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Martha
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Well, I made my first ob appt for this baby for Nov. Let me begin by saying I really do think my ob is a good dr., as far as ob drs. go - I could and have done much worse. Which is why I suffer through the other ob "stuff".
I call and get the usual circus, and cut to the chase.
"I need to schedule my 1st ob appt for this pregnancy for November please. Monday or Wednesday if possible."
"Are you new here?"
Nope, she was present for babies #6 and 7.
"Oh okay, the nurse sees all new moms on Thursdays around 8 - 10 weeks. I've got you down for the 13th at 3"
Well, that's nice but I won't be there then. I need an appt. for Nov. Why am I seeing a nurse instead of Dr. S? And I cannot do Thurdays. Can we make it a different day in November please?
"The nurse sees all the new ob patients before their first ob visit with the dr. and is only available on Thursdays. Is there another Thursday that will work for you?"
Why do I need to see the nurse at all?
"Oh she verifies your pregnancy w/ a pelvic exam, schedules blood work, answers your questions, gives prenat rx, gets your medical history, and such out of the way before your ob appt."
hmm. Okay. I don't have nurses do my physicals, you can look in my charts for blood type and medical history, I have my vitamins already, and do not have any questions for her. Well, I do have one. Knowing all that is out of the way, can I schedule with the dr. for a Mon or Wed in November please?
Long silence and mental groaning I'm sure. "No, I'm sorry all appts start with the nurse. What Thursday can I schedule you for?"
None, but you can schedule me for Nov. 17th and we'll see if a miracle happens between now and then.
"okay I have you down for 9:30!" chirpy voice that drives me nuts.
This is my practicing catholic ob, who is always saying how her not prescribing bc or doing such procedures cuts her revenue down to 20% of what it coud otherwise be. Well you know if you only take new patients 1 out of 5 days a week, that'll happen regardless.
ARGH! I hate ob/gyn offices and hosptials. I've decided to be a royal pain and bulldoze to get my way this round. Think major passive-agressive!  I'm so sick and tired of the "drills". If I ask a question they'll be irritated that I don't just let them be the drs. and nurses. They won't listen when I say no pitocin, it doesn't help. They'll roll their eyes when I warn them I'm ready to push and then act annoyed when without pushing I deliver in 2 minutes flat with no medical staff there. They'll give me staydol, even though both my dh and I insist it makes me hysterical and overly emotional. The epidural will be either non-existant or too late to help. And every time I turn around, they'll want to drop my pants to do a useless exam. (Yes, it's still there!) They'll insist I pre-register and give a small blood bank only to say it's procedure to ask for it all again when I get to the hosptial.
Am I the only mom who gets this cranky with medical staff? I'm just so tired of it all and find after going through the standard operating procedure for so many years/babies - I just have zero tolorance for it anymore. 
Thank you for letting me rant and rave here. I don't think I've ever been this emotional and irritable with any other pregnancy. 
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Martha
mama to 7 boys & 4 girls
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momwise
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Martha wrote:
| Am I the only mom who gets this cranky with medical staff? |
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Oh my goodness no! That's why I had my last 3 babies in my bedroom with my 2 Christian midwives
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Gwen...wife for 30 years, mom of 7, grandma of 3.....
"If you want equal justice for all and true freedom and lasting peace, then America, defend life." JPII
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Martha
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momwise wrote:
Martha wrote:
| Am I the only mom who gets this cranky with medical staff? |
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Oh my goodness no! That's why I had my last 3 babies in my bedroom with my 2 Christian midwives |
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*sigh* That does sound rather nice, but alas is not an option for me for various reasons. Although I have considered just bunkering down in a locked hospital bathroom until I'm ready to be bothered with them.
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Martha
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momtomany
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Martha wrote:
Why do I need to see the nurse at all?
"Oh she verifies your pregnancy w/ a pelvic exam, schedules blood work, answers your questions, gives prenat rx, gets your medical history, and such out of the way before your ob appt."
hmm. Okay. I don't have nurses do my physicals, you can look in my charts for blood type and medical history, I have my vitamins already, and do not have any questions for her. |
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My OB's office does this to, except with nurse practitioners. Also they are supposed to give the advantages of breastfeeding/ the advantages of bottlefeeding talk. As a La Leche leader for 23 years, this is a total waste of time for me. How I get around all this is to just call and schedule for a well woman visit. With a doctor. Of course I get the evil eye from the nurse when they do the preliminary stuff like asking when my LMP was and they realize that I'm pregnant. But it's so worth it to avoid that silly nurse appointment!
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Mary Ann in PA
wife to MIchael, mom to Elizabeth, Becca, Tim, Peter, Andrew, Sarah, Matthew, John, Leah and Joseph
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Elizabeth
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Martha,
You really need to find a good certified nurse midwife. The entire mentality of CNM's is differenet and their approach would address so many of the concerns you've noted. Do a little hunting around. Call a La Leache League leader and ask for referrals. Call a Bradley method instructor. Use all that anger and irritation and be an advocate for yourself ina positive way. The enitre "industry" of birthing was changed a generation ago because women were proactive. You can make this birth different. Many, many of us have gone from horrible experiences to really beautiful ones.
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Elizabeth Foss is no longer a member of this forum. Discussions now reflect the current management & are not necessarily expressions of her book, *Real Learning*, her current work, or her philosophy. (posted by E. Foss, Jan 2011)
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Martha
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| Posted: Oct 11 2005 at 9:27am | IP Logged
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Elizabeth wrote:
Martha,
You really need to find a good certified nurse midwife. The entire mentality of CNM's is differenet and their approach would address so many of the concerns you've noted. Do a little hunting around. Call a La Leache League leader and ask for referrals. Call a Bradley method instructor. Use all that anger and irritation and be an advocate for yourself ina positive way. The enitre "industry" of birthing was changed a generation ago because women were proactive. You can make this birth different. Many, many of us have gone from horrible experiences to really beautiful ones. |
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*sigh* CNM's are rare and far between in my state. Plus, as we don't live close to a hospital, my dh will not discuss it and CNM's rightly insist that both of us be ready and willing to do that. (I hemoraged badly with the last.) This area is just now starting to hear about doulas - there's exactly 1 at one of the hospitals in Tulsa.
Even if all that could be worked out - CNM's and home births are not covered by our insurance at all. Which means I'd be looking at about $3500 due in less than 8 months and we can't afford that.
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Martha
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MaryM
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Martha wrote:
| CNM's and home births are not covered by our insurance at all. |
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CNMs are Certified Nurse Midwives and are the ones who practice in hospitals (although in some areas can do homebirths). I think that's why Elizabeth was offering that as an option. It's in a medical setting and is covered by insurance but you get a different philosophy and approach to the birth process. Direct Entry midwives or certified professional midwives are the ones who traditionally do homebirths.
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Mary M. in Denver
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MicheleQ
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MaryM wrote:
Martha wrote:
| CNM's and home births are not covered by our insurance at all. |
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CNMs are Certified Nurse Midwives and are the ones who practice in hospitals |
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This is what I had last time (and in a hospital) and it was the best birth experience I have ever had. The one before that was the worst (induction with a doctor I can't stand).
I absolutely will ask for a CMN next time (if there IS a next time). 
God bless,
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Michele Quigley
wife to my prince charming and mom of 10 in Lancaster County, PA USA
http://michelequigley.com
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Martha
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MaryM wrote:
CNMs are Certified Nurse Midwives and are the ones who practice in hospitals (although in some areas can do homebirths). I think that's why Elizabeth was offering that as an option. It's in a medical setting and is covered by insurance but you get a different philosophy and approach to the birth process. |
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No, I knew what she meant and no they are NOT covered by my insurance. My insurance only pays for care given under the plan drs. They might cover the hospital stay, but everything else would be mine to cover.
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Martha
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Elizabeth
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Martha,
I found twenty doctors in the Tulsa area who are in practice with CNMs. I like your chances of finding a doctor with your plan who is in practice with a CNM...Start here and call down the list. You'll find the whole experience much more pleasant .
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Elizabeth Foss is no longer a member of this forum. Discussions now reflect the current management & are not necessarily expressions of her book, *Real Learning*, her current work, or her philosophy. (posted by E. Foss, Jan 2011)
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amiefriedl
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Martha wrote:
| Although I have considered just bunkering down in a locked hospital bathroom until I'm ready to be bothered with them. |
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I did this!! (Well...the door wasn't locked.)
It wasn't intentional, but I ended up trying the new bath tub at the hospital and I went from a 3 to a 10 in dialation while sitting in the tub for only 45 minutes.
I delivered on the nurses shift change right there in the water. Just 3 pushes. Then my husband pulled the nurse-call cord and said "We have a baby!" The nurses (all 8 of them) were so mad, poor things. But it all did go so fast! I wasn't even sure I was in transition and they hadn't checked on me the whole time.
It was an awesome birth.
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In Christ the King through Mary our Mother,
Amie
Blessed with an awesome hubby and Mom of ds10, dd7, dd3 and dd 10months.
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julia s.
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Martha,
Secretaries come in many forms: the really helpful, but catch flack from the doctors if the fail proticol; the really helpful and will bend the rules for you if you ask (my personal favorites); and the gate-keepers -- they love the rules it makes their life seemingly easier and they get to say sorry I can't help you without all the guilty they might feel if there weren't those rules.
My mom was a secretary a good one and would bend the rules when she could, but she also worked for two doctors one of whom would scream so the whole floor could could hear (he was horrible). But I will tell you that most patients never complain to the doctors and most of the doctors will back down and change the "rules" if you ask. That was my mom's biggest complaint was that when she complained to the doctor on behalf of the patient the doctor could care less, but if the patient did they'd sing a different tune. Unfortunately most patients ever want to burden their doctors.
So my long winded advice is talk directly to the doctor. Explain the whole seven babies and insurance complaint and I bet she'll come around. Last resort is the visit with the nurse isn't usually covered by insurance (at least there is usually a co-pay) and you could say that this would be a burden to you right now. They might just waive the fee and still request you go, but you might get lucky and they'll say never mind .
Good luck. I've dealt with my share of gate-keepers in the past and it isn't fun. Some times in the same office there are different secretaries and you might find the one who is really accomidating -- if you do get her name and ask for her each time you have an extra-ordinary request.
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julia
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teachingmyown
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Amie,
That is hysterical! What a pefrect scenario, a nice private birth, with all the emergency and professional help you may need right outside the bathroom door.
I might just have to try it!
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Molly
wife to Court & mom to ds '91, dd '96, ds '97, dds '99, '01, '03, '06, and dss '07 and 01/20/11
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Martha
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Elizabeth wrote:
Martha,
I found twenty doctors in the Tulsa area who are in practice with CNMs. I like your chances of finding a doctor with your plan who is in practice with a CNM...Start here and call down the list. You'll find the whole experience much more pleasant . |
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hmmm, compared that list of drs. with the insurance list. Exactly 2 are on my insurance, but NOT the hosptial they go through. My dh is yammering behind me that he doesn't like the CNM plan of action either... He doubts it will change the "standard operating procedures", so to speak as most of the facilities here are the same. He also REALLY likes my the current ob. 
Curious to know... exactly how does a CNM under a dr. in a hospital change anything for the patient? It sounds like it would just be adding a middle man.. er woman..? Can anyone give specifics?
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Martha
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cswini
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Dear Elizabeth,
I had #4, 5, and 6 in a hospital with a CNM, and it's a completely different philosophy. They view birth as a natural process that should be interfered with as little as possiible, while most OB's view it as a medical situation that must be managed. CNM's are much more likely to let your body do the work,and support the birth in a much less intrusive way. I also had a doula for #6, and I can't say enough about how wonderful that was. My dh is fine at being a labor coach, but there is nothing like an empathetic woman to make the process bearable. And #5 and #6 were born when I was in my mid forties, and we live in Omaha!
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Catherine, wife to Joe, mother to Ben '86, Laura '88, Samantha '89, Jessica '92, Max '02, & Julia '04
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momwise
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Martha wrote:
| Curious to know... exactly how does a CNM under a dr. in a hospital change anything for the patient? It sounds like it would just be adding a middle man.. er woman..? Can anyone give specifics? |
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Martha,
CNMs are not insurable for some reason. They have to (in theory) be employed by an MD. In practice, they work on their own under the umbrella of the dr's practice. In a hospital or birth center they would not be directly supervised by anyone; it's just a technicality for ins. purposes. It's not as though the dr. will have any influence over the midwife's practice.
As far as money goes, there was a great deal that we had to pay for by choosing a midwife over an OB (even though we saved the ins. co. a ton of money). Something you may want to consider is using your child tax credit refund; that's how we paid for the last bill.
And St. Anne is a wonderful intercessor. You'd be surprised how much she can help...with dr.'s, insurance co., dh's, etc. I did a novena to her each time I got pregnant with the last 3 and those births were far and away the greatest out of 7.
Also, the doula doesn't have to be the one hired by the hospital. There are lots of doulas around who are in private practice.
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Gwen...wife for 30 years, mom of 7, grandma of 3.....
"If you want equal justice for all and true freedom and lasting peace, then America, defend life." JPII
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Elizabeth
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My CNM deliveries with CNMs who are in practice with an MD have been very good experiences. With my 6th, we had no maternity insurance; medical insurance but not maternity coverage. The CNMs moved heaven and earth to cut costs for me, including allowing me to stay in a triage room overnight while the baby was still officially admitted (he was covered, but not me). When I had to have a C-section with number seven, my midwife stayed with me and assisted at the surgery. When I had postpartum depression, they made housecalls. When I miscarried, they cried with me.
I've had low tech no med deliveries in a hospital with a CNM (several years apart with two different CNMS in different towns and hospitals) and I've had a high tech emergency C-section with a CNM and the doctor in the practice. In my mind, given my medical history and the inadvisability of homebirth, I could not have asked for anything better than my CNM experiences. And for what it's worth, there is a decided differnce in the office staff in a practice where women are empowered and even honored in the birthing practice.
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Elizabeth Foss is no longer a member of this forum. Discussions now reflect the current management & are not necessarily expressions of her book, *Real Learning*, her current work, or her philosophy. (posted by E. Foss, Jan 2011)
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Bookswithtea
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I had my first birth with a private practice CNM with #5 (3 others with a hospital that employs CNMs who are almost as medicalized as OBs and one home birth). They worked with a doctor and billed under the doctor's name so that my insurance would pay for it. Insurance covered everything that they would have covered with an OB.
They were *awesome*. Easily as good as my home birth experience. It was so nice for someone to take me seriously with my previous pg/birth experiences. They didn't make me repeat all the STD testing, for instance. I hate it when they tell you, "even though you've been faithful, we can't guarantee your dh has!" blech!..They also heard me loud and clear when I said emphatically "NO CONTINUOUS MONITORING!!" and made sure that was the case, and really let me push when I was ready. That was the best part of all...I was so used to people telling me "push now" and I was having pushing contractions, but I just wasn't ready, mentally, to push. She told me to push whenever I was ready, and around contraction 4 or 5 I was ready and gave one big push and he was out! :-) I had the best recovery I have ever had after delivery and I believe it is because no one forced me to push. The great recovery was really significant to me, and I would definitely work with them again, should the Lord bless us with another baby.
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MicheleQ
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Martha wrote:
| Curious to know... exactly how does a CNM under a dr. in a hospital change anything for the patient? It sounds like it would just be adding a middle man.. er woman..? Can anyone give specifics? |
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In my experience the CMN was with me the entire time and I never even saw the doctor (which was fine with me). She listened to me and let me do things how I wanted. I wasn't hooked up to monitor, I wore my own clothes, and there was no "traffic" in and out of my room. It was quiet and peaceful and at #9 really and truly the best labor and delivery I have had yet. My recovery was SO much better than my recovery from the bad experience I had with #8 (I was induced).
There's no doubt in my mind if I have another baby I will at the very least go with a CMN but a big plus is that it opened my dh's mind to the idea of a CMN assisted home birth (which I have been wanting to do for years). He even remarked "wow that was so easy, we could have done it at home!" and he's right, we could have!
God bless,
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Michele Quigley
wife to my prince charming and mom of 10 in Lancaster County, PA USA
http://michelequigley.com
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ALmom
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I can sympathize. I switched to a CNM at 8 months with our first and had to drive 3 hours to another state to get it. Our state is a mess as far as midwives of any variety - none can assist at delivery even with a doctor (ie we don't have any CNM in our area). The rest of our births we did at home - till we found out we had been mistaken about the legal interpretation in our state. Our next (if we are so fortunate), we plan to drive across the border to a house in Tennessee with a midwife with physician back-up and insurance coverage. All other births were out of our pocket (except the other TN one)but worth it. We also do not have any pro-life doctors (one or two who will not do surgical abortions, etc) and every doctor has the same standard proceedures but a different quirk. One year the only doctor our plan would allow was the doctors doing surgical abortions (we had heard rumors but no proof until we saw their form - we got as far as the office to interview the doctor, saw the form and walked out of the office without talking to anyone except to say we would not be seeing them, we were offended by their form - we let out a loud moo in the parking lot(dh and I together).
Those in our area who cannot or do not feel comfortable with midwives/homebirths have done some of the following:
bring a child to all appointments - then they cannot do pelvics. Mom got real good at smiling apologetically. Another mom's approach for avoiding silly tests: Dh came to the first appointment, developed a joking comaraderie with the doctor and then was able to joke - ah come on doc, we've done this how many times before, can't we just skip that. This doctor was known to be very arrogant and inflexible, but agreed to everything they wanted with this approach. We have all noticed that dh is the one that gets results in a medical setting. I take him with me anytime I have to deal with them, they take me more seriously that way - plus you can play foil off of each other. The only exception is when I know they are going to be pushing a test I don't want - then I can always say I have to think about it and talk to dh first and I'll let them know if I want it. We find that they often forget by next time because that is not on the SOP for the week or it is too late for that test anyways - but if it does come up again dh is there to second my refusal.
Some knowing that they did not want pelvics, simply refused (or dh always politely asked for them to come back later - this wasn't a good time.) I know a mom who had homebirth for one but due to finances was forced to use the hospital and she actually got the question about how can I tell where you are without such and such and she said surely they could do it without if the midwives could (she could say and phrase it in a non-confrontational way and did not offend, but did make her point - after that the nurses started asking her how she wanted things done. One couple had a signal between them when something was not going as wife wanted - she would have a contraction and cough and dh could then step in and get what dear wife wanted by request or stealth.
Cannot get out of continual monitoring in our 1 hospital, so moms simply go to the bathroom a lot and stay in there a long time, often bringing dh in for backrubs, etc. or to help them pace. Then when nurse comes in to check, dh can assure that everythings fine-.
Some worked out to have a hep-lock with doctor ahead of time so there was no IV and no temptation with medication.
As for the paperwork drill, the Mom always smiled and said she would wait for her dh while he filled out forms (despite being in transition - and at some point they got the insurance #, took forms with them and did that later - after baby was born- as the nurse was getting antsy). The attitude portrayed was polite, sympathetic, always listening to any reasons given for a proceedure, but they came across as in charge of their own care, regardless of the policies.
In all cases where people got what they wanted, Dhs did not hesitate to put their foot down, always in a polite but firm way. Some of the nurses really respected them and some were annoyed. The doctors generally aren't around till time to push - and their ideal plan was to walk into the labor and delivery suite in just enough time to push - then there wasn't time for all the shenanigans.
One mom would always say things like - I have to talk to my husband first(one nurse got so frustrated that she asked if the mom ever made any decisions without her husband). This also works to avoid the ultrasound, or other tests they can push during appointments or when something you thought was worked out is falling apart- it gives time to get your thoughts together and plan how to say what you want. We do have 24 hour rooming in but we do know people who have been told otherwise by nurses.
So definitely challenge anything that doesn't sound right. When nurses wanted to take the baby - mom told nurses they'd have to speak with dh as she thought they had made some other arrangements. Nurse announced to dh that they would be taking the baby to nursery now for weighing, etc. He simply said, "that is totally unacceptable" He listened everytime the nurse tried to explain why it was so essential and repeated the phrase until they basically got to what had been agreed upon ahead of time (delay all that until mom, dad, and baby went together for weighing - they skipped the bath as it brings temp down and then staff gets paranoid)
Some things can be handled ahead of time through the pediatrician.
They planned to arrive at the hospital so late that there was no time for anything but check-in and have the baby - One mom I knew labored in the hospital lobby walking around the non-maternity sections with her husband until she was sure it was transition. Then dh would use the excuse that she was having a contraction and they'd have to do the exam later (which turned out to be time to push) The husbands in these cases were not angry/ugly but were very authoritative. One husband listened politely to whatever was asked and then simply said, "That is absolutely unacceptable"
Some moms have worked out birth plans ahead of time with the doctor and simply say no over and over to whatever it is they didn't want - this was mostly handled by the dh after the wife's initial response. But several doctors in our area are known to sign whatever you want and then blithley ignore it at the birth, others will honor or try to honor it.
Some moms hired a midwife to be a personal duola or advocate for them in the hospital, as dh was more intimidated by medical staff and wanted more time with mom and baby and didn't want to have to fight all those battles alone. In a state that recognizes midwifery, there might be some real advantages to doing this if you have to be in a hospital.
One mom stayed with an OB because he was the only one willing to wink at the hospital policy of all VBACs having to be transferred to the delivery room - he simply said there just wasn't time(of course she also labored mostly at home and after 7/8 children, the doctor knew her well enough to know to meet her at the hospital instead of waiting for the nurses call. He was not one that would respond kindly to birth plans, etc. but they were both great cons. They planned what they wanted between themselves and then just did it or manipulated out of it, drawing the doctor along as if it was all his idea. I remember her asking the OB to release her right after birth - took him by surprise, said well ok I'll sign but the pediatrician probably won't let the baby out - but she knew the pediatrician ahead of time and knew he would release baby if everything was OK. They went home within a few hours of birth - never even checked into a room. Then once you've done it once, its hard for them to argue that it cannot be done.
If you get agreements from your doctor, see if you can get them in writing (make sure he knows that it isn't that you don't trust him, but that you have to have proof for the hospital staff to go along - except if you know the doctor becomes ugly when approached with forms).
I think some are frightened by a written list of non-standard things because they might get sued or in trouble with the hospital staff - but will sort of go along if they can pretend that there just wasn't time, etc.
I know listening to all that these moms had to put up with just to get what they wanted and they were, in essence laboring at home unattended for most of their labor, I found it hard to believe it really was safer going to our hospital circus. I did at least have continual care from beginning of labor to end and wasn't afraid to show up. We don't have a lot of choices in the area and to be successful in getting the kind of birth you want in the hospital setting, you do have to go in knowing they have no right to do anything that you do not agree to - they are your consultants and you do have to be firm. But a mom in labor simply cannot fight those battles so dad really has to step up to the plate here.
But you are certainly not the only one to have trouble - and the more specialized our medicine becomes and the further away we get from the country doctor that was an overall medical person who could look at the whole picture instead of the one organ system and generally a family friend, the more difficult it is to get truely good care in a manner in keeping with human dignity. It's as if they are looking at a kidney and not a person.
Janet
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4Real Forums : Mothering and Family Life
Topic: cont. yapping from me
