Not surprisingly T. wasn’t very satisfied with this conversation.  She didn’t feel heard or respected.  Rather she felt that she had been lectured to.  She wanted to have a genuine conversation with him about some important topics regarding her birth.  He felt like she was questioning his authority and just wanted her to trust him.

This stressed T. out as she is in her third trimester and it had been hard to find an OB who would accept a late transfer.  She had called a whole list of OBs and he was the first who was willing to take her, so she felt stuck.  She knew she didn’t want her old OB, and this new OB was at a better hospital.    

She asked me, “Does it really matter who my OB is?  Aren’t they just there to catch?” Well often during the birth they do show up just to catch, but it IS important for a number of reasons. 

1.  Induction Happy OB – If you have an induction happy OB, you are on the path to an intervention filled birth before you may even get close to your birthing time.  Some OBs like to induce all their moms at 38-39 weeks, some 40 weeks.  Seeing as on AVERAGE a first time mom won’t birth her baby until after 41 weeks, that is a lot of moms getting induced before their bodies and babies are ready.  There are a lot of issues and questions regarding inductions.  

Also it is important to ask NOW to any OB (even if you are 10 weeks pregnant) does your OB use Cytotec/Misoprotrol/Miso, to ripen the cervix.  If the answer is yes, that is a huge red flag.  A letter from the makers of the drug issued a letter years ago advising not to use it to induce saying:

Serious adverse events reported following off-label use of Cytotec in pregnant women include maternal or fetal death; uterine hyperstimulation, rupture or perforation requiring uterine surgical repair, hysterectomy or salpingo-oophorectomy, amniotic fluid embolism, severe vaginal bleeding, retained placenta, shock, fetal bradycardia and pelvic pain.

The problem is MANY care providers still use cytotec.  I have had 2 Hypnobabies students who were told they needed to be induced that day and then found out the hospital/careproviders only had cytotec to help ripen the cervix.  No other option was available.  This is NOT something I would want to find out if I was being pressured to induce that day.  

So ask this NOW!  If they usually use cytotec, are there other options available if you refuse (for instance cervidil or a foley bulb?)  There was one OB who made a comment, “Oh, you must have been reading scary things on the internet.”  Is it foolish for a mom to do research?  Should she just submit to using a drug KNOWN to cause death in moms and babies.  She may not have a choice unless she asks early in her pregnancy, to be sure there are other options available. 

2.  Scared of Big Baby OB – This could lead to pressure to induce or have a cesarean.  It is impossible to know how big a baby is before he is born.  A big baby doesn’t need to be a big problem.   Some OBs like to play the big baby card, just to convince a mom to induce or have a cesarean, because it is easier for them! 

3.  Cesarean Happy OB – There really ARE OBs out there, who will come up with a reason to perform a cesarean, so they can go home for dinner.  I would say most are NOT like this.  But if you never ask your OB their cesarean rate, how would you have any idea?  What if they don’t know their statistics or vaguely respond.  Well that would be a red flag for me.  Low intervention OBs will be proud of their statistics and want to share them!  Ask them specific questions about their cesarean guidelines.  (It is also important to find out the cesarean rate of the hospital you are at, that can make a big difference too) 

4.  Informed Consent –  Why use scare tactics when talking to moms?  You need an IV or we won’t be able to find a vein in case you hemorrhage.  Don’t eat a cheeseburger on the way to the hospital, you may die!   If she has questions, answer them, don’t lecture her and make her feel bad for asking.  Why not have a normal conversation explaining the pros and cons and let the mom decide.   Isn’t that what informed consent is?   

T’s OB said “ if he’s going to be our doctor, then we have to trust him; lots of people are giving lots of advice that have never been in his shoes and don’t have his liability.”

ALL patients have the RIGHT to informed consent.  I don’t understand why OB’s think they are above giving moms informed consent.  If a mom can’t even have a simple conversation on equal levels, gathering information from their OB about pros and cons of different interventions before their birth, then how are they supposed to “trust them” to provide informed consent during their birthing time? 

5.  Birthing Time/Pitocin Happy OB – Did you know some OBs put every mom on pitocin.  Even if she comes in and is having consistent and strong birthing waves, automatically she gets put on pitocin.  Why?  Who the heck knows?  It makes no sense.  Maybe because they have a routine and they like to have something to do?  So on the pitocin goes.  Ask your OB, What percentage of your patients get pitocin?  In what circumstances do you usually use pitocin? 

6.  Actually Catching the Baby - Even if the OB isn’t really involved before the birth and is just there for catching, they can have a huge effect!   Here is a story which demonstrates the difference an OBs attitude towards birth can have on a birth.   

Also what about episiotomy’s?  This is a huge thing to think about.  Some OB’s really think all first time moms need an episiotomy.  If your OB thinks that what are the odds of you getting an episiotomy?  I would say 99% chance.  This is another area where asking ahead of time is important.  If they are real vague and say, “Let me decide if it is necessary.”  I would really press for their statistics or at least ask, “When do you feel it is necessary?”    

So yes, it does really matter who your OB is, even though they may only be there to catch the baby. 

So what can T do?

She had called so many OB’s on her list and he was the first that was even willing to take her.  Could she find anyone else who would be willing?   What if they were no better than this OB was?  She was stressed out and really just wanted to be done with this process and have an OB.

Find out what happens in the next installment.