In Which I Switch Providers at 25 Weeks

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February 11, 2012 by Leah

Thanks, in large part, to the response I received to my last post from my awesome internet-based support team (aka friends), I realized that my relationship with my CNM wasn’t making the minor ups and downs of pregnancy any easier. In fact, the stress of the whole “borderline gestational diabetes” thing coupled with a lack of any kind of positive support from my medical team had me intermittently crying, feeling sick to my stomach (almost certainly an anxiety/stress reaction), and generally in a downward nutritional spiral. Chocolate is not a vegetable, after all.

I think I’d been rationalizing away red flags with “but she’s a midwife!” since my first meeting with the CNM, during which she talked the whole time, barely looked at me, told me people like Aaron and myself (educated and in our 30s) tend to expect perfection, and told me to stop reading. So on Wednesday I did a few proactive things. I went and got a copy of my lab results from the three-hour diabetes test (and from my brief research and lay-person standpoint I decided my provider had been seriously overreacting), and I called a local clinic about which I’ve heard great things to see if any of their OBs were taking new patients. Turns out several were, but only two are willing to take in-town transfer patients (I’m guessing because this is a small town). I asked if I could get an interview with one or the other, and the office manager said they don’t normally do that but she’d talk to them and call me back. The office manager also asked if I had any questions for her about the doctors, but I didn’t know how much to reveal at the time as I was flustered, so I didn’t really.

I called the office manager back the next day and said I was interested in one of her two doctors in particular. I explained what I was looking for (someone who listens and has good communication skills, mostly) and filled her in on how I wasn’t pleased with how the GD saga had been handled. She started talking about patient noncompliance, which freaked me out and put me in a defensive position so I was backpedaling (I mean, of course we all want what’s best for the baby), but she said she’d talk to the doctors anyway. I spent a tense two hours, after which she called back and said the OB I was interested in would love to meet with me at 9 the next (yesterday) morning. (She also tried to impress on me that I couldn’t get clinical advice during a consult, and I reminded her I was looking for a personality match and didn’t need any clinical advice at this juncture. This cracked me up, because I’ve been a business manager. You kind of have to be a hardass sometimes.) Anyway, I had passed the office manager gauntlet.

The meeting with the OB was great. She’s somewhere around my age; she and her family just moved to the area; she was genuinely interested in me; we switched between chatting and me interviewing her with ease. I asked her what she thought about patients who educate themselves and she said that she thinks this is great, and that even if people might not have access to the peer-reviewed journal type articles they should be reading, the information available on the internet leads her patients to ask the right kind of questions. (I made a comment about journal articles often being available in the footnote section of Wikipedia, which seemed to please her. Sometimes I also ask my father-in-law the MD for such arcane fodder as journal articles, which he happily provides.)

When I asked the OB what she thought of doulas, her response was: “If a woman wants to have one, I’m happy to have her have the extra support.” We talked about many other things, too (I totally asked her if it was weird to take in-town transfer patients and she said many of her patients so far have been just that, so no). She told me how she would have handled the GD saga and it sounded like a lot more information would have been communicated to me than what I then had to work with. She also had a sense of humor and seemed genuinely happy to meet me and said she wanted to take over my care and gave me positive reinforcement about good habits like taking exercise classes at the Y. She made me feel welcome and valued, rather than judged and a waste of time.

Long story shorter, I have an intake appointment on Wednesday. I am thinking we will also switch hospitals. The one we are switching to had a 4% higher c-section rate in 2009 than the one we’ve been assuming we will deliver at, but I’m guessing that trusting my provider and being comfortable with her will lead to a better experience than basing a decision on statistics will. (Both hospitals are still under the national average.) I’ve been so much happier since I made this decision. My appetites and energy are normal. I’ve barely cried, and then only out of relief. I feel like a huge weight has been lifted off my shoulders.

I also finally have a meeting with Walla Walla’s one and only doula scheduled for Wednesday.

And, in what may be the best news, I called the diabetes education specialist yesterday to ask why I hadn’t heard from her about getting set up with and trained on a home blood-sugar-monitoring machine. She said, “I probably shouldn’t be telling you this, because I need to talk to your provider and she’s not calling me back. She needs to take another look at your labs, because I don’t understand why you were referred to me in the first place.” And then went on to ask if this were my first baby, congratulate me heartily, and to end the conversation by saying, “Keep taking good care of yourself.” Yes! Yes, I will! And thank you for the positive reinforcement, nice lady whom I’ve never even met!

Obviously we need to wait to hear what my new provider’s opinion of all this is, but I have a feeling we are going to return to the healthy and non-eventful pregnancy I had been having prior to that fall on the ice. I even had a piece of fruit to celebrate.

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4 thoughts on “In Which I Switch Providers at 25 Weeks

  1. Abbey Valentine says:

    You are doing a great job Leah. Keep it up. Sometimes people aren’t reinforcing enough and I hope people continue to reinforce what you’re doing, especially your doctor. You need to be able to trust her methods and reasoning, as well as feel that the treatment you are getting is based on facts and sound medical advice. You made the right decision switching because if you’re crying over a provider (and trust me, I’ve done this more times than I like to think about), you’re seeing the wrong person. Being proactive is the best choice for you and Sprocket. You know what’s best for Sprocket and you have a wealth of information to discuss and it’s always good to have a well educated person to talk to about it, not someone who seemed intimidated by your intellect. Go go pregnant mama!

  2. Marla says:

    then chocolate is a fruit.

  3. David G says:

    Good for you, It sounds like you are happier with your new provider. Being comfortable with your provider makes a huge difference in the quality of your birthing experience.

  4. Kathryn says:

    I am so happy for you. The hardest part of navigating the medical system seems to be trusting your instincts over what institutionalized experts are telling you. If you don’t have a bond of trust and a level of comfort with your caregiver you add an unnecessary layer of anxiety to every decision you make. So Kudos to you for making change on your and your baby’s behalf.

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