In which I visit the obstetrician

I did not see the doctor wearing spandex this time.

I am not one who fears or hates the medical establishment. Before getting pregnant, I was finishing prerequisites so I could start the accelerated nursing program at Pitt this fall. I embrace medicine and all the miracles it has wrought. As a doula, I have supported women who very much required medical intervention to birth their babies. I have seen moms and babies saved with my own eyes and I value medical technology.

That said, for this birth I am choosing to be at home and have hired a very qualified and experienced midwife to assist me and my baby. My previous pregnancies and births were low risk and fast, once active labor began, with my younger daughter being born just 5 hours after my very first birthing sensation. So needless to say, I feel much safer and more comfortable not having to race down the highway just to push my baby out somewhere else with a professional attendant.

In order to have the safest homebirth plan, it was very important to my husband and me to have a relationship with a hospital-based care provider, too, in case we should need extra help at the hospital. A few weeks ago I posted on Facebook, asking for referrals to obstetricians that might be willing to do backup care for a planned homebirth. After calling many offices, I learned two things:

1. Most practices are not open to providing prenatal care for someone planning a homebirth. They perceive it as "approval" of the plan and are afraid of liability.
2. Women on medical assistance (which I currently have because I do not have private insurance) do not have a choice in obstetricians. They are only seen by residents in hospital-based clinics.

So, there went my plan to "pre-qualify" someone as supportive. I had to forget everything I teach in my Hypnobabies class about finding supportive caregivers because I am on Medical Assistance. I have no choice. Great.

I spent a few weeks dreading this appointment. As the day approached, I got sick with a cold, then bronchitis and I considered cancelling the appointment. I also considered what I might tell them: that I was from out of town, but spending time here in my last trimester and needed care, or some other falsehood. But I knew in my heart, that I really needed to see someone for support that my midwife is unable to provide should I need it: birth emergencies, suturing after birth or prescriptions for postpartum depression medications. I also knew I would not feel right not telling the truth because I hate lying and because I'm an adult and I have a right to birth where I feel safest! So, I kept the appointment and did not really have a plan other than to tell the truth.

This morning I saw the resident at West Penn Hospital's clinic. I had expected a crowded, rushed, impersonal office. What I got was an experience more like my visits with my midwife than any obstetrician I have ever seen. When I checked in, I asked to use the bathroom (of course!) and was immediately introduced to a medical assistant who took my specimen and spent 15 minutes going over my medical history. Not more than 10 minutes after she left, the resident came in and spent another 30 minutes with me, taking my history, discussing my pregnancies, miscarriages and birth with me in detail. When we got to my current pregnancy and prenatal care, he asked if I had been seeing anyone before then. I simply explained about my plan to homebirth and that I was in his clinic to seek backup care in case of an emergency or something else my midwife couldn't handle.

Without missing a beat he told me he thought it was great, that I certainly knew what I was doing and sounded very educated and that they would be happy to play this part. They would have to put on my chart that I was planning to birth at the hospital, but I was free to make my own plan. He noted my concerns about postpartum depression, told me that they would also be happy to see me for any issues I had related to that and offered me whatever tests and procedures they typically prescribe at this stage of pregnancy.

No pressure, no shaming, no warning, nothing. Simply respect as a parent who was making the best decision for herself and her baby. As a Hypnobabies instructor, I teach my students that one of the "big secrets" of birth is that doctors and nurses are people, just like me. And that the parents are the ones who bear the ultimate responsibility for the decisions for their child, so they have the final say. And this should not lead to confrontation and conflict, rather mutual respect between the caregivers and the parents. I have seen this go right for families and I have witnessed situations where parents were not given this respect. What I realized today (for the first time) is that this respect wasn't mine to be given, rather it was mine to claim. When I talked to this doctor as a peer, rather than as a patient; when I shared my plans honestly, without shame, instead of lying there was no other option for him to treat me with anything but respect.

If we go into interactions feeling inferior and expecting conflict, very often that is what we find. Not because the other person is a bad person, but because we bring negativity with us before any words are said. But when we go into it expecting to be treated equally and we choose to claim the respect we deserve, there is nothing for us to receive but that respect. Maybe I'm just brainwashed by my four years of teaching the best consumer-based childbirth education that exists... but I don't think so. I think I just grew up a little more!