VBAC CP Question

[MamaMichelle]

If you were contacted by someone hoping to have a VBAC and knew the care provider and/or practice and hospital she's hired are not supportive and were the bait and switch kind, would you tell her? Why or why not?

[pambell]

I would definitely tell her. I would say something like "In my experience, you are not likely to get the type of birth experience you are telling me you want with xyz practice. Here are some questions you might ask so that you can get a better idea of whether what you want is in alignment with what they offer." And then have her ask about whatever stuff they do to bait and switch.

[Apple Blossom]

I would suggest she inquire as to her care provider's/hospital's VBAC success rates/intervention rates. That way she getting the info (hopefully) but she's the one making the discovery herself.

[happydoula]

Quote:

Originally Posted by Doula Sara I would suggest she inquire as to her care provider's/hospital's VBAC success rates/intervention rates. That way she getting the info (hopefully) but she's the one making the discovery herself.

I would try this approach first. If I had firsthand knowledge about them, I would make sure she found out somehow though - I consider that part of my service as a doula!

ETA: I would only say something if I'd been hired to be her doula already!

[JessicaE]

I wouldn't say a word until after she had hired me.

Then I'd try to open up a conversation about her practice, asking about how they've been supportive so far, whether she knows their VBAC success rates, opening up questions she might ask to figure out if this practice is supportive of the kind of birth she wants to have. This usually leads to mamas asking me about my experiences with their practice, which would give me an appropriate opening to share what I had seen/witnessed. I give people the opportunity to ask, and I'm straightforward about my experiences -- I feel like I owe it to them.

[DoulaCindy]

I voted undecided because it would depend. I would probably hint that she would have some challenges and suggest that she really engage her provider in a conversation about VBACs. I'd also try to gauge what her relationship was like with her provider. Some women are very funny about their doctors if they really like them. Those are less likely to listen to you and will get very defensive. So for me it would depend. I think if they hired me, I would probably eventually have that conversation with them.

[sunshine]

Quote:

Originally Posted by JessicaE I wouldn't say a word until after she had hired me. Then I'd try to open up a conversation about her practice, asking about how they've been supportive so far, whether she knows their VBAC success rates, opening up questions she might ask to figure out if this practice is supportive of the kind of birth she wants to have. This usually leads to mamas asking me about my experiences with their practice, which would give me an appropriate opening to share what I had seen/witnessed. I give people the opportunity to ask, and I'm straightforward about my experiences -- I feel like I owe it to them.

that, exactly. if she hired me, i'd make sure she knew.

[AMotz]

I would definitely tell her. Coming from the birthing atmosphere in my community, it's really important that a mom know what she's getting herself into. There are maybe 2 OB's in the area that are truly ok with a VBAC, and they deserve to know who is and who isn't. If they choose to stay with their OB, that's perfectly fine and I will help them by arming them with as much information and ideas as possible, including what she might need to do to get what she wants. She is then informed, educated and prepared for her birth and she is left to make all the decisions.

I will in NO way insert myself into that decision making, but I WILL educate and inform.

[DoulaWendy]

I said yes but I would also gauge the way I would word it by the mom's willingness to hear it. Some people just don't want to hear anything that would bash their ideal birth or make it seem like you weren't supportive. Others prefer a direct approach. It all would depend on the mom's openess to the information.

[Doula_Steph]

her care providers VBAC, CS, Epi stats I would tell her so. Actually, I've been known to give these stats to those who need them, VBAC moms or not.

[DoulaCBE]

I voted yes, but I don't need women to pay me for that info. However, since I run a doula practice, I often get calls seeking out supportive care providers. So there's a lot of "call Angie . . ." in our community already.

[MamaMichelle]

I spoke with the woman yesterday and I did tell her. I gave her information for other care providers I know she will have a better chance with. I'm unsure whether or not I'll hear from her again and that's okay. I just hope she gets her VBAC. Thanks everyone! I know I made the right decision.

[JessicaE]

Quote:

Originally Posted by DoulaCBE I voted yes, but I don't need women to pay me for that info. However, since I run a doula practice, I often get calls seeking out supportive care providers. So there's a lot of "call Angie . . ." in our community already.

It's not that I need women to pay me, it's that I'm not going to go out on a limb and "warn" someone away from their unsupportive care provider, about whom they've expressed no concern, unless we've formalized our relationship. We don't have any trust basis built up yet, as strangers, so perhaps they are perfectly happy where they are, they don't hire me, and then it gets back to that doctor somehow in a twisted way. I feel that if I'm going to be the one to bring it up out of the blue, that in-depth conversation is best held in the trusted confines of a doula-client relationship.

But I completely agree in that if someone calls me out of the blue and asks for a provider recommendation, I give those freely, client or not.

[WestsideDoula]

I voted absolutely, but only if there had been a level of trust established. THe poll doesn't leave a lot of room for real life.

For example, I often send potential clients to www.ratemds.com and ask them to find their doctor (especially when I know that doctor's reputation). I also ask if they are open to switching to a provider that is aggressively PRO VBAC rather than willing to let her "try." If they say, "I love my OB, he's great." and I know that their bedside manner doesn't translate into a VBAC friendly environment, I might say, "What has he done to earn your trust? What is his VBAC rate? Can you talk to a successful VBAC patient of his? How did you find him? or Have you spoken to his other patients?"

I think that anything short of full support of an OB is heard strongly by expectant mothers.

I am leery of giving negative opinions about specific doctors and prefer to say, "i've heard mixed opinions about Dr. X, how did you come to choose him/her?" After all, a doctor might be a good match for one woman but not for another. And, I don't want to be passing along hearsay. My own experiences may differ from other doulas.

Also, when it comes down to it, there are some docs that I really don't want to work with. When they come up, I will say "For Dr. X, I will refer you to another doula." When they ask why, I will give my own personal experience as to why.

I pass clients over to other doulas for a host of reasons: Live too far away, at a hospital that I don't like with a doctor that I don't love, want PP Doula to be same as Birth Doula, if I'm full for that EDD, if I will be out of town, and of course, if there is an OB that I ahve on my won't work with list. ( I know I'm going to get an earful for this post...)

[Garden Doula]

I put tell her, but I would not directly say that "Dr. X pulls the bait and switch". I would give her ICAN's information and CC's "How to choose a careprovider/birth location" and the names of consenting VBAC/CBAC moms who birthed with the care provider.

While I do not feel it is my place to say whether a CP is supportive or "good", it is my place to help the mom find the information she needs to make the right choice.