I laughed and said, "Oh yes, he did!"
I was able to communicate that my goal is a natural birth, provided there is no placenta previa. And he said that sounds great to him.
He thought I was nuts for requesting the fetoscope. He couldn't actually hear the heartbeat through the fetoscope (he blamed his age), and seemed a bit exasperated with me, but said my baby is moving lots so it's just fine.
He only wants to see me once or twice more, depending on when I go into labour, and he said as long as I go into labour on my own and my baby is head down, he doesn't have to be there for the birth itself at all. Which I appreciate: I can still have a midwife attended birth this way, just with an OB who happens to know I'm there and know me and know my history. Maybe that's kinda nice, just in case, you know?
But of course we discussed at length my previous birth, including the fact that Riley had 'some degree' of dystocia and was born flat: my midwife attributed cord compression because he handled labour so well right up til the last two minutes, and because she saw his cord behind his shoulder blade. I also pointed out there was some discussion as to *how* flat he was, because the compressions that were done were not agreed upon as necessary. We don't know in retrospect whether he needed them or not, because the nurse running the resuscitation called out, "Heart rate less than 100, start compressions," which is incorrect. If an infant's heart rate is less than 100 they need oxygen and a bag valve mask, and if their heart rate is less than 60, they need compressions. So either the nurse misspoke, or he didn't need compressions. He also recovered quickly and completely, which speaks more to cord compression than dystocia. It also indicates he wasn't as flat as was possibly thought. Anyways, we talked about it for awhile. We also talked about rupture, VBAC, long term obstetrical health, whether I want more children, why I want to avoid a cesarean (I stuck to health facts and didn't mention the emotional side), why I think a drug free birth is important, and diabetic management, research, outcomes, and issues around the globe.
He wasn't a midwife, and it wasn't an empowering visit per se. But it wasn't overtly negative, or bullyish, or even interventive. He didn't order more tests, he didn't mention induction, and he didn't seem opposed to physiological or natural birth. It was evident he believes in physiological birth, but he's also a 'worst case scenario' thinker. We also talked about the difference between the midwifery approach and the obstetrical approach: midwifery looks at the statistical probability and says, "this is safe," whereas obstetrics looks at the worst case scenario and says, "this or this or this could happen." And he responded that this is because the buck stops with obstetricians. They're the ones ultimately looked to for expertise and answers in worst case scenarios. This makes sense to me, like the captain of a ship. No matter if s/he's sleeping off watch; if the ship crashes, s/he's responsible.
But it's hard to know that worst case scenario thinking actually causes problems when it inspires more fiddling with the physiological process than is absolutely necessary, and fully trust this type of thinking. If there were a way to believe in and trust birth and yet still be an expert surgeon for worst case scenarios, THAT would be the ideal obstetrician.
Now I need some more help from you guys.
#1, suddenly I'm petrified of my ability to give birth to this baby. Suddenly, I've lost my belief in myself. Suddenly, I'm thinking the baby's too big, I'm too small, it can't be done, my uterus will rupture and explode and we'll both die, I can't, I can't, I can't...
#2, I have my intrusive ultrasound tomorrow to determine the position of the placenta. PRAY. We need a 2 cm margin. Please, please, please, please....