Reply to Infertility-Sensitive/HAES-Friendly OB-GYN?

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[quote=Anonymous][quote=Anonymous][b]Ahh the midwife defenders are out in full force tonight on a thread requesting OB recommendations. WTF. [/b]

Yes being AMA makes you high risk. Literally I just asked this at Georgetown and one of the lead OBs said that alone means you are treated as high risk because AMA puts you at greater risk for a host of complications. Some of you treat this like a personal affront or a character flaw when it’s a medical reality. I’m AMA and I don’t take it personally, and you shouldn’t either. I choose to delay having kids and I have no one else to hold responsible for that but myself. Yes, being obese puts you at a much higher risk of a C section and other complications. Yes, IVF puts you at higher risk for certain complications. Doesn’t mean you’ll have them but that they are more likely.

A hospital based midwife having backup OBs doesn’t necessarily mean the OB gets called in when they should. Midwives and OBs can have different ideas, perspectives, risk thresholds, and ideas about when an OB should be alerted or if they should be brought in to a delivery at all. Collaboration is only great if everyone is singing from the same songbook. Midwifery students and medical students are currently taught from different songbooks. And there is plenty of evidence is available in the media and elsewhere that shows what happens when midwife/physician collaboration works poorly. You can also easily search the DC Superior Court cases for medical malpractice. Undisclosed settlements with NDAs mean the news never reports the stories from the affected families, but the cases are easily found if you search. [/quote]

I'm the first PP who suggested either a CNM practice or a small OB practice.  I also went through IVF and was AMA for my first.  Pregnant again with my second (I'm 40); still seeing midwives.  Yes, as AMA, I am certainly at a higher risk than I would be if I was, say, in my 20s.  I'm not denying that.  I've already been told by the CNMs that I see that I will need extra monitoring due to my age and, if I develop any sort of complications, obviously I will be risked out.  That's fine with me.  When I was initially under OBGYN care for my first (at 37), they did not view me as "high risk", just due to AMA.  There were no referrals to an MFM; they did not plan on extra monitoring just due to my age.  Frankly, every practice (yes, even OBs) seems a bit different with their level of panic over AMA.

I made the suggestion for a hospital-based group of CNMs because OP stated that she was looking for someone who might be more sensitive to anxiety.  I read that as maybe wanting someone who would spend more time with her at appointments, provide more reassurance, etc.  That, typically, is a hallmark of CNM practices.  Not saying that it can't be found with OBGYNs, either, [b]which is why I also suggested looking at a smaller OBGYN practice[/b].  I was just offering my recommendation based on my own experiences in a very similar situation.  Honestly, I didn't even realize CNMs were an option in this area until my RE suggested I look into it after our successful IVF.
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