Anne Rogers wrote:

Well I did last time, but the thing is, I seem to have fast labours, DS
was 1.5 hrs 1st stage, 16mins pushing. DD, was still fast in the grand
scheme of things, I didn't really have any warning of labour, just hit
transition straight away, I was already in the hospital and was up to
delivery in 15 mins or so, already vomitting and shaking, I was 6cm, 2
hours later I was fully dilated, but may well have been for up to an
hour given how I was feeling. But it was heading towards 2.5hours in 2nd
stage when I finally got her out and there were clear warning signs, I
was asking the midwives to call the doctors, but they were clock
watchers and didn't until the two hour mark, by which stage we were
pretty much at the point of no return and they just hung around in the
room to see things did continue to progress. From what I'm reading about
birth in the US, the nurse can have a lot of influence on what goes on,
sometimes to the extent of going against doctors orders, not calling
them even if they've been ordered to if certain things happen for
example, I know that is probably extreme, but I have a hard time putting

This is where bringing a well informed midwife or doula with you could
help. You already had a history of precipitate labor. You now have
more history of fast labors. Having someone else who can quickly convey
this and your other needs to the nurses using medical abbreviations can
make a big difference.

myself into the hands of a stranger as in my mind that is a lot of what
went wrong last time and as far as I can tell finding an ob doesn't
equate to having someone you know in the delivery room, I read somewhere
that the average attendence rate at births for obs was 30% and if you
are unlucky and get the nurse who things she knows best etc.

Picking a family practice physician can change that. Family practice
doctors tend to attend their own patients births, while obs tend to go
by a schedule and whoever is on call comes. Some family practice
doctors do their own C sections while some do not.

I am guessing that your midwife would be able to reach a doctor even if
the nurses chose not to call. You could ask about that.


For that reason we've already booked a midwife, I think they will give
me the best chance at a happy, healthy pregnancy and if I do birth
vaginally I want someone like that present, it's just that the way
everything is with midwives and doctors, it makes deciding in labour
harder, though it is something I will talk through with them.

Does your midwife do hospital births too? If not, does she stay on as
a doula if you have a hospital birth? I would feel uncomfortable with
having a midwife who wouldn't necessarily be present for the birth in
some capacity.

With my second baby, I went through the whole pregnancy doing both the
midwife's and the doctor's standard prenatal care. This was more
expensive, since it was double care, but much less expensive than trying
to fix problems after the birth.

One thing my doctor did that was helpful was to write all planned
deviations from standard procedure directly on my chart. Even though no
one had time to even think about the birth plan, the nurses did glance
at my chart after they received the call I was coming in. When
something is written on the chart by the doctor, it carries more weight
with the nurses.

--Betsy