Switching Providers in Pregnancy for a Supported Birth

by Mrs. BWF on November 1, 2011

*This post is not to tell you to fire your provider or who to hire as your provider. It is also not telling you to go from an OB to a midwife or vice versa. It is for women who are finding themselves with an unsupportive care provider and needing more information and support in switching to a new provider.

You hire a midwife or OB to support you in one of the most memorable days of your life. The person you hire to catch your baby (or support you in daddy or you catching baby), should do just that…support you and your choices (barring any medical emergencies).

I knew a beautiful woman from church who was expecting her first child. She was 39 weeks pregnant. As I sat beside her, I felt a strong impression I needed to talk to her. This was way before BWF, but I was still a birth advocate and always wanted to help anyway I can. I don’t push my views on my friends and acquaintance though.

I gently said hi and asked how she was feeling. Not so great. She was very down and concerned. Her OB was not being supportive and wanted to induce for no reason other than convenience. This level headed mama said she knew it was the wrong choice for her and her baby. Her high risk OB brother-in-law even told her to run.

Through our talk (I mostly listened), she told me she just didn’t know what to do. With tears in her eyes and her hands softly resting protectively on her belly, she didn’t think she had any options at 39 weeks pregnant. This is when I told her she did. I told her it was her baby and birth and she deserved a doctor who would listen to her. I asked if she was open to suggestions. I watched her demeanor change as hope crept into her heart. She eagerly took the names of two OB’s I knew would support her.

She called me two days later and informed me she and her husband prayed about it and picked one of the OB’s (my favorite). She called her current Dr.’s office and told them she would be picking up her records and changing doctors! The new OB’s office fit her in for that Friday. At almost 40 weeks she had her first appointment with this wonderful OB who took his time answering all this couple’s questions, was willing wait for baby to pick her birthday and support her in a natural birth. Later that evening she went into labor and he did just that…supported her in a natural hospital birth.

I do not have the opportunity to talk to this mama very often, but when I do, she always thanks me for speaking up. I always thank her for taking action.

It is never too late to switch providers.

I asked other women in our BWF Community about experiences in changing providers in pregnancy. Here are some of their stories.

“I switched from a family practice dr. to a CNM in a group practice at 30 weeks, then from her to a CPM at 37 weeks so I could have a home birth!”

“I switched at 34 weeks from an OB to a midwife. It was a hard decision because I truly loved my OB and I think I would’ve had a great birth with him- but because of his huge practice, there was no guarantee he would be the one at my birth. Plus I wasn’t thrilled with the hospitals he was affiliated with. So I talked to him, told him my concerns, and switched to a midwife. Best decision!”

“I switched 3 times. The 1st doctor only got 1 visit at 9 weeks. The 2nd doctor got a few more but I left her at 30wks. I’m super happy I followed my doula’s advice and switched to my 3rd doctor. She practices more like a midwife and even had natural birth center childbirths herself. I can’t wait to see what a difference this will make for my upcoming delivery.”

“During my first I switched halfway after every appt I had my doc was late due to a C-section. If you have a feeling or you don’t like the way it is going, don’t hesitate. You aren’t hurting anyone’s feelings.”

“I switched from OBs(that delivered my first 2) to a HB MW a little after 20wks. MW was WAY better! I absolutely LOVE her and our relationship.”

“I went through a total of FOUR with my firt pregnancy before finally finding one who would treat me (as I am a high risk pegnancy) and that I liked!!!”

“I did at 36 weeks…CNM hospital birth to CPM homebirth.”

“I switched at 34 weeks. I was told all along that we could “try” for a VBAC, but at 32 weeks I heard, “Are you sure? It’s so dangerous. Have you talked to your husband about this?”. I found a great VBAC supportive practice with a high success rate and LOW cesarean rates. We had a beautiful, happy and healthy little girl, and a very quick and easy vaginal birth.”

“I switched at 35 weeks with my second. BEST decision I EVER MADE!!!! My new docs were awesome and I couldn’t have asked for a better experience. Even if my planned VBAC went section.”

“I wanted to VBAC and my provider was feeding me a line of BS and I finally realized he had no intention of letting me do it, so I left him. I didn’t get my VBAC, but leaving him was the best decision I made. (I went on to VBA2C with a great OB!)”

“Switched from an OB group to a midwife (birthing center) at 28/29 weeks…best decision I EVER made. I was so sick of stressing about delivering in a hospital with an OB and the fear that I would have to argue with someone during a less than ideal time *labor* to ensure that I got the birth I wanted. I don’t regret switching for a second.”

You can read more here.

Make sure the provider you switch to is competent and supportive. Ask for referrals and any other relevant information in making a decision to hire them. This decision is yours to make (and your spouse if present).

Remember, it is your body, your baby and your birth!

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{ 18 comments… read them below or add one }

Jennifer Lindsey November 1, 2011 at 10:11 am

Hi I stood up for me and my daughter because at 37 weeks my dr. wanted to induce me for no reason at all other than convenience for her and she didn’t want me to go into labor and the hospital not be ready.My daughter had anencephaly but I knew she wasn’t ready to come out at 37 weeks with an unnecessary c-section so I told them no. My dr kept pushing so we decided 10 days before my due date I would be induced, but my daughter decided by herself that Aug 2nd she would make her arrival ten days before she was due. She is my only child so I wanted to go into labor by myself no drugs or help from dr’s and no unnecessary c-section.

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Natasha Hall November 1, 2011 at 10:48 am

I switched from an OB/ hospital birth to a CPM Birth Center birth at 30 weeks. At first my OB said she was supportive of VBAC but after going to more ICAN meetings and learning the right questions to ask I quickly found that she wasn’t. If the stars aligned perfectly I would have a VBAC, if they didn’t I would have another C-section. I was scared but in the end sooo incredibly happy that I did. The way my labor went (stalling, water broke, ect) there is NO WAY I would have had a VBAC with my 1st provider.

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Stacie Robinson November 1, 2011 at 12:00 pm

I switched 4 times during my 1st pregnancy… the first OB had some issues with insurance (I had double coverage & he only accepted one). The 2nd OB had a pretty unorganized office & practice and around 26 weeks said something about my baby being a girl… I reminded him AGAIN we were not finding out the sex and asked him what he was talking about, did he know we were having a girl? He claimed it was a handwritten note from him in my chart, he must have wrote it in my chart by mistake; so he either is so unorganized he wrote someone else’s note in MY chart, or he ruined the surpirse (I do have a beautiful little girl)… I’ll never know! The 3rd OB ended up pushing for induction at 38-39 weeks due to the “size of the baby” (or maybe because I was due on a holiday weekend?). At 39 weeks he “made a deal” with me that if I didn’t go into labor spontaneously he would induce at our next appointment so I never scheduled that appointment and had everything switched over to a CNM/ARNP who was gracious enough to take me on at such a late date. The day I met our midwife was the day my daughter was born, 2 hours before to be exact. We had a midwife/hospital birth which wasn’t perfect but I was sooo much happier with the support we had, we definitely made the right choice for our family. My daughtere was born ON her estimated due date and was only 6 1/2lbs, I can’t believe that last OB was worried about her size!
I am expecting #2 in March and have been seeing a fantastic homebirth midwife team since 8 weeks along and have been nothing but happy about the support and attention I’ve received so far!

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kp November 1, 2011 at 12:36 pm

I switched at 18 weeks with my youngest. A previous cesarean (baby #4) had nearly killed me, due to an anesthesia allergy, and I felt sure I wouldn’t survive another surgery. I had had a VBAC with #5, but because complications supposedly increase withe each pregnancy and I am overweight, there were no local hospitals that would allow me to deliver naturally. I do have a history of hemorrhage, though, so I knew I had to give birth in a medical facility. After calling 5 hospitals and at least a dozen OBGYNs, I went back to the center where all but my first child had been born. It was over an hour’s drive from our new home, but well worth it. I birthed on my own with a midwife and two nurses present. Baby was born in the caul just an hour after arriving, and we went home several hours later.

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Xylina Weaver November 1, 2011 at 1:45 pm

I switched care with my first pregnancy at 35 weeks because one of the OB’s at the office said he would induce without medical reason on my due date. My new OB was patient and I birthed my daughter at 41 weeks 6 days!!
With my second pregnancy my home birth midwife didn’t respect my decision on treating GBS so I switched the day AFTER my due date to another midwife and had a beautiful waterbirth the next day!
I am SO glad I followed my intuition and made the switch both times!!! It was hard, but some of the best decisions we make often are!

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Vanessa February 8, 2012 at 12:20 pm

So she didnt want to treat the GBS? Thats odd. I know there are other ways besides antibiotics to treat this so that you are able to move around during labor.

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Brittany A. November 1, 2011 at 2:04 pm

I switched to a freestanding birth center at 26 weeks and NEVER looked back!!!!!!!!!!!!!!

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Doula Caz November 1, 2011 at 6:20 pm

I’ve figured out that around one in four of my clients switch care providers at some point during pregnancy. Usually close to the end, when the NHS starts pushing them to have an unnecessary induction!
Sometimes it will become apparent that the Midwives don’t support home births, or aren’t trained in water births etc.
I would always say follow your instincts. If you don’t speak up and walk away from poor quality care, the people providing it will carry on making the same errors. And other women will pay the price.

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Shary November 1, 2011 at 6:30 pm

I switched early in my pregnancy because although at the time I didn’t know much, I knew that a cesarean was something I wanted to avoid and at my very first appointment (8 weeks) my OB opened a talk about cesareans and her c-section rate was too high for comfort. I switched to a free-standing birth center, and then to a different midwife when I moved. I didn’t get the midwife who had done all my prenatals and early in labor it bothered me, but by the end I was satisfied with the midwife that was on call and had a lovely experience.

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Karla November 2, 2011 at 3:10 pm

I’m so glad you posted this BWF! Women need to know that switching docs is common and totally acceptable.
At the time of my second pregnancy I left my doctor, who claimed he wold support me through a VBAC, at 30 weeks because I found out his true intentions. It took me 6 weeks to find another provider in my area that would support me in a VBAC. It felt like I met with a hundred OB’s and none were right for us. Some denied to even see me because I was so far along and others we found to be less than supportive. At the time I had never known anyone that had switched providers mid-pregnancy and I thought I must be crazy to do such a thing. The thing was, I knew I didn’t want to EVER have a c-section again and I believed in the depths of my heart and soul that I could have this baby vaginally. I was even willing to deliver at home all alone if that was necessary. lol In the end, it all worked out. We found an awesome midwife and she supported me through the birth of my 9lbs 10oz VBAC!

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Maile November 3, 2011 at 5:02 am

I was blessed to learn early in my pregnancy about birthing choices. I was unable to find a midwife with my insurance plan, and in a new state and town while under very tough circumstances (I had to move in my fifth and in my eighth months) I was unable to arrange for a home water birth as I’d hoped, but the nearby hospital birthing center seemed okay (they had a birthing pool in the basement but politics had it staying there for the moment) and I thought I’d found a sympathetic OB. She had been VERY convincing when she answered all my questions and discussed my birthing plans. She told me she would honor my wishes to have an all natural birth. When my baby was not ready to birth on her schedule, (two days before the “due date” and all was peachy in every way) she suddenly informed me that if he didn’t come “on schedule” that she intended to induce and wanted me to birth before she left for a trip that weekend. !!!!! She had never even informed me in advance that she had a trip out of the region planned within days of my expected birth date. I was so very freaked out by her change in demeanor that I began to wonder if she could have injected me with pitocin without informing me, in that examination –would I have felt it?? I immediately called another OB I had heard about and switched literally at the last minute. I tried reaching him for a couple days and I believe I finally got to speak with him *on the phone* on Friday and went into 2nd stage labor Sunday evening by 9 pm. Labored at home, mostly in the bathtub until about 2 am, somehow got into the back of the car between contractions, got to birthing center fully dilated and birthed within about 45 minutes of arrival -alternately standing and kneeling upright on the bed literally climbing the wall by my fingernails, (they never made it back with the birthing bar I’d requested) with my back to the OB. My baby was in my hands immediately and then on my chest, and things went our way from then on. They didn’t honor my birth plan after all–the nurse refused to turn down the lights even after I asked twice in the throes of labor. But I stroked his feet & did not allow them to suction his mouth (he breathed just fine) or bathe him in their chemicals and his skin only touched mine & the soft organic things I brought to block the light and cover his back. I bathed him gently myself when I felt he was ready. I was 39 years old, first birth. All blessedly natural. Barring the lights –which were turned down only after the birth & the horrendous noise of the speaker directly by my head that the desk used to communicate with staff they were seeking. I would’ve bludgeoned that box with a club if I’d had one and was willing to put my babe down. I’d have never dreamed something so loud and intrusive could have been so poorly placed in a birthing room. But overall all went very very well. Never even really met or even saw the new OB’s face who attended the birth until he came to check in on us in our recovery room the next day. That was a little weird, but not half as much as my woman OB deceiving me and trying to bully me at the last minute into an early induction for no reason but her own convenience, which could have wound up a nightmare for me and my baby. Our birth was fast and furious, but flawless on my boy’s schedule, only 4 days after “expected”. I took a few stitches and the small tear hurt while healing but I was glad I’d insisted on no episiotomy. The last minute OB was very respectful of my wishes and I was so glad I’d walked away from the OB who disappointed me. Go with your gut and insist on your birth your way.

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Julie November 3, 2011 at 9:40 am

I’m 30 weeks and I’m switching from my OB to a CPM for a HBA2C. He flat out told me that I HAD to have a repeat c-section since I’ve never given birth vaginally even though the reasons for my c-sections were unnecessary. I still haven’t gotten the guts to call and “quit” my current OB but I’ve already met with the midwife and I’m feeling a million times better about my decision!

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Amanda November 3, 2011 at 6:37 pm

At 32 weeks, I switched from a CNM at an OB office. She told me she’d ‘try’ to deliver me, but there was no guarantees I wouldn’t be passed off to one of the OBs – that her priority was her family (she had run a birthing center for many years prior to working for the OB). While I respected her allegiance to family over practice, it left me in a bad place. I knew I wanted a natural birth and couldn’t trust that an OB I had never met would help me achieve that in a hospital environment. I was fortunate that my CNM was supportive of me finding the right birth experience for me and my husband (even though I’m fairly certain she didn’t support home births). So, at 32 weeks, I took my doula’s recommendation to speak with the CPM she assisted. After meeting her, I knew absolutely that I would have a home birth and she would catch my baby. I think women have a remarkable intuition in regard to their bodies and pregnancies – especially in the last few weeks of gestation. As you become more comfortable with your pregnant self and making choices as a mother, you begin to develop a sense of what’s right. If you follow that and trust yourself, you will never choose the wrong path.

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Mina February 8, 2012 at 1:22 pm

When I told my family doctor that I was thinking about using a midwife, he didn’t stop to ask who it was or listen to the details. Instead he began telling me horror stories about midwives denying women emergency c-sections and babies being born with brain damage. Alternatively, when I met with my midwife, she told me she had great respect for the medical community and that I should check in with doctor anytime I want. I think this speaks volumes on its own.

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Heather March 10, 2012 at 2:37 pm

When I first read this post a couple months ago I thought, “wow, I’m so glad I don’t have to worry about switching providers.” I had chosen to go with a midwife who I also worked for and I knew exactly how she practiced. The best part was that she was giving me such an amazing deal. Our insurance would cover a hospital birth 100%, and money was so tight that it would have made sense to go that route. My midwife knew I wanted a home birth though, and vowed to help me make that possible in any way she could.

Then when I was about 26 weeks, she called and said she thought I should look for a different provider. She says it is because she didn’t think I was getting the care I deserved because of our working relationship, but I had the feeling it was really about the money.

Well, going to another CPM is just not an option for us financially. I detest the hospital in our area and do not feel comfortable with any of the OBs here. None of the CNMs here deliver babies anymore. The only option I felt like I had was to travel to a hospital an hour away and see a CNM there. I really like her and I know she will be great. But I still have such a hard time with the fact that the home birth I was planning was taken away from me. It’s just so ironic to me that everyone I told about my home birth plans talked about how “scary” it was, but I wasn’t afraid at all. Now that I’m going to be delivering in a hospital, I’m terrified!

I know my story is a completely different situation than many of those mentioned here, but I felt the need to share, so here you go.

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Debbie April 20, 2012 at 8:30 am

I really needed to read this article today. I have been having some trouble with my current OB, but she’s already the 2nd one I’ve switched to! I didn’t think I should switch again, but the office staff treats me like a pain in the butt every time I call. I’m going to try one more appointment with her (my 24 week appt.) and if the tone doesn’t change, I’m going to investigate other OBs in my area. Thanks for reminding me that it’s alright to stand up for yourself. :)

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Carrie April 20, 2012 at 11:57 am

I switched from an OB (at a large practice) to a mw at 25 weeks. The choice was simple. When we told the OB we were taking Bradley Method Classes in hopes of an intervention-free birth, he looked at me and said “Huh. Well, the nurses at the hospital [where we were going to have the baby] don’t like Bradley Method patients”. I think he meant that HE didn’t like them, b/c the nurses we had were A-mazing.

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melissa June 24, 2012 at 2:11 pm

hi. i’m 16 weeks pregnant with my first child and feeling so overwhelmed. i’ve been to 2 different OBs. the first one i knew right off the bat was not a right fit. even though it seemed like it would be perfect because it was a practice that had midwives AND OBs and they birthed in a hospital but i cold labor (not birth) in water. this sounded great on paper. but upon our first meeting i knew this wasn’t right for me at all. i was so disappointed. so i just went with the OB my reproductive endocrinologist told me about. he seemed great at first. seemed to listen and take his time with my appointment. but in the initial paperwork i had to sign it said in big bold underlined letters that they would not under any circumstances allow doulas or birth coaches in the delivery room. that was a HUGE red flag. when i went in for my 2nd appointment i went in with a list of questions (as i’ve been encouraged to do by everything i read), he became defensive as if he was annoyed i was questioning him at all. he became short with me. he made me scared to read all of my questions. i felt bullied. obviously i’m getting the vibe from this guy that he wants me to just shut up and do what he tells me. like this is his craft and who am i to question him. i left there sobbing and feeling bullied and so alone. i can’t go back to this guy. what i really did not appreciate was the fear mongering. he tried to scare me into not going with a midwife (which i told him i was considering) because i’ve had weight loss surgery. even though i’m NOT high risk. all my tests have been immaculate. and last i heard, my uterus is not connected to my stomach. what a jerk.

so now here i am again in this horrible limbo. i just want to find someone i’m comfortable with so i can relax and enjoy my pregnancy. people keep harping on me because i know what i don’t want. i’m not totally inflexible. they tell me, don’t have a birth plan because nothing is going to go as planned. i’m not saying it has to go exactly this way. i just want a general outline. i want someone to respect what i am and am not comfortable with. is that too much to ask? people are making me feel like i should just give up and go with whatever the doctor tells me and just settle. but i can’t.

i’m going to visit a birthing center next week. i’m really hoping since the OB and the hospital environment didn’t fit that this will fit. i’m sick of everyone jumping to the worst case scenario. just because emergencies happen doesn’t mean they WILL happen. i guess i just have a little more faith in my body than they do. thanks for this post. i wish i had more supportive people in my life.

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