Thursday, September 10, 2009

Maybe some issues with the OB?

I think I might need some advice. I am not overly crazy about my OB. I am going to give it another shot on Tuesday...and I've heard great things...but here is the situation. First, I very rarely get any time to talk to anyone in the office. Second, I had to actually request an anatomy scan (no one suggested any testing or ultrasounds at all), which they are giving me on Tuesday, but they told me that my ultrasound appointment is at 2:45, my OB appt is at 3. Isn't the anatomy scan supposed to be detailed and take a long time? Don't they check every organ that they can to make sure all is okay and measure everything on the baby, the placenta, etc? How can this happen in 15 minutes? They also haven't done ANY tests at all. I told them I didn't need genetic tests but I know there is a urine protein test that should have been done around week 16 and that time period has passed. I am getting confused.

Then, this morning, I went to a prenatal aqua fitness class, which was fun. However, of the 5 other women in the pool, 4 of them have had repeat c-sections and the 5th one had her first baby 16 years ago, so she doesn't really count. This prompted me to do some research. It turns out that NY is one of the worst states for c-section rates. The rates are incredibly high - mainly b/c of malpractice insurance. However, the World Health Organization has researched this issue and found that the ideal number is 15% of births can be c-sections. Over that number and women start having complications and babies have health problems and higher mortality rates. Well, NY's rate is 36%. My hospital's rate is 33.7%. My OB, though he hinted we'd be going for a vaginal birth, seems to go along with these stats- of the 2 women I know who have gone to him, both have had c-sections. I am not anti-c-section. I am anti-unnecessary-c-section. My thought is that God provided an exit for them and if the exit is available, the baby should use it. If something causes a problem and the exit is blocked or inaccessible or the baby is in distress, my doctor is free to create another exit. Until that point, I'd like to go the natural way, please. So, now I have more research to do and more questions to ask my elusive OB.

I realize that it is early to be considering labor and delivery type things but my concern is that birth has very much been taken away from women. Our decisions frequently are made for us and, if they are not, we are rarely provided the information to make our own informed decisions. So, I want to know now and discuss things this early so that, if I don't like the answers, I can find other options (aka, other OB's or midwives, etc). I wish I could come up with another OB practice in Syracuse that I heard was good and delivered at my chosen hospital...but maybe they are fine. The truth is that I am not very high maintenance in this department at all...I just want to feel like I am included in my own care and have things explained to me. I'd also like to feel cared for so that I don't need to research all of my own options and ask them to give me scans. It seems that all of my fellow February Due Date girls get suggestions for tests from their OB's - not the other way around. I'm frustrated.

Things I am going to ask my OB:

1. How long do you allow a patient to go after her due date before you induce? (ideally, he should say up to 2 weeks if all is fine)

2. What is your practice's particular c-section rate and what medical reasons would prompt you to perform a c-section? Do you automatically do c-sections if the baby appears "big" and how big is "big"?

3. How long do you allow your patients to labor (in early labor) before you either break their water or give pitocin to move labor along?

4. Do you allow your patients to get up out of bed or sit up on a labor ball to let gravity help with labor?

5. What are your recommendations about the swine flu and the vaccine? Will your practice be getting the vaccine?

6. Are there other screening tests that I need to be aware of?

Do you guys have any other ideas of questions I should ask? I really have no idea, I've just been paying attention to stories of other women and recommendations made by friends. So, please share if you have ideas that I've forgotten about.

Also, what is your take on the anatomy scan thing? did yours take longer than 15 minutes?

Sorry I've been away...I think I am trying to just live again a little. I am at the boring stage in pregnancy (which is LOVELY), where nothing much is happening, I'm not overly stressed, I'm not feeling movement yet, not showing too much yet, etc. So, I'm just trying to get by. Tomorrow night, I have a great date night planned with my hubby. First we are going to one of the most elegant restaurants in Syracuse (not saying much, lol) but truly, this is one of the only real culinary experiences in the area with a chef from NYC (food is what I miss most about living in NYC) and they are willing to cook gluten free for me!!! They were very gracious and confirmed that my favorite salad - lobster and goat cheese- is gluten free and the cheese IS pasteurized, so I can eat it! yay! Then, we are going to Cirque du Soleil! Granted, it is probably the "D" string of performers since we aren't in a big city, but I think it'll be fun anyway!

In other news, the state fair was in town and Brett and I hit every country concert that they had. We do it every year. And, just in time b/c our little girl already started we've got her started early. During the free Darius Rucker show (which was seriously a BLAST- he did his new country stuff but then lots of Hootie too - and random other fun stuff. surprisingly good performer), my neighbor on the grass leaned over and said, your daughter is getting an early start -she's going to love this music. How fun was that? Then I got nervous at the level of noise at Big and Rich (we were in the 7th row on the floor, center), but looked around and from my seat, could see 2 other HUGELY pregnant women who were doing just fine too! I think I am done with loud concerts for a while, but it was fun. There were some great shows and it is really rare to get good shows up here.


Amber said...

I can certainly understand your concern with your OB. If I were in your situation, I would feel like the practice is too lax for me. Especially with all the crap you've been through- sometimes a doctor that is proactive and takes charge is a great reassurance.

The 15-minute anatomy scan worries me a little, too. I mean, this is the only opportunity you have to see you baby in detail before she is born. It's also essential to make sure she is developing correctly (not to mention you won't see her again until 34 weeks, and you'll need a pretty good fix to survive that long wait!)

I'd say give Tuesday a shot, ask the questions you have (very good questions, by the way!) and play it by ear. If you still have a gut feeling that this OB isn't right for you, listen to it. You're probably right. If they spend so little time on things like anatomy scans, how are they going to treat you when you're in labor? Will they try to rush you then, too?

The information about c-sections in NY is very interesting to me. I, too, would like to have one only if medically necessary. My abs still haven't recovered from 2 laparoscopies, so I'm afraid of what a major surgery would do. I looked up the rate for my hospital, and the first birth c-section rate for low risk women is currently at 28.4% (their goal is 15% or less), and repeat c-sections for them are at 90.5% (!!), although their goal for that is 63% or less. I'll definitely be bringing this up with my doctor at my next appointment!

Jill M. said...

Well, you know we're on the same page regarding L&D after our discussion. I think it's time to get a new OB for starters.

Have you considered interviewing some midwives? They are all for natural over medical intervention if at all possible. I feel they would be your advocate and help you to avoid falling into the traps that lead to unneccessary medical intervention.

Hope you get some great advice. Keep us posted!

DonnaPetit said...

We talked about your OB questions, so that issue doesn't require comment. I just wonder if you may want to rethink your music genre choice???? hahaha

jenna said...

I was just checking in and saw the concern about the ob. If you are interested in changing I would recomend mine, although not sure if they deliver at your hospital. The anatomy scan worries me as well. Mine was blocked for an hour and two hours with the twins. They are easy to talk to and accomidating. Let mw know if you want any info.

Barefoot said...

On the anatomy scan, my OB suggested I make the appoinment during my first visit with her (at 10 weeks). I ended up having two -- one at 18 and one at 21 weeks -- and they both took between 30 and 45 minutes. You should definitely talk to your OB about that, and any other questions you have. That is what they are there for!!

I have concerns about my OB as well, but they're more along the lines of personality fit. I've never questioned her thoroughness, but that would be a dealbreaker for me.

Me said...

It is good to hear that you are doing well.

Leigh said...

Hi Sue, I don't think I've ever commented before so am coming out of hiding!! First of all, congratulations on your pregnancy!!

I couldn't agree with you more about everything you said. I just gave birth one month ago and it was a disaster as far as everything my doctors did during the delivery. I'm all for pain medication but otherwise think your body should be allowed all the time it needs to labor on its own. I will 100% be finding a new doctor for next time.

Good luck and stick to your guns! I wish I had been more proactive and assertive.

kayjay said...

I'm sorry to hear that you are having so many concerns with your OB. My 20 week anatomy scan has already been booked for Oct 28th and I was told that it was going to be *at least* 1.5 hours to 2 hours b/c I'm having twins. If IF has taught us nothing else, ASK if you have questions and keep at it until you are comfortable. As for the c-section thing, I am totally in agreement with you. I am also anti-unnecessary-c-section as well and for me, I get awful keloid scars on the trunk of my body so I am extra sensitive about having major abdominal surgery. If I can avoid it at all than I will but if medically they need to come out via c-section, than fine. However, to have that choice taken away from you isn't right. Have you checked out I found it pretty useful in finding out more info on my OBs and every doctor that I know that is rated on that website is pretty bang on accurate. Change OBs if you're not comfortable - you'll never see them again and you have to do what's best for you. Good luck!

Lost in Space said...

No useful assvice, but to follow your gut. If something doesn't feel right to you, then move on. You've come through too much to be shifted around at this juncture.

Glad everything else is going so well!

Angie said...

Hey, do not know about ?'s for your OB since I haven't got there (yet!)...sounds like you have a good list going though. Ask your questions, seek answers until you are comfortable and then make your decision (go w/ your gut!). Like you said, now is the time to move on if you need to.

So happy 4 you that things are rather boring! LOL Oh and btw, saw Darius last summer ~ thought he was great, too!

Anonymous said...

I would find a new doc ASAP. I have a DS and I liked my OB a lot, but I found the birthing procedure very disempowering (is that a word?). The point being if I ever do it again, I'd get a doula to look out for me and what's going on (my DH is lovely, but that's not his forte either) b/c you aren't in a position to do it yourself. If you are already feeling disempowered now--look out--so I think you are correct to already be thinking about what it will be like when you get to the birth experience.

Kris said...

If you are not comfortable with your OB, change now. After all, this is the person who will be delivering your precious, well thought out, paid for in advace precious miracle cargo:)

I always listened to music on the side of loud when I was pg with Logan and he loves music now. Whenever any kind of music comes on he immediately starts dancing. And if the music is too quiet in the car he asks us to turn it up if it is one of the songs he likes. I love it! He also has a mini kids keyboard/piano set that he plays with all of the time.

DAVs said...

I agree with the others--and sorry I'm so late to the post.
Trust your gut (even if it is starting to resemble a beer gut :) !)
Glad you're at the boring part :)

Phoebe said...

Good luck tomorrow! I think this is the second time you have had questions about your OB. If he or his practice don't feel right to you, try to find another! This is really important that your birth experience be a good one and that you feel good about your OB. Just like any doctor, you have to shop around for a good OB.