WWYD: Choosing a MW

[meltoine]

I have two choices of midwives. 

A. The midwife who attended me with DS2. She has 40 years experience, 10 as a L&D RN and 30 as a midwife. I loved her throughout my pregnancy with DS2, untik I went into labor. We called to tell her, and she told us, "I just got home from a 3-day birth that ended in a c-section, I'm going to sleep for two hours and then I'll come over." Ok fine. Twenty minutes later, H decides that, no, we really need someone here now. Calls her back. She says, "Ok, but I have to wait for my assistant to get here because I'm too tired to drive." You're too tired to drive, but you want to attend the birth of my child? Um..... Anyway, birth goes fine, I felt like she kind of rushed out afterwards, but didn't really care in the moment. Also, she didn't bring a second midwife, like she was supposed to, because the second midwife was attending another client who'd gone into labor while my MW was at the c-section. Then she didn't come back for a post-natal for SIX days. She's supposed to come at 24 and 72 hours, and 10 days. I called repeatedly because I had some concerns about his nursing, but she bagged on a few appointments we scheduled before she finally came. 

I discussed this all with her after the fact, and she said that she had 4 clients give birth in 48 hours, which has never happened before in the history of her practice and she was just really busy. 



B. Other midwife. 2.5 years experience. Met her today, she seems great, knowledgable. Less, idk, burnt out maybe? Than the first. But her office is located within a chiropractic practice that I know to be full of quackery. I saw the chiro there once, and he's a total quack. (And I'm not one who thinks all chiros are quacks) Even has an advertisement in the waiting room about how he "treats" down syndrome with chiropractic care. She's not really on his staff, she seems to just co-exist with him within his office space, but IDK. Plus, way less experienced than Midwife A. 


So which would you pick? And if you pick B, how would you break up with A without burning your professional bridge/damaging your reputation? (Yes she knows I'm pg, I tried to set up an appt with her but it's been canceled three times for snow.) Both have the same certification, though A is also an RN. 

[achi]

I'd probably still go with midwife A. While I would have been extremely unimpressed by what happened, it sounds like it was a fluke and if you had a good trusting relationship with her throughout your first pregnancy I would hope that you can have that again. I would for sure be addressing your concerns regarding what happened last time and also asking what steps/methods/backups/whatever she has put in place to deal with that type of situation should it occur again.

You can always switch practices if you don't feel comfortable with her as your pregnancy progresses.

[countthestars]

Is there an option C? If no, I think B. She may just be renting the space from him.

I can't remember - are you in the medical field? I see you mentioned a professional bridge.

[thefield]

Less experience + quackery = not good

[meltoine]

Mar 12, 2015 13:29:04 GMT -5 countthestars said:

Is there an option C? If no, I think B. She may just be renting the space from him.

I can't remember - are you in the medical field? I see you mentioned a professional bridge.

I'm a doula and I teach childbirth education. I get referrals from her semi-regularly. 

[meltoine]

Mar 12, 2015 13:38:04 GMT -5 @tambcat said:

Does it have to be one of those two? I'd be really hesitant about B, but I don't know if I could forgive A for the postnatal care stuff.

There are only these two nearby. The next closest is three hours away, and given that my labor with DS2 was exactly that long, it's too far. 

[meltoine]

Mar 12, 2015 13:41:03 GMT -5 @cookiemonster03 said:

B is not also an RN? So a direct entry midwife? NO EFFING WAY.

I'm not comfortable with your experience with A, but B sounds horrible based on the lack of degree + chiro issues.

Both are CPMs, so not nurse-midwives, but A is also a regular RN. There are no CNMs in my state. 

ETA: I do not know whether A's RN license is current. I know she worked as an L&D nurse in the 70s-80s 

[AmyRI]

I couldn't in good conscience return to A. She was not making good choices and canceling on the postnatal appts is not because of poor timing of births.

I'd have an appointment with B to feel out the quackery level. If she seems ok, I'd try her. 2.5 years of experience with a person that will be in a good mindset to help you medically if necessary is better than someone with 40 years of experience that can't be bothered to show up or make sure she has enough backup for her client load.

[meltoine]

To clarify, I met with B today. SHE doesn't seem quacky at all, just,the office she works in.

[mellimel19]

Given that these are your only two options, I'd meet with them both once again. I'd be concerned about B's limited experience, and being affiliated with a quacky office. So I'd meet with her again to feel her out a little more. I'd also meet with A again to discuss her contingency plans should a similar situation arise this time around, and see if her answers alleviate some of your lingering feelings about your last experience with her. Honestly though, I'd probably be pretty hesitant to go with her again.

[Deleted]

Mar 12, 2015 13:59:22 GMT -5 newnamesameperson said:

I couldn't go with A after your experience.

However, I'd simply straight up ask B what she thought about the office she's in and then decide if she'd be an appropriate choice.

This is what I would do too.

[meltoine]

Mar 12, 2015 13:56:29 GMT -5 @mrswindycity said:

Mar 12, 2015 13:43:36 GMT -5 AmyRI said:

I couldn't in good conscience return to A. She was not making good choices and canceling on the postnatal appts is not because of poor timing of births.

I'd have an appointment with B to feel out the quackery level. If she seems ok, I'd try her. 2.5 years of experience with a person that will be in a good mindset to help you medically if necessary is better than someone with 40 years of experience that can't be bothered to show up or make sure she has enough backup for her client load.

Ditto. There is zero chance I'd go back to A. I wouldn't personally feel comfortable with B, but I'd at least feel her out. If those were my only options, I would seek out an OB I felt comfortable with, honestly. I didn't have a problem having an intervention-free, med-free, blah blah blah-free L&D with my OB.

The hospitals here suck for med-free birth. 60% c-sections rates, mandatory separation of mom and baby, mandatory constant monitoring, etc. Maternity care options here are really limited. 

[Deleted]

I'd stick with B for a while and feel it out. A has to know that her level of care last time was totally inappropriate and that it does impact your choice this time. If B is too kooky, I would also probably move on to an OB if you can find an acceptable choice (or are you doing a home birth?).

[thebreakfastclub]

I'd probably fly @tokenhoser in to catch your baby in the kitchen first.

Clearly there are major cons to both, but I think I'd pick B, but probably look around for an OB and hope to show up at the hospital at 10cm.

[Deleted]

Mar 12, 2015 14:15:08 GMT -5 thebreakfastclub said:

I'd probably fly @tokenhoser's husband in to catch your baby in the kitchen first.

Hey, I have no experience.

[spk926]

I would speak to B and ask her some questions before assuming what she's like and writing her off. I would point blank ask her, "Do you believe down syndrome can be treated with chiropractic care?" Based on her answer I would go from there. If she answered that and other questions in a way that aligned with my beliefs then I would go with her.

I would not pick A. I don't know tons about midwives but what I do know is that they shouldn't take on 4 women with due dates so close together. She had her chance to earn your repeat business and she lost it.

B if her beliefs are like mine and if not I would look for C.

[kershnic]

I would meet with A now that you're pregnant and you both have some space from the prior crazyness. Ask her what she has put in place to ensure that what happened before would never happen again. Does she have more back up? Taking fewer clients? Or is she just praying bad luck doesn't strike twice? I agree that the poor post partum care would particularly bother me.

Do you think she was more flexible with your care because she knows you're a doula and therefore "know what to do"? I know my sister is a doctor and she sometimes feels that other doctors treat her like a doctor - like, they don't explain things as thoroughly as they would to a regular patient, or defer more to her judgment, those types of things.

I would be really uncomfortable with B based on what you've presented here, though I understand the bad impression your first birth left you with A.

[karinothing]

Honestly, I am not sure I would be up for either of those too. I would need to know more about the backup plans if she can't attend the birth. It does sound like she is over scheduling.

For the one with 2.5 years? What was her background pre midwife? Is she a nurse? What is her backup plan?

[heygrey]

B.

my midwife had been practicing 3 years and she was fantastic. the oldest in the practice had only been practicing 12 years.

[meltoine]

Mar 12, 2015 14:11:13 GMT -5 @tokenhoser said:

I'd stick with B for a while and feel it out. A has to know that her level of care last time was totally inappropriate and that it does impact your choice this time. If B is too kooky, I would also probably move on to an OB if you can find an acceptable choice (or are you doing a home birth?).

Home birth. 

[meltoine]

Mar 12, 2015 14:15:08 GMT -5 thebreakfastclub said:

I'd probably fly @tokenhoser in to catch your baby in the kitchen first.

Clearly there are major cons to both, but I think I'd pick B, but probably look around for an OB and hope to show up at the hospital at 10cm.

My other concern about OBs and hospital birth (aside from that the hospitals here are terrible for med-free birth) is that I wasn't sure I was in labor last time until my body started to push on its own, and at that point I wasn't going anywhere. I think A and B are both better options than an unattended home birth. 

[Deleted]

Yeah, I don't recommend paramedics for a home birth. I'd take option B over those dudes.

[meltoine]

Mar 12, 2015 14:23:08 GMT -5 kershnic said:

Do you think she was more flexible with your care because she knows you're a doula and therefore "know what to do"? I know my sister is a doctor and she sometimes feels that other doctors treat her like a doctor - like, they don't explain things as thoroughly as they would to a regular patient, or defer more to her judgment, those types of things.

Yes, I'm sure this is part of it. I was low-maintenance and didn't have a lot of questions, had some experience, etc. While the other clients that delivered that week were FTMs, one of whom had a csection, all of whom needed more intensive breastfeeding assistance. 

A has not changed her practice at all. She still has the same one backup, and her doulas actually split off from her practice as well, so there are fewer support people available. The assistant that ended up driving her to my house last time was her doula/office manager. I'm not sure if she's even still there. 

[meij]

I'd make an appointment with B and feel her out and then go to A if needed. I bet B is just renting space and doesn't necessarily endorse the chiros beliefs. The birth center I started at shared a small building with a few other practices but they didn't seem to be intertwined in any way, just sharing office space.

I know if it were me I'd be worried midwife A would flake on me like that again. It would stress me out and have me worried while in early labor that she'd pull similar stunts. I wouldn't want to spend a second of my labor worried about my midwife.

[meltoine]

Mar 12, 2015 14:23:08 GMT -5 kershnic said:

I would meet with A now that you're pregnant and you both have some space from the prior crazyness. Ask her what she has put in place to ensure that what happened before would never happen again. Does she have more back up? Taking fewer clients? Or is she just praying bad luck doesn't strike twice? I agree that the poor post partum care would particularly bother me.

Do you think she was more flexible with your care because she knows you're a doula and therefore "know what to do"? I know my sister is a doctor and she sometimes feels that other doctors treat her like a doctor - like, they don't explain things as thoroughly as they would to a regular patient, or defer more to her judgment, those types of things.

I would be really uncomfortable with B based on what you've presented here, though I understand the bad impression your first birth left you with A.

A hasn't changed her practice. Her doulas actually split off to form their own group, so there are fewer support people available through her office. 

I think she definitely thought that, off all the clients who gave birth that week, I was the one in least need of support. But I paid for the same level of support they did, and just because I'm a professional doesn't mean I deserve less care, KWIM? I think this is what gets under my skin most about it. I don't want to be left to fend for myself just because I can. I choose midwifery care because it (should) come with a higher level of support. 

[meltoine]

Mar 12, 2015 14:23:19 GMT -5 karinothing said:

Honestly, I am not sure I would be up for either of those too. I would need to know more about the backup plans if she can't attend the birth. It does sound like she is over scheduling.

For the one with 2.5 years? What was her background pre midwife? Is she a nurse? What is her backup plan?

B is not a nurse. Pre-CPM she was a SAHM for 12 years. (She has 6 kids, 7-17) Her backup plan is much better - she always brings another midwife to a birth (which A was supposed to too, but didn't when it came down to it.) She has two midwives she partners with, one is the same as A's supposed backup. She also has two other midwives, who are current in certification but don't take on their own clients at this time, who will back her up if the first two can't. So much better plan.

[meltoine]

Mar 12, 2015 14:28:08 GMT -5 jjwritergirl said:

I wish you had a third choice, because these options are not ideal. I would not be interested in A after the poor follow up she's had with you. I would be willing to forgive the unfortunate delivery circumstances, but the delayed visit after birth and her continuing to cancel appointments this time would not be okay with me. Why is she still so busy this time? She doesn't seem reliable.

My appointments this time have been canceled for inclement weather, so not her fault, though she has been remiss in calling to reschedule.

[Deleted]

Based on what you're posting, I think you're leaning toward B.

[meltoine]

Mar 12, 2015 15:06:16 GMT -5 @tokenhoser said:

Based on what you're posting, I think you're leaning toward B.

I think I am too (and so does MH). I'm not sure why I'm so conflicted, other than I'm not sure how to break up with A without losing referrals from her. 

I think maybe I will go meet with A and ask her about her backup plans to ensure that what happened last time doesn't happen again, then maybe I will feel better telling her that I'm choosing B who has a better backup plan.

[AmyRI]

B is sounding better and better. And honestly, why would it matter if she thinks a chiropractor can treat Down Syndrome? She's not your pediatrician, she's your midwife. Ask questions to make sure you're comfortable with her standard of care and go from there. Bottom line is that your care provider needs to provide care, and A is not cutting it.