How to switch OBs late in a pregnancy...

douladot · 05-23-2007, 04:38 PM

I have been asked to give a referral for someone who is late in her pregnancy (due the end of June) and she is not happy with her OB (not sure why since she isn't my client) and she is getting the excuse from other OB offices that she is too far along in pregnancy to switch. What do you do in a situation like this? I am not super familiar with all of the OBs in my area enough to know who would be willing to take a client in late pregnancy. Any suggestions?

RosyDoula · 05-23-2007, 04:55 PM

*lurk lurk*

UtahDoula · 05-23-2007, 05:08 PM

Well, she can always call around more - and she doesn't necessarily have to say she is switching - she can say she's 38 weeks (or whatever she is) and needs a doctor. For all they know, she could be new in town.
I always advise women to have a new doc lined up before firing the old.

ama2j · 05-23-2007, 05:10 PM

If I remember correctly, as doulas we don't give referrals. We can say things like "when I worked with dr. so-and-so at a client's birth she was very pleased" or something similar. And if we don't know about the local drs. or midwives we just say so. Unfortunately, she is the one who is going to have to do the calling and investigating to find another provider it sounds like. One call she might make is to the local county Health Center to ask for a provider who meets her criteria. It is late in the pregnancy, but it is never too late. I'm wishing her success in her search and Birth Blessings.

Hugs,
Sara

Wendy79 · 05-23-2007, 05:12 PM

I think not saying she's switching could be hard--she'd probably be put in a position of having to lie and say she hasn't gotten any care up to then, which then puts her in the high-risk / "highly suspect" category. Best to find a doctor who will take her on knowing the situation (not saying you don't agree--just pointing out a drawback).

UtahDoula · 05-23-2007, 05:20 PM

Wendy, I am just saying that she shouldn't START saying "I'm switching". When she gets the receptionist, just say "I need a doctor" because sometimes they say no before they even listen to the situation. And the receptionist doesn't need to know all the background, and shouldn't be the one making the decision at all.

helpinghands · 05-23-2007, 07:37 PM

Quote:

Originally Posted by UtahDoula

Wendy, I am just saying that she shouldn't START saying "I'm switching". When she gets the receptionist, just say "I need a doctor" because sometimes they say no before they even listen to the situation. And the receptionist doesn't need to know all the background, and shouldn't be the one making the decision at all.

I totally agree! Although..I have to comment on the posters saying to call saying she needs a dr., etc.. they can actually refuse her based on dates.. I have had several clients lately unable to find pregnancy care at dates not even that late in the game. My clients were advised to just arrive at the local hospital in labor.

I think it depends on the area.

SabbathD · 05-23-2007, 08:43 PM

I switched at 35 weeks. I just called a local midwifes office and asked to make an appointment. When they asked me how far along I was I told them 35 weeks. They asked me if I had had care up to that point and I said yup! Would you like me to transfer the records? I just approached it as matter of factly as possible. I was seeing an OB and was THOROUGHLY unimpressed with his bedside manner, and he told me that I would require an episitomy because all of his patients got one, and ect ect not the direction I wanted to go in. So, in the last 5 weeks I went from OB in hospital birth, to a midwife birth center natural birth. Good times!

Tell us how it goes!

heidi · 05-23-2007, 10:02 PM

I switched care providers at 38 weeks after a very very upsetting prenatal with my OB.
Basically I called a local midwife group recommended to me, and begged, yes begged them to take me. The nurse transferred me to one of the midwives, and finally someone took pity on me and then squeezed me in for a prenatal asap. Of course I had to transfer my records as well. A huge pain in the neck, but SO WORTH IT! The midwife who delivered my son was just amazing, I was so thankful!

DoulaCBE · 05-23-2007, 10:05 PM

Quote:

Originally Posted by ama2j

If I remember correctly, as doulas we don't give referrals. We can say things like "when I worked with dr. so-and-so at a client's birth she was very pleased" or something similar.
Hugs,
Sara

We don't? Do you mind sharing your source for that belief?

b'earth angel · 05-23-2007, 10:29 PM

Why is it that the feed us this line about woman's rights and choice while all along holding us over a barrel when it comes to a woman't right to choose her doctor and fire him/her if necessary?
[Yes, I'm a bit cynical over this kind of bully behavior.]]

mammamayI · 05-23-2007, 10:46 PM

Find out who supports/backs up the homebirth midwives in the area. Chances are, they'll be the ones to take her. The docs in our area who back up the homebirth midwives are also the ones who, *gasp* believe in a woman's right to choose her care provider.

I was taught by ALACE that it's our job to give our clients resources and let them make decisions on their own. There is nothing wrong, in my way of thinking(following this line of thought), in providing her with the name or names of providers, and letting her do the legwork to make sure that THEY'RE even a good fit for her...a better fit than the doc she has now!

ama2j · 05-23-2007, 11:20 PM

Quote:

Originally Posted by DoulaCBE

We don't? Do you mind sharing your source for that belief?

Well, it's obvious I had just returned from a long birth when I read and typed a response. I apologize.

Of course we can give referrals, always encouraging women to find the provider that is best for them. In my mind I was thinking of something entirely different: talking badly about a provider. Nobody at all said that. My brain just wasn't working.

By the way, the mom I was supporting had a 36 hour labor flat on her back: an induction. Then they shut off the pit for the night. At 2 in the morning they told her they had "lost" the baby's heartbeat and were going to section her "within the hour". Doc also suggested that mom get her tubes tied because "you are, after all 40 now".. grrrrr. Baby was born perfectly healthy. But she signed the permission for tubal while I was getting my scrubs on. AND this doc has a 50%....yes 50% section rate.

Now you can see why my brain wasn't working. :-)

Hugs,
Sara

DoulaCBE · 05-23-2007, 11:37 PM

Quote:

Originally Posted by ama2j

Well, it's obvious I had just returned from a long birth when I read and typed a response. I apologize.

Of course we can give referrals, always encouraging women to fine the provider that is best for them. In my mind I was thinking of something entirely different: talking badly about a provider. Nobody at all said that. My brain just wasn't working.

I've never talked badly about a provider, but I have told cilents "Based on what you've told me you want for your birth my expreiences with your provider don't lead me to believe that you're likely to get what you want without a major battle, if at all." Loosely paraphrased.

Or if I have a client who is expressing displeasure with her provider we explore that and often I tell her to follow her instinct and give her a list of names and numbers of providers who are more on her philosophical plane.

Sorry to hear about your client, how frustrating!

douladot · 05-24-2007, 06:22 AM

Thanks ladies! I will share this info with my other area doula that was looking for info.