Oct 23, 2019: 16 week appt with OB
I saw my OB today (one of three main male doctors recommended for vbacs in the area) for the 3rd time (8, 12, 16 weeks) and discussed my plans for transferring to a midwife for the rest of my care for planning a home birth. I was very happy with the experience and his willingness to meet me where I am at, be honest that I have a very “uneventful” pregnancy going on (a good thing), and he said I can come back and see him towards the end, before labor, perhaps at 35 weeks if I wanted. ( I had asked him if he’d be open to that should I want to.) I was super happy with this “co-care” methodology and I believe it’s how all maternity care should be which is: flexible and going with the needs and desires of the mother as well as treating the pregnancy as it is, a low risk, normal pregnancy (regardless of one prior c section due to breech). He gave high remarks about the two midwife groups I told him I was considering and spoke highly of his hospital which is five minutes from my house should I have to transfer there during birth. He said it was the best hospital around for taking homebirth transfers. He shared how some other “good” hospitals around would not be so open and ok with it. You would be met with a tone of “oh another one of those homebirthers are here” kinda a reaction at many hospitals which is obviously not cool. I wouldn’t be able to cal him in labor, but if later in the pregnancy things change and I am high risk, then I’d switch back to seeing him or see both him and the midwife. He normalized the whole thing for me which in my head I can sometimes think, “I’m the first to be doing this.” Absolutely not. I am a normal, pregnant woman, with nothing showing up of concern. It is natural for me to not need medical interventions. It’s just against our cultural norms now of everyone going to an OB and all births “needing” hospitals.
Prior to my experiences in the last four months, I never even realized I could have co-care, which essentially means I can see who I need to see without an “allegiance” to one provider. Call me crazy…but that sounds like how it should be. I’m hoping we can see a shift to more of this in our country to lessen the amount of unnecessary interventions, which lead to c sections, and trauma many women experience with birth… midwifery care for most pregnancies unless/until the pregnancy necessitates medical interventions, and therefore an OB. Medical interventions and good OB’s are gifts to this world for the moments that are actually necessary.
I’ll see where I’m at by the end of this pregnancy. Perhaps I’ll actually need an OB or a hospital, and I will then seek it out. But for now, it appears that all is well with my pregnancy, and I believe in normal, healthy physiologic childbirth.
Have anyone else had a positive experience with establishing co-care with a midwife and an OB?
Quick reference: The following is an excerpt from the Journal of Perinatal Education.
“A normal physiologic labor and birth is one that is powered by the innate human capacity of the woman and fetus. This birth is more likely to be safe and healthy because there is no unnecessary intervention that disrupts normal physiologic processes.17 Some women and/or fetuses will develop complications that warrant medical attention to assure safe and healthy outcomes. However, supporting the normal physiologic processes of labor and birth, even in the presence of such complications, has the potential to enhance best outcomes for the mother and infant.18–,21
Normal physiologic childbirth
- • is characterized by spontaneous onset and progression of labor;
- • includes biological and psychological conditions that promote effective labor;
- • results in the vaginal birth of the infant and placenta;
- • results in physiological blood loss;22
- • facilitates optimal newborn transition through skin-to-skin contact and keeping the mother and infant together during the postpartum period; and
- • supports early initiation of breastfeeding.1
The following factors disrupt normal physiologic childbirth:
- • induction or augmentation of labor;23–,25
- • an unsupportive environment, i.e., bright lights, cold room, lack of privacy, multiple providers, lack of supportive companions, etc.;26,27
- • time constraints, including those driven by institutional policy and/or staffing;28
- • nutritional deprivation, e.g., food and drink;29
- • opiates, regional analgesia, or general anesthesia;30,31
- • episiotomy;32,33
- • operative vaginal (vacuum, forceps) or abdominal (cesarean) birth;6,34
- • immediate cord clamping;35–,37
- • separation of mother and infant;38 and/or
- • any situation in which the mother feels threatened or unsupported.39“
Birth and Botox 