Prenatal Conflict

Yesterday, I had my 32 week prenatal appointment, during which I think I overwhelmed the doctor with my birth plan. He began with an "oh, no" and said that it is the "kiss of death" when someone brings in a birth plan. He said a few times that he doesn't want us to be "adversaries." I made sure to let him know that I understand things may come up that make certain things in my plan impossible, but I would like to make it our goal to stick to it as much as possible. I'm a very reasonable person, not combative at all. He raised some concerns over a couple things, delayed cord clamping in particular. He said that they will only allow 45 seconds because in a full-term baby too much blood volume can increase the bilirubin levels and cause jaundice. He wanted to know if I had read any studies and what kind, which I admitted that on THAT particular topic I had not. He proceeded to patronize and condescend and almost acted insulted that I would question him and the many doctors who are "smart enough" to have done studies and compiled all this information. He said it would be like him coming into my practice, my expertise and saying that that is not how he wants it done, or something along those lines. It made me very uncomfortable and made me feel very small. I'm just a mother trying to piece together conflicting information in order to make the best decision possible for my son. I don't have a medical degree, but I do have a brain and the ability to read and the right to be informed and to question medical advice, especially considering that medical mistakes are the third leading cause of death in the US. So I have spent the morning so far researching the topic. I have several studies indicating a significant benefit of delayed cord clamping, especially from 1-3 minutes, without an increased risk to mother or baby. While there can be an increase in polycythemia, which can cause an increase in bilirubin as extra red blood cells break down, there was no significant increase or need for further treatment in most cases. This article in particular was very thorough and insightful: https://www.medscape.com/viewarticle/708616_4

He also brought up circumcision. He asked if the father was circumcised. He is. The doctor said I might want to consider it for appearances so that baby looks like daddy and that it might matter to him when he gets older if he looks different. I almost laughed at him. I said I'm not concerned with appearances. He only followed by saying it is something to talk to the pediatrician about. I think it is ridiculous that that is the only reason he could come up with to try and talk me into circumcising. I wanted to say that when he starts asking we will tell him that he was born that way, just like Daddy was, but Daddy's parents decided to remove some of his skin at birth, and that it is ok to look different. He was born that way for a reason, and he is perfect and whole. Daddy wishes that he could look like him, but he didn't get that choice.

Long story short, I am most concerned with this doctor's attitude. I did not feel supported at all. I would like to find other options, but I am limited because of insurance, money, and distance from the hospital. Ideally, I would give birth at home, but I live 45 minutes from a hospital in the event of complications. If I need an ambulance, it takes 45 minutes for them to get to me and another 45 to the hospital. It would most likely be too late at that point. (I know this because of my miscarriage 2 years ago. It took an hour and a half to get there and be seen by a doctor.) My next best option is a birth center, the only one in the state as far as I know, but they will not take me because of my BMI. My next option is to bite the bullet and go to an out-of-network hospital and spend twice the money. My final option is to find a midwife in town, closer to a hospital, who has the facilities to deliver there. The thing I worry about is the cost. Our money is already spread so thin I would need someone who could work out a payment plan with us. My chiropractor has given me contact info for a local midwife, but she practices at the out-of-network hospital. I'm hoping she will know of someone who can help us. If you have any info or suggestions, I would greatly appreciate it. I'm beginning to panic a little bit.