Reply to Why did you pick a midwife over a doctor?

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[quote=Anonymous][quote=Anonymous][quote=Anonymous]"My argument is that inconveniences like long waits and office environment are not the markers of bad patient care, which, up until you responded was what we were discussing."

I'm not going to copy and paste the whole thing, but why do you think the above is true?  To people who don't have hours to wait for their healthcare providers, yes, long waits become bad care.  If the office environment is such that it ignores patient privacy, or doesn't facilitate communication between front office staff and providers, yes, it becomes bad care.

The quality of healthcare is, to me, comprehensive (and most organizations who research that construct agree).  Some aspects of care may be more salient than others, but it all goes into determining quality.  Also, if you look at the first page of this thread, most of the women described some version of wanting personalized attention/being listened.  One woman on the second page talked about wait times, clearly mentioning that she had experience working as a medical assistant in an OB practice, i.e., it was an informed decision.  Why are you focusing on wait times as the reason to argue that the women on this thread can't tell what defines quality care when what PPs are actually mentioning is providers paying attention to them?[/quote]

I'm a brand new poster to this thread. I have been reading this back and forth with growing annoyance.

I am a woman that had a very normal, uncomplicated first pregnancy become a VERY abnormal very complicated very dangerous pregnancy at week 33 very suddenly. My primary MFM at Georgetown was Dr Zilbermann. He was an enormous d. After stepping in the room to do my first BPP after being hospitalized he pretty casually informed me I was at a high risk of stillbirth. He also managed my care so that I made it to almost 37 weeks and delivered a baby that was breathing on her own. He predicted her stay in the NICU to the day. Dr. Drassinower was MUCH nicer to me and I liked her a lot and I have nothing but good things to say about her, but I trusted Dr. Z more by the end.

I waited for no less than 45 minutes for every appointment I had at Georgetown. They had crappy food and a crappy parking facility and crappy admins. And they saved my life and the life of my baby. And I was so grateful for that that when pregnant with my second I happily waited for those appointments again, and more frequently because I was high risk.

At the end of the day if sh*t really hits the fan, the rest doesn't matter. You really do want that weird antisocial guy that seems to know exactly what's going on with you.

To be fair I also think that overall patient care is important and the two should not be mutually exclusive. In my third pregnancy I got that. I was in a smaller city at a prestigious hospital and never waited more than 10 minutes and had excellent care.

And so if I was choosing I would rank them 1) great environment and great doctors, 2) crappy environment and great doctors, 3) great environment with blah doctors, 4) crappy environment with blah doctors, 5) great environment with people who aren't doctors.

I know I personally am biased here because my pregnancy was basically like, worst case scenario, but I agree with the PP that people really do put an oversized amount of importance on things that do not really matter in the end. And for the record, I don't think that means black women should accept not being listened to or that there aren't problems with OB GYN care in this country. But the midwifery model [b](outside of those groups associated with hospital practices)[/b] is just insane to me. Midwives in the united states are not trained and monitored in the formal way they are in other countries and until that happens I just do not understand anyone that doesn't have an OB as backup. My pregnancy was so dangerous that there was a real possibility that both myself AND my daughter would have died. I'm so happy my jerky doctor saved our lives, even if I do wish he had been a little more gentle.

[/quote]

I'm a PP from the first page who used midwives (and I'm also the one who commented about how I wished there were more apples-to-apples research on choosing an OB vs. a midwife in a hospital setting). I'm so sorry you had such a scary pregnancy, and I'm so glad you got the care you needed and that you and your daughter are okay. I do want to address the part of your comment that I bolded above - that is not just a throw away, rare situation. The "midwife group associated with a hospital practice" model is very, very common - just in DC proper, you've the the GW Midwives and the Midwives of Medstar (WHC). And in those cases, you're generally talking about Certified Nurse Midwives (CNM) which ARE trained and monitored in a formal way.

In fact, looking at this sheet http://www.midwife.org/acnm/files/ccLibraryFiles/Filename/000000005950/CNM-CM-AttendedBirths-2014-031416FINAL.pdf, they are claiming that for CNMs and CMs, in 2014, 94% of their births were in hospitals. And according to this sheet https://www.midwife.org/acnm/files/cclibraryfiles/filename/000000007531/essentialfactsaboutmidwives-updated.pdf, the majority of midwives in the US are CNMs.

While I'm for freedom of choice in this area, I personally would never use a midwife that was not a CNM, and I would never give birth outside a hospital. But based on the stats above, most people who are using midwives are not doing that - they are doing exactly what you're addressing in your parenthetical. That is the standard, not the exception. [/quote]

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