Anonymous wrote:

Anonymous wrote:Saw one of the obs in Bethesda. She knows the name of my children and treats me like I am a real human. She delivered by first baby with forceps after the midwife had me push for 5 hours. I followed up with her and never looked back. During COVID-19, I have emailed her and she let me know what days she is in the office. So continuity has not been an issue.

Thanks for the info! Does the Bethesda office run more or less on time? Or do you usually spend a lot if time in the waiting room?

I usually don’t wait much if at all, and if I have it hasn’t been more than a few minutes and the waiting room is usually very empty, I’ve never seen more than 2 other people there at any given time. The one time I had to wait they were very apologetic and seemed to be very conscious of the fact that I was waiting, checked in on me to tell me I’d be back soon etc.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Saw one of the obs in Bethesda. She knows the name of my children and treats me like I am a real human. She delivered by first baby with forceps after the midwife had me push for 5 hours. I followed up with her and never looked back. During COVID-19, I have emailed her and she let me know what days she is in the office. So continuity has not been an issue.

It pisses me off to read how often the GW midwives let women push for hours and hours on end. I’m a former patient of theirs who wrecked my pelvic floor under their care because they had me push for hours with no discussion of the potential consequences. I guess apparently anal and urinary incontinence, fistula, severe tears, and prolapse don’t matter to them as much as avoiding a dreaded C section. As a potential patient you should be aware that they will let you push for many more hours than any responsible provider would ever allow.

Except I pushed for 6.5 hours with my second and have zero problems. No pelvic floor damage, I didn't even require a single stitch for tearing. Sometimes babies are malpositioned but that doesn't mean you can't deliver vaginally without consequences. I understand you want to blame someone, but perpetuating fear based maternal care isn't the way to go.

Prolonged pushing is associated with a number of complications. You were the exception, not the norm.
That’s making delivery decisions based on facts, not fear.

Not really a fact. There's a slightly greater chance of pelvic floor damage, that's the only additional risk with a drug-free, intervention-free delivery.
Look it up on NCIB. Compared to a litany of additional risk factors with every drug and intervention pushed upon birthing women. That's why our maternal care here sucks, people like you..

And what is considered "prolonged", anyway? Longer than you expected? So much fear on this thread.

ACOG has definitions for prolonged labor for primips and multigravids. They aren’t my definitions. And no, there are plenty of risks of prolonged labor. Injuries to the mother as well as the baby. But keep believing your NCB nonsense that somehow just avoiding interventions when labor goes poorly somehow will stilll ensure a good outcome. The rest of us will gladly take advance of the luxury of 21st century’s modern medicine and be grateful for “interventions” that now allow us and our children to survive when history would have resigned us to a different

“As a result, prolonged labor or prolonged pushing is sometimes encouraged in order to avoid a cesarean section. However, while safe for the baby, it appears that these concepts may not be in the best long-term interest of the mother. We know now that prolonged and difficult labors may lead to permanent nerve damage and weakening of the pelvic muscles and the supporting structures to the uterus, bladder and rectum. This can eventually lead to dropping of the pelvic organs (known as pelvic organ prolapse) or https://www.uclahealth.org/womens-pelvic-health/childbirth-

“Observational research has shown that for mothers, longer pushing times are related to higher rates of postpartum hemorrhage, infection, and 3rd and 4th degree tears. Severe tears are more common with longer pushing phases even after adjusting for instrumental birth and episiotomy. Unfortunately, no study has measured what impact “hands-on” intervention to speed up the birth (the care provider using their hands to facilitate a prolonged second stage through perineal massage, etc.) might have on tears.

Most people with prolonged pushing times will end up with a vaginal birth. However, longer pushing times are still associated with a higher chance of Cesarean and vacuum or forceps assisted birth.

For babies, longer pushing times have been associated with higher rates of low Apgar scores, NICU admissions, birth trauma and other newborn health problems. In one study, researchers found the overall combined rate of newborn complications is around 2.5% for first-time mothers who push 3 or more hours.”

https://evidencebasedbirth.com/prolonged-second-stage-of-labor/

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Saw one of the obs in Bethesda. She knows the name of my children and treats me like I am a real human. She delivered by first baby with forceps after the midwife had me push for 5 hours. I followed up with her and never looked back. During COVID-19, I have emailed her and she let me know what days she is in the office. So continuity has not been an issue.

Thanks for the info! Does the Bethesda office run more or less on time? Or do you usually spend a lot if time in the waiting room?

OP why exactly are you sticking to the midwives? If your goal is avoiding unnecessary interventions (hint: it’s often not clear which interventions are unnecessary or not in the thick of things and many women prefer to be more interventionist then less when considering their child’s health), you will still get that with the OBs. The OBs are really the best of birth worlds. The midwifery fellows are basically RNs who did a master’s degree. It’s much less training than even a first year resident has. If they aren’t meeting your expectations why would switching locations make a difference?

Hint: unclear to you. An uninformed patient. Some of us have educated ourselves and know better.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:Saw one of the obs in Bethesda. She knows the name of my children and treats me like I am a real human. She delivered by first baby with forceps after the midwife had me push for 5 hours. I followed up with her and never looked back. During COVID-19, I have emailed her and she let me know what days she is in the office. So continuity has not been an issue.

It pisses me off to read how often the GW midwives let women push for hours and hours on end. I’m a former patient of theirs who wrecked my pelvic floor under their care because they had me push for hours with no discussion of the potential consequences. I guess apparently anal and urinary incontinence, fistula, severe tears, and prolapse don’t matter to them as much as avoiding a dreaded C section. As a potential patient you should be aware that they will let you push for many more hours than any responsible provider would ever allow.

Except I pushed for 6.5 hours with my second and have zero problems. No pelvic floor damage, I didn't even require a single stitch for tearing. Sometimes babies are malpositioned but that doesn't mean you can't deliver vaginally without consequences. I understand you want to blame someone, but perpetuating fear based maternal care isn't the way to go.

Prolonged pushing is associated with a number of complications. You were the exception, not the norm.
That’s making delivery decisions based on facts, not fear.

Not really a fact. There's a slightly greater chance of pelvic floor damage, that's the only additional risk with a drug-free, intervention-free delivery.
Look it up on NCIB. Compared to a litany of additional risk factors with every drug and intervention pushed upon birthing women. That's why our maternal care here sucks, people like you..

And what is considered "prolonged", anyway? Longer than you expected? So much fear on this thread.

Anonymous wrote:

Anonymous wrote:Saw one of the obs in Bethesda. She knows the name of my children and treats me like I am a real human. She delivered by first baby with forceps after the midwife had me push for 5 hours. I followed up with her and never looked back. During COVID-19, I have emailed her and she let me know what days she is in the office. So continuity has not been an issue.

Thanks for the info! Does the Bethesda office run more or less on time? Or do you usually spend a lot if time in the waiting room?

OP why exactly are you sticking to the midwives? If your goal is avoiding unnecessary interventions (hint: it’s often not clear which interventions are unnecessary or not in the thick of things and many women prefer to be more interventionist then less when considering their child’s health), you will still get that with the OBs. The OBs are really the best of birth worlds. The midwifery fellows are basically RNs who did a master’s degree. It’s much less training than even a first year resident has. If they aren’t meeting your expectations why would switching locations make a difference?

Anonymous wrote:Saw one of the obs in Bethesda. She knows the name of my children and treats me like I am a real human. She delivered by first baby with forceps after the midwife had me push for 5 hours. I followed up with her and never looked back. During COVID-19, I have emailed her and she let me know what days she is in the office. So continuity has not been an issue.

Thanks for the info! Does the Bethesda office run more or less on time? Or do you usually spend a lot if time in the waiting room?

Anonymous wrote:

Anonymous wrote:The Obs are superior to the midwives. Give them a shot, I promise you will want to switch.

I haven’t seen the midwives but have been very happy with the Bethesda OBs. They will let you schedule with a doctor you prefer if you want you just have to ask for their schedules. I have been with D. Sheth and Gallagher and have felt very comfortable. They have been very prompt at appointments, spend a lot of time with me, always make sure all of my questions are answered, and I feel very supported.

Thanks! Are the appointments usually on time? For my last two ultrasounds I’ve had to wait around 20 minutes, which is definitely not fun under the current circumstances.

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:

Anonymous wrote:The Obs are superior to the midwives. Give them a shot, I promise you will want to switch.

With the new covid protocols you end up seeing a different OB in every visit, so not sure how much I'll gain then. But yeah, so far they haven't lived up to our expectations after the "meet the midwives" event and everything we've read so far regarding the midwifery model of care.

Can you be more specific about how they aren't meeting your expectations?

Visits tend to be short, most of the times the midwife we see hasn’t even read our chart before we start, some of the questions we have aren’t answered and we have to ask again in our next visit, we tend to be prepared and our questions might not be the most common ones but still some of them answer random things instead of saying “I don’t know, I’ll look it up and get back to you”. We need some extra monitoring and every time we have to be on top of our situation and report precisely the results from ultrasounds, otherwise they don’t seem like they would know. This pattern has been more common with the midwives that are fellows so far, and we understand they are continuing their training and GW is a teaching hospital, but that’s no excuse for not knowing your clients.

Maybe this is usual or maybe we were expecting more care and continuity from their part (as is advertised as the key in the midwifery model of care), maybe this is just a consequence of the pandemic and how it has affected the way they work.

I did GW midwives for my first. Crazy delivery but was vaginal with no meds. Would have definitely been a c without them and there was an in in the room fighting with them to do a c but they advocated for me and my baby was born a ok and I was hiking 2 days later. Baby 2 was with midwifery care associates because I felt the same you are feeling. That GW didn't give me the compassionate care I was looking for. These ladies were much worse and had an incompetent front office to boot. Had baby two vaginally with no major complications and again with no drugs.

After these experiences I was jaded with midwives and did baby three with OBs. Oh my God. It was so much worse. This was an all female practice that was supposed to support a women's birth plan. They havew no attention of care and didn't know me from Adam. They started aggressively pushing c in second trimester and we had arguments constantly about it. It was so stressful and ultimately I ended up having a c. I 100% attribute that to being with the obs. It was a terrible recovery and the reason I won't be having a fourth.

All that to say, I don't care what a woman wants to do. Everyone's birth plan should be what is best for them and their situation. But if you are with GW, my guess is that you want less intervention rather than more.

They may not be perfect but they are one of your best shots in the area of having the delivery you want. I didn't realize how good they were until I saw how bad others are. The bar is so low and in my experience maternal care is a joke in the DMV.

OP here, thanks for sharing, this is useful. We do want to avoid interventions that might not be necessary. I’ll probably schedule my next appointment at the Bethesda office to give it a try while still sticking with the midwives.

Anonymous wrote:The Obs are superior to the midwives. Give them a shot, I promise you will want to switch.

I haven’t seen the midwives but have been very happy with the Bethesda OBs. They will let you schedule with a doctor you prefer if you want you just have to ask for their schedules. I have been with D. Sheth and Gallagher and have felt very comfortable. They have been very prompt at appointments, spend a lot of time with me, always make sure all of my questions are answered, and I feel very supported.