risked out of Wisdom, now what

[Anonymous]

This may not apply to OP, but I wanted to make clear. Wisdom kept me with diet-controlled GD. I risked out when my blood pressure shot up and I started taking medication. My understanding is that Wisdom will keep you if your GD is controlled by diet and risk you out if you need medication (metformin, insulin, etc.).

I personally don't think this is merely to keep down their c-section rate.Midwives see easy, uncomplicated pregnancies and deliveries. They are not doctors. GD that requires medication is a serious complication and blood sugar can be unpredictable during labor (stress can raise or lower blood sugar).

[Anonymous]

The history of depression is particularly offensive. What would a "normal" OB do here that Wisdom wouldn't or couldn't?

[Anonymous]

Anonymous wrote:This may not apply to OP, but I wanted to make clear. Wisdom kept me with diet-controlled GD. I risked out when my blood pressure shot up and I started taking medication. My understanding is that Wisdom will keep you if your GD is controlled by diet and risk you out if you need medication (metformin, insulin, etc.).

I personally don't think this is merely to keep down their c-section rate.Midwives see easy, uncomplicated pregnancies and deliveries. They are not doctors. GD that requires medication is a serious complication and blood sugar can be unpredictable during labor (stress can raise or lower blood sugar).

This is PP with the somewhat harsh view of why they risk out GD. I don't know that your experience is universal. I know two women who were risked out for GD and one of them said Whitney specifically said she was disappointed in her. So that's where this is coming from. That said, I don't know that woman very well, so who knows if she was putting a spin on it. Agree with you about the more serious forms of GD, but not the easier ones. If they really don't risk you out for that, then good.

[Anonymous]

Why would a history of depression risk you out? I'm assuming this isn't someone currently on anti-depressants but who just was at some point or something.

Genuine question.

[Anonymous]

Get thee to Midwifery Care Associates, OP. I had GD at age 40, needed glyburide to keep the AM readings down, and delivered a 9# baby vaginally at 41 weeks. Labored in tub, etc. You can still have midwives.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

jindc wrote:..and GD is a big deal. I was really worried about it (had a first tri test for it because I am heavier) and wish people took it seriously. It can have lasting issues for mom and baby, and a doctor should be your provider to ensure everything is going well with the GD.

They don't risk out every GD patient from what I've heard, though. They do three "strikes" - so GD plus history of depression plus expecting twins, for example (twins is probably a bad example - does Wisdom do twin births?), will get you risked out.

Wow. Am I the only one who thinks this sounds somewhat punitive and offensive?

The practice or what I wrote? Midwives tend not to take high risk patients. I was risked out by Birthcare at 30 weeks (for very specious reasons). The reasoning still pisses me off, but if you're a better candidate for birth with an OB, they're better off transferring your care.

I'm a wisdom patient and I'm fairly happy. I appreciate that they will NOT risk you out for things like twins, or a breech birth, de facto. On the other hand, they will risk you out for GD, or for hypertension, etc. (The latter being much more serious). For GD, I think they risk you out for a combo of three reasons:

1. You get risked out and go to OB's a CYA but without any pain for GW, since you just get risked out to other GW doctors and your money still stays there. Neat trick.
2. Whitney believes that a GD diagnosis is proof that you did not follow her diet.
3. They worry that GD and the big babies it can sometimes cause will cause more women to want epidurals and need c-sections. While this is a legitimate possibility, I think their risking you out has way less to do with whether or not it's "safe" for you to deliver with them (you're in a hospital surrounded by top notch OB's steps away) and more to do with keeping their c-section stats as low as they can.

Fair enough...or is it?

I completely understand and support a legitimate need to transfer care to an OB in a high risk situation, but points 2 and 3 are a large part of why I chose MCA over Wisdom. I got the very strong impression from Wisdom that keeping up their stats was a higher priority than working with each individual's needs.

[Anonymous]

What a bunch of assholes. And they claim to be supportive - yet refuse to treat women with issues beyond their control. Why do people frequent this place?

[Anonymous]

As to the original question, Dr Larson was attending during my 48 hour labor when DD's heart rate started dropping a bit. My midwife thought we could keep going and I wanted a second opinion. I spoke with Dr Larson and his opinion was that at that point, a c-section would still be considered elective. My doula was floored- she was sure he was going to say we should just get baby out that point. I ended up delivering vaginally.

I think overall, GW is very supportive overall of supporting vaginal deliveries.

[Anonymous]

Anonymous wrote:What a bunch of assholes. And they claim to be supportive - yet refuse to treat women with issues beyond their control. Why do people frequent this place?

I'm not with Wisdom, so I'm no apologist, but I think you need to dial it back. Just because some person on DCUM says that Wisdom might risk you out if you have a several "strikes" against you, doesn't mean that they are jerks. They aren't doctors and it's the right thing for them to refer out if a pregnancy becomes more complicated than they feel comfortable with. And yes, depression might be one of the factors, but they certainly don't risk out someone just because they have a history of depression. And GD that isn't well controlled with diet might be another. I expect my providers to refer me to specialists if and when they feel they've reached the end of their scope of practice. This is no different.

[Anonymous]

Anonymous wrote:

Anonymous wrote:What a bunch of assholes. And they claim to be supportive - yet refuse to treat women with issues beyond their control. Why do people frequent this place?

I'm not with Wisdom, so I'm no apologist, but I think you need to dial it back. Just because some person on DCUM says that Wisdom might risk you out if you have a several "strikes" against you, doesn't mean that they are jerks. They aren't doctors and it's the right thing for them to refer out if a pregnancy becomes more complicated than they feel comfortable with. And yes, depression might be one of the factors, but they certainly don't risk out someone just because they have a history of depression. And GD that isn't well controlled with diet might be another. I expect my providers to refer me to specialists if and when they feel they've reached the end of their scope of practice. This is no different.

It isn't really just one person, though, because these kinds of threads pop up all the time.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

jindc wrote:..and GD is a big deal. I was really worried about it (had a first tri test for it because I am heavier) and wish people took it seriously. It can have lasting issues for mom and baby, and a doctor should be your provider to ensure everything is going well with the GD.

They don't risk out every GD patient from what I've heard, though. They do three "strikes" - so GD plus history of depression plus expecting twins, for example (twins is probably a bad example - does Wisdom do twin births?), will get you risked out.

Wow. Am I the only one who thinks this sounds somewhat punitive and offensive?

The practice or what I wrote? Midwives tend not to take high risk patients. I was risked out by Birthcare at 30 weeks (for very specious reasons). The reasoning still pisses me off, but if you're a better candidate for birth with an OB, they're better off transferring your care.

I'm a wisdom patient and I'm fairly happy. I appreciate that they will NOT risk you out for things like twins, or a breech birth, de facto. On the other hand, they will risk you out for GD, or for hypertension, etc. (The latter being much more serious). For GD, I think they risk you out for a combo of three reasons:

1. You get risked out and go to OB's a CYA but without any pain for GW, since you just get risked out to other GW doctors and your money still stays there. Neat trick.
2. Whitney believes that a GD diagnosis is proof that you did not follow her diet.
3. They worry that GD and the big babies it can sometimes cause will cause more women to want epidurals and need c-sections. While this is a legitimate possibility, I think their risking you out has way less to do with whether or not it's "safe" for you to deliver with them (you're in a hospital surrounded by top notch OB's steps away) and more to do with keeping their c-section stats as low as they can.

Fair enough...or is it?

Really? Does she have any medical training at all? What an idiot.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What a bunch of assholes. And they claim to be supportive - yet refuse to treat women with issues beyond their control. Why do people frequent this place?

I'm not with Wisdom, so I'm no apologist, but I think you need to dial it back. Just because some person on DCUM says that Wisdom might risk you out if you have a several "strikes" against you, doesn't mean that they are jerks. They aren't doctors and it's the right thing for them to refer out if a pregnancy becomes more complicated than they feel comfortable with. And yes, depression might be one of the factors, but they certainly don't risk out someone just because they have a history of depression. And GD that isn't well controlled with diet might be another. I expect my providers to refer me to specialists if and when they feel they've reached the end of their scope of practice. This is no different.

It isn't really just one person, though, because these kinds of threads pop up all the time.

Yeah, Whitney sounds like a demagogue and incredibly judgmental. I base this on the threads on this forum but more so on the accounts accounts of several friends. Most friends delivered successfully with Wisdom but endured judgment and even bullying at the hands of Whitney and a couple of the midwives. There's an attitude of if something goes wrong it's your fault and if you deviate from their approach or even question it, you're clearly not woman enough. Not supportive.

[Anonymous]

Anonymous wrote:Why would a history of depression risk you out? I'm assuming this isn't someone currently on anti-depressants but who just was at some point or something.

Genuine question.

I'm the PP who got bounced out of Birthcare, and I think it's just another factor. When I saw Whitney for a well-woman check she said that since I'm obese, plus history of depression, plus previous c-section meant that I'd have to lose weight before I was a candidate for them. It's all just a matter of risk, and I suppose with depression the concern is that during pregnancy you might need additional meds or that you wouldn't be mentally fit enough to get through delivery.

I'm no Wisdom rah-rah girl, but I appreciate that they are one of the few providers (and the only hospital based provider I can think of) that have a goal of unmedicated birth and use good science in making their birth decisions. For example, you're never going to hear one of the midwives suggest you induce at 40 weeks just because, whereas I've heard and read dozens of stories about all sorts of OBs who pressure you into inductions for iffy reasons.

Those of us who are interested in non-medicated, hospital based births really need to band together to push for reforms in hospital obstetrical practice.

[Anonymous]

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:What a bunch of assholes. And they claim to be supportive - yet refuse to treat women with issues beyond their control. Why do people frequent this place?

I'm not with Wisdom, so I'm no apologist, but I think you need to dial it back. Just because some person on DCUM says that Wisdom might risk you out if you have a several "strikes" against you, doesn't mean that they are jerks. They aren't doctors and it's the right thing for them to refer out if a pregnancy becomes more complicated than they feel comfortable with. And yes, depression might be one of the factors, but they certainly don't risk out someone just because they have a history of depression. And GD that isn't well controlled with diet might be another. I expect my providers to refer me to specialists if and when they feel they've reached the end of their scope of practice. This is no different.

It isn't really just one person, though, because these kinds of threads pop up all the time.

Yeah, Whitney sounds like a demagogue and incredibly judgmental. I base this on the threads on this forum but more so on the accounts accounts of several friends. Most friends delivered successfully with Wisdom but endured judgment and even bullying at the hands of Whitney and a couple of the midwives. There's an attitude of if something goes wrong it's your fault and if you deviate from their approach or even question it, you're clearly not woman enough. Not supportive.

I'm a wisdom patient but haven't met with Whitney yet. I'm not easily bullied. I plan to report back after I meet with her. Especially after I'm purely honest that I think her diet is mostly good but that I'm not going to pretend I don't feel bad about myself for eating a cookie every now and again. If she asks about the diet I'll tell her I'm following it most of the time, because most of the time it makes sense for me. I really-really-really want to give her the benefit of the doubt, because I think you hear the worst of the worst online and i have also heard great stories. But I'm not one to be bullied so it will be funny if she tries it on me. I have other options and know it. AND, I wouldn't keep my money at GW is I leave them.

[Anonymous]

I was a FHBC patient and they risked you out of the practice for GD. However, this policy was put in place because WHC required it in order to allow the midwives to deliver there. So simmer down there, folks. They might need to risk people out for reasons outside of the midwives' control. Either way, it's silly to jump to conclusions.