I have a great story. It's about a couple who educated themselves and broke free of their OB at over 39 weeks. It was the difference between a vaginal birth and a c-section. She was planning to give birth at the hospital where we did our rally last year - the worst in the area, as far as I'm concerned. I wish I could tell you our rally made all these great changes in our community, but all it did was cause more animosity and bitterness - on both sides.
I was so proud of this woman, not only for hiring a new care provider so late in her pregnancy, but also for writing this letter afterwards:
*This letter is shared with permission by the author.
As you may already be aware, I discontinued my prenatal care with your practice at 39 weeks on September 16, 2010. I am writing this letter to give brief explanation as to why, in the hopes that a better understanding of the situation will positively affect the care of current and future patients.
Until September 16th, I had been a patient with Dr. Udell for 10 years, I trusted her and respected her opinion. So when I found out that I was pregnant on January 10, 2010, it only made sense for me to continue my care with her. However, I was deeply interested in keeping my prenatal care as natural as possible. I am of the belief that my body was designed to create, carry, and deliver a baby with limited outsider involvement. This is not to say that I am completely against medical advancements and screenings, but I do not subscribe to inductions and cesarean sections when one or both lives are not potentially in jeopardy. I do not agree that there is a sound medical reason for the cesarean rate in America being well over 30%. Being that I had done significant research on pregnancy and birth, I was well aware of possible complications that could happen and the implications carried with each of them. This being said, I made my wishes very clear to Dr. Udell early on in my pregnancy. Dr. Udell was agreeable and said she would do whatever I wanted as long as I kept in mind she was going to do whatever it took to keep both mother and baby safe.
When my husband and I took the tour of the hospital on June 13, 2010, we were unsettled by the policies surrounding labor and delivery at Medical Center of Arlington. The fact that the hospital did not seem to have any “pro-baby” policies, but instead had very rigid policies that were very counter intuitive made us very nervous about our impending delivery. The requirements for continuous fetal monitoring, and baby being taken from the room for 3 – 4 hours following birth, are the two that stand out in my mind at this time. However, the most unsettling issue was the statement, “Most of our births are scheduled inductions or cesareans.” The fact that Monica, our nurse tour guide, gave Dr. Udell a glowing review, was about the only saving grace for the entire tour.
I felt secure in the fact that Dr. Udell was going to do exactly what she said. It wasn’t until my 30 week ultrasound on July 15, 2010, when my suspicions were confirmed that my son was going to be large, that my confidence began to waver. I explained to Dr. Udell that both my sister and I had above average birth weights and my husband at the higher end of the average as well. She seemed to accept this response at the time, however getting a baby that was too big seemed to remain a recurring theme for the rest of my visits. It was not until my 37 week appointment, August 30, 2010, that I started to truly doubt Dr. Udell’s word. I remember the comment that planted the seeds of doubt specifically, “I find that it’s best when somebody goes into labor naturally at 38 weeks, otherwise you run the risk of baby that can be too big.” At the time, I wrote it off and prepared for my 38 week exam.
At my 38 week exam, I expected a vaginal exam that was similar to the two I had already had on April 12, 2010 and August 24, 2010. Instead, what I got was a very painful experience that resulted in spotting. I fully understand that vaginal exams are painful and can often result in spotting, the statement that Dr. Udell made, “You’re thinning, but not dilated. I tried to push through, but couldn’t,” was what worried me the most. In hindsight, I should have asked her what she meant immediately. However, I was too shaken up by the whole experience to think about it at the time. When I called and spoke to Amy, her initial response was something along the lines of, “Dr. Udell was just trying to get things started.” Then when I mentioned that I did not want anything like that it became the standard of care. Several times during the phone call I felt as though I was being made to feel like I wouldn’t know the difference because I was a first time mother. This, combined with my 39 week visit, where I was called out in the waiting room by Dr. Udell, told that she was feeling for the baby’s head, reassured that she woulddo whatever I wanted, then told me whether I liked it or not to expect the next visit to be rough. After that visit, I was very confused. I got the answer that I ultimately wanted – I will do whatever you want- but it was followed by another comment that conflicted with the last.
In the end, the combination of the poor policies at Medical Center of Arlington and thecontradicting statements I got late in my prenatal care with Dr. Udell led me to believe thatthe likelihood that my birth would turn into a Cesarean section very quickly and easily. After my 39 week visit on September 13, 2010, an opportunity presented itself to switch to the Certified Nurse Midwives at Harris Methodist Fort Worth. After several days of conversations with my husband and the midwives office, I made the decision that their philosophy of limited medical interventions, limited vaginal exams, intermittent monitoring, clear fluids, and the option of hydrotherapy during labor were exactly what I was wanting. That combined with the fact that Harris Methodist Hospital was a “pro-baby” hospital, and had a wide array of policies that supported the birth that I wanted, including the fact that all testing immediately following birth are performed in room with the parents present.
I am happy to report, that on September 27, 2010 at 0130, I spontaneously went into labor, during which I was allowed to and instructed to freely walk the halls after my water broke, I was able to have clear liquids, and use the tub for pain management. After being allowed to labor down for an hour and pushing for almost 3.5 hours, at 1552 on September 28, 2010 I vaginally delivered a 10lb 3.9oz baby boy. While he was posterior until the last hour of second stage labor; we did not experience shoulder dystocia despite his above average birth weight.
While the prenatal care I received at your office was great, medically, I believe that it was the lack of confidence in the natural process and in my intuition in my body’s abilities that finally ended my care with your practice. I do continue to believe that if I had stayed with your practice this delivery would have definitely turned into a c-section and I would be fighting for my VBAC on the next one.
Thank you , Tiffany C.
If you were dissatisfied - or satisfied! - with your care provider, I encourage you also to write a note explaining why. Take it a step further and take a few minutes to fill out The Birth Survey. In my humble opinion, this is how change takes place.