I have seen a lot of different OBGYNs and midwives over the last 11 years.
I will soon have 7 children which include 2 sets of fraternal twins, 1 C-section, and 3 successful VBACs (which type of birth happens for this next set of twins is still TBD).
I have delivered babies in Utah, Indiana, Texas, and soon New York. I have delivered at different hospitals and with different practices every single time.
For the first three pregnancies, all my medical bills were, thankfully, covered by Medicaid. But, the last singleton and my current set of twins have been cash pay babies, with us being reimbursed 100% of the maternity and delivery costs by Christian Healthcare Ministries.
I have gone to a lot of prenatal appointments, follow-up appointments, Maternal Fetal Medicine appointments, non-stress tests, 1-hr glucose tests, and so on.
I have had four epidurals, long labors (12-40 hours long), and big babies. I’ve had back labor and a sunny-side-up son.
I like to think I know a little something about birthing children in the United State of America.
And I am sorry I haven’t shared more of my thoughts and experiences with everyone on my blog or online. But, it’s time.
Today, let’s talk about those monthly to weekly prenatal appointments with your OBGYN or Midwife.
Typical Prenatal Appointments
Prenatal appointments when you are pregnant are not blood work. They are not ultrasounds. They are just “checking in” with your doctor (OBGYN or Midwife) to make sure you and baby are good.
Every single time, a nurse will ask you to pee in a cup (why every time I still haven’t figured out as they never tell me anything about my pee sample), and she will ask you to step on a scale to weigh you (and hopefully not make any comments about said weight, like “Oh wow you did it! You passed 200lbs… but I guess you are tall…”).
The nurse will also take your blood pressure reading (and may or may not tell you what it is, and if that is a good reading or not in case you are medically illiterate like myself and those numbers are meaningless to you), your pulse ox (which they don’t usually say anything about), and your temperature.
She may ask you additional questions like “have you had any bleeding, discharge, or foul odor from your vagina? Have you had any contractions?”
Then your nurse will leave you in your room, always promising that the “doctor will be in shortly” which can be a very big lie as “shortly” can go up to 20-30 minutes or more at times, especially if he or she happens to be finishing up a delivery at the hospital next door (another true story).
When your care provider comes into the room, he or she will typically ask you to lie down on the exam table so they can measure your fundus (the height of your uterus) with a measuring tape (and likely won’t tell you that measurement anyway, or if you’re measuring big or small).
While you are lying down, they will put some gel on to a portable heart-rate doppler and plop it onto your belly and move it around until they can hear the heart-rate of your baby (or babies).
They may or may not tell you the speed of the heart rate, but if you do, it again can be meaningless if you are medically illiterate or don’t believe in old wives’ tales about gender predictions based on heartbeats.
But, another reason they listen to the heartbeat is to make sure there isn’t a murmur (though I swear some don’t listen long enough to discover if there would be one) and that, well, your baby still has a heartbeat (sad, but true).
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After these formalities are over, what happens next is totally dependent on your doctor.
The most typical event that has happened to me is that my doctor will sit back and ask “Well, do you have any questions?”
If I don’t, cause, well, as I established at the beginning of this article, I’m kinda a baby-making pro, and there are so many of these appointments over the life-span of your pregnancy that you may not have a new question every month or week, or you may just be unsure what the heck to ask anyway, then it will usually be, “Okay, then, well, I’ll see you at your next appointment in 4 weeks” followed by him leaving as the nurse then comes back in to schedule your appointment, or you go to the reception desk to schedule that appointment.
Now, if you do have questions, hopefully, your doctor will be able to answer them, but they can’t always, or, if you are going to a practice with multiple doctors, you may get a different answer from one than you did from the other.
Reasons they can’t answer your questions is sometimes because they aren’t physical therapists (if you have physical pregnancy pain you’d like help dealing with), nutritionists (if you have questions about diet), hospitals (if you have questions about hospital policies or hospital care), billing departments (if you want to know how much a certain test or procedure is going to cost you), or well-versed with your specific question for whatever reason.
Most do not have stats and information readily available, as they typically aren’t actively researching birth, they are just aiding in births, nor do they actively keep track of their own C-section, VBAC, twin, GD, high blood pressure, episiotomies, or induced birth stats, in case you wondered about how often they perform such births or procedures.
And that cost you between $45-$160 for your 5 minutes or less with the doctor! Let’s do it again in 4 weeks!
What Women Wished Happened at Their Prenatal Appointments
Probably the #1 thing women wished happened at their prenatal appointments was that they were truly listened to and their desires respected.
Too many feel their doctors are just busy, impersonal, insensitive, arrogant, my-way-or-the-highway doctors. They spend a lot of time watching their doctors backs leave the room shortly after arriving.
They wished their doctors didn’t respond to their wishes with “Well, we’ll see what happens” or “we’ll worry about that later on.”
They wished their doctors trusted them more to know what they wanted and how they wanted it, rather than second-guessing those choices and options, like my last doctor who completely disregarded my desire to have a TOLAC with my current twin pregnancy, despite three previous VBACs of large babies, quoting vague “it’s more dangerous” as reasoning.
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They wished their doctors actually asked them what their pregnancy and birth goals were and then did everything they could to help them reach those goals and have the birth of their dreams! They wish their doctors were truly supportive of their pregnancy and birthing journey.
I personally wish that my doctor would come in and update me on what’s going on right now in this stage of my pregnancy and what I should expect, and what warning signs I should be watching out for.
I don’t care that many women have apps, and read books or websites that have all this information.
Aren’t we paying good money for a medical doctor to see us? Why can’t he go over that information with us, instead of just assume we know or aren’t curious or that we don’t need a refresher, or that we have an app telling us these things?
I want my doctor to come in and say “Alright! You are 28 weeks pregnant today! You’ve officially made it to the third trimester and are 7 months pregnant! As your fundus is measuring right on track, we expect your baby is currently about the size of an eggplant, measuring about 15in from head to toe, and a little over 2lbs! I want you to make sure you start doing kick counts now to make sure baby is doing okay in there. Here’s how to do it…. “
Women wish their prenatal visits with their care providers were personal. They wish they had a real connection with them, got to know each other, so that they could trust each other when one of the most defining moments of their lives arrived.
I can’t tell you how many times I have met a new doctor who simply told me his or her name, but never told me anything else about themselves! And then it’s all “Hey lift up your shirt now and show me your belly.” It’s totally weird and strange to do so with a stranger, even if they are a doctor.
Women love when their doctors call them personally, and take their concerns seriously, and check on you, especially outside of work hours.
They wish they actually read the charts before entering the room so you wouldn’t have to go over your entire reproductive health, again. Or forget that you’re carrying twins.
They wish their doctors heard their complaints and instead of just saying “yup, that’s normal” actually offered solutions!
Women wish their OBGYNs talked about every aspect of health and pregnancy, like nutrition, exercise, emotions, pains, aches, fears, birth planning, postpartum care, and support systems, making sure she has all the resources she needs now and after delivery.
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Many pregnant women wish doctors didn’t judge them or make comments about certain choices they have made or want to make. This can be because you are a young teen (or 40+ year-old) mom, or on Medicaid or not on any insurance, or because you are a certain color, religion, sexual orientation, weight, or appearance!
But doctors can often be annoyed or even downright hostile because you don’t want drugs during labor, or want a water birth, or want to keep the placenta, or want/don’t want a repeat C-section, or want/don’t want to be induced, or don’t want the DTaP shot, or don’t want genetic testing, don’t want to breastfeed, or whatever!
Too many women feel completely helpless when it comes to their own pregnancies, labors and deliveries.
They feel they “had no choice” or they didn’t know that something was even a choice in the first place, or what alternatives there were, or what the risks and benefits of certain choices were.
The reality is, pregnant women are extremely vulnerable, and for many, it’s the first time in their life they are seeing a doctor so frequently, and just assume “this is how it is.”
Doctors are revered as experts, as extremely knowledgeable, and as putting you and your baby’s health at the top of their priorities.
And honestly, we kinda fear them because of it. We “do what the doctor says” because this is his job. He’s experienced. We are not (at least, or especially, as first-time moms).
Some friends have said they felt like these appointments were a nine-month training course in accepting and relinquishing control over to them, because every time you go in they tell you something you can’t control. They have all the control and they just train you to accept it.
But, what we too often forget is that we are the one hiring them.
This is our body, our babies, and our lives at stake! They are supposed to be supporting us in our birthing choices. They are working for us! We should not have to work to please our doctors! We should be the one’s in control over our own health.
Yes, our doctors should let us know about the TRUE risks of whatever choices we say we want to pursue: that is their job. But that information should be actual numbers and statistics not just “oh, it’s riskier.”
Women have been birthing babies since Eve and without a “doctor” telling them how to do it.
Let’s recap: Here’s what women want from their OBGYNS and prenatal visits:
- Get to know the doctor and them know us
- Not in a rush
- Present all options
- Share real statistics and risks
- Encouraging and positive
- An advocate for your birthing goals and objectives
- Truly listen to you and respect you
- Share test results and information in layman’s terms
- Free of judgmental comments and attitudes towards you for any reason
- Cared about your whole health, including mental health
- Read charts before entering a room
- They call us personally for results, concerns, or check-ups
- Offered real solutions to various aches, pains, and concerns
- Prompt and on-time for appointments (short waiting times)
Why Pregnant Women Prefer Midwives
It should come as very little surprise then that the women who have the best prenatal visits, who rave about their prenatal care, are the women who use midwives for their care.
Whether those midwives work at a large facility affiliated with a hospital or birth center, or physically come to your home, pregnant women (generally) love the care they receive from midwives over obstetricians.
Midwives, also referred to as birth attendants and birth assistants, are there to help, not interfere with nature or with a woman’s desires; they are there to help her excel in her pregnancy and birthing, to have it be LESS scary, painful, long, or life-threatening.
Midwives typically take their time during prenatal visits to evaluate your whole picture of health. They take a much more holistic approach to your pregnancy and your desired birth and work hard to respect it.
Some of my friends have said they actually spend 30-60 minutes at these prenatal appointments with their midwives and love these appointments! They become friends. They bond. They discuss every aspect of health and get helpful and respectful answers to all of their questions and concerns.
While there are many amazing obstetricians who do many things pregnant women want during their prenatal and postnatal care, midwives as a whole are far more to give women the type of care they want.
And you do not have to have a home birth or even birth naturally (without drugs) in order to receive care from midwives or CNMs! I know that seems to be a common misconception.
Of all my prenatal care, my favorite has been with a midwife (which I’ve only managed to have for one of my pregnancies). When I said I wanted to have a VBAC, she said that I was a great candidate for one, and that they did VBACs all the time and that it shouldn’t be an issue.
She listened to my concerns and didn’t have her hand on the door ready to leave as we chatted. She didn’t make me feel stupid for the questions I had. She explained things to me with common language instead of medical jargon.
She even spent a lot of time trying to strip my membranes to help me go into labor at the end, never losing her patience.
She let me go almost 2 full weeks past my due date in order to achieve my first VBAC.
At the hospital, they didn’t put me on a clock, or seem worried about anything, despite the fact that I was there for almost 24 hours before my son finally arrived (the hospital policies there were fabulous too with intermittent fetal monitoring, letting me shower, letting me walk the halls, eat, etc).
However, midwives typically don’t, choose not to, or are not allowed by certain organizations or laws to handle certain high-risk pregnancies. So, depending on your situation, they may or may not ultimately be the best for your specific needs.
Some states also don’t allow for midwives to deliver at hospitals (why, I don’t know).
Advocate for Yourself
But, whatever you do, don’t settle for a doctor who belittles you, who treats you like a dumb (immature, young, foolish, fill-in-the-blank) person who will never be able to achieve their birthing desires.
Don’t continue seeing a doctor who, at your first appointment with your first child, tell you at 12 weeks of gestation, that because you pretty petite, that you will need a C-section (like my friend Carmen).
Don’t continue to see a doctor that you have to reassure of your capabilities to do things like birth a big baby, especially when you’ve already done it before.
You need to advocate for yourself, your pregnancy, and your baby. You need to ask questions, ask for stats, ask for more information, ask for second opinions, and research the heck out of everything (start reading research on PubMed). You need to know your rights and options so you can go in knowing what you will or will not accept.
The last thing you want, need, or deserve is a power struggle over your care and delivery when you are at your most vulnerable (in labor). It is so important you give birth in a way that you feel comfortable and confident in.
That’s why taking an excellent prenatal and/or childbirth class can help. If you would like to take one, this is an EXCELLENT prenatal class that is all 100% online too (so no need to go in-person or take up your entire Saturdays). Use code FAGANS10 for 10% off too!
And, if possible, choose an OB that isn’t part of a large practice, or go to a practice that will let you see your preferred doctor only, every visit, so you can start to develop a relationship with them.
You can also switch doctors and switch practice up until the very end. You can also decline appointments, procedures, IVs, and a whole host of things if you really want to.
Again, it is your health. Your body. Your baby. So stand up for them. Doctors have been known to do things on their schedule and based on their preferences and experience rather than based on what may be best for you or what you want.
Listen to your body and do what will be best for you and your baby based on your own research and personal beliefs and preferences (and then pray like crazy that everything goes well).
Moms-to-be, you are amazing and deserve only the best care. My hope and prayer is that you will get it and not accept anything less than the best for both you and your baby, the entire 9 months and beyond.
For more pregnancy-related posts, check out the following:
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