What’s better, a CMN or an OB/GYN? That’s the real choice. The “oncologist” scenarios are specious.
Funny - the primary care doctor I had for nearly 20 years told me up front when I first met him “I don’t deal with babies or children. If you get pregnant I can refer you to an OB/GYN, and I know some fine pediatricians if you have children, but I’m strictly adults.”
Which I was fine with, as he was up front about it from the start. I like people who know their limitations.
I don’t think that guy has performed surgery since he was in medical school - and he’s pushing 80 now. I’m not sure he’d be any better at, say, an emergency c-section than a layperson at this point. Surely 50-60 years of no practice is going to seriously impact your skills.
Yep, I’d probably rather have my landlord - who helped deliver all three of his kids (in a hospital setting, so calm down) plus helped out two more of his tenants when the kid came before the ambulance did - over that old primary doc of mine. My landlord has had more recent experience in catching kids, and I doubt either guy would feel up to doing an emergency c-section.
But yeah, that’s a bit of a contrived circumstance.
I know this won’t change a damned thing, but here goes anyway: Folks have spent this entire thread explaining in minute detail why these CNM’s are in fact highly qualified, more so than many doctors who are not OB-Gyns, and yet you still are tossing off casual dismissals of every piece of info you’re given. After rebuttal upon rebuttal of your concerns regarding their qualifications (yes, they have considerable medical training, yes they can prescribe actual medications, etc.) you appear to have run out of factual objections and instead of conceding that gee, maybe they’re not just a bunch of woo-woo types waving herbs over the woman’s vulva in lieu of real medical care, you instead chose to go for broke and sum up the group of highly trained professionals with a disrespectful, sexist vulgarity. (Sorry, Mr. Dumpty, trying to redefine “bitch” as a gender-neutral term doesn’t fly.) That’s what I found offensive.
Okay, all joking aside, I can’t answer that. No one can. There is not one profession which is “better” for all women, for all labors. The letters after someone’s name are not important; their priorities being similar to the laboring mother’s are much more important, after a bare minimum of competence and legal authority.
Depends on what your preferences are, not to mention the preferences of the individuals in question. There are CNMs who are so dedicated to minimizing interventions they really would have become lay midwives if it was legal, there are CNMs who are essentially OB’s in thinking, but didn’t want to go through all of med school (which makes sense to me: why do rotations in dermatology and oncology if all you want to do is maternal/fetal medicine?) There are OB’s who are quick to run to the OR, and there are OB’s who will fight tooth and nail to use positioning changes, forceps or vacuum assisted delivery to avoid c-section.
You can’t tell what a person thinks, or how they think, or what they’ll encourage during labor, by looking at the letters after their name. You can only do it by talking to them a lot and looking at their previous history.
It’s not sexist. I think you’re the one who has some stereotyped perceptions of doctors and nurses.
I can.
Honestly? Depends entirely on the experience level. I’d take a 20-year CNM over a just-out-of-residency OB/GYN, hands down–for a straight-up normal labor and delivery, anyway. Risk factors would change that. Increased C-section risk? Yeah, OB/GYN. Breech birth? Even my OB/GYN told me that was entirely a function of raw experience and not title, and said he’d’ve got in a specific (younger, even) experienced CNM who’d seen a few more than he had to take point if we’d have had one–and this was a guy with coming up on 30 years experience.
And it goes without saying, at this point, that my generic preference order has both of these classes light-years above any other medical specialty.
It also goes without saying (well, it might not)–no CNM within four hours of my town would do a home birth, period. “Birthing center with OB/GYN-specialty surgeon in the building” was the minimum.
Now you are moving the goalposts. You were the one that brought up the any doctor/any nurse standard. If you are backing down from it, it’d be nice if you’d admit it.
Maternal/fetal medicine specialists are more qualified to deliver babies than your run of the mill ob/gyns: they have all the training that those doctors do, plus a couple extra years working with the really high risk stuff. There’s absolutely no question that a maternal/fetal medicine specialist would be better to have between my legs if the delivery of this baby I am carrying starts to go bad.
But I see an OB. And I’m ok with seeing an OB. I don’t think I’m taking a terrible risk with my child’s life because, frankly, 99% of the additional stuff the maternal/fetal guy knows is irrelevant to the sort of labor and birth I am likely to have.
In the same way, 99% of the additional stuff an OB knows is above and beyond what is needed for very routine labor and births. I’m with you on the hospital part: I want to be close to people and locations that can help me if something unexpected comes up, but I can’t see being attended by a CNW as a terribly irresponsible thing. To some degree, an OB is really overqualified to be there.
I’m moving them back where they were in the first place.
That is exactly it!!!
And, another for me that I love from the same place is:
the icon of the brain with a shaded area that says, *Section that is devoted, no matter where I go in life, to planning the ultimate treehouse! *
I’m such a kid at heart.
I would rather have a parlor maid who didn’t know nothing about birthin’ no babies than a DDS. Although I guess it is a kind of extraction…
Throw the pizza delivery guy in there, and it’s quite a party.
Can we sticky this? Because the next time Dio starts The Dio Show, someone should just quote this, and we can all go back to our regularly scheduled, non-insane thread.
Now I’ve got a picture of a dentist poking around down there with a mirror and probe.
I’d rather have an OB/GYN than a CNM in a hospital setting. In fact, I have dozens of hippy crunchy friends, and the vast majority of them chose an OB/GYN. Most babies in the U.S. are - it looks like 10-20% of babies are born attended by a CNM.
But you can choose to have a CNM - and I don’t think its an inherently bad choice in a hospital, since there WILL be the “decision to incision” delay, and in a hospital, their will be a surgeon ready to start scrubbing.
(BTW, mean “decision to incision” in the U.S. appears to be 20 minutes. The recommendation is no longer than 30, and the little googling I did it appears to be highly hospital dependent, not doctor dependent. If the ability to do a quick c-section is important, its a question worth asking when you are hospital/doctor shopping)
We need someone to fix the cable.
Look at my previous cite for the IL scope of practice for advanced practice nurses. They can certainly prescribe, in IL anyway.
I’d rather be a hammer than a nail.
Yes I would.
If I only could.
Yeah, and I’d rather be a forest than a street…unless I’m in labor. In which case, I’d rather see a CNM between my knees…yes, I would.
Hey, can I choose Anthony Bourdain as my “guy to deliver my baby”? Wait, wait, that’s not the right word–I meant “conceive”.