Help please?! Have lost faith in my OB at 31wks and desperately need advice

[Amber4]

Hi everyone, I'm hoping to get your advice on my dilemma which is causing me a lot of angst. I'm 31 wks with my first pregnancy, and have booked a private OB and a private hospital for the birth. At first, I went with this OB because he was available (lots I tried were away on summer holidays) and seemed to have a good bedside manner. He was also quite reassuring in the first trimester when I had a few complications (this is an IVF pregnancy). As the pregnancy has progressed I've educated myself A LOT, including going to a Calm Birth course (can't recommend highly enough) and my DH and I have developed more solid opinions and made decisions about our preferences for a natural birth.

I now wish we had factored this in at the beginning with our choice of OB, as I've just been advised he has a high induction/intervention rate, and since I recently developed gestational diabetes (which I've controlled well so far with the help of a dietician and no need for insulin), he appears to be pushing the line that the baby is likely to be oversized (although so far all measurements have been spot on) and may not fit through my pelvis (there's no indication whatsoever of this occurring in mine or my family's history). He also told me when he diagnosed the GD not to "go and be silly now with endless research on the internet"!!! I get the sense that he's already put me in the category of needing intervention and when I told him I wanted a natural birth he didn't even acknowledge my statement. I now find myself in a huge quandry about what to do. My DH and I are considering whether to forego the fees we've already paid him and switch to the public system, or whether to change to another OB at this point (expensive and difficult), or a friend suggested I look into hiring a doula to help me assert my choices in labour. Don't get me wrong, I know complications can and do happen, but I want to go into this birth with the expectations that things will be alright, and I find his approach very negative, and get the sense that he would prefer to have me in the dark, not doing my own research, and just saying yes to everything he suggests. ANY advice would be greatly appreciated! Thanks.

[~clover~]

I haven't been in your position personally, but I have had an ob kind of like that. When I second guessed him, (got my gp to second guess him too) he gave up on me altogether. Did what he had to do & nothing more.
If I was you I would go public, but thats totally up to you. I have faith in the public system & midwives as I've been there 3 times & my only issue with was the first time with an ob. Well 2 seperate obs, but anyway.
Don't let him take control. Its up to you if you stay with him or not, but don't let him bully you. Have him know that you are well informed of your rights & that you know your chances of a perfectly healthy baby with a natural labour aren't as far fetched as he's trying to make you think.
A doula could be great support & reassuring, but as far as I know, a doula can't tell an ob what to do & is to avoid any confontation if possible. They are there to support you & can't cause conflict. Your DH on the other hand, can stand up for you.

[MummaSue]

Personally, I'd go public.
They have a much lower intervention rate and you're more likely to be attended by midwives who will support your decision for a natural birth.

Hugs
Sue xxx

[grub17]

hey love, well that's ust a terrible situation to be in.

Personally, if i'd already paid the fees and wanted to go private for the hospy, I would write a very clear birth plan, get a doula and get DH to obtains his phd in obst ASAP. That way if your doc tries anything on, you can access your two support people who have a fairly good knowledge of what's happening and make an inforrmed decision.

but if you will find having to fight for your natural birth too stressful, cut your losses and go public.

you really shouldn't have to fight for anyting or be in this positon. Good luck, I hope you get the birth you want. I think you'll be fine tho cos you are obviously already pretty clear on what you want and have been doing your own research.

[onthefly]

I know it's hard, but forget about the money. If you're not comfortable with your doc, then going public is probably a good idea. There are too many possible regrets if he ends up pushing you down a path you don't want to take.
Who knows, all sorts of interventions might be necessary, but if you go public then you have the reassurance that they will not do anything if not necessary.
A Doula can be a great support for you, but they can't argue your case with the OB or offer medical advice, kwim? (They can remind you of what you're aiming for - natural birth - and help you to remember positions/movements/etc to help during birth). Your DH can certainly question and stand up for you, but - especially in the throws of labour - it's pretty hard to stand up to an adamant OB. It's much better if you're all on the same page to begin with.

All the best~~

ETA - on birth plans. They're a great tool for thinking about what preferences you might have and figurign out what you'd prefer under different situations, but they can mean sqat to OBs if they don't agree with your preferences.

[Janie]

Oh hugs what a difficult situation. If I were in your shoes, having already had a baby these would be my options.....

1) Change Obs (by far what I would feel most comfortable with, as long as I felt comfy with the Ob, if that makes sense). I know it might seem tricky, but it is doable.
2) Go public. Keeping in mind that you need to do a whole lot of research into which hospital to choose, not *all* public hospitals will be low-intervention. Especially given that you have GD, they also might try to pull a shifty on you.
3) Hire a doula and stick with the Ob. Not really an option for me I guess, I wouldn't be trusting that your Ob will be willing to listen or negotiate anything much with you. Even with a doula, you could still find yourself fighting a very difficult uphill battle to get the birth you want.

However, a doula is a really good idea if you go with either of the first two options! I understand that it may not be financially possible if you change Obs, but if you go public it could be a really good option for you.

You guys sound like you've done a lot of research and are very well informed and sure of what you want for you and your baby. A tip - you never get a chance to birth this baby again. And a wonderful birth is just that - more wonderful than you could imagine. I still get a high thinking about my son's birth two and a half years ago (under the care of an Ob )! I know the money seems important now.......but you will likely feel differently after the birth. If you've come this far to be asking these questions......well, I can't help but think that you are better off without this particular Ob. Good luck

[Amber4]

Thanks so much to all of you for your replies and good advice. They've helped to reassure me that I'm not being unrealistic, or ridiculous for not wanting to be automatically put in a high-risk category just because I have GD, and when all indicators at this stage suggest things are going well. While everything looks fine I want to plan accordingly (and feel supported in that choice by my caregiver) rather than assume worst-case scenario and be filled with fear. I'm going to see my GP today (I trust her implicitly and she works as part of the public, shared antenatal care scheme) so it would be good to get her thoughts. I'm happy with the hospital I've chosen (good reputation, great midwives and really well equipped birthing suites) so I guess my first preference would be to change OBs if we can so that I can stick with this hospital, but if it all seems too hard or stressful then I'm not afraid to go to the public system. If I end up staying with this OB, my Calmbirth instructor suggested I go to my next appointment with a list of birth preferences to discuss with him, to show him DH and I are serious and have an informed opinion about the natural birth experience we want, and ask him whether he's willing to support that all things going normally. Hopefully we would then get either an undertaking from him that he's willing to support our plans or a definite vibe about his lack of support in which case we'll absolutely go elsewhere. Thanks again for your support.