. You will likely not find anyone in the private practice community who is willing to accept that type of liability. You should contact OHSU, b/c they have a CNM group and always have doctors in the hospital 24-7. But honestly, with twins, you should strongly consider a C-section for the safety of the babies...and yourself!



answers from Portland on

the laws change all the time, but one call to one licensed lay midwife should answer whether they are legal to attend for twins--last time I was pregnant they were, but the first time they weren't ... the lobbying in Salem is a heavy job, with the OMA better funded and established.

So, if they still are, you can choose a licensed midwife based on whether they are themselves comfortable taking on a twins birth and whether they have a working healthy relationship with a perinatologist.

If it's not currently legal for licensed--and this is going to sound SO weird but hear me out--it is legal for unlicensed, in Oregon. (We have a funky set of laws that way.) So, midwives who wanted to be free to attend twin births all the years that it was not licensable, and midwives who want to attend breach births (I think still unlicensable), would choose not to license--meaning they don't have the 'legitimacy' of the license (and therefore have a harder time gaining a client base), but they probably have more experience with the tricky births. Of course, the chances they are going to have a healthy relationship with a Doctor when they have rejected the licensing standards enforced by the OMA, seems unlikely. Licensed midwives can probably point you to unlicensed ones--I nearly had to call on one with my last birth because the baby waited until the last legal day to start labor (21 days late) ... my midwife gave me two numbers, since I was determined to stay out of the hospital unless I felt like something was going wrong.

My first birth I accidentally discovered an OBgyn that was herself a homebirth mom. Last time I saw her she was practicing at ... SW Women's Health Associates maybe? ... it was a building just south of Hwy 217 on Hwy 99, I think at Greenburg Rd, and there were two OBgyns and three nurse midwives on staff. Unfortunately her hospital was StV's ... at least at the time. I left her practice because the hospital contracts she had to sign to maintain her right to practice there required induction if the pregnancy went more then 2 weeks over (I knew mine would--intuition and all that) and C-section if the labor went more than 24 hours (mine did) ... plus by that point I was already not a big fan of hospitals anyhow because of the research I had done.

Hospitals are pretty good with C sections nowadays. The decision I reached (after leaving that OBgyn practice) was that I would labor very close to a hospital, and deal with the emergency transport if it needed to happen. I didn't want to be bothered with the rest of the hospital routine (especially the ultrasound monitoring) ... so I picked a birth clinic two minutes from its hospital, and if the attending surgeon thought I was a crackpot evil mother for my birth choices, I just wasn't gonna care.

I hope you can find a medical specialist and midwife partnership that really works. More and more the two 'sides' are talking together, and hopefully by this time they have started working together as well.

Good luck, God bless, I hope you have a WONDERFUL birth :).



answers from Portland on

Check out the midwives at Andaluz. They may be able to help you and if not, they may be able to point you in the right direction. I can say as a birth doula, they are an amazing group!

Good luck!

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