Midwife or OB?
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Category: Pregnant
Forum Name: Pregnancy
Forum Description: Pregnant! Wanting to chat to other mums-to-be (or dads-to-be)? Share your thoughts, experiences, and ideas... This is that place!
URL: https://www.ohbaby.co.nz/forum/forum_posts.asp?TID=32317
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Topic: Midwife or OB?
Posted By: Bobsta
Subject: Midwife or OB?
Date Posted: 17 March 2010 at 11:49am
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Hi Everyone!
I'm really excited as after a year of TTC we are finally pregnant for the first time! 
I need to get myself sorted in terms of choosing a midwife or OB but I just don't know what to do. I'm really confused and am hoping for some advice. My GP has recommended the Auckland Obstetrics for me. It's fairly pricey, $4400 which is everything up to the 6 week post natal care. I don't mind spending that much on an OB if it's worth it, but it seems most people go with a midwife which I understand is fully paid for under public health. I need some advice and the pro's and con's for OB's compared with a midwife. I would be grateful to hear comments from people who have used an OB before and what your experience was. Was it worth it? If anyone has used both before I would be grateful to find out which you preferred! I don't yet know what I want as have never been through this before so don't even know what the options are! I really want someone for the pregnancy care that will give me all the facts and support me through my decisions. ------------- Me 34 Him 35 DD almost 2 years old and... Baby #2 on it's way! http://www.babygaga.com/" rel="nofollow"> 
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Replies:
Posted By: kebakat
Date Posted: 17 March 2010 at 12:16pm
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Did you GP give you the reasoning behind recommending an ob instead of a mw?
My inlaws offered to pay for an ob for us this time around but we said no because an ob can't give us any extra than a mw can. |
Posted By: littlestar
Date Posted: 17 March 2010 at 12:57pm
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Ooh - this is one of those topics that people feel strongly about. Brace yourself!!
We went through AOC and I loved the care we got and for us it was worth every penny. But it is a lot of money. 
I have absolutely nothing against MWs and I think if you team up with one thats a good fit you will have perfectly good care for you and your baby. Shop around - meet up with a couple of MWs (get recommendations from friends) and go have a chat with the OBs before you decide whats going to be the best path to choose. Happy to answer any questions if you want to send me a PM. ------------- http://lilypie.com"> 
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Posted By: Bobsta
Date Posted: 17 March 2010 at 12:59pm
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Not really, he just said they are the best to go with and first pregnancies are unchartered territory. He used to be an LMC so I fully trust him and he is a very good GP.
So a midwife can give the same care as an OB? That's mainly what I'm confused about, what are the differences between the two!?! I feel like an complete fool for asking but I just really have no idea! 
ETA - thanks littlestar!!! I have no strong opinions about either so that is good advice. I might make some calls and speak to a few midwifes and Ob's and see how that leaves me feeling. ------------- Me 34 Him 35 DD almost 2 years old and... Baby #2 on it's way! http://www.babygaga.com/" rel="nofollow">
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Posted By: Mattsmum
Date Posted: 17 March 2010 at 1:14pm
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My midwife worked closely with the clinic at the hospital and I saw specialists when required, my delivery got pretty hairy and within minutes she had 5 specialists in the room, I don't see how any amount of money could have got me better care than she provided. ------------- http://lilypie.com">  http://lilypie.com">
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Posted By: Bobsta
Date Posted: 17 March 2010 at 1:28pm
That's a really good point mattsmum. If something was to go wrong the midwife would refer to an OB anyway. Thank you  ------------- Me 34 Him 35 DD almost 2 years old and... Baby #2 on it's way! http://www.babygaga.com/" rel="nofollow">
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Posted By: kebakat
Date Posted: 17 March 2010 at 1:31pm
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The only extra I've heard is that you get more scans and thats about it.
My first MW got the docs/obs in when Daniel got stuck in labour.. my 2nd MW even though I hate her now got the ob involved as soon as a problem was found at my scan. I think so long as you get a MW that comes highly recommended and is someone you can get on with and will go into bat for ya theres no problem with going with a MW. Its easy enough to be referred. |
Posted By: SnuggleBear
Date Posted: 17 March 2010 at 2:43pm
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that sounds very expensive bobsta, Shore Care is only 3200 for full care.
I was tossing up between full OB care and shared care with MW, the thing that swayed me is with full care you get more scans etc but not really one on one care at your labour and delivery....once you get to the hospital you are at the mercy of hospital wives (who may or may not be good) who you've never met before with the OB popping in every now and then. Also most OB practices have 2 or more OBs so on the day you may or may not have your preferred OB Shared care to me best of both worlds, OB care and personalised care from MW JMO  ------------- Ds1 - 20 months old Ds2 - 4 months old |
Posted By: Travelbug
Date Posted: 17 March 2010 at 2:48pm
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Bobsta - I'll second the advice you've been given above. As long as you are comfortable with the person/team that you choose there is no right or wrong.
I've had the same very experienced midwife for all of my pregnancies. She knows what she's doing and being older and experienced means she's not trying to prove anything and will get an OB straight away if required. So definitely get some recommendations from others - meet them and see if you are comfortable and remember you can always change at any time. -------------   
3 Angel Babies (July 04, August 07, September 09) |
Posted By: Bobsta
Date Posted: 17 March 2010 at 4:45pm
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Thanks for all the advice everyone, this is such a great place and I would be lost without you all!
I'm not 100% what I'll do yet but have started making calls so that big first step has been taken ------------- Me 34 Him 35 DD almost 2 years old and... Baby #2 on it's way! http://www.babygaga.com/" rel="nofollow">
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Posted By: Rachel1982
Date Posted: 17 March 2010 at 4:49pm
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I've gone with full OB care and not regretted it for a moment. This is our first baby and I wanted to be totally sure I was in capable hands.
My mum is a neonatal nurse and rather a large number of babies have ended up in the care of NICU either because a midwife didn't take appropriate action or didn't take the appropriate action quickly enough. After reading a lot of negative feedback on the forums about midwives who were hard to contact, disorganised and didn't refer people when needed for extra tests/care I was pretty sure I wanted an OB. It has turned out to be great - we had a couple of issues with viability early on and also a scare with a potential amniotic fluid leak a couple of weeks ago, but everything was handled quickly, competently and with a dose of honesty and humour. If we decide to have another baby I will definitely go back to the same OB. ------------- http://lilypie.com">  
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Posted By: Harley
Date Posted: 17 March 2010 at 6:21pm
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Congrats Bobsta! I remember you from the charting thread - so pleased for your BFP I went with an ob - Birthright in Remuera. We went with them because we were a little worried about the PCOS/high cholesterol history. I'm sure a midwife would have been just as great, and I will probably go with that option 2nd time around, but first time around it's been really nice knowing there are a team of dr's on call 24hrs a day if I have any niggly questions or concerns. This is the first of MANY decisions you will get to make! Next it will be hospital/birthcare, drugs/no drugs, cloth nappies/disposables, bottle/breastfeeding, cot/basinett...and so on and so on. 5 months on - even deciding what to have for dinner is a mission ------------- http://lilypie.com">  http://lilypie.com">
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But it's all so exciting!! All the best for the next 8 months Bobsta!!Posted By: Bobsta
Date Posted: 17 March 2010 at 7:48pm
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LOL Harley! And thank you, I am super stoked I finally got to see that second line
Hopefully I get better at the decision making 
I'm almost there with making the decision! I have chatted with a really good midwife one of my fellow november mums suggested. I'm going to arrange a meeting with her and if it's all good will go with her. If I need a OB she was very open about referring me on to a few of the OB's she works closely with. FX all goes well tho and I don't need it. ------------- Me 34 Him 35 DD almost 2 years old and... Baby #2 on it's way! http://www.babygaga.com/" rel="nofollow">
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Posted By: gannet
Date Posted: 17 March 2010 at 8:33pm
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I'm currently with Auckland Obstetrics and they are awesome! They were recommended to me by a few people, all of who raved about them. I also like the shared care idea, in that they work a one in six roster for deliveries so you will always get someone who is not dead on their feet because they have been working such long hours. Yes it is a lot of money, but you don't have to pay it all in one go. ------------- http://lilypie.com"> 
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Posted By: Raspberryjam
Date Posted: 17 March 2010 at 8:51pm
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I have a heart child - as soon as the problem was picked up (19 weeks in utero) we were referred to the OB's and heart teams at the hospital for high risk care - It didnt cost us a cent . You will be referred to the appropriate teams if required.
Its not like the OB can fix something a midwife cant, you just need to go with someone you are comfortable with Im with a midwife this time round too ------------- http://lilypie.com] 
http://lilypie.com] 
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Posted By: LittleBug
Date Posted: 17 March 2010 at 11:37pm
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You have a few options with care. You could even have a midwife/GP/obstetrician combo if that's what you want.
Basically a midwife's scope of practice covers normal pregnancy and childbirth, and the common complications. If anything goes outside that scope of practice (things become complicated, like you get gestational diabetes, or have a kick to the stomach, or your membranes rupture early, you have bleeding, etc etc.) then the midwife will refer you to someone that specialises in that area. Midwives tend to provide more holistic care to do with pregnancy and childbirth (in other words, not just the medical aspects - for example they try to facilitate breastfeeding and baby bonding with the family, community support, etc.) Usually with a midwife you will see the same person all the time and that person will usually be at your birth, which is nice for continuity of care. Of course there are limitations, as midwives may be attending another birth etc. when you go into labour and you may end up with a backup. If you do choose to go with an obstetrician, they are meant to have midwives attached to them that help to fill in the gaps in their care (all of the non-medical aspects that aren't in the Obs scope of practice). So you can rest assured that either way you should get all the care that you need. Basically the maternity system in NZ is designed so that you will be able to choose a good midwife that you are comfortable with, and she will direct you to the appropriate places as needed during your pregnancy. You may not end up with a good midwife, but then again, you may not end up with a good obstetrician. The important thing is that if you are not confident in the care that you are receiving, you are absolutely entitled to change your lead maternity carer, and your LMC is legally entitled to help you find another LMC that will fit your needs. ------------- Chloe (4 years) and Oliver (3 years). |
Posted By: ginger
Date Posted: 24 March 2010 at 10:57am
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I'm not reading the other comments, so that I don't shy away from giving my honest opinion
I went with an OB (Paul Robinson at Origins in Mt Eden) due to an IVF pregnancy (considered higher risk) and he was wonderful - I won't do my second pregnancy (if I can brave up to it!) without him or another highly recommended OB. Any problems and concerns I had were acted on quickly (eg. I saw him immediately I had any issues and scans were regular - every appointment. I know that for some that's not desireable though) and when it came down to it, I had a strong trusting relationship with the person who cut me open for my c-section. When my husband followed by baby after delivery, having him there with me (my OB) meant a huge amount. He also saw me for a problem about 4 months after delivery, and considered it absolutely part of my antenatal care. I think the thing with OBs is that they have more 'power' as such, and for any complications you're actually dealing with them, instead of being handed on by a midwife. For me, it was ideal. Not everyone feels that strongly though. ------------- Cuinn Lachlan 23.1.09 - 22:00 Antonia Helene 4.8.11 - 09:41 |
Posted By: Spirals
Date Posted: 24 March 2010 at 11:16am
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I had a similar experience to ginger - my obs was fantastic - and he was there providing one on one care throughout my labour. When the complication arose and I ended up having a c-section he was the one that performed it.
His team of midwives do the 6 weeks follow up care but it was back to him for the 6 week check up. And yes - we did get to see baby on the screen at every single visit
Someone also said about them having more 'power' and I honestly think I was given top top treatment in hospital because I was under his care. I will be using him again this time around. |
Posted By: BuzzyB
Date Posted: 24 March 2010 at 12:49pm
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Congrats Bobsta! So glad you got your BFP!
If you have health insurance you may be able to get some of the costs of the OB covered, esp if your pregnancy spans two policy years bc then you can claim twice
I was referred to an OB last time bc I had a history of mc and a clotting problem. The OB worked in combo with a midwife and the appointments alternated. My pregnancy ended up being very straightforward so didn't really need the OB, but I enjoyed the mix of a midwife who was supportive and a good 'friend' and the OB who allowed me to ask all my crazy medical questions. The best bit though was that when it all went pear-shaped in labour and I needed an emergency c-section, it was my OB who explained everything to me and did the procedure, rather than the random OB on call if I'd been public. For me, the trust and confidence I had built up over months with my OB made the c-section much less scary and I actually feel very positive about the birth. It's a difficutl question though and a lot probably depends on your own personality. I'm an information junkie and feel very comfortable in hospitals. So an OB worked well for me and I've chosen to go that way this time too. If you're like my friend though, who prefers not to know too much because it makes her worry and hates doctors and hospitals, then you might be better with a midwife. Regardless of your choice, at the end of the day you'll get the care you need. The choice you're making now is really what makes you most comfortable. GL ------------- http://lilypie.com"> 
http://lilypie.com"> 
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Posted By: mummyofprinces
Date Posted: 24 March 2010 at 8:41pm
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I personally dont see the point but it is totally personal.... A good midwife who is well respected can have a lot of pull in the hospital.
My mw with Jake got my scan report and phoned the OB clinic at the hospital immediately and got me the first available appt. I was then under shared care... There is nothing about my pregnancy or birth that would have been any better had I gone with an OB from the get go. That said, if I knew I had a high risk pg from the get go then I may have gone with a OB... -------------   
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Posted By: Emmecat
Date Posted: 25 March 2010 at 9:42am
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Yep I agree that unless you are a high risk pg then a mw is absolutely fine...as they will refer you to an ob if the need arises. I will be having a mw for this bubba, but a different one from my first...I don't think I can go through another labour listening to my LMC rather haughtily saying that in *her* day they diidn't have epidurals! Congrats BTW in case I haven't said it already! -------------   http://lilypie.com" rel="nofollow"> 
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Sucks to be her then aye lol Posted By: Treen
Date Posted: 25 March 2010 at 10:40am
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Congrats Bobcat!
We went to a OB in Mt Eden as recommended by a friend for a couple of appointments whilst TTCing (PCOS was confirmed and the OB prescribed me clomid). We got a pricing schedule while we were there for OB care and it was approximately $5500. Although PCOS is considered by some as a high risk PG, I have had a very easy pregnancy with no complications. I decided to go with a MW but if at any stage I had had any bleeding or any issues whatsoever, we would have switched quite quickly back over to the OB. I think if you're low risk, there's probably not too much difference in the antenatal care you get. The OB I went to had Audis parked out the front, a chandelier in the reception area and better magazines, but apart from that, I don't feel I'm getting any less of a service from my MW! I have also been told that you do see more of the hospital MWs than you do of your OB during the birth, too. DH was told that this is because the OB is there to care for the baby, not you. Not sure if this is true, but it was another reason for us to go with a MW. I want someone who is there for bubs AND me. Oh, and DH! ------------- http://lilypie.com"> 
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Posted By: LucysMummy
Date Posted: 25 March 2010 at 9:34pm
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Tricky subject everyone is quite strong dependent on what they did.
We used Origins OBGYNs for our first baby (now 2y) and now going back for this pregnancy (twins!). They are $3900 ... $200 at first appointment then half at 20 week appointment and balance after birth. They include a midwife post natal care as well for 6 weeks. I cannot rate OBGYNs highly enough, they not only have more experience but from my experience they can get you the better rooms (both hospital and birthcare) and if you need a c section or emergancy assistance there is no waiting or hanging around. The Origins guys also do ultrascans every appointment as they have the machines in the rooms and for me personally it was such a comfort to see my baby each visit. Good luck choosing at the end of the day you will choose what is best for you and everyone is different so do not feel there is a right or wrong. |
Posted By: kaybeecbe
Date Posted: 27 March 2010 at 10:21pm
Hiya, from experience from friends, an OB costs a lot of money, and well, does very little 
Twice I have been told by friends(2 different ob's) that they paid thousands, saw him as often as a m/w, and he turned up at the hospital to deliver, then left again. So they paid extra money to still deliver in a hospital, to still be attended 99.9% of their labour by a m/w, and postnatally too. I think if you have an exisiting medical condition that requires specific care, you would be referrred to a high risk team, and seen at a local clinic. |
Posted By: kaybeecbe
Date Posted: 27 March 2010 at 10:25pm
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oh - also, this is from my current study, not any personal experience, but stats have shown that births attended by OB's have a higher intervention rate than those attended by m/w's, and higher use of opiod pain relief.
Thats things like drugs to speed up labour, artificial breaking of membranes, episiotomy, vetouse, forceps and c section. Theory is that they are 1) too scared to let labour progress normally in case 'something' goes wrong 2) they have a schedule to keep! I would ask for their opinion on things like intervention, drugs and if they are ok for you to labour the way you want (out of bed etc) or if they are a 'get on your back on the bed' type of DR before you make your mind up. |
Posted By: Treen
Date Posted: 27 March 2010 at 10:51pm
Yikes! Do they have more experience? That would depend on the individual, wouldn't it? As for the rooms, I thought it was just first come, first served, basis? Especially Birthcare who to me seem quite MW / natural birth focussed. I am paying for one of their premium rooms, but they obviously can't guarantee me one. I'll be pretty annoyed if I find out I'm in shared room just because I chose the public healthcare opinion for my antenatal care!
And will I really have to wait around if I need an emergency C-section or medical assistance just because I chose not to pay for an OB? Now I'm really worried! As for the ultrascans, I was told that if your baby is healthy, the less ultrascans you have the better? Can't remember why, though. Anyone know? ------------- http://lilypie.com">
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LucysMummy wrote:Posted By: maya22
Date Posted: 28 March 2010 at 3:21pm
This theory is all very well but: in many parts of NZ you have no choice about a midwife, so if you aren't happy then there is not much you can do, eg smaller towns. In many parts of NZ te midwives are so stretched that to swap midway through the pregnancy means that there is noone to switch too, ie they are all booked up. |
Posted By: Bobsta
Date Posted: 29 March 2010 at 10:39am
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Thanks everyone for all your comments, it's been great to get comments from you all and I appreciate all your advice and support.
I have chosen to go with a midwife, Christine Ealson from Epsom Midwives. So far we have only chatted but she seems to be very experienced, not all airy fairy, and very open with her communication which is what I like. I was recently in hospital for hyperemsis and all the doctors and midwives there knew her so she seems to have a very good reputation and be well respected and liked by the hospital staff. I think that's a good thing as I plan to deliver there too. Good luck to everyone and thanks again for your support  ------------- Me 34 Him 35 DD almost 2 years old and... Baby #2 on it's way! http://www.babygaga.com/" rel="nofollow">
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Posted By: Rachael21
Date Posted: 30 March 2010 at 11:25am
Its because ultrasounds have not been proven to be safe, they haven't been proven to be unsafe either they just don't really know 100% they are harmless. So although the risk of adverse effects are low a lot of people think its best to limit the use of ultasounds unless medically indicated. Also babies don't particularly like them. Dopplers (the thing to hear the heart beat) use ultrasound waves as well which is why some midwives/women prefer to use a pinard/fetoscope. I'm glad you found a mw you like Bobsta.
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