The past few days and some questions

2009 November 6
tags: , , , ,
by mama bea

Things are finally starting to sink in a bit. I still can’t quite believe it in a strange way–it’s easier, for some weird inexplicable reason, to believe “I’m pregnant” than it is to believe “there’s a baby in there.” Maybe once more symptoms kick in and/or I start to grow out that will be easier to wrap my brain around.

Yesterday I spoke with the wonderful nurse practitioner who has been my gynecology provider since I moved here. She’s the one on whose exam table I had a huge freakout back in April, and the one who referred me to a hoo-ha-workout-ologist to resolve my speculum fear. She rocks in pretty much every way, and I was really hoping that she did maternity. She was so super excited to hear about the pregnancy and although she doesn’t do maternity (shitballs), she spent quite a while on the phone with me talking to me about the various options. She recommended a Certified Nurse Midwife (CNM) in her practice because “she is the most nurturing, and I think I know you well enough to think you probably need someone very nurturing.” HA! THAT is the understatement of the year.

Since the weekend, I’ve been plowing my way through the “choosing a provider” sections of the approximately 800 books I checked out of the library. I’m learning a lot, and The Other and I are leaning toward a CNM for pregnancy care (because, you know, of the high maintenance, aka “need a lot of nurturing”). The one that my gyno recommended is in a collaborative practice, though, meaning that it’s unlikely she would attend the birth. If I deliver during the day, it would be whichever midwife is on call; if at night, or god-forbid something happens during the day, it would be whichever doctor is on call. It would be in what I’ll call University Hospital. (I have also looked at two other hospitals close by, which I’ll call Park Hospital and Saint Hospital. We could tour all three, but not until the beginning of December.)

So here are my questions, oh wise women of the blogosphere:

In your opinion, which comes first: the place or the provider? In other words, do we pick a hospital with amenities we like and figure out which of their providers would be a good match for us,  or choose a provider first and just go with whichever hospital she is affiliated with?

What do you think about collaborative practices? How important is it that the person who has provided your pregnancy care be there for delivery?

Our last visit with Fancy Fertility Center is November 20, at which time I’ll have an ultrasound. Should I have my provider lined up by then? If so, we have to figure out who that is BEFORE we can do any of the hospital tours. Is that bad? I guess we could always switch if need be. Right?

This is a biggie: what do the pregnancy books not tell you about how to choose among all the various options for providers–collaborative practice vs. single provider, etc? What other advice would you give?

Finally, if you were putting together a box of goodies to send to a couple of lesbians who got married about a year ago, would you include two of these, one red and one blue?

banana_guard

It’s called a Banana Guard. (More information can be found here.) I’m not going to lie, I use the thing, and it guards the hell out of my bananas. But you can imagine the near-accidental-pee-inducingly-hilarious conversations we had after receiving them.

from → early days no whammy no whammy (1st trimester)

  • I went to a collaborative midwife/OB practice, and while I saw an OB for my first few months, I really wanted a midwife-attended birth, so I saw all of the midwives (there were three) so that I would know whomever ended up there for the birth. As it turned out, both my OB and midwife were on the days of my labor and delivery, so it turned out well.

    Place is very important too, though, and you do need to consider what you're looking for in a birth experience, and then research the hospitals/birth centers to find out which matches up best with your needs. I also found it helpful to talk with others who had recently had children, for they definitely knew which were the good hospitals in the area and which to stay away from. Luckily, our practice worked with two different hospitals, so we really did have a choice.

    And finally, I do believe that any lesbian couple should have a couple of banana guards. That thing is VERY suspicious!
  • metalstork
    chiming in a little late here but since i've worked in maternal special care for the past year, i have to say "place" before "provider" only because eeeek, WHAT IF, you ended up on bed rest? there are so many doctors coming and going through that you'll surely find someone you'll connect with. i've worked with patients who spend the last four months of their pregnancy in the hospital unexpectedly (and it's not a fancy place, let me tell you) so you want to make sure you'll be comfortable in this event.
  • Well, I obviously can't offer advice on selecting a provider, but I can tell you that banana guards are a must for a care package! I found them a few years back online, but couldn't bring myself to order one because I work with a bunch of gutterminds. Instead, I just deal with slightly bruised bananas. *sigh*
  • Tui
    I am waaay behind in commenting and I'm really really sorry I haven't dropped in to say it yet but a huge congratulations on your bfp. I am so happy for you and so glad that everything is going well so far. I really have no weigh in on your questions, but I'm sorry to hear that you can't keep your nurse right the way through. At least you have her rooting for you though and helping you make your decision.

    And I love the banana guard haha brilliant...
  • poppycat
    I'm sorry, I totally thought that was something from babeland too! In fact, I'm still not convinced it isn't. too funny.

    I wish I had some advice for you but I gots nothin. I will come back later and see what everyone else had to say.
  • I can really only answer your question as an about-to-be mother, but we seem to have some similar needs (ie, someone nurturing). I agree with Strawberry that what matters most is what you want. Some women are completely fine with not knowing exactly who will deliver their baby. Personally, knowing was very important to me, and therefore I chose a solo practitioner (OB) and a doula. My guess is that your fertility center will recommend having your next practitioner selected before you "graduate" on the 20th. How exciting!
  • libberal
    I'm not sure about any of the other questions, cuz I just ain't there yet (other than the first, which my guts tells me place,) but the banana guard should be sent in each color of the rainbow, if that is an option.
  • mamadeux
    THE BANANA GUARD. I can't stop grinning. You should absolutely include two of those for the good laugh alone! As for your other q's -- we have many of the same. From knowledgeable mama friends in this city, I've learned that every one of them used the collaborative midwives practice in a university hospital. Yep, every one. We're tentatively planning to do the same. My close friend had a 36-hour labor at their birthing center (it's on the same floor as the OBs but an independent entity) and the experience was v. positive. She had two different CNMs during the labor as they changed shifts partway through, but she knew both of them. The practice has just 4 midwives, so it was easy enough to meet all of them before the birth. I grew up with a super home birth advocate mother and saw a couple of my siblings come into the world on my parents' bed, so in an ideal world I'd go with a home birth and one or two CNMs to attend, but that's not so doable in our little apartment. Plus, Uno isn't as familiar with home birth, so it's reassuring to be in a hospital just in case. I'm rambling, but I guess my point is, the collaborative CNM practice seems like a good compromise between at-home and hospital options. Also, I'll second nutella on the recommendation to get a doula -- you want a nurturing knowledgeable advocate even with a midwife. Have you read Ina May's Guide to Childbirth? We love it. Uno has been devouring it. It reinforced a lot of what I'd learned (but forgotten) r.e. birth and what our bodies can do without intervention. Very empowering. Kinda Mama Earth hippie/fruity, maybe, but who can't use a little of that when it comes to a birth book?

    And by the way, congrats on the BFP!!!!!!!! I've been off the radar, visiting family, but I came back to your awesome news and am so excited for you guys. Now, if only we get our BFP this cycle, our babies will be almost exactly the same age. Aaaaah, fingers crossed.
  • nutella
    OK, that product needs a whole SNL skit. But, to your questions. First of all, keep in mind that it is TOTALLY ok to switch providers along the way. I switched to a midwife practice at 30 weeks because their office wasn't very convenient, but I wanted to deliver with them. I like my OB practice, but I did NOT want to deliver with them or at their hospital. The hospital is very important because even the most nurturing caring provider still has to follow the rules of the hospital. You'll need to decide what types of things you are hoping for with your birth. An example: I'm needle phobic and did not want a mandatory IV upon admission. All the hospitals in our area required them. The midwives delivering in the birth center did not. However, they were attached to a hospital and a transfer would take 5 minutes if I needed it. I ended up needing it, got the IV when I transfered, but got to keep my midwife throughout labor. I FIRMLY believe that had I been under the care of an OB my labor and delivery would have gone very differently, almost certainly a C-section. I think that if you are looking for a continuous nurturing presence for your care/ labor/ birth then you should look into a doula. She will be with you supporting you all the way no matter where or who you deliver with. She will be there for you.
  • Never seen one of THOSE before...and I was wondering if it was safe to view at work...

    As far as all your questions go, what matters most is what YOU want. When you think of your best case scenario, what is it? Then try your best to get it. If you only want to work with one doctor who will be delivering your baby, then see what you can do to make that happen.

    This is what we did-- after graduating from the RE, we went to Nutella's OB. We decided that we would stick with the OB for a while, but it was our goal to be in the care of midwives for the latter pregnancy and birth. At the OB's office, we met with at least 3 doctors in the practice, any of whom might deliver when the day came. Personally, I didn't like that idea. At 30 weeks, since there were no complications, we switched to midwives. Of course, the midwife practice worked much in the same way- any midwife could be assisting during the birth. But there were fewer than the OB and we liked the idea of midwives better, so it was ok.

    We did not get the midwife we wanted when delivery came (not sure she even had delivery privileges yet because she was new), but we did get a competent midwife who stuck with us throughout, even after we had to transfer to the hospital (where the on-call OB ended up delivering with a vaccuum). You just never know what's going to happen, but if you've got the idea of what you want, that's your best bet.
  • malea
    why did i think that was something from Babeland.lmao
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