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An OB's Birth Plan



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No. 10
from Jaybird310
Old Mar 04, 2009, 10:40 PM

Default Re: An OB's Birth Plan
My first question is why didn't he discuss this with you on your first visit? Most of this type of thing was discussed with my fiancee and me when we had our first appointment with the OB that would be delivering our baby (she was living in another state when we first found out she was pregnant and after telling her doctor she planned to move 4 months into the pregnancy, he didn't feel like discussing birthing issues and proceedure was nesscary). Now my second question is why was the paper handed to your husband and not you? I know personally that I feel like all of that information should be presented to my fiancee. While some of the things we might need to discuss, she is the one who will actually be going through labor, not me. It almost seems like a sexist move. That action actually makes me more uncomfortable than the whole issue with the birth plan. If you're not comfortable with it find a new doctor. That's the best advice anyone could give you. I know after something like this my fiancee and I would have to have a long discussion about if this was the right doctor for us.
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No. 11
Old Mar 04, 2009, 10:49 PM

Default Re: An OB's Birth Plan
Originally Posted by Jaybird310 View Post
Now my second question is why was the paper handed to your husband and not you?
Because he's misogynist!!!!!
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No. 12
from Jaybird310
Old Mar 04, 2009, 11:00 PM

Default Re: An OB's Birth Plan
Originally Posted by yelnikmcwawa View Post
Because he's misogynist!!!!!
If this is a true statement then my fiancee would have to do some serious convincing if she really wanted this man delivering our baby. The idea of a misogynistic OB delivering my child and handling my pregnant fiancee just makes me uncomfortable.
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No. 13
from PICNICRN
Old Mar 04, 2009, 11:01 PM

Default Re: An OB's Birth Plan
The only unfortunate thing is that you found out your OB's beliefs this late in the game.
We could argue all day on the topic of home births vs. hospital, bradley vs. hospital philosophy, vaccinations vs no vaccine ect ect.... we, even as health care professionals, will never agree. I happen share the opinions of your doc from my personal experience as a NICU nurse(home births gone wrong resulting in trached/vent dependent baby, IVH in term infants who did not receive Vit K for example). And I totally understand that for every 1 horrible NICU admit there are 100s of healthy home births/ tubs births/ births unmonitored with no IV, ect, ect that others can attest to. I say to each his own.
It is unfortunate that you are finding this out at 26 weeks. I think that you should let your OB know that you do not share the same "birth plan" and you feel that you cannot continue to see him/her- that this is a deal breaker for you. Make sure you suggest that this letter be given to patients on their FIRST OB visit- after all, this would have saved you alot of trouble and stress!
You say you believe this is a good doc, I'm sure he/her could refer you to someone who shares your same ideas.
Congratulations on your pregnancy!! Please keep us posted!
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No. 14
Old Mar 04, 2009, 11:16 PM

Default Re: An OB's Birth Plan
Originally Posted by psychRNinNY View Post
Sorry ....but I was a L&D nurse out of school for a bit in a hospital that did 300+ deliveries a month. HOWEVER, that being said........I can't say as I disagree with one single thing in this "plan". Yes it is blunt but it is to the point.
What is "a bit"? One week?

Epidural anesthesia is optional and available at all times. The most recent scientific data suggest that epidurals are safe and do not interfere with labor in anyway even if administered very early in labor.
Scientific data? But not evidence based.

I perform all vaginal deliveries on a standard labor and delivery bed. Your legs will be positioned in the standard delivery stirrups. This is the most comfortable position for you. It also provides maximum space in your pelvis, minimizing the risk of trauma to you and your baby during delivery.
Um, LIAR! lets re-phrase that. "I perform all vaginal deliveries on a standard labor and delivery bed. Your legs will be positioned in the standard delivery stirrups. This is the most convenient position for me. It also does not provides maximum space in your pelvis (squatting does), increasing the risk of trauma to you and your baby during delivery; oh and your pushing against gravity."

I will clamp the umbilical cord shortly after I deliver your baby. Delaying this procedure is not beneficial and can potentially be harmful to your baby.

Yet another lie. Studies show OTHERWISE:

RESULTS: The late cord-clamped group showed consistently higher haemoglobin levels than the early cord-clamped group, both at the age of 1 hour (mean (SD) 13.4 (1.9) mmol/l vs 11.1 (1.7) mmol/l), and at 10 weeks (6.7 (0.75) mmol/l vs 6.0 (0.65) mmol/l). No relationship between delayed clamping of the umbilical cord and pathological jaundice or polycythaemia was found. CONCLUSION: Immediate clamping of the umbilical cord should be discouraged.
Based on a summation of all findings the author concludes and advocates that slightly delayed cord clamping between 30 seconds and five minutes after birth is superior to immediate cord clamping done at delivery.
as well as several others.

I believe in EBP (evidence based practice) not DCP (doctor convenience practice)
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No. 15
from morte
Old Mar 05, 2009, 12:42 PM

Default Re: An OB's Birth Plan
Originally Posted by PICNICRN View Post
The only unfortunate thing is that you found out your OB's beliefs this late in the game.
We could argue all day on the topic of home births vs. hospital, bradley vs. hospital philosophy, vaccinations vs no vaccine ect ect.... we, even as health care professionals, will never agree. I happen share the opinions of your doc from my personal experience as a NICU nurse(home births gone wrong resulting in trached/vent dependent baby, IVH in term infants who did not receive Vit K for example). And I totally understand that for every 1 horrible NICU admit there are 100s of healthy home births/ tubs births/ births unmonitored with no IV, ect, ect that others can attest to. I say to each his own.
It is unfortunate that you are finding this out at 26 weeks. I think that you should let your OB know that you do not share the same "birth plan" and you feel that you cannot continue to see him/her- that this is a deal breaker for you. Make sure you suggest that this letter be given to patients on their FIRST OB visit- after all, this would have saved you alot of trouble and stress!
You say you believe this is a good doc, I'm sure he/her could refer you to someone who shares your same ideas.
Congratulations on your pregnancy!! Please keep us posted!
i would think it is the almighty dollar....if he does it late enough, some persons will simlply cave, and stay with him, if he did it early on, they would more likely leave, arshole
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No. 16
from PICNICRN
Old Mar 05, 2009, 01:00 PM

Default Re: An OB's Birth Plan
Originally Posted by morte View Post
i would think it is the almighty dollar....if he does it late enough, some persons will simlply cave, and stay with him, if he did it early on, they would more likely leave, arshole
You may be right..... also, It might be harder to find a new OB when you are already this far along???
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No. 17
from NurseNora
Old Mar 05, 2009, 01:14 PM

Default Re: An OB's Birth Plan
I give the guy props for being honest with you, it's just a shame he doesn't hand this out at the first prenatal visit. He's probably not quite as bad as his "plan" makes him sound, but I'm glad you're looking for another doctor. This it the doc for the patient who doesn't want to make any important decisions for herself. There are providers who enjoy working with women who do want to make their own informed decisions.
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No. 18
Old Mar 05, 2009, 01:38 PM

Default Re: An OB's Birth Plan
Thank you all for your responses. Elvish, I read over the links and feel like I can formulate a more informed response now. I realize that he is extremely unlikely to listen to me but I also think it's my duty as a human being to send an articulate and non-inflammatory response.

You know...if he had just said this is the way I like to work and I'm not willing to do things in an inconvenient, for me, way. I would have respected that. I would have left but at least it would be honest. What is most upsetting is not that he does these things but that he is lying and manipulating in a way that takes away the ability of his patients to make an educated informed consent. Maybe I did want to go to the hospital and get "plugged in" immediately and have an early epidural then lay there in stirrups while he suctions the baby out but I think that if I choose to do that I should be made aware of the risks. I worked in the medical field for years (predominantly plastics) and informed consent is such a huge deal. Our pre-op appointments were an hour and we would go over every minute detail and risk to make sure that people were choosing wisely and carefully. As I was ranting on the subject of informed consent yesterday it dawned on me that informed consent is barely present in obstetrics. My last OB was more flexible but I was certainly not really aware of the consequences of the choices I made and I always felt solely personally responsible for that but after some thinking I feel that OBs should be required to educate their patients of the risks and benefits in the same way that other specialties have to.

Sigh. I am off to meet with a midwife and I'm sure she will be wonderful but I feel like my choices have been narrowed and they didn't need to be.
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No. 19
from Batman24
Old Mar 05, 2009, 02:04 PM

Default Re: An OB's Birth Plan
I'm sorry he didn't let you know sooner. While it's better you know all this before you are actually in the hospital ready to deliver I can't help feeling it was handed over so late in the game to somewhat trap you into staying with him. I wouldn't. It would be a cold day in hell when someone told me I had to have stirrups, etc. He doesn't sound flexible or warm or even remotely modern in his thinking. I'd pass and find another doctor.
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