How to tell my OB/GYN?

Hello everyone. I could use some advice.

I'm 19 weeks pregnant (which came as a shock to my husband and I -- we'd been through years of infertility and were planning to adopt) and thus far have been seeing my gynecologist for my prenatal care. He's a wonderful doctor and so far has been supportive of my choice to have a VBAC, but as the weeks have gone by and I've been thinking what my hospital experience was like when I had my son (pitocin because I wasn't dilating fast enough, which led to a c-section, my arms strapped down and not seeing my son until he was all cleaned off and bundled up, then dealing with nurses who were totally unsupportive of breastfeeding), I've decided to skip the hospital altogether.

I've hired a homebirth midwife and am super-excited about birthing at home, but the hard part is that I have to tell my doctor. I would like for him to be my backup OB if I should need to be transferred (ugh!), and I will need to keep seeing him for gynecological care after I deliver (because I've had issues with abnormal cervical cells) so I want to make the break without damaging our doctor-patient relationship too much. Any advice on how to go about this would be much appreciated!

Thanks in advance.

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Permalink Reply by Marcy H on April 30, 2010 at 4:18pm

I think you should bring up the fact that you are considering a home birth. His reaction to this statement (support, skepticism, derision) will tell you what his thoughts on home birth are in general. From there you can probably decide if telling him that you are actually planning on a home birth is wise, or go with Sarah Bradford's suggestion.

Permalink Reply by tamara on May 7, 2010 at 5:17pm

I would NOT tell him. I told my OB and she told me I was not allowed to continue coming in for prenatal care. You can ask if he does back up for midwifes, but I would not say you are doing a homebirth. And my OB was very supportive of homebirths, but when she asked her malpractice insurance, they denied me all together. I also would not lie to trick him to be the back up doctor. This does not do well with midwives and they usually have great back ups that will help you IF you need it. If you want to continue to see him for prenatal, do not tell him you are even considering a homebirth.

Permalink Reply by Marcy H on May 10, 2010 at 8:26am

This is what I'm afraid of. In California, malpractice insurance forbids doctors from being "back-ups" for a homebirth. So it's not even the dr's decision-- it's out of their hands.

We have Kaiser Permanente for health insurance, and I think the saving grace there might be that the way their hospitals are set up, when you go in to give birth they don't go get your OB for you, you just deliver with whatever dr is on shift that day. So whoever you do your prenatal visits with won't be your "birth" doctor, meaning they don't have to sign up to be your "back-up"... which gives them a little more lee-way, I believe, to help out and be supportive.

Permalink Reply by Katie Watson on May 9, 2010 at 2:41pm

If he rally is a good doctor he will support your decision and continue to be kind and professional in your future care. This will be a great way to know if he is the doctor for you.
Keep strong and make sure you hold firm to what you believe is right for you and your baby. Don't let scare tactics work. Good luck on your vbac.

Permalink Reply by Maggie on May 10, 2010 at 8:40am

Thanks so much to everyone for all the comments and advice. I did end up telling him, because my midwives wanted me to ask him to be there for me if I needed medical attention. However, he was NOT happy about it and launched into a lengthy anti-homebirth lecture that felt like it went on for hours, and my husband and I were both a bit shaken when we walked out of his office. I had hoped for more from him since up until that point he had seemed like the kind of doctor who respected his patients' ability to make their own decisions about their bodies.

So my plan in case I need medical care -- and my midwives transfer rate is less than 10%, so chances are good that I won't -- is just to go in through the emergency room of our nearest hospital. By law they have to treat me if I am in labor, and to be honest at this point I would prefer dealing with a doctor I've never met than to have my now-ex-OB standing there shaking his head and saying "I told you so."

Permalink Reply by tamara on May 10, 2010 at 5:20pm

That sucks that he had that attitude. And that sounds like a great plan.. You don't want to feel judged for your decision especially at that point. Good luck with everything, I'm sure it will go great!

Permalink Reply by Sara Bradford on May 11, 2010 at 5:41am

Good choice! Wish you all the best of luck with your up and coming delivery! If you have to be transfered, at that point you probably won't care what dr helps you as long as someone does! LOL. Lots of prayers for a safe home delivery of a happy, healthy baby!

Permalink Reply by Levonne Pettway on May 11, 2010 at 6:06am

I think that what so many of us forget is that doctors work for us. They are providing a service and getting paid for it. We don't really owe them loyalty or explanations. They work for us. It's their job to provide us with the care and outcomes we desire, but this has been forgotten over many years of putting the medical community on a pedestal. Certainly, if you've spent years seeing an OB and you feel that you have a relationship, then you will want to be able to share with him/her...but you aren't required to put yourself in a situation where you are going to be belittled for your decision. Nothing infuriates me more than a doctor/nurse who has never witnessed a home birth and hasn't really researched it trying to tell me that I'm not intelligent enough to understand all of the information I've been studying.

My idea about "back up" doctors is that it's a nice idea but it doesn't really happen that way as much as you would think. If you are transported, the situation will most likely be more emergent than just calling your OB for him to come help out. You will be more likely to see the doctor on call at the time, because they are more readily available. If you have an OB that is willing to help, then great but don't feel like they are your only option. :o)

How to tell my OB/GYN?

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