Friday, November 14, 2008

The Breakup

I broke up with my OB today.

It was sad.

But I told her I guessed it was time to cut the cord. (Har har.)

As you loyal blogoreaders know, I want a planned homebirth for my third - and FINAL - child. And my OB, unfortunately, only delivers at the hospital. In the feet-in-the-stirrups position. IF she happens to be around that day.

So it had to end. We just couldn't make it work. I have finally found a midwife, which is great. Thing is, I really like my OB. Over the past six years, I feel we've really developed a nice rapport. She is Korean-American, so she can relate to my Korean mother-in-law stories.

She also now has three kids, and two of them had speech delay. She was the one who encouraged me to get Sage evaluated and directed me toward the proper resources.

A couple weeks ago I went in to have her look at a large, painful lump under my armpit. We chatted for 20 minutes before we got down to business. And she even took the time to advise me to get a new bra, as I was spilling out all over (one of the few side benies to being knocked up).

When I saw her today for my 24-week checkup, she said she'd just read this article in the New York Times. It's about, in part, how homebirths aren't just for crunchy granola treehuggers anymore.

More and more professional women are deciding that they want a different birth than one offered at the hospital, where the nurses want you to be quiet and still and flat on your back. And where after the birth, seemingly every employee wants to come in and poke you or your child - usually when you've just gotten the little bugger to figure out how to nurse.

I know that many of my friends think I'm brave for even considering a home birth. Turns out the medical establishment here also isn't in favor. According to the Times story:

The American College of Obstetricians and Gynecologists has had an official policy against home births since 1975, and this year it asked the American Medical Association to adopt a similar statement. The A.M.A. agreed, and in June also condemned home births.

“The A.M.A. supports a woman’s right to make an informed decision regarding her delivery and to choose a licensed health care provider” and “stresses that the safest setting for delivering a baby is in the hospital or a birthing center within a hospital complex,” Dr. Steven Stack, a board member, said in the statement. “Serious complications can arise with little or no warning even among women with low-risk pregnancies.”

In contrast, health authorities in Britain view home births as a safe option for women at low risk of complications. In April 2007 the United Kingdom Department of Health rolled out plans for a “national choice guarantee,” to be put in place by the end of 2009, ensuring that all women can choose among giving birth at home, or at a hospital or another facility, and still have access to midwifery care"

Kinda interesting that places with universal health care are more apt to support alternative births. I wonder if that's why the U.S. has the highest rate of Caesarian Section in the the industrialized world.

According to a story last year in the Washington Post, the rate of C-sections in the U.S. was at a record-high 29 percent of all births in 2004.

That's more than 1 in 4. Meanwhile, the rate of C-sections for those attempting home birth is well under 10 percent (2 percent of the births my midwife attends result in C-section).

My OB would prefer me to give birth in a hospital. Just in case. And I would, if there was one that allowed a midwife delivery. But there isn't, so my option is home birth - a service my OB can't provide.

In other words, it's not her, it's me.

Of course I'm nervous. Leaving security for the unknown is always a little scary. But I know it's the best decision for me.

Besides, my OB assured me she'd take me back if changed my mind. And she'll definitely take me back when she's just my GYN.

So it wasn't really goodbye, just so long for now.

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