Monday, August 1, 2011

Best Decision I Ever Made

(or why you should never be afraid to change prenatal care providers...)


When I was pregnant with my daughter, who is my first child, I knew I wanted to have a natural childbirth, i.e. medication free.  My mom and my mother-in-law both gave birth naturally, and I was determined to do it too, not to mention the fact that the thought of having an epidural needle stuck in my back terrified me.  My journey into preparing for such a birth began with this thought and led me to Labor of Love Doula and Childbirth Services where I hired a doula and attended breastfeeding and childbirth preparation classes.  My little sister, Kayla, also encouraged me and sent me Ina Mae Gaskin's Guide to Natural Childbirth and The Birth Partner to read.  

To give a little history, the first women's care physician that I ever saw, Dr. Elizabeth Schultz, that I went to for over ten years, always took her time during appointments, asked questions, provided nice cloth shawls, and even asked you to fill out a stress questionnaire before your appointment, so you felt like she was addressing you as a whole person and not just a cervix and a set of breasts to be examined.  Unfortunately, I had to change care providers to a more traditional (larger?) OB office near where I worked because my original physician didn't take insurance.  I chose this office on a referral, and because it was less than 2 miles from my office.  I didn't like the feel of this office as much as the one at Dr. Schultz's, but despite the rushed atmosphere, thin paper shawls, and grumpy nurses, I liked the doctor I was seeing for my annual exams fairly well.  So when I got pregnant, I began my prenatal care at my OB office.  It was, after all, conveniently close to where I worked....

Keep in mind that during these first few visits I was reading the material I mentioned before and preparing for a natural childbirth, which emphasized feeling safe during the birth above all else.  At my first prenatal visit at the OB office, I was informed that they had 6 doctors that I would rotate appointments with and whoever was on call would be the one to deliver my child.  This immediately sent up a red flag; I was expecting to deliver with the doctor I requested for my annual exams.  Also, my current doctor was not the first doctor I had seen at this office because I severely disliked the first doctor I went to and had requested to see a different doctor the next year for my exam.  So now they were telling me that not only would I have at least one prenatal appointment with the doctor that I didn't like, but there was a possibility that she would deliver my daughter.  Added to this was the fact that there was a male physician on staff, and I have never been comfortable with the thought of a male doctor providing any kind of women's care services for me.

But, telling myself that I was being silly and that I should think of it as having an entire "team" at my disposal, I persevered and continued to go to my prenatal appointments.  During this time I mentioned the hospital that my OB office delivered at to Teresa Howard, and she suggested that might not be the best hospital for me because of their record for interventions, which was a second red flag.  My second prenatal appointment was with the doctor I disliked, and despite trying to give her a second chance, I still didn't like her.  Third red flag.  Despite all of these warning signs going off in my head, I was terrified to change care providers.  It was completely irrational, and looking back I still can't tell you why I was so afraid, but it seemed like such a big deal to jump ship and ask someone else to guide me through this process.  

Then I went to my third prenatal appointment, which was with the male doctor.  And I nearly jumped out of my skin when he merely pulled on the top of my pants to put the machine that allows you to hear the baby's heartbeat on my stomach.  I tried to laugh it off after I left (still desperately, irrationally trying to make this situation okay that I was growing to hate more and more with each appointment), but the more I read Ina Mae's book, the more I realized this was not going to work.  I wrote a letter to the nurse practitioner who was assigned to me at the OB office asking if there was a way I could request the doctor who delivered my daughter because I absolutely could not do it with the doctor I didn't like, or with the male physician.  I also laid out my birth plan, explaining I wanted as natural a process as possible, because I didn't want to have to fight the doctors when it came time to give birth.  I heard nothing back from anyone at the office, but I had an appointment coming up so I waited until the appointment to address my letter.  The doctor that saw me that day (a 3rd, different doctor) checked the baby's heartbeat and then bluntly told me that my letter had been read by everyone in the office and they couldn't provide the kind of care I was asking for, and that I needed to change physicians.  I remember feeling stunned, as if she had slapped me in the face; one because I didn't intend for every doctor there to read my letter, and two because of her blunt and uncaring attitude.  

I literally cried when I left.  Despite hating so much about this OB office, I was still terrified to try anywhere else.  Ridiculous, I know.  I called my husband and calmed down and got on the computer when I got home.  Looking at the list of physicians provided by my insurance company was overwhelming; I had no idea where to start.  Then, I remembered that Labor of Love recommends Intown Midwifery, so I looked them up.  I knew I had two hurtles to overcome in convincing my husband that it was okay for me to deliver with a midwife...one, I had to prove that they had some sort of actual medical degree (they do, they're Certified Nurse Midwives, with multiple degrees from credible schools), and I had to make sure they took my insurance (Blue Cross Blue Shield, and they do).  Once I made sure both of those requirements were taken care of, I made an appointment.  I immediately felt better just from talking to the receptionist at Intown, who happily answered all of my questions. 

My first appointment with Intown was like a breath of fresh air.  The staff was nice, the other moms in the waiting room struck up a conversation with me, and when I was asked to go back to a room for my appointment I was handed a real, cloth shawl, not a thin piece of paper to cover myself with. I felt like I had come home.  My first appointment was with Anjli, who spent probably close to half an hour with me or more (as opposed to the less than 10 minutes at my previous office).  She treated me like a person, not a chart, and so did Margaret when I saw her for later appointments.  I didn't have to corner her to ask questions, she actually asked *me* if I had any.   I felt completely comfortable with both of them, and extremely silly that I had ever been afraid to change practices.  The level of personal care at Intown is worlds above what I was getting at the OB office. I felt like my wishes would not only be respected, but supported, and I knew that with these women at my side, I could have the kind of birth experience I was dreaming of.  I couldn't have been happier.  Switching to Intown Midwifery was the best decision I made during my pregnancy.

So, long story short...don't be afraid to change care providers, even if it seems like it's at the last minute.  Your birth will go much more smoothly if you trust the people helping you through the process.  

2 comments:

  1. There is also a doctor in Atlanta named Dr Tate (he is the only one that will perform a breech NATURAL vaginal delivery from what I've heard...in the southeast!) He has, in fact, taken on new clients who were already in labor so it is never too late to find someone you are comfortable with. I wish I had. But there is always next time!

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  2. I've heard good things about Dr. Tate. I had one friend who didn't like his bedside manner, but I've heard other people rave about him so maybe she caught him on a bad day. lol

    Intown Midwifery will take you late, also, though probably not in the middle of delivery! But I know people who switched to them as late as 38 weeks, and they were so glad they did :-D

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