Thursday, February 08, 2007

Solicitation

by Mouse

After spending several months obsessing about trying to become pregnant, my mind has reached a saturation point in thinking about the actual process. I’ve moved on to how I’ll be getting to point B (as in baby).

In my first pregnancy, I used an obstetrician recommended by a colleague. The obstetrician participated in a group practice, so I also got to know some of the other obstetricians since there was no telling who would be on call when I finally went into labor. Although the appointments were not incredibly long, I was encouraged to ask any question I had and never felt rushed. Other than a minor scare at 6th week, I had no complications and my pregnancy proceeded within all normal ranges.

This practice’s office delivered at one particular hospital in the nearby city, perhaps the nicest one there. Each woman had a private labor and delivery room with attached bathroom, TV, adjustable bed, and a reclining chair. I won’t go into the details here—that would fill a whole other post—but my delivery was more complicated than we were expecting and ended in a forceps delivery.

For the two days my insurance required I stay in the hospital, I shared a room with a woman who was spending four days in the maternity ward after a Caesarean delivery of twins. We had our own bathroom and a shower down the hall (walk right in, no edge to step over). I had a choice of keeping Scooter with me in a portable bassinet or leaving him in the nursery for a while. The nurses knew I wanted to breastfeed and were very helpful with that—there was even a special lactation session given every day or two for mothers to attend with baby and partner. Before leaving, there was a short care session to answer questions and remind us about things like caring for the umbilical stump.

Besides all of the above, Trillian and I were both impressed by the security procedures. Scooter had both a bracelet and anklet that matched mine. Each time a nurse brought Scooter in, we checked my bracelet against his. Trillian also had a matching bracelet. To enter the maternity ward, she had to stop at the locked doors, display the bracelet, and wait for someone to let her in. Anyone leaving with a child was similarly checked.

And while not a necessity, Trillian and I also appreciated the freebies. I’m not referring to the free bag from a formula company (which, yes, we did get, but I don’t want to step into that mess right now). We were encouraged to take anything we wanted from the drawer of the bassinet: extra disposable diapers (which we left because (a) we were going to use cloth at home and (b) the newborn size didn’t provide adequate coverage for our long and skinny guy), the very soft hairbrush, extra alcohol pads for stump care, the small plastic basin for sponge bathing, and probably a couple other little things.

Now I come to my point. Or rather, my plea for help.

Since we no longer live near our old city, we can’t just use our previous experience as a guide for the second pregnancy. We’ve started looking into options here and are trying to figure out our options. Of course, right now, our reading raises as many questions as it answers.

So this is where you come in

Midwife or obstetrician? Where we were in the states, midwives were most often used when one expected to deliver at home or at a birthing center. Because I knew that at least some women in my family had difficult deliveries, I went with an obstetrician and hospital. But from the explanations we’ve had, a midwife seems like a real possibility in Toronto.

Which hospital? I know that the privileges held by my obstetrician or midwife will largely determine this, but I’d like to know some specifics about the downtown hospitals—which will, in turn, influence the first decision.

Share a little or a lot. Just the bare bones or your entire birth story. In the comments or via email (mousenest at gmail dot com). It’s your chance to offer advice to a (hopefully) pregnant woman and actually have it heeded!

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Mouse is: a mother, a lesbian, a graduate student in the Humanities, an American in self-imposed exile, an observer, an introvert, and an expert in Thomas the Tank Engine and Mighty Machines.

13 comments:

penelopeto said...

I'm about the biggest cheerleader for midwives out there.

You should at least go and talk with a midwife. As a client (you're not a patient because pregnancy is not an illness), it would tough to have a better experience, and you can deliver wherever the heck you want. but be warned - appointments take upwards of 45 minutes each, and you will leave armed with all the information and choices you can possible bear to carry, as well as a hug.
I truly cannot say enough amazing things about midwives. Did I mention that they come over every day if you want them to (every two days otherwise) after the birth to make sure you're doing well? Oh yeah, and you'll absolutely know who will deliver your baby, and it won't be someone you've never met before.

There are much more intellegent and objective things I could say about why midwifery is such a wonderful, safe, healthy, progressive choice, but I just get so darn choked up and emotional when thinking about mine that it's tough. (how many women can say that about their ob!?)

Lisa b said...

I had my first through my GP obstetrics group at Women's College. I was really happy with the experience the team of doctors is great, the delivery nurses were excellent and Dr Newman's breastfeeding clinic has classes everymorning just down the hall from the post-partum wing.

That said I had really wanted a midwife last time and could not get one. This time I was lucky and lined one up then all my pre-natal tests went haywire. My midwife told me she would hold my spot until we could determine if a higher risk OB was more appropriate. She has been fantastic in dealing with the genetics group, I have found her more knowledgeable than my GP in most areas.
Truly I am thrilled with her. As P says you may feel loaded down by all the information provided at appoinments but that is the price we pay to make informed decisions.
I'll email you more details as I think you should call asap. Penelelope has (or had) a link to a midwifery page where you could look up all the practices.
Best of luck.

Naomi said...

I'm another fan of midwives. But, and this is a big but, they are VERY difficult to get. Call the minute...no, the SECOND you know you are pregnant. Do not wait.

You do not really get that much of a choice which clinic you go to. Well, there is always a choice, but as a general guideline, you will go to the clinic for your geographical encachement area. (I think that's the right term).

Check the website of the college of midwives and then contact each clinic directly.

http://www.cmo.on.ca/findingGTA.asp?id=Greater%20Toronto%20Area

As Penelope said, it is a fabulous experience, both pre and post natally. I would be happy to answer any questions you could have, and lots you haven't thought of yet.

We used a midwife with both of our sons. My first was delivered at a hospital (North York General for reference). The birth ended up being quite traumatic, and he was delivered by an obstetrician with forceps.

My second was born right here at home (you can read abit about it on my personal blog if you like).

metro mama said...

I went with an OB the first time. I loved him, but he was not the one who delivered my baby when the time came. My birth was horrific. I will go with a midwife next time.

I delivered at North York General - it was fantastic.

Karen said...

I am yet another HUGE midwife supporter. It made my pregnancy/birth/post-natal experience so incredible. When you have a one day old, the last thing you want to do is bundle them up, drive to the doc. and sit in a waiting room full of sick kids! I had my one day appointment in MY BED!! I had been napping, and the midwives showed up and just hopped up on the bed beside us. That is one small example of how wonderful it was for me. There are SO many more.

penelopeto said...

I should just clarify that when I enthusiastically said 'you can deliver wherever the heck you want,' I did mean home v. hospital. Like Naomi says, the clinic/hospital considerations are geographical.

Sandra said...

I delivered at Mount Sinai with my GP (well actually 3 doctors and a bunch of other folks because my delivery was awful).

My friend works at a wonderful new midwifery collective and they are currently accepting patients. It is funded and set up to service aboriginal women but more than half of their clients are not from that community. They have privledges at Sunnybrook the website is: http://www.sgmt.ca/

While I didn't have a midwife (because of how my delivery unfolded a midwife wouldn't have delivered my baby anyway), I supplemented my GP with monthly visits to a phenomenal naturopathic doctor who was the most supportive, informative, amazing resource during my pregnancy. She couldn't deliver my baby but I was so grateful to have her.

kittenpie said...

My own family doctor, who I have been with since I was 5, actually still delivers, so I went with her since I am so comfy with her and love her so much. She works out of East General, and I had a very good experience there and really liked their facility.

The birthing rooms are private and feature birthing beds with all kinds of adjustable bars and such that tuck away when not in use, and all the med equipment is in wooden cabinets, so it feel more homey. There are bathrooms in the rooms, some with whirlpool tubs to relax in while you labour, too.

I spent my first day in one of those, and then, after it became a c delivery, I spent my recovery in a private room down the hall (there are semi-private and ward - I think my insurance covered semi-private and we coughed up all of $15 extra for private). That room was quite spacious and had a fold-out chair for Misterpie, as well as a bathroom right in the room, again.

Pumpkinpie's bassinet stayed in with me, though if I had needed to, I could have left her with the nursing station for short periods. We got quite a bit of care instruction on how to bathe her, and so on, and there are in-house lactation consultants from the associated clinic who come and visit you in your room. Most of the nurses were great, though one night nurse (who was a subsitute, not a regular, I might note) was a pain.

The nurses were also really good about my care, encouraging me to walk around, changing dressings, helping me to the bathroom a couple of times, suggesting things like advil for pain and stool softeners to help things start working more easily.

I wouldn't hesitate to recommend the facility. As to obstetricians, while I was not her patient for my whole time, my c and in-hospital care were done by Dr. Gans (I don't know her first name, but could perhaps find out), who I quite liked. (And my scar is not too bad, so her sewing is pretty good!)

kittenpie said...

(oh, also my doctor came to check up on me in the hospital and attended the c, too, working with dr. Gans).

Mouse said...

Something I mentioned over at my home blog is that I'm severely limited to which hospitals I can use, because I am on UHIP (university insurance for international students) instead of OHIP. Technically, it's equivalent coverage, but only a few hospitals have agreed to accept UHIP upfront (vs. requiring me to pay and hope that I can get the paperwork done correctly enough to get reimbursed). I've only looked at the list for downtown--Toronto General, Toronto Western, and St. Michael's.

Her Bad Mother said...

Are you not able to go to Women's College? That would be weird, given its affiliation with UT. And it. is. fantastic. Phenomenal mother care, phenomenal family care. We were referred there by my doctor at the UHC, to their Family Practice, and the woman who became our family doctor delivered E (we also, however, had a doula, which I HIGHLY recommend.)

Mouse said...

I've got an email into the insurance administrator at my university, since I noticed that there are inconsistencies on their information page. I'm also going to start calling midwife offices on Monday to see where they have privileges so that I can make a decision as soon as I have the full story on my insurance.

And for those who haven't been by the Mouse's nest recently--I got my two lines last week, and so this is all well-timed info for me!

Bloor West Mama said...

I delivered my daughter at Mount Sinai Hospital downtown. I have to say that it was a great experience once the epidural kicked in. I did not have an OB but a Family Doctor that had an office at the hospital. I have to say that she was just amazing, not only was she great throughout the pregnancy but she was there for the delivery even though she had been in the hospital delivering another baby the previous night. I also had a doula and I highly recommend getting one if you do go with an OB, I can't say enough about my doula, she was such a great help to both my husband and I.

Best of luck and congratulations on your pregnancy.