the OB swap

Starting around 20 weeks pregnant, I became worried about finding a good birthing class. I really want to try to have a medication-free birth if possible, so I feel like to need a class that focuses more on natural pain management, rather than medication. All of the classes offered by my hospital are one part Lamaze, which I’m not crazy about, and one part medication focused, so they didn’t feel like a good fit to me. I thought about Bradley classes, but we just don’t have the time to commit (they seem to be 3-4 hours a week for 12 weeks). Plus, since we share custody of our kids, we really like to be home on the nights we have them. Suddenly, I thought to myself, “This is stupid. I’m sure my doctor’s office has a list of classes I can take home and pick from.”

So, at my 24 week appointment, which was really during my 25th week because of my crazy work schedule, I asked. The conversation went something like this:

Me: I was wondering if you had any information about childbirth classes. I really want to try to have a natural birth (I hate that phrase, by the way, because what exactly is an unnatural birth? But it was a short-hand). I looked at Bradley classes, but the time commitment is too much for us, so we were looking for something a little more low-key.
Dr. Condescending: I really don’t like Bradley method. Let me tell you why. They are very anti-doctor. I’m an excellent doctor. I know what to do. I’ve won (some random award I don’t give a shit about) for being so great. So I will tell you what you should do. I’ll tell you when to have the epidural, you don’t have to worry about that. I’ll tell you when to push. Etc. (I sort of stopped listening here because it was all just the same.)
Me: Okay. But I didn’t want to do Bradley classes. I was wondering if you had any information about other classes. And I really wanted to avoid an epidural if I can.

You can imagine how it proceeded from here. It was basically a monologue by Dr. C at this point because I was speechless. Some gems include:
“If you wanted a birth like that, you should have gone to a midwife or some kind of Chinese medicine, not come to a doctor’s office.”
“Just take the class at the hospital.”
“Stop worrying about this stuff so much and try to enjoy your pregnancy a little more.”
“You’re in the significant minority here.”
“Only 10% of women can give birth without some kind of medical assistance.”

He wrapped it all up with a delivery horror story about another doctor who did not force his patient to have an epidural against her wishes, and how she ended up in all kinds of pain. The story concluded with, “Maybe it’s true what they say about male OBs but I don’t like to see my patients in pain when I know I have the power to fix it.”

All in all, it seemed to me like he had some kind of God-complex. Like he was the bringer of life and I was some kind of extra, wandering around the set and getting in the way of the drama he was starring in. I left the office without saying anything, got in my car, and called my wife sobbing. I wanted to switch practices.

A couple of things about my wife. First, this was the first and only appointment she didn’t come to. It was supposed to be an easy one! Second, she has given birth three times, all of them with an epidural. So while she is supportive of my desires, I am more firmly in the trenches on this one. I’m not an idiot, however. I’d rather have an epidural if there is a chance of having a c-section, because then I am awake. I would have an epidural if my labor was really stalled and they thought it would help me progress. I don’t want to do these things, but I will. I want the baby to be healthy, right?

So we devised a plan. Rather than switching doctors at 25 weeks, we’d meet with one of the women in the practice. We would explain what was said to me, and what we wanted, and they would reassure me and everything would be fine. And Dr. C would not deliver our baby, no matter what. I could live with this, I thought. Also, I got the sense that my wife thought I might have been overstating things just a bit. So I was willing to give it a try with her there to help me out a little.

So at the 28 week appointment, with the one female doctor that was more senior than Dr. C, I launched into it. I didn’t repeat verbatim all the really nice offensive things that were said to me, but I did throw in the bit about Chinese medicine, because it was too good to leave out, and I think gives a good sense of the tone of the conversation.

She started out great, with some nice words about how that is horrible and of course it’s my body, so no one can make me have an epidural if I don’t want one. But then it shifted a little. She started lobbying me to change my mind. She told me that most people can’t handle the pain, even if they go into it thinking they can. She said that many labors stall, and the epidural is the only way to get them started again. She made a joke about a woman who brought a birthing ball. She said she didn’t like birth plans, especially if they requested no pitocin after the birth, because “most women need it to stop the bleeding.” I didn’t say anything, because my mind was pretty made up at this point that I wanted to change practices.

After all of this, my wife threw her a softball. “But she gets to consent to anything, right? So for example, you wouldn’t just do an episiotomy?”

“Oh, we do them all the time. Otherwise you tear. We don’t really ask about it, there isn’t time.”

And with that, we were done. We thanked her, and left the office without making my next appointment. It wasn’t so much what she said, but the whole attitude of the office. No one has ever mentioned nutrition to me, other than once when Dr. C said, around 12 weeks, “don’t get fat, and you’ll be fine.” No one has mentioned breastfeeding. No one suggested a flu shot, or any resources to educate myself about anything.

In the car, after the appointment, I think my wife was more surprised than I was.

So that is why we changed. I found an all female OB practice that uses the same hospital, since I really wanted to deliver there. They have a midwife on staff. I made an appointment and walked in 32 weeks pregnant to meet my new doctor, with a horrible feeling in the back of my mind hat it was totally possible that she would be just as bad as the practice I left, and I would still be searching for a doctor, four weeks more pregnant than the last time I did this.

When she called me back, my wife and I stood up. “I’m sorry,” she said. “We need to see the patient alone first. Then we’re happy to meet with both of you.” I was actually elated by this. Not because I had anything I didn’t want my wife to hear, but because what if I did? What if I was secretly eating laundry starch in the closet or something? I had a safe space to talk about it. I sat down in Dr. O’s office and said I wanted to try for an unmedicated birth.

“If you’re determined, we’ll do everything in our power to help you. I had an unmedicated birth for my two sons, so if I can do it, I know you can too.” The whole conversation basically went like this. She noted in my file that I wanted an unmedicated birth and asked me to bring in my birth plan so they could add it to my file and have it sent to the hospital. The next appointment, the doctor asked me to get a flu shot, talked to me about how to keep having a healthy pregnancy, and said she had also had an unmedicated birth. It was so nice to feel like my doctors supported me.

And you know what? I never brought in that birth plan. I thought through the issues, and talked about it with my wife, but I never brought it in. I guess I will, maybe at my next appointment, but it suddenly seems so much less important. I guess when you actually trust the care you are getting from your provider, it’s a little easier to let go and see what will happen. I would feel 100% ok having an epidural if one of these doctors thought it was the best thing for me. I would have felt bullied, and pressured, and like a failure having one at the recommendation of one of the doctors in my previous practice.

Changing providers late in my pregnancy was scary, but I would absolutely recommend it if you don’t trust that your doctor is giving you the kind of care you need and deserve. Oh also. The wait times at my new doctor’s office are less than half the wait times at the old office. Just another way they treat their patients respectfully.

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4 thoughts on “the OB swap

  1. I’m so glad you switched! What a terrible experience! I’ve heard that doctors think and say those kinds of things but it’s still shocking to me to hear it from someone. I had to talk possible induction with my midwife and it just confirmed for me why i love the practice. She was so thoughtful and engaged and wanted me to understand. I totally trust her and it makes a huge difference.

  2. Oooh, I was seething reading the first part of this post. So glad it had a happy ending. Now here’s hoping the birth story does too (delivery-wise, I mean; OBVIOUSLY the healthy baby goes without saying). Well done switching. Trust and respect are SO important, on both sides.

  3. We also switch out OB…a little sooner at 25 weeks but it mAde the world of diffrence. She was kind and gentle and supported our decisions. We wanted as “narural” of a birth as possible and with twins that can get a little hairy. It worked out just was we wantes (minus the c-section but she heard us out for a vaginal delivery through the whole process). Good for youfor going with what makes you feel comfortable and having a dr who listens!

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