Staying or Leaving OBGYN Group

Yes, I did for my second - to VBAC. Although my OB said he was VBAC friendly, he wanted me to sign a form at each appointment regarding induction and cesarean and VBAC risks - and had all of these VBAC restrictions. I knew it was a big red flag and switched around 18 weeks. Best move ever!!!!

If you have red flags, then switch. If are other VBAC friendly practices, than switch. My VBAC friendly OB told me I could go to 42 weeks. At that point, we would make decisions on a daily basis. At 42 weeks I did a stress test, all was fine. I asked how long I could go and she told me the longest she ever had was 42weeks 6 days. I asked what happened, she said the woman's water broke and a baby came out! I went into labor at 42 w 1 day.

C.

I knew exactly who would be attending each of my births. I had to trust them, I had to be comfortable talking with them, we discussed my wishes extensively. The few doctors I dealt with I wasn't too thrilled with, but luckily they weren't needed. In you're case, I suggest a doula, too.

Don't expect the doctor to call you back in any of these practices. The nurse calling you back was actually pretty good - it wasn't one of the folks in the office. The reason is that the doctors are pretty booked up, and they would rather talk about things like this in your regularly scheduled appointments. I do know that it is normal for them to schedule a C-section even when they intend to try for a VBAC...

I didn't dislike the docs in my practice - I only met 2 of the others, outside of my OB. I loved him, and he came in especially to deliver my first because I had complete bedrest with him from 24 weeks on. But with my second, he had been up all night the night before, so I wasn't destined to have him deliver me again.

Now here's the thing. Even if I had met all of the doctors, with my second child, it wouldn't have mattered. It was the ONE weekend of the month that another practice subbed for them. I had a doctor who I had never met, with a practice I'd never heard of, and I only saw him TWICE throughout my entire labor. The second time I saw him was when he delivered my baby. I tell you this because it could be that you get someone you don't know ANYWAY. But worse for me was that he didn't have a bit of incentive to go out of his way for me because I wasn't part of his practice. A doctor in my own practice would have.

This doc, when he came in to meet me, reminded me of how long I had been laboring and told me that if it went on much longer, he'd just do a C-section. I told him that I didn't want a C-section just because I had been there since morning. I wanted to know why I was still laboring. He left and didn't come back until after my NURSE had turned the baby. (He was face-up and STUCK and it was the nurse who figured it out. Bless her.)

If it had been any other weekend, I am sure another doctor in my practice would have been more interested and willing to use his head more than this guy who delivered me. They don't want to upset the doctors they share an office with. It's perfectly fine for you to discuss vaginal vs C-section and birth plans with your practice doctors.

I'm not saying that you shouldn't change practices, but you may find the same thing with the new practice. Incidentally, I told my doctor exactly how I felt about this guy. He appreciated knowing.

My doctor is very supportive of VBACs and actually prefers his patients have them.....would encourage me if I do have a third because I have already successfully delivered vagionaly. My last pregnancy my daughter was breeched at 32 weeks and stayed that way. My doctor said I had choices such as doing an inversion, waiting to see if she turned, or scheduling a c-section. We wait to try to turn her, she did not turn, then we scheduled a c-section at 37 wks. I would find a practice that is willing to give you options and work with you. I will say though it is important that both the patient and the doctor work together and listen to one another to find the best solution. As much as I would have my heart set on a VBAC if my trusted dr had a valid reason as to why one might not be the best option I would listen to my doctor.

None of us knew who would deliver our babies. No doctor is on duty 24/7 - and you wouldn't want one who was exhausted anyway. And yes, the labor nurses are with you much more, although if you're in labor for more than 8 hours, you're going to cross into the next shift. I went through 3 shifts, and my doctor wasn't there for all of it. If you're in a teaching hospital, there is a parade of interns coming in.

I don't know of any practice where the doctor calls you back first - it's always a nurse, at least for the first call.

I do think you should be comfortable with the others in the practice, and you seem very concerned about their policies. If you can spell those out, we can try to help you sort through them.

Have you had a bad experience? It seems that you have the idea that your primary OB/GYN will be with you through the whole delivery. You're just not going to love everyone in the practice - but you should feel confident in them and not feel forced into a C-section IF you are a good candidate for a VBAC - but not everyone is.

My OB/GYN was a solo practitioner with relationships with other practices. I had worked with him before, and I had worked with 2 of the other doctors he shared emergency duties with. I realize that's highly unusual. (Even so, they all need back-up, whether they are on vacation or with 2 patients in labor at the same time.) I knew I wanted a competent physician who had not be up for 36 hours! So we all accept early on that we may not have the doctor whose patient we are. Changing practices won't change that reality.

I think you should meet with your doctor, share your concerns (be honest!), and decide whether you should change practices. But if you change, you should have realistic expectations of what you can ask for and what you can't, so you aren't disappointed later on.

I transfered to a new doctor after my first trimester. I liked my old OB, but some of his affiliates, staff and practices had changed since I had my first child, and I was no longer keen on the practice as a whole.

Vetted the new one carefully. Made sure not to burn bridges with the old one before instituting the transfer. Asked that they forward to my records to the new OB, because I believed the new one would prove more "convenient." Once the new one reviewed my records and agreed to take me on, I then advised the old practice I would no longer be using their service.

For what it is worth, I haven't yet met all the doctors in the new practice, there are 4. I do not know for certain who will birth my baby. I am alright with that level of uncertainty. I do like the OB I am primarily working with. I will make my rounds through the rest. I am pleased that my appointments are timely, the staff is friendly and supportive, and that my lab results and follow ups are communicated appropriately.

Good luck to you.
Best,
F. B.

If you aren't comfortable with your doctor, you should switch practices. Just make sure to ask a lot of questions of the new doc before leaving.

When we did IVF, we got pregnant and switched from the fertility specialist at 3 months to my OB/GYN (they just do it that way, the specialist doesn't deliver the babies).
I found a good practice with 2 doctors, one man, one woman - and I liked them both.
They asked me what my birth plan was.
I said it would be nice not to have a c section, and not have a severe episiotomy, I was fine with having an epidural - AND I said the goal here is to have as healthy a baby as possible so if an emergency comes up - just do what you've got to do and I'll be ok with it.
Everything worked out perfectly!

The doc is only there for the very end of delivery. A great hospital and labor nurse is more important. Most practices have many docs on call so you won't know.

You might also consider a doula who will be your advocate. I didn't like all my doctors the same, but and my favorite ended up not being on call the afternoon that DD was born. I think that you need to be frank about policies that you are concerned about and go from there. I think a new practice would be more likely to take you on at 20 weeks than 34, so if you are going to jump ship, now would be a good time. I wouldn't wait 4 weeks to discuss policies and if you are waiting to meet the other 2, why not call them and ask to talk to them?

In the end if you don't feel comfortable it is up to you to stay or switch.

I am not sure I saw the same doctor twice with either of my pregnancies, and I have no idea who delivered me. Both of my boys were born on military installations overseas, with me moving from Japan to England while 7 months pregnant with my first. It really did not bother me, I just made sure to know what I wanted when the time came and had my husband prepared to advocate for me during labor to make sure I got what I wanted. I would not let them schedule and induction on my due date and they respected that, but they did not allow me to go much over 42 weeks before pushing the issue.

it's a tall order to find a practice that will have ALL doctors, midwives and attending nurses whom you love. that being said, you do need to have a pretty high comfort level with most of them. so you need to prioritize your needs and wants.
if you're looking at a VBAC you do need a) doctors who are supportive of that and b) to be prepared that it might not work out, and trust that your doctors are competent and willing to make that call, and to go with them on it. if you really feel that they're going to go C-section on you for their own convenience, then you probably won't like this particular group. but you need to get cracking if that's the case- finding a super pro-VBAC practitioner will probably take some digging.
it's hard to say with the 'concerns about the policies'. some policy concerns i can live with. some i can't. you'll need to think about that.
but i can't imagine that you're going to find ANYONE who is on call 24/7 and who can guarantee that they will be the one attending your delivery.
it's also very rare for a doctor to return phone calls personally, especially over a policy question. if you absolutely speak with a doctor and only a doctor about it, you'll probably need to do it at an appointment, or make one specifically to do so.
i would suggest finding a doula who will attend and advocate for you if you're not comfortable having your husband do that. and remember that if you're planning to deliver in a hospital (and with a VBAC being considered, i'll assume you are) it'll be the L&D nurses who are hanging with you for 90% of the time. and they're usually awesome.
good luck!
khairete
S.

I have not, but I do know several women who wished that they had. One was laid up for months after she gave birth because he was so intent on a vaginal birth, it damaged her spine. When I talked to about it she did say she was never truly comfortable with him but thought it would be rude to change doctors so late in the pregnancy.

Now is not the time to be polite. Choose the doctor that makes you comfortable and that you can trust.

My question would be why are they scheduling a c-section? are you high risk? Typically if a c-section is needed, they don't want to risk you going in labor and having to have an EMERGENCY c-section.

I've never switched mid-pregnancy but I would if I felt I should. I would suggest that you talk, ask questions, at your next appointment. Have a list ready and maybe have someone with you so you don't forget anything.

in your SWH - yes and make a convenient schedule so they don't miss their Saturday golf game, maybe? This kind of thing irritates me.

It seems like you have two options - #1, expressly forbid them scheduling a C-section on your due date (or just don't show up), and try to stand up for yourself and not let them bully you - which once you're on the table you aren't going to have a lot of control so that would scare me, it doesn't sound like they can be trusted to have your wishes at heart - or change doctors.

It sucks and you're halfway along so it sucks even more, but I'd have to lean towards finding a new doctor/office at this point. If you're in a big enough area to support such a big office (and I've never heard of ALL the doctors in an office seeing you, you should only have one doctor, right?) surely there are better practices nearby. Good luck, sorry you're going through this.

You may also want to check with your admitting hospital: some don't allow VBACs. They may be following a protocol you don't know about, but they should be forthright with you in allowing you to make your choice about care. I would call and be expressly clear if they even do VBACs at all. Some doctors won't; some hospitals won't due to their own insurance policies. It's worth checking out.

FWIW, I hated my OB I had been assigned during one pregnancy (that pregnancy miscarried, but that's another issue)-- and found a midwifery group which worked better for me. (My reason for distrusting the OB was because he lied to me about something important.) I ended up using the midwives as my providers when I became pregnant again.You aren't the first person who wants to change providers. I would do it if I felt I wasn't being heard. There's nothing we can plan, outcome-wise, that we can really rely on, but being heard is so important.

Start calling other practices. Don't let a doctor bully you if you don't want something. I switched doctors after I went in for my second appointment with my first baby and the doctor said "so what are we doing here today?" I was pissed off, because I was a first time mother and he'd made me make an appointment, and then I was supposed to know what the hell we were there for? Grrrr, I'm getting mad again just thinking about it. Anyway, the point is that you shouldn't stay with doctors you arent happy with. It's your body.

Generally, I'd say if you were not comfortable with your doctor(s) to find new ones, but you're at a point in pregnancy where a new practice might not take you on, so keep that in mind before you burn the bridge.

The reason planned c-sections are scheduled on or just before the due date is because going into labor increases risk to mom and baby (if the c-section is needed, not purely elective) and labot makes the opperation more difficult.

What I don't get is why they'd schedule a planned c-section at all if it wasn't necessary and you didn't want one.

Added: I just saw your SWH. I think in your case, it makes sense to not let you go past your due date. You may have to make peace with this aspect if you're high-risk. If you think you're not high-risk and this practice is a bad fit, then start seeing other doctors immediately for a second opinion.