Regional Variation in Referral Practices and Approach to CDMR

I learned something last night - something that had I known last time, I would have taken a very different approach to my pregnancy and birth plan. I learnt that the referral practices in Victoria are very different from the referral practices in Vancouver - so different that I would almost expect them to be from different provinces or different countries instead of just a short hop-skip across the Georgia Straight. Specifically, I discovered, that it is infinitely easier to get an OBGYN to look after you for your pregnancy in Vancouver than it is here. Victoria has some weird custom whereby the OBGYNs do not take low-risk pregnant women on until fairly late into their pregnancies. In contrast, in Vancouver - a woman can ask to be referred to an OB (instead of the choice of GP who does maternity care and midwife) and actually expect that request to be carried out in a timely way.

I anticipate my first meeting with my OB will be in 4-6 weeks from now - when I'll be about 12-14 weeks pregnant. That is 22-24 weeks sooner than my first meeting with the OB in my last pregnancy.

I also learnt that in Vancouver, a scheduled c-section is just that - a scheduled c-section (regardless of the reason) and that I should expect a specific time and date for my c-section at some point between 39 weeks and 40 weeks gestation and that I should not expect to be 'bumped'... apparently bumping in my new OBGYN's experience is very rare (less than 5 percent of the time) and generally of a short duration (an hour or less) when it does occur. I cannot begin to tell you the kind of piece of mind this brings - unlike my last pregnancy where I was on tanterhooks for 36 weeks fearing that my request would be denied, only to have my request granted, breathe a sigh of relief for 3 weeks and then ultimately be denied what was a very well informed and clearly communicated decision on how I wanted my child to be born.

So it looks like I will be shlepping back and forth to Vancouver over the coming months - and that's okay, I want the person who will deliver my baby to also be the person who looks after me during my pregnancy - and given that I prefer a surgical birth route, the person who will deliver my baby isn't a GP and isn't a midwife.

Logistically, financially, and emotionally - this appears to be a very workable plan. If I were drinking, I'd pop open that bubbly we didn't quite get to before seeing two lines on the pregnancy test -- but I guess some fancier potato chips and fancier ginger ale will have to do in my morning sickness induced quesy state.