Birthing center pros/cons....

[TravelingChris]

I am done having children- having had three births in three hospitals. Now for my two daughters if they have children- number one will be a high risk pregnancy because of her thrombophilia so I think hospital will have to be the place where she gives birth and number two gets to choose. I will still recommend to number two to be in a hospital because we aren't sure that the one thrombophilia factors is the only one we have-she doesn't have that one but she may have a yet undiscovered one anyway. Also, she has asthma so I think it will still be a pregnancy that needs to be monitored well.

[ktgrok]

Either medical care varies greatly from one location to another, or there are some harsh misconceptions about hospital births being stated in this thread. When I went through nursing school over 20 yrs. ago, and did my maternity training in both a birthing center and hospital settings, there was already a move toward natural child birth. The same was true when I had my own children. When I labored at the hospital, not only were my wishes for no medication respected, they were encouraged, and I was given assistance with alternative ways to control pain.

 

Although they may be some hospitals still like that, things have changed a LOT in the past 10 years. When I had my son 11 years ago natural labors were not the norm, but were not unusual like they are today. Drugs for pain were pretty common, but that was it. Now the trend is "active management", which means inducing, using pitocin on all mothers to keep contractions and progress exactly according to the plan, an early epidural, active traction to remove the placenta, etc. This is based on my talks with nurses, OB's, and mothers who have recently given birth at ICAN meetings, as well as the births I've witnessed in the past year (3 not including my own). My sister is a CLASSIC case...she was induced because she was a few days overdue. They do NOT allow anyone to go past 41 weeks, and most patients are induced by 40 weeks. She was given multiple medications that are known to cause too strong, too frequent contractions, which they did, so then they gave her different drugs to slow the contractions, then gave her the first drugs again to get them going again, back and forth to get them "just right". Again, this was for a un needed induction on a mom that didn't have a ripe favorable cervix. Then, despite the fact that she had low blood pressure and a history of passing out they gave her a walking epidural epidural, which lowered it more. When she told them she felt faint they checked her blood pressure and it was very low, but they said huh, the machine must be broken, I'm sure it's not really low. Then they told her to get out of bed and use the bathroom while she still could walk, and she fainted. They didn't have anyone big enough to carry her when she was passed out so my BIL did. She is the 2nd woman I've known to pass out at this hospital in the pas 10 months, under similar circumstances. Then the epidural slowed the contractions, and so they increased the pit again. The combo of the pitocin, and the low blood pressure led to fetal distress. They refused to let her try other positions to see if that would help with the heart rate because it made the monitor slip off her belly, and no one was available to help hold it on. Finally they did the c-section for repeated decels. It was ridiculous. My parents were SOOO grateful the baby and my sister were "saved", when in all reality every problem she had were known side effects of the drugs used. And again, I know at least a dozen women that have used this hospital, and this is normal operating procedure for them. The c-section rate is over 40 percent, and climbing. For a while it was 70 percent.

[mommaduck]

It boils down to this: the expectant mother should be informed and take several things into consideration.

 

1) There are competent and incompetent people that are OB's, RN's, CNM's, CPM's, and DEM's.

 

2) There are competent and incompetent people that work in hospitals, birthing centers, and in home birth settings.

 

3) There are hospitals that are very open to a range of delivery, from normal & natural to high-risk intervention ready, to hospitals that are very controlling, short staffed, and treat everything as though it will become a medical emergency (even if that means creating the emergency) simply to cover their rear ends from lawsuits.

 

4) Different areas will also have different mindsets, mainly around cultural attitudes, what they are familiar with seeing/practicing, and the rate of lawsuits/insurance issues.

 

5) FIND OUT and know THAT hospital/birthing center's typical practices. Speak with others that have birthed there!!! (simply because a dr gives a head nod at a list of desirable hopes and dreams, doesn't mean that they intend to pay any attention to it...however, a dr that has their own checklist and takes the time to actually ASK the patient in an office visit if they want/don't want this or that is a good sign that that OB/hospital gives the patients options).

 

6) (And the most important!) What is YOUR medical history and how are things going with THIS pregnancy??? Some women are NEVER a good candidate for homebirth, but may be for a birthing center...or a hospital may be the ONLY place that she is best at for a delivery. Some women are EXCELLENT candidates for homebirth/birthing center. Many times, it depends on how THIS pregnancy is going. However, a high risk woman could end up with a perfectly normal birth at a hospital and a low risk, every delivery is always easy type of woman could end up with a complication that takes her from hb/bc to the hosp.

 

It's a crap-shoot and you make the best decision for YOUR situation and circumstances. We can give all the experiences and advice and opinions we want, but we don't know the variables of each woman's situation or practices of her area.

 

I've had both good and nightmarish situations in hospitals. I've had a couple of wonderful homebirths (though the first one was bit interesting).

 

I won't get into the "who's had more education/experience" bit. Simply put...there are idiots with high degrees and there are people with less formal education and more experience with a lot more common sense. So I don't judge on the letters behind someone's name.

[dirty ethel rackham]

Either medical care varies greatly from one location to another, or there are some harsh misconceptions about hospital births being stated in this thread. When I went through nursing school over 20 yrs. ago, and did my maternity training in both a birthing center and hospital settings, there was already a move toward natural child birth. The same was true when I had my own children. When I labored at the hospital, not only were my wishes for no medication respected, they were encouraged, and I was given assistance with alternative ways to control pain.

 

Unfortunately, this is not the reality everywhere. I taught Bradley Method classes for 12 years. It was an uphill battle for my students to have unmedicated births with few interventions. In the last 10 years, the induction rate has been rising and has recently SKYROCKETED and, along with it, the primary c-section rate. Most of the CNMs I knew have been forced into defensive medicine rather than midwifery - they even call themselves "medwives." Of all the CNMs I have known over the years, there are only 2 or 3 that I would recommend without reservation anymore. The due date pressure is outrageous. Pregnant women are told at 38 weeks that their induction will be scheduled at 41 weeks so they can "get them in." Nothing like being told that your body will not work. ROM means delivering within 12 hours whether a mom is in labor or not. Due to malpractice changes, home birth midwives could not get back up doctors, so many stopped doing home births. I think we have less than a handful of legal homebirth providers in our state. There are some underground midwives of unknown training - some are very experienced CPMs, but most qualified providers left the state due to sting operations from our Department of Professional Regulation. Having a healthy out-of-hospital birthing community seems to create competition for hospitals and force them to have more mother-friendly and baby-friendly policies.

 

I got burned out trying to help my students get births remotely close to natural and stopped teaching 2 years ago. It makes me sad to hear how hard people have to fight to have normal births.

[mommaduck]

Unfortunately, this is not the reality everywhere. I taught Bradley Method classes for 12 years. It was an uphill battle for my students to have unmedicated births with few interventions. In the last 10 years, the induction rate has been rising and has recently SKYROCKETED and, along with it, the primary c-section rate. Most of the CNMs I knew have been forced into defensive medicine rather than midwifery - they even call themselves "medwives." Of all the CNMs I have known over the years, there are only 2 or 3 that I would recommend without reservation anymore. The due date pressure is outrageous. Pregnant women are told at 38 weeks that their induction will be scheduled at 41 weeks so they can "get them in." Nothing like being told that your body will not work. ROM means delivering within 12 hours whether a mom is in labor or not. Due to malpractice changes, home birth midwives could not get back up doctors, so many stopped doing home births. I think we have less than a handful of legal homebirth providers in our state. There are some underground midwives of unknown training - some are very experienced CPMs, but most qualified providers left the state due to sting operations from our Department of Professional Regulation. Having a healthy out-of-hospital birthing community seems to create competition for hospitals and force them to have more mother-friendly and baby-friendly policies.

 

I got burned out trying to help my students get births remotely close to natural and stopped teaching 2 years ago. It makes me sad to hear how hard people have to fight to have normal births.

 

:iagree: with the bolded. I know when I lived in Southern Illinois, the only homebirths I knew about had to be done "underground". The hospitals strapped you down to a bed, IV's, and every monitor imaginable (including internal) as soon as you hit the door. In PA, many women deliver both at home and in hospitals and the attitude in our area is different than what I experienced in IL.

[snipsnsnailsx5]

Unfortunately, this is not the reality everywhere. I taught Bradley Method classes for 12 years. It was an uphill battle for my students to have unmedicated births with few interventions. In the last 10 years, the induction rate has been rising and has recently SKYROCKETED and, along with it, the primary c-section rate. Most of the CNMs I knew have been forced into defensive medicine rather than midwifery - they even call themselves "medwives." Of all the CNMs I have known over the years, there are only 2 or 3 that I would recommend without reservation anymore. The due date pressure is outrageous. Pregnant women are told at 38 weeks that their induction will be scheduled at 41 weeks so they can "get them in." Nothing like being told that your body will not work. ROM means delivering within 12 hours whether a mom is in labor or not. Due to malpractice changes, home birth midwives could not get back up doctors, so many stopped doing home births. I think we have less than a handful of legal homebirth providers in our state. There are some underground midwives of unknown training - some are very experienced CPMs, but most qualified providers left the state due to sting operations from our Department of Professional Regulation. Having a healthy out-of-hospital birthing community seems to create competition for hospitals and force them to have more mother-friendly and baby-friendly policies.

 

I got burned out trying to help my students get births remotely close to natural and stopped teaching 2 years ago. It makes me sad to hear how hard people have to fight to have normal births.

 

I do have to give some words of encouragement, maybe. :) I've had five births, all in a hospital. Two were non-medicated by choice and the OB and staff were totally accepting and supportive of that. Even when I started to ask for meds at one point (nearing transition), they encouraged me to keep going because I was so close.

My other three I did get epidurals with, by choice, because I wanted to not have to worry about the pain of childbirth. lol

They worked just fine, although the last two weren't really needed as I literally had minutes before it was suddenly time to push (in both cases went from about a 6-7 to a 10 and ready to push in just minutes).

So I've learned by lesson with the last two and am not going to go for the epidural again. :)

Anyway, my OB has never tried to induce contractions with pitocin or pushed a c-section, etc. She did induce labor via water breaking with my 3rd and 4th sons who I was dilated to 4cm with one and about 2-3 cm with the other. Contractions started on their own within the hour. :)

Also, at the hospital I was allowed to walk around (pre-epidural), and they had me try a birthing ball before. One of my labors (number 4 I think) I spent nearly entirely in a rocking chair. It was the only place I felt comfortable for some reason. lol

[wapiti]

I am done having children- having had three births in three hospitals. Now for my two daughters if they have children- number one will be a high risk pregnancy because of her thrombophilia so I think hospital will have to be the place where she gives birth and number two gets to choose. I will still recommend to number two to be in a hospital because we aren't sure that the one thrombophilia factors is the only one we have-she doesn't have that one but she may have a yet undiscovered one anyway. Also, she has asthma so I think it will still be a pregnancy that needs to be monitored well.

 

It may or may not be comforting :D to know that anticoagulants may prohibit one from receiving an epidural in certain situations, such as when the last shot occurred too recently. Thus, preparation for natural childbirth can come in handy.

 

FWIW, I can't complain about any of my in-hospital high-risk deliveries, in spite of having read plenty about horror stories and alternatives. One was unmedicated, albeit with continuous fetal monitoring and an IV (a vbac on heparin :D). I admit I had an epidural for my premie twin vbac, which came in handy when the OB reached in to turn the second baby head down...

[LittleIzumi]

Unfortunately, this is not the reality everywhere. I taught Bradley Method classes for 12 years. It was an uphill battle for my students to have unmedicated births with few interventions. In the last 10 years, the induction rate has been rising and has recently SKYROCKETED and, along with it, the primary c-section rate. Most of the CNMs I knew have been forced into defensive medicine rather than midwifery - they even call themselves "medwives." Of all the CNMs I have known over the years, there are only 2 or 3 that I would recommend without reservation anymore. The due date pressure is outrageous. Pregnant women are told at 38 weeks that their induction will be scheduled at 41 weeks so they can "get them in." Nothing like being told that your body will not work. ROM means delivering within 12 hours whether a mom is in labor or not. Due to malpractice changes, home birth midwives could not get back up doctors, so many stopped doing home births. I think we have less than a handful of legal homebirth providers in our state. There are some underground midwives of unknown training - some are very experienced CPMs, but most qualified providers left the state due to sting operations from our Department of Professional Regulation. Having a healthy out-of-hospital birthing community seems to create competition for hospitals and force them to have more mother-friendly and baby-friendly policies.

 

I got burned out trying to help my students get births remotely close to natural and stopped teaching 2 years ago. It makes me sad to hear how hard people have to fight to have normal births.

 

Heck with 38 weeks--the CNMs gave me the form around 20 weeks, I think. Very medwives. But they were pretty good at letting me do what I wanted as long as things looked stable. I highly preferred my home birth though.

 

I do have to give some words of encouragement, maybe. :) I've had five births, all in a hospital. Two were non-medicated by choice and the OB and staff were totally accepting and supportive of that. Even when I started to ask for meds at one point (nearing transition), they encouraged me to keep going because I was so close.

My other three I did get epidurals with, by choice, because I wanted to not have to worry about the pain of childbirth. lol

They worked just fine, although the last two weren't really needed as I literally had minutes before it was suddenly time to push (in both cases went from about a 6-7 to a 10 and ready to push in just minutes).

So I've learned by lesson with the last two and am not going to go for the epidural again. :)

Anyway, my OB has never tried to induce contractions with pitocin or pushed a c-section, etc. She did induce labor via water breaking with my 3rd and 4th sons who I was dilated to 4cm with one and about 2-3 cm with the other. Contractions started on their own within the hour. :)

Also, at the hospital I was allowed to walk around (pre-epidural), and they had me try a birthing ball before. One of my labors (number 4 I think) I spent nearly entirely in a rocking chair. It was the only place I felt comfortable for some reason. lol

 

Wow, you had awesome OBs!!! Nice to know there still are some :D.

[happyhappyjoyjoy]

I'm a former Bradley teacher. Our first was natural in a hospital, because we labored 80% at home. The next two days were miserable. Our 2nd was a birth center with CNMs that had hospital privileges. Our baby in heaven was an 8 wk miscarriage that I labored through on my own at home (6 hour labor with 3 hours of hard labor). Our 3rd was a different birth center with CNMs. I wouldn't have it any other way.

[amy g.]

I really think the attitude varies greatly depending upon what part of the country you are in.

[SweetBean]

I really think the attitude varies greatly depending upon what part of the country you are in.

It would be interesting to see a poll.

[Shawna in Texas]

I do have to give some words of encouragement, maybe. :) I've had five births, all in a hospital. Two were non-medicated by choice and the OB and staff were totally accepting and supportive of that. Even when I started to ask for meds at one point (nearing transition), they encouraged me to keep going because I was so close.

My other three I did get epidurals with, by choice, because I wanted to not have to worry about the pain of childbirth. lol

They worked just fine, although the last two weren't really needed as I literally had minutes before it was suddenly time to push (in both cases went from about a 6-7 to a 10 and ready to push in just minutes).

So I've learned by lesson with the last two and am not going to go for the epidural again. :)

Anyway, my OB has never tried to induce contractions with pitocin or pushed a c-section, etc. She did induce labor via water breaking with my 3rd and 4th sons who I was dilated to 4cm with one and about 2-3 cm with the other. Contractions started on their own within the hour. :)

Also, at the hospital I was allowed to walk around (pre-epidural), and they had me try a birthing ball before. One of my labors (number 4 I think) I spent nearly entirely in a rocking chair. It was the only place I felt comfortable for some reason. lol

 

I'll preface by saying I've have two natural births in a birthing center. Your dr. sounds like a gem as does the staff. And as much as I like to promote midwifery, one of the reasons I do so is so that women can have a birth much like the ones you've had. I took Bradley classes with my first and half the time we talked about how to manage your hospital birth experience. I would stick with your dream OB and hire a doula if you're wanting more personal support. I had a doula with both mine and liked them more than the midwives.

[Peek a Boo]

5 kids, all planned homebirths. #1 was 7 weeks early, so we went to the hospital. He was so healthy he could have been born at home tho...

 

The other 4 were homebirths. worked great. would do a homebirth again if the situation provided itself.

 

If you do go the hospital route, I'd strongly suggest having a doula too: her job is to be YOUR advocate during the birth. My midwife for #1 made a great doula at the hospital. :)

[HS Mom in NC]

I emergency transferred from my second homebirth to a hospital with a placenta tearing off the uterine wall (it came out of the incision before she did during the crash c-section) and a fallopian tube spontaneously ruptured as we left the house for the hospital. The hospital was 10 minutes away. YOU'LL BE FINE. We both were.

 

Doesn't the birth center routinely deal with complications and transfers? Did you ask them about it? What do you think will happen to you that they haven't dealt with before? I was always surprised by people, who hearing about our homebirths said things like, "Well, it sounds good, but what would they do if a complication came along? I just couldn't risk it." Uh, I asked them what they would do (and what they have done) when complications come up and you know what? They managed to deal with it every time.

 

Here's another way to look at it:

If I planned at birth at the hospital the chances of me having a c-section is 1 in 3 or 1 in 2 depending on which hospital I choose. If I plan a homebirth with my midwife the chances of having a c-section is.......1 in 80. Why put myself and my baby at risk for the complications caused by routine interventions by birthing in a hospital? If I'm getting a c-section (I did for kid #2) it's going to be for a legitimate reason. Birth centers also reduce the risk of unnecessary interventions and the risks associated with them.