Tuesday, April 27, 2010

Prenatals Midwife vs OB

Today was our monthly prenatal appointment, we're 22 weeks-ish, and almost 5 months-ish. I found this appointment very interesting though. A friend of mine asked if I needed her to watch Liam while I went and I didn't really understand why at first, so after some thought, I began to really see the difference is the care of a Midwife prenatally, and the care of an Obstetrician. We did in our last pregnancy with Liam go through an OB for the roughly the first trimester, and then switched to a Birthing Center here in Austin. This time we are Homebirthing with a Homebirth Midwife so I feel like I have gotten to really experience all types of care and I can adequately see the differences. So here is a little bit of how our appointment went today.

10:00-got to Christy's office, went inside and waited for her to show up. It's about the size of an efficiency apartment, with queen size bed, fire place, sofa, rocking chairs, massage table, dresser, and a bathroom with a real tub, turquoise tiled, toilet, and sink. Liam went to the toys, she had a few baskets and a few other bigger toys for kids to play with. This must be why a friend offered to sit, OB offices, of what I know don't have these commodities in the "exam rooms" (such a funny term for a pregnancy related room)

10:01-Christy shows up, and we start to chat. She first states that I"m glowing and look very pretty today, even having not showered or washed my face. The first thing she always asks as she plops in one of the rocking chairs and gets comfortable is "So, how are you feeling? What's going on?" We talk about all the issues going on with our families health. Phillip got to talk about his stresses with his dad's health. I talked about my worries of VBACing. She said things like, "I went through the same things", "It's good to cry". "I wish you would have called me when you were feeling down." (For those who don't know, I had an emotional cry fest a couple weeks ago and Phillip was left subject to it). She encourages me, but at the same time, truthfully tells me, how every woman has to find their trust in their bodies themselves, no one can say or do anything that will make them trust themselves. She asks me how I'm eating, sleeping, drinking, etc.

10:15-she check my blood pressure, 100/something I forgot already, it's normal. She asks me to go pee and check my urine, I get to do this myself instead of peeing in a cup and handing it off to a stranger who I always felt sorry for, having to deal with other's excrements. It's normal. I weighed myself, 170, gain of 9 lbs so far. To which she says 'yay!, you gained some weight!'.

10:20-we listen to baby heart beat, it's in the 140's. Sounds wonderful. She asks about baby movements, and I say oh, yeah, moving a lot. Then we start the Arvigo massage. For those who don't know, it' basically helps release the ligaments and muscles that are stressed and stretched in pregnancy. It's a little uncomfortable, but very relaxing. We chit chat through it, laugh and talk about potty training, tattoos, and other stuff.

10:50-we chat some more, she plays with Liam a little, and then let's me borrow a book on empowering, positive VBAC women and their experiences. I felt better.

11:00-we leave

The only thing I would have changed is remembered to pick up some more pregnancy tea. ERRR! I'll stop by tomorrow on the way to the grocery store.

So to me, this is A LOT different than an OB visit. It used to be, go in to office, pay, wait in waiting room where you feel weird if your baby even babbles (if you dare to bring him with that is), get called back, weigh yourself, asked to pee in cup, see nurse, change clothes (why do we need to do this again?) wait for Dr. on table that is weird to sit on, especially in those gowns, it's small, cold, and again, if you make any regular conversational noise, you feel like people are ease dropping on you, wait for OB to come in, have BP checked, lie back and hear baby heart beat (this was always the best for me) for a few seconds, and then helped up and asked for any further questions. This always made me uncomfortable because I felt like I was always taking the Dr.s time, and he was always in a rush. So I limited my questions, and his answers were usually short, and rarely did I dare to ask him to elaborate further. No more questions, he leaves, I dress, we schedule another appointment at the front, and leave. All that (not including waiting time) usually was about 10 min, if that, and usually only 5 of those minutes were with the OB himself.
I always felt "sick". Like they were waiting for something to go wrong, or something to be an issue, with weight, growth, BP, ect. Like me and my baby were a ticking time bomb.

Now, let's talk about what is the SAME:
Medically, everything. They check BP, heart tones, weight, urine, and you get questions answered. I know the OB I saw may have not been typical for an OB, but of what I hear and know, it's just about right. The amount and frequency of the appointments are the same. Once every 4 weeks till 30 weeks, then once every 2 weeks, till 35 weeks, then once a week till 41 weeks if you get that far, and then maybe 2 twice a week after that, depending on what is going on in your pregnancy.
They do all the same tests, all the bloodwork etc. The glucose test which is done at 26-ish weeks is different. The OB will usually have you come in before you eat or drink anything, draw blood, have you drink a sugar orange drink, and then come back in an hour to see how the sugar metabolized, then then draw more blood and usually you will have to wait for the results. The MW, will say, come in about 2 hrs after you eat a big breakfast. She pricks your finger, tests it on a test strip and tells you what it is, and what is normal, and what you can do if it's not. She may have you then change your diet, eliminate trigger foods, and have you experiment on what foods spike your blood sugar. If things are concerning, she will retest, and then go up from there. The reason this is different is because very few women, especially in pregnancy, wake up, and on an empty stomach drink that much sugar. This is why with the 1hr glucose test there are many false positives, basically saying, something is wrong when there is nothing wrong, which calls for more testing, etc. It doesn't read your normal blood sugar. So, if you eat a normal big breakfast, that will tell you what is normal for you, and compares that medically.

Don't get me wrong, there are plenty of OBs who give better wholistic care than most MWs, and there are plenty of MW who give worse care than a typical OB.

I feel like sometimes I take for granted the care and compassion I get from our MW. I am so lucky I have her. This also makes me feel sorry for those moms who don't get to experience their wonderfulness. I truly feel blessed. I really encourage any one who gets to thinking after reading this to go interview a Midwife. It's free, they will take as much time as you need, but generally block out a full hour for you. It's worth atleast knowing what options you have, especially as a pregnant mom, you want to be educated on options and choose the best for you.

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