Choosing a practitioner
Right now I am trying to find a practitioner for my pregnancy. As some of you know, I am very pro-natural childbirth and against the routine medicalization of pregnancy and birth.
Where I live, direct-entry midwifery is illegal. The closest freestanding birth center is 2.5 hours away. There are no CNMs in the area who do deliveries. There is one family practitioner (a DO) that does home deliveries that I have heard about. There are also underground midwives who practice illegally.
So I feel very limited in my options. I am going to talk to some experienced doulas I know about practitioners who are friendly to natural childbirth and maybe go to a La Leche League meeting and ask around there too.
I went to my first prenatal appointment yesterday at my gynecologist's office. I had an appt to see a "doctor," but it turned out the woman is a nurse practitioner who has a PhD. She told me she would handle my prenatal and postpartum care, but she does not attend deliveries. For my delivery, I would have whichever of 11 doctors is at the hospital at the time. I really don't like the idea of not meeting the doctor until I'm already in labor and having no idea what they are like and what their philosophy about birth is. And it does not seem feasible to try and meet with all 11 of them during my pregnancy.
I told her I wanted to do natural birth and she was very encouraging that I hire a doula and write up a birth plan, so I thought that was a good sign. However, she seemed put off when I asked about their c-section rate (26%) and episiotomies. I did not like her answer about episiotomies--she said they would do one if they thought I would tear into my rectum because it would save my rectum. Last I checked, 4th degree tears were more common with episiotomies. She seemed a little defensive and like she felt that she had to convince me that an episiotomy might save my rectum.
So I guess a smaller practice would be better. I know there is never a guarantee that the person you've been seeing will be the one to catch your baby, but if the practice is smaller, I could meet with the different doctors and get a better feel for the culture of the practice and how much they will support me in my hopes for a natural birth.
I'm going to make a couple more appointments with some other doctors I've heard are supportive of natural birth (one is the doctor my friend had a water birth with and had no IV or monitoring or anything). But I am feeling discouraged about my options.
Last edited by iris427; 01-15-2008 at 09:13 AM.