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Looming problem with midwife
We are in Texas, and my wife is due in December. We got the services
of what we thought was a good midwife in June, however during three 1-hour monthly appointments (June, July, and August) my wife began piecing out a pattern that suggests this midwife is not right for us... - Will not do external versions for breeches at all - "Wasn't sure" if she would attempt a home breech birth - Doesn't know anything about herbs or other natural remedies - Very hard to reach by phone and doesn't return her messages - Complained about another client's comment about the phone tag problem - Couldn't offer any advice about coping with headaches - Takes clients to the hospital 18 hours after water break, no exception - "Couldn't remember" her cesarean rate - Never made an effort to discuss diet or nutritional counseling - Condescending ("Sweetie", "We don't want...", etc) which often deflects serious concerns my wife has (the midwife is only 40 yrs old) Just a bit of info about her... the midwife claims about 500 births over the past 10 years. The sessions have been at her suburban house; she has five kids and her own home office room where she sees us. Are midwifes usually ok with a partial refund at this point, or should we be digging in for a fight? I am trying to provide my wife with some support right now and figure out where we stand. We can eat the money, but we'd rather not, of course. She is already going to talk to another midwife on Friday, but I'd like to give her some reassurance now. Thanks, Arthur |
#2
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Looming problem with midwife
"Arthur Kludge" wrote in message
..com... We are in Texas, and my wife is due in December. We got the services of what we thought was a good midwife in June, however during three 1-hour monthly appointments (June, July, and August) my wife began piecing out a pattern that suggests this midwife is not right for us... - Will not do external versions for breeches at all - "Wasn't sure" if she would attempt a home breech birth The doctor at my birth center won't do these either. She used to be have admitting privileges at the hospital and could admit you and try a version there. Now that she doesn't have privileges, she will refer people to one of her hospital friends to have a version attempted. Also, according to her, there is not a single doctor or midwife in my state (at least publically) that will do a planned breech delivery at *all* (home or otherwise). It is all about liability and insurance. - Very hard to reach by phone and doesn't return her messages - Complained about another client's comment about the phone tag problem These seem worrisome. - Takes clients to the hospital 18 hours after water break, no exception You might ask her about her reasoning for this. There might be a legal one in Texas. - "Couldn't remember" her cesarean rate Though I understand why someone wouldn't bother keeping track, this does seem a bit odd considering that *lots* of expectant parents will ask about it and it seems like one would want to have a better answer than, "I can't remember." Doesn't seem that professional. - Never made an effort to discuss diet or nutritional counseling My observation is that most doctors don't discuss these things at all, but that most midwives or doctors following a midwifery model, will at least touch on them a little bit. - Condescending ("Sweetie", "We don't want...", etc) which often deflects serious concerns my wife has (the midwife is only 40 yrs old) This I *really* wouldn't like at all. Just a bit of info about her... the midwife claims about 500 births over the past 10 years. The sessions have been at her suburban house; she has five kids and her own home office room where she sees us. Have you talked to any of her previous clients for opinions? Are midwifes usually ok with a partial refund at this point, or should we be digging in for a fight? I am trying to provide my wife with some support right now and figure out where we stand. We can eat the money, but we'd rather not, of course. I'm not positive, but most care providers will charge you only for the services you have already recieved. When I left my old OB practice, I was billed for the visits and ultrasounds I had had up until 21 weeks only, even though I had signed a financial agreement that included charges all the way up through the delivery. At my birth center, if I had to transfer before I am in labor, they would bill only for the visits I had to that point, *not* for the delivery and would refund the rest. Once I am in in labor, there is no refunds, even if I do end up transferring to the hospital. She is already going to talk to another midwife on Friday, but I'd like to give her some reassurance now. I would say that you should go with your instincts and find a new person, but be aware that the new person may have the exact same views about breech deliveries and a few other things. Also, I feel reasonably confident that you'll only have to pay for actual services rendered to this point. -- Em edd 9/23/03 (36 weeks) |
#3
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Looming problem with midwife
Arthur Kludge wrote:
We are in Texas, and my wife is due in December. We got the services of what we thought was a good midwife in June, however during three 1-hour monthly appointments (June, July, and August) my wife began piecing out a pattern that suggests this midwife is not right for us... - Will not do external versions for breeches at all This is common--in many states she could be in legal jeopardy if she does so. I wouldn't take this as a bad sign in and of itself. - "Wasn't sure" if she would attempt a home breech birth Ditto. And you sure don't want someone who's not experienced and comfortable with vaginal breech births doing yours. - Doesn't know anything about herbs or other natural remedies Not all midwives believe in herbs and other alternative medicine treatments. Obviously, if you want this, she isn't the midwife for you, but I wouldn't question her overall competency on this point. - Very hard to reach by phone and doesn't return her messages This is definitely a bad sign. - Complained about another client's comment about the phone tag problem Also not good. - Couldn't offer any advice about coping with headaches Not sure here. Sometimes there aren't any great suggestions beyond the obvious if you're trying to avoid meds. - Takes clients to the hospital 18 hours after water break, no exception This is more conservative than many, but may also be due to legal requirements in TX. (I.e., she may be unable to retain backup or other good things if she doesn't have this policy--don't know if that's true, but it would be something to check out.) - "Couldn't remember" her cesarean rate I wouldn't worry about couldn't remember, but I'd worry if she wasn't willing to find out at least an approximation. - Never made an effort to discuss diet or nutritional counseling Very worrisome. - Condescending ("Sweetie", "We don't want...", etc) which often deflects serious concerns my wife has (the midwife is only 40 yrs old) Her age wouldn't worry me. There are plenty of fine midwives under 40yo. But being condescending isn't a good sign at all, nor is ignoring your wife's concerns. Are midwifes usually ok with a partial refund at this point, or should we be digging in for a fight? I am trying to provide my wife with some support right now and figure out where we stand. We can eat the money, but we'd rather not, of course. What does it say in the contract you signed? Most contracts I've seen specify precisely what you can expect if you leave prior to the birth. If nothing is specified (shame on both you and the midwife! ;-) then you ought to be able to work out a partial refund. Best wishees, Ericka |
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Looming problem with midwife
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#5
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Looming problem with midwife
In article , Arthur
Kludge wrote: We are in Texas, and my wife is due in December. We got the services of what we thought was a good midwife in June, however during three 1-hour monthly appointments (June, July, and August) my wife began piecing out a pattern that suggests this midwife is not right for us... - Doesn't know anything about herbs or other natural remedies It sounds like you had a pretty clear idea of who your ideal midwife would be, and she's really not turning out to be it. - Couldn't offer any advice about coping with headaches We had lots of specific questions (what's your opinion of ____) for our midwives based on what we'd read and found that really helpful. When we just had an open-ended question, we didn't get much more than you seem to have gotten. - Never made an effort to discuss diet or nutritional counseling Actually this would be my red flag--it just seems that a midwife who ideally is willing to take on risky situations in home birthing would want to ensure that her client has taken steps to be in the best shape for it. - Condescending ("Sweetie", "We don't want...", etc) which often deflects serious concerns my wife has (the midwife is only 40 yrs old) How long have you lived in Texas? I grew up in Louisiana, and seriously it's kind of expected from people with expertise. Or at least it's one of the prevailing "dialects" for getting on socially. Being used to it, I'd prefer it over the brutal honesty one gets in the upper midwest. But if you want a close relationship with her, it could be reason to shop around. She is already going to talk to another midwife on Friday, but I'd like to give her some reassurance now. Ask the other midwife what's the ordinary way to handle this situation. Who knows-she may want out of the deal too. APS |
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Looming problem with midwife
"Arthur Kludge" wrote in message om... - Doesn't know anything about herbs or other natural remedies - Very hard to reach by phone and doesn't return her messages - Complained about another client's comment about the phone tag problem - Couldn't offer any advice about coping with headaches - Takes clients to the hospital 18 hours after water break, no exception - Never made an effort to discuss diet or nutritional counseling Okay, so she's not willing to be flexible, doesn't make herself available, bitches inappropriately about other clients to you, has rigid policies and doesn't know much about basic comfort measures for pregnancy? So what IS her transfer rate, anyway? And the diet thing... ya gotta at least ask. I'd run screaming. Jenrose |
#7
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Looming problem with midwife
I've seem pictures of "dangling" the baby -- the body is out, face down; body is allowed to dangle, which helps with the angle of the head. I can't remember if the body is partly supported or not, but I think so. Won't many more doctors do breech vaginals on multips than primips? That was my impression. Breech vaginal deliveries may be a dying art, or possibly a profitable new subspecialty. Hint to obstetricians reading this... "Liz S. Reynolds" wrote in message ... In article , Daye wrote: I was told by a midwife at my hospital that delivering breech babies vaginally is a dying art. Most (if not all) end up with a c-section. The problem is that doctors don't know how to deliver them. It is not something they are taught. Does anyone know what the trick is? Besides doing a version so it's not breech anymore? As I understand it the problem is the head getting stuck because the behind is a little smaller than the head and doesn't open the cervix so much. Plus I guess at that point the cord is alongside the head and getting compressed. What sorts of things can be done at that point? -Liz |
#8
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Looming problem with midwife
Dagny wrote:
Won't many more doctors do breech vaginals on multips than primips? That was my impression. I'm not sure what the situation is in your neck of the woods, but around here you'd be hard put to say "many more." When Genevieve was breech and I was investigating my options should version fail, I found that very few OBs did versions (no midwives) and only one (in a very large metro area) would even *consider* a planned vaginal breech delivery The difference between 0 and 1 isn't much ;-) Breech vaginal deliveries may be a dying art, or possibly a profitable new subspecialty. Hint to obstetricians reading this... I don't think it would happen in the US. The feelings are so strong that it's unacceptably risky (despite evidence suggesting that in some cases the risks are no more than with some other things are people are allowed choice over) that the legal exposure is likely way too high for it to make a resurgence in popularity. So we'll continue to have a situation that provides little experience in handling vaginal breech births, which *does* up the risks (who wants to be a guinea pig?). Best wishes, Ericka |
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