Midwife vs. Hospital

[Aubrey]

Ok, so I have one more real question after all...

 

I've had all 3 of my dc with the same midwife in the same birthing center. It's a remodeled home in Dallas, very simply furnished, &, most importantly, all I've ever known.

 

So we're an hr away from there now, but I call her anyway to see if that would work. My births have ranged from 4hrs to 19 min, start to finish, so I have some reason to...wonder.

 

She's moved her business another 30 min away. She said she'd still take me, since I've had babies w/ her before. She rec. a home birth, to save $ & to save travel time. That way, worst case scenario, dh delivers baby, & she arrives soon after. (Also, we've had a neighbor volunteer to deliver baby. LOL)

 

Dh is uncomfortable w/ this plan. Hee-hee. Some of my friends around here have friends who've delivered in the hospital with a group of local midwives they love. This would be fine w/ me, in theory, as the hospital sounds like a bed & breakfast. Dh always forgets to feed me the first couple of days after the birth. Not that it gets better after that, just that then I can feed myself. Poor guy. He does feed the other dc. (I think.)

 

What I want to know is, what differences would there be? What questions should I ask these midwives? Some that I've thought of include:

• Do I have to be hooked up to an IV? (I might could deal w/ this, but yuck. I hate needles.)
  
• Do I have to deliver in bed, lying down? This would be a deal-breaker.
  
• Could I eat/drink during labor? Not that it matters w/ such short labors. I've never cared. LOL
  
• Will they take the baby? Another deal-breaker. I'm used to mw weighing baby in a little cloth scale right there in the bed w/ me. And if I want baby bathed, I have to ask. In which case, she & dh take baby to bathroom sink, like 10 steps away.
  
• Who will be in the room? I've never even had a birth assistant. They just can't drive fast enough. W/ #1, she got there after the birth & helped. W/ #2, there was an apprentice. W/ #3, it was just mw & dh. That was my FAVORITE birth. Although it was a little like a drive-through w/ so little pomp & circumstance. But really. We're not planning a wedding, kwim?
  
• What kind of stuff will they do to the baby? W/ mw, nada. I get a form ahead of time, offering to do various things, but nothing is "standard." I generally go w/ everything, but I like deciding. I don't want baby standardized, kwim? (Can you tell I hs? LOL)

What else might freak me out at a hospital? I'm thinking this might just be too hard for me. Too foreign, kwim?

[AnneJ]

Of course, the answers from the midwife group may differ but my experience is that you wouldn't have to have an IV (unless there were complications),

you could eat/drink if you wanted,

you can deliver wherever you want in whatever position you want provided it is in the birthing room (I think they'd rather avoid the hallway LOL!),

you would be in the room with DH, the midwife and the nurse,

you can still choose whatever tests you want run on your little one,

you don't have to stay for 2 days if you don't want to--although if the hospital has all private rooms then it wouldn't be a bad idea.

 

All your questions are good ones and I'd probably vote for using the midwives at the local hospital rather than using a birth center that is 1 1/2 hours away--especially since your labors have been so short.

[beansprouts]

I had two homebirths after a natural, midwife-assisted hospital birth and all three were wonderful :) I do think in your case homebirth may be worth a look, but I would never try to push anybody to make that decision.

 

While in the hospital, it was very important that I was allowed to walk around freely. I probably walked miles up and down those hallways, and it was what I needed for my labor to progress.

[litabitm]

Hi Aubrey, I am a doula trained by DONA (www.dona.org) and a lamaze trained childbirth educator. I have attended 5 hospital births and most of my clients have been able to have exactly what they wanted in the hospital. I say most because 1 client chose to get an epidural and the interventions just spiraled from there. If you are working with a midwife at the hospital, they are usually more open to the idea of a natural birth without any interventions. It is important for you and your dh to research and write a birth plan and talk to your midwife about it ahead of time. I'd also pack a copy in your hospital bag. I think it is a pretty standard question now to ask if you have a birth plan. Just remember it is your birth and you have the right to have it the way you want. I'd suggest you look into hiring a doula to help you with this process. I know you have very quick labors, but maybe a doula looking to get her certification would help you with a birth plan for free.

 

Here are some common things the moms request when wanting to go natural:

 

1. freedom of movement - I cannot stress the importance of this enough!

2. keeping hydrated and eating lightly during labor - moms need their strength

3. no ivs - if they insist, ask for a heplock

4. pushing in the position most comfortable for you: standing, using a birth ball, all fours, on your side - just don't lie down in that bed!

5. ask for baby to be placed on your chest immediately and you should try to have skin to skin contact with baby.

6. you may ask for delayed baby care and many moms ask that any necessary care be done while baby is on their belly. you can delay the ointment in the eyes - even better you can squirt colustrum in the baby's eyes instead of the ointment.

7. ask for baby to have bath in the room with you

8. if you are choosing to nurse, try to establish that within the first hour.

9. Ask for you or dad to be with baby at all times if you wish.

 

As far as people in the room, there will be the midwife, nurse, and usually a couple of baby nurses. You can deny requests made to have a cervical check by any medical students.

 

Ina May Gaskin wrote a beautiful book called "Ina May's Guide to Childbirth". It is a wonderful resource. You can also check out www.birthsource.com It is a wonderful site with loads of info.

 

I hope this helps you. If you have any questions please feel free to pm me. :)

 

Liz

www.heartfeltlabors.com

[Faithseed]

I would ask the mw what authority does the hospital have over the births there.

 

At what point would the hospital demand to "take over"? (in the case of c-sections, and such)

 

At a mw/home birth- it is basically your and your mw's rules to play by, but at a hospital you are on their playground. I know of some hospitals that mw's have a lot of pull, but there are always rules that they have to live under.

 

I would also ask what the soonest you could go home (just in case you want to bug out), and what the procedure would be to allow you to go early.

 

Also, would you have access to any equipment (birth balls, birth tubs and the like), and would they be readily available to you as a mw patient.

 

I hope for your sake that this is as wonderful as it sounds like it is!! Unfortunately, even after living in several different states, all I've ever seen at a hospital (and any medical facility, frankly), has been mw unfriendly at best- hostile at worst. It really does sound like a wonderful compromise!

[Aubrey]

9. Ask for you or dad to be with baby at all times if you wish.

 

As far as people in the room, there will be the midwife, nurse, and usually a couple of baby nurses. You can deny requests made to have a cervical check by any medical students.

 

(I don't know if I've done the quote-thing right!) This is the kind of stuff that freaks me out. My mom was "asked" if some firefighters could "look" for training purposes. That was just one of many horror stories that, when I first heard of natural births, sold me immediately, as. a. kid. Only later did I discover that there were a host of other, even better reasons for natural/home/birth center birthing.

 

And btw, I forget who mentioned not going to the bc 1.5 hrs away, but I'm kind-of looking at options around here. Iow, should I consider the hospital mw's or look for more traditional home birth/bc birth rte?

 

Thanks so much for your input!

 

My mw had dh & I write birth plans for ea of the other 3. I was kind-of flippant about it, though, because I knew that she offered what I wanted, & I didn't really want anything else. She actually commented after our last birth that my plan was virtually blank & that the birth actually matched that plan.

 

I wasn't sure I was in labor, but because of speedy previous births, she met us immediately, & she went to sleep in another room until I called her. Dh went to sleep in our room, & when I couldn't sleep because I really was in labor, I just walked around, etc. by myself. It was VERY peaceful. When I woke them up, baby was nearly crowning.

[beansprouts]

And btw, I forget who mentioned not going to the bc 1.5 hrs away, but I'm kind-of looking at options around here. Iow, should I consider the hospital mw's or look for more traditional home birth/bc birth rte?

 

The hospital where dd was born was a 35 minute drive - a trip I made while in heavy labor :eek:. I NEVER wanted to do that again!

 

I think a 1.5 hour drive is pretty much out of the question for you. I would encourage you to check out both the hospital midwives and homebirth options. Gather all the facts first then sit down with hubby and discuss them and determine what is right for you :)

[Chris in VA]

Hi Aubrey,

I delivered dd7 at Baylor with a wonderful midwives group. If you want the names, email me (I'd say now, but I can't remember!--not that they weren't great, it's just been 7 years!).

 

I had juice and water all thru the labor, no iv, could walk around, etc. I actually didn't want the baby on my tum after, until she was cleaned up. I didn't have a mandatory episiotomy--my midwife asked if I wanted a little "digital" help in opening my cervix (I don't recommend it--it hurts!). They provided hot towels to ease the pain "there," and even showed me The Tree of Life on the "pretty" side of the placenta.

 

Oh, and I'm the one who needed nipple stim to get things going. lol

It actually sounds like there were interventions, but really, it was very natural and supportive.

[AnneJ]

And you don't think he'll change his mind, then I would go with the midwives at the local hospital. You want this to be a good experience for both of you and if he has lots of anxieties about the home birth, then you'll sense that and it might cause anxiety for you. I know my DH would be passed out on the floor if I asked him to help with a birth. :D He absolutely refused to watch any of the kids come out and still almost passed out!

[litabitm]

Aubrey, if you are open to home birth, then I would absolutely do that and find a mw that is closer to you. You could even rent a birthing pool if you wanted a water birth - they are awesome! Of course, with your fast labors, you might not have time to fill up the pool!

 

I am in Ohio and sadly home births are considered "a-llegal" meaning if your mw is "caught" she can be charged with practicing medicine without a license - just happened to a mw in my doula group - that is really scary!

 

Let me know if you have any more questions! Keep us posted.

 

Liz

www.heartfeltlabors.com

[dirty ethel rackham]

A couple other questions, based upon my experience as a childbirth educator here in IL.

 

1. As mentioned before, what kind of autonomy do they have over "hospital policy?"

2. When do they recommend induction?

3. What kind of testing do they require (or push you to have)? Triple screen, ultrasound for dating or size of baby or amniotic fluid index, amniocentesis, glucose tolerance test, group B strep test, etc. Around here, the hospital based midwives talk a good game, but all of the sudden, my students are hit with a bunch of "requirements" that were previously "optional".

 

I would not only ask these questions of the midwives, I would ask them of anone you know who had a baby with them. The people who give them rave reviews may have a different frame of reference than you.

 

I personally would go with the home birth option, if I could.

[Mama Lynx]

Chris - may I ask which Baylor?

[Aubrey]

And you don't think he'll change his mind, then I would go with the midwives at the local hospital. You want this to be a good experience for both of you and if he has lots of anxieties about the home birth, then you'll sense that and it might cause anxiety for you. I know my DH would be passed out on the floor if I asked him to help with a birth. :D He absolutely refused to watch any of the kids come out and still almost passed out!

 

 

Nah. Dh has had to play assistant for the last 3.

[Aubrey]

You could even rent a birthing pool if you wanted a water birth - they are awesome! Of course, with your fast labors, you might not have time to fill up the pool!

 

LOL--nope, they couldn't even fill up the bath tub before #1, & his was 3 hrs. Of course, that incl the time before we arrived.

[Mama Lynx]

Hmmm, Aubrey. Have I talked with you about this before, and my sieve-like brain can't remember? I had baby #2 at a birthing center that was a remodeled home in Dallas :) Then I moved 1.5 hours away from it.

 

In my case, I was determined to avoid a hospital, so I hired a midwife. I ended up in the hospital with complications. (The hospital was just fine, but it was a hospital, and since I was having complications, I got an IV and pitocin and the works. But they were respectful, and allowed DH to remain with the baby at all times.)

 

#4 was a homebirth.

 

I would not choose to birth in a hospital, but my experiences were not good. But my hospital births were with OBs, never with attending midwives.

 

There is an excellent birth center in Grand Prairie, as well, fyi.

[AnneJ]

Your original post said that DH was uncomfortable with that plan (where you birth at home and then the MW comes). I assumed he was uncomfortable with the home birth. Sorry for the misunderstanding.

 

With as short as your labors have been, you might end up with a home birth whether you plan for one or not. :)

[Aubrey]

There is an excellent birth center in Grand Prairie, as well, fyi.

 

That scares me a little, too. I started out at a different bc w/ #1, & it was SO awful. I mean, like, if you Google them now, there are reports of them using some kind of scary illegal drug that can potentially cause women's uteruses (uteri?) to explode.

 

So bc, homebirth, hospital--anybody but my one trustworthy lady--I'd rather not think about. I'm always very full of gusto at this point, willing to try anything, incl delivering the baby myself. But when it comes time? Uh-uh. It's my way (my mw) or NO way, kwim?

 

Makes it kind-of hard to know how I'm going to feel about it a few mos from now. But, uh, I'm getting far enough along, I think I kinda oughta...do *something.* Kwim? LOL.

[Aubrey]

Not that *that* was the bad BC, just that a different one than what I know makes me uncomfortable. But I'm made uncomfortable quite easily. LOL

[Aubrey]

Your original post said that DH was uncomfortable with that plan (where you birth at home and then the MW comes). I assumed he was uncomfortable with the home birth. Sorry for the misunderstanding.

 

With as short as your labors have been, you might end up with a home birth whether you plan for one or not. :)

 

I think he just wants to know someone's coming a little quicker than that! LOL

[Mama Lynx]

Not that *that* was the bad BC, just that a different one than what I know makes me uncomfortable. But I'm made uncomfortable quite easily. LOL

 

... Because as much as I loved the BC in Dallas, my homebirth midwife, who I am convinced is the best in the area, came out of that GP birth center.

 

But I certainly understand the uncomfortable/unknown factor.

[Mamagistra]

Aubrey, if you are open to home birth, then I would absolutely do that and find a mw that is closer to you. You could even rent a birthing pool if you wanted a water birth - they are awesome! Of course, with your fast labors, you might not have time to fill up the pool!

 

I totally agree with Liz here, and I personally would avoid a hospital birth at all costs. I think that you are more likely to be pressured into something that you don't want simply by being in that environment.

 

Check your library for these books if you feel like researching the subject further:

Born in the USA by Marsden Wagner

Pushed by Jennifer Block

The Thinking Woman's Guide to a Better Birth by Henci Goer

 

And FWIW, the exploding-uterus drug, Cytotec (Misoprostol), is sometimes used to induce labor. Wagner's book talks about it in detail. ::shudder::

[Sebastian (a lady)]

9. This is the kind of stuff that freaks me out. My mom was "asked" if some firefighters could "look" for training purposes. That was just one of many horror stories that, when I first heard of natural births, sold me immediately, as. a. kid.

 

FWIW, I have a different perspective on the conga line in the delivery room. In my first delivery, it was a necessity for both of our health (I think I counted an even dozen in the room who were not related to me). However, I've pretty much had an open door policy on the other two. The last delivery was the senior resident teaching a junior resident. When one proceedure was going poorly, I was the one to reassure the junior resident and tell her that she was doing fine. The young corpsman who kept taking my vitals and asking me to rate my pain level thought I was having trouble understanding her when I consistently said "2." I finally had to explain that I knew what 10 was like and that this wasn't it.

 

I sort of hope that folks can see me behaving as if labor were normal and perhaps be convinced that in fact it is. Maybe if they see that I can do a delivery with no or almost no pain meds, they will be less likely to suggest/recommend/order that at the onset with the next mom.

 

Although I can understand other moms not wanting to be the guinea pig, if the only people the student docs and nurses see are those who think every pain is a level 10 and that the only way to deliver is with as much pain medication as possible, why would they ever conceive of there being another way?

[Suzanne in ABQ]

I had two of my kids with midwives, in the hospital. Both were entirely drug free. Both were on my terms. Both midwives were warm, and caring, and strong, and knew exactly what was going on. Both deliveries were fast and furious. Both children were healthy and strong.

 

It seems to me that a hospital that has midwives would be the kind of hospital that would be open to letting you have it your way. If they were going to be rigid, intervening, and 50s-ish, they wouldn't have midwives on staff. KWIM?

 

The negatives I had in the hospital didn't have anything to do with the delivery, but came afterward. The hospital staff doesn't seem to know that night time is for sleeping. They wake you up at all hours to take vital signs, take blood, check you out, etc. Very annoying, but not dangerous.

 

Keep an open mind when talking to the hospital midwives. Most likely, they have your best interest at heart. They'll listen to you, and they'll take time with you to get to know you, and your history, and your hopes/wants/needs with this delivery. Most of all, they'll want a healthy mom and a healthy baby when it's all over.

[swimnactmom]

giving birth to a baby in anything other than a fully equipped hospital, provided that it one is accessible, is nothing but SELFISH. When you (many women in general) plan this event, there is so much talk about how YOU want it to go and how YOU want it to be and what YOUR plan is. It's fine have preferences and but the focus should be on the baby and being somewhere an emergency can be easily addressed. This is the technology God has given us. We don't live in the 1800's and we shouldn't have babies like we do (live in the 1800's.) If something goes wrong during the delivery and the baby, or you, weren't in the best place medically, would you be okay with that situation just because your "plan" was executed the way you wanted to be?

[Barb_]

You're right. That was harsh to the point of stunningly arrogant. Studies have shown that homebirth is at least as safe as hospital birth for healthy women. Some have shown it is considerably safer. Example:

 

A.M. Duran stated in The Farm Study, published in the American Journal of Public Health in March 1992, that "home births attended by lay midwives can be accomplished as safely as, and with less intervention than, physician-attended hospital deliveries." Dr. Lewis Mehl compared matched populations of 2,092 home births and 2,092 hospital births. Midwives and family doctors attended the home births, while OB/GYNs and family doctors attended the hospital births. Within the hospital group, the fetal distress rate was 6 times higher, maternal hemorrhage was 3 times higher, limp unresponsive newborns arrived 3 times more often and there were 30 permanent birth injuries caused by doctors. In another study, Dr. Mehl compared matched groups of 1,046 home births with 1,046 hospital births. There was no difference in infant mortality. In the hospital births, there was greater incidence of fetal distress, lacerations to the mother, neonatal infections, forceps delivery, cesarean section, and nine times as many episiotomies.

 

Infant mortality is lowest in countries with the highest rates of homebirth. In the USA infant mortality is going up all the time because doctors are trained to fix things, and they often attempt to fix what isn't broken. Attempting to hurry along or control a normal, natural process like childbirth is akin to pulling a butterfly from a cocoon. Unlike the typical OB, a midwife remains close by, waiting and watchful during labor and delivery. She is highly attuned to the nuances of the laboring woman and is quick to note potential problems, often solving them before they escalate. Midwives are better trained and more patient with situations such as shoulder dystocia or stalled labor. Midwifes carry oxygen and pitocin in case of hemmorhage. In an emergency requiring C-section (often caused by the interventions themselves), the standard for "decision-to -incision" in a hospital is 30 minutes. A woman laboring 20 minutes away is still well within the standard so long as the hospital has been alerted she is being transported. Finally, a hospital is possibly the germiest place possible to bring a baby into the world...barring perhaps a Walmart.

 

I understand that homebirth isn't for everyone, just as homeschooling doesn't suit every family. Even in the face of evidence many, probably most people will feel safer in a hospital and that's a personal choice. But remember, technology isn't virtuous simply for being modern. Don't trash those of us who decide to step outside *your* personal comfort zone.

 

Barb

[Natalieclare]

Especially because my dh is a pediatrician, and as a rule, most of them freak out at the thought of home birth. My dh certainly did, until the birth of our 3yo. She was born at a hospital very. rapidly. with a midwife (and who knows how many others) in attendance. The birth was fine, drug and intervention free, and we went home not even 10 hours after she was born. The worst part of the birth was deciding when to go to the hospital. However, it became clear that what I used to think was a matter of course (uncomfortable hospital beds, heplocks, intrusive nurses) was actually pretty needless in my case.

 

So, 2 years later, we had a baby at home, with a midwife in attendance. It was quiet, peaceful, less painful, smooth. And actually, one of the things that changed my husband's mind about home birth is a medical concern, namely that MRSA cases are on the rise. This trend is even being reported in conservative medical journals -- I read a headline last week: MRSA Cases Rising in Healthy Neonates Born In Hospitals. I don't know if that's the exact title, but that's the gist. Scary!

 

I'm kinda feeling like I don't really want to go to a hospital unless it's absolutely necessary.

[Aubrey]

Although I can understand other moms not wanting to be the guinea pig, if the only people the student docs and nurses see are those who think every pain is a level 10 and that the only way to deliver is with as much pain medication as possible, why would they ever conceive of there being another way?

 

It's not that I mind being a guinea pig; for one of my births, the mw had an apprentice. That was fine with me. There were 2 of them, & they were both girls.

 

It's that I'm private. If a man, or a group, for that matter, want training...sorry, they're gonna have to find some of those women who don't mind making the birth videos, either. LOL

[Aubrey]

Even in the face of evidence many, probably most people will feel safer in a hospital and that's a personal choice. But remember, technology isn't virtuous simply for being modern. Don't trash those of us who decide to step outside *your* personal comfort zone.

 

Thank you for your very educated input.

[Tammyla]

I enjoyed midwives in a hospital setting for the birth of my ds. There were no "rules" and birth plans were welcomed.

Blessings~

[Mamagistra]

You're right. That was harsh to the point of stunningly arrogant. Studies have shown that homebirth is at least as safe as hospital birth for healthy women. Some have shown it is considerably safer.

 

Amen! The 'technology first' mindset is an abomination to both women and babies when applied without common sense, as it is in the shinyhappymodern world of drug-and-cut obstetrics. In research for my own births, I found that the OB and the hospital are more likely to do harm to babies, not a "selfish" woman whose body is doing what bodies have done since the beginning.

I had to fight our health insurer tooth-and-nail to cover a safer birth that cost THEM less. :mad: The birth industry is the very model of arrogance!

 

::walks away to maintain composure::

[Amy in NH]

I had two unmedicated hospital births before I finally wised-up and stayed home. Granted the hospital births were not with a midwife, and the home births were; but I would avoid a hospital at all costs, especially with the rise of nosocomial infections such as MRSA.

 

I hated the belly band fetal monitor they felt they had to strap on every 1/2 hour, and which required me to sit still when I wanted to be up and walking.

I was unhappy walking the labor & delivery hallways. It was so much nicer to be home and walking through my neighborhood or my yard, or even around my dining room table.

I wasn't allowed to eat anything, even during a 15 hour labor.

I was allowed to labor on the birthing stool, but had to get back into bed to deliver in a most uncomfortable position.

Even though they knew I was determined to have unmedicated births, the nurses continually asked if I was ready for drugs.

When I knew I was ready to deliver, everyone was out in the hallway gabbing and had to be called 3-4 times.

 

Some other issues I encountered being in the hospital with my newborns, whom I specifically requested to have rooming in with me:

 

The nurses were just plain pushy (and I was a new mom so I was intimidated).

They would come take the baby to check vitals instead of doing them in the room.

They would ask me if they could give my baby sugar water in a bottle when they knew I was trying to establish breastfeeding. Also pacifiers.

They sent me home with a pile of formula samples, even though I told them I was not going to use formula (which I didn't).

The hospital bed was totally uncomfortable.

I forgot my hairbrush.

 

 

If it were my choice, I'd stay home and find a closer midwife (if possible).

 

I loved it that my little ones were able to be playing upstairs during the hard part, with a grownup friend, and they could come down right after the delivery was cleaned up and bond with their new sibling.

I loved it that I could sleep in my own comfy bed with my dh and new baby, and shower in my own bathroom.

[battlemaiden]

As a former Labor and Delivery nurse there is no way I could do a home birth. I simply have too many memories of things going wrong.

 

I have had midwives in the hospital and this is my favorite option.

 

As for your wishes, that depends on just how assertive you are. I'm a pain in the arse.:o I refuse almost all interventions. As long as I'm certain of what I want, and everything is going fine during labor, they leave me alone until I'm pushing. I like it this way. You can also refuse to allow the baby to be taken anywhere without you or your husband.

 

I haven't read the other responses. I'm sure there is a wide variety of opinions on this topic. My ultimate advice is to go with what you feel most comfortable (not just in esthetics but also in safety).

 

Jo

[litabitm]

Aubrey, there is a wonderful documentary circling the country called, "The Business of Being Born". Different birthing groups are holding screenings of this movie as it was only released on the coasts. It is produced and directed by Ricky Lake and Abby Epstein. It is coming out on DVD in April. You might check with your midwife to see if she has ordered a copy or knows of a screening you can attend. It is a MUST SEE! Ricky Lake had a typical hospital birth full of interventions the first time around and hated every minute of it. Her second birth was very, very different and a joy to watch.

 

There's also a very funny Monty Python clip to watch about birth in a hospital - it's hilarious and overdone, but can be so true.

 

Now don't get me wrong, hospital births can be beautiful experiences - all 5 of mine were born in a hospital, but for me, it's a case of ignorance - I didn't know better at the time, but I still treasure every minute of my birth experiences.

 

For the case of my oldest daughter, being in a hospital probably saved her life. She was born with an undetected case of transposition of the great arteries (major heart defect)- a blue baby in laymen's terms. We had no idea and she was immediately taken care of by the pediatricians and then transported to the children's hospital. I've often wondered what would have happened in a home birth setting. I've been told that 911 would have been called and we would have been transported to the hospital then. Being in a hospital and learning of this was scary enough - having to be transported by 911 - I think I would have lost it. I tell you this not to scare you, but for you to be informed. We had no idea she had this problem and I underwent extensive testing with babies 4 and 5 to rule this problem out. Both were normal.

 

I think birth is a woman's choice and every woman should be supplied with unbiased information so that she can make the right choice for her birth setting. I know that once the birth is upon us, everyone just wants what is right for mom and baby. Go with your gut instinct because that is where you will be truly comfortable.

 

Liz

[Jennifer in MI]

For the case of my oldest daughter, being in a hospital probably saved her life. She was born with an undetected case of transposition of the great arteries (major heart defect)- a blue baby in laymen's terms.

Liz

 

Hi Liz. I'm going to go off topic here (but, I'm reading and loving this conversation!) - but my cousin had this same defect when he was born 38 years ago. I think he was one of the first to survive the surgery as it was quite new then! How is your dd doing? I read that now, these children can grow up and live quite normal lives. ((hugs)) I can't imagine how scary that must have been for you!!

[litabitm]

Jennifer, my daughter is fantastic - thanks for asking. A new surgery was invented about 20 years ago where they actually went in and switched the arteries - so no more baffles and bands like they used to do. She requires no more surgeries, is 10 yo, has been off all meds since she was 6 months old, and you would never know she was so sick at birth. We see her cardiologist every 18 months and she is allowed to participate in whatever sports she wants!

 

We feel so blessed. It was a terrifying experience to go through. We were in Texas at the time and she was air ambulanced to the Cleveland Clinic in Cleveland, Ohio, for her surgery, but had the world's best pediatric heart surgeon do her surgery there. She knows all about what happened and even journals about it from time to time. Her friends think it's pretty cool!

 

Liz

[Jan in SC]

3 Quick things:

 

1. Go where YOU are most comfortable- that baby is coming out of you and as important as your dh may be, this is your time to be comfortable!

 

2. If you have a home birth, which I think is completely up to the mother, then have a "what-if" plan, because...

 

3. My youngest would not have survived at home. We had no idea anything was wrong with him.

 

Good luck!

[StaceyinLA]

I had a c-section with #1, 2 birthing center births, then my homebirth. I LOVED the homebirth. It was such a wonderful experience!

 

That said, if dh is really uneasy with it, you may not have a choice but to do the hospital with mw. I would just make sure to be VERY detailed in a birth plan and make sure you can get what you want. Since you are pretty informed, you should have a decent shot at a really good experience even if you have to go that route.

[LisaKinVA]

Some people's definitions of "wonderful" or "excellent" may not turn out to be yours.

 

I've had 3 children at home, and one with a midwife in the local hospital. The midwife at the local hospital came highly reccomended. All four of my children have had different midwives (moved around a bit).

 

My midwife-hospital story was AWFUL.

 

Called them to see if I should go in (having regular contractions 10 min. apart for 5+ hours -- I wasn't in enough "pain.") When I told them at my last ch/up I was 4.5cm dialated they sighed, well I guess you could come in and we'll see.

 

Arrived at Hosp. hooked up to machines and told to rest for an hour. They said "I don't think you'll be here for long -- you aren't in any pain." An hour later I'm told, well you're definitely in labor, but it's goint to be awhile, because you aren't in enough pain.

 

Moved into a new room. Hooked up to an IV. Midwife comes in to check me. Water breaks. I take a nap. Nurse comes in to check me, gets the room ready -- I say, it won't be long now. Nurse says, "trust me, you've got plenty of time." 3 contractions later my son's head is past crowning (much to MY surprise -- as there is usually some sort of urge to push, etc.), panic button nurse, husband moves in to cradle baby's head now out to shoulders. Nurse yells, "stop pushing" (and I'm NOT). Baby emerges to husband & nurse. Others come rushing in... flabbergasted, flitting about attempting to get ready for my now-here son.

 

Midwife comes back 30 minutes afterward birth of my son to tell me we're moving to yet another room, and do her final check to make sure everything went fine.

 

Staff proclaims my delivery the "best" in the history of the hospital...

 

Originally, we were supposed to leave early Sunday, but the pediatrician wasn't available until much later.

 

FWIW, My local hospital has a much higher than national average induction and c-section rate. And they seem to be VERY short handed on the weekends. Did I mention the midwife I used in pre-natal wasn't the midwife who was available when I gave birth.

 

If I can avoid it, I will never have a baby in the hospital again.

[Aubrey]

Moved into a new room.

 

Midwife comes back 30 minutes afterward birth of my son to tell me we're moving to yet another room, and do her final check to make sure everything went fine.

 

You know, that might be the last straw. I can't imagine the insanity of moving to 3 different rooms during... THAT!

 

And, whoever said you have to be assertive, I'M NOT! I cry & tell my dh, "Let's sneak out."

 

I'm thinking home or birth center will be the best for us.

 

BTW, dh has no problem w/ a home birth. He just wants a midwife in attendance, & he thinks a mw 1.5 hrs away would not get here in time. His only beef is that he wants somebody closer. Other than that, I think he's pretty much game for whatever I want. I mean, if I suddenly switched personalities & wanted an OB out of nowhere, that might freak him out, but he'd probably go w/ it if I insisted.

 

Thanks so much, everybody!

[Mamagistra]

FWIW, My local hospital has a much higher than national average induction and c-section rate.

 

This "rate" is not even required to be reported in most states. The published numbers for my local hospitals are 17 to 21% for cesareans, but hospital staff who don't know any better will tell you the truth: upwards of 40%. And there are OBs out there who believe that ALL births will someday be "sections!" App.all.ing. :eek:

 

I'm one of two people I know (IRL) who hasn't succumbed to the "section!" How the H@des did the human race survive before all this intervention? :eek: It won't be long before we're all off to the day-surgery each time we're expecting a bowel movement... :rolleyes:

 

::walking away again, luring myself with chocolate::

[Marie in Oh]

The rooms were nice, the midwives were great, the food was awesome. I would do it again. Midwives at a hospital will be overseen by an OB becasue of insurance, but most that I know will only call them if they are in over their heads-- and believe me-- if they are, and you have a true emergency, that is exactly what you will want them to do. I would not be comfortable going 1.5 hours to a birthing center with a 4th baby. And I have eternal labors. I would really look into this other option. I think it is like a homebirth where someone else cleans up. My room was so nice and peaceful. I wouldn't want my kids around anyway-- I couldn't concentrate. HTH.

[Nicole not in CA]

I have had problems in both of my pregnancies and deliveries. With the birth of my second dd, I nearly bled to death. I ended up with a blood transfusion and surgery for retained placenta. I think once you experience something like that, it makes you realize how crucial it can be for some people to be in a hospital. And I have talked to others who have had babies that have had serious problems and needed immediate medical care that only a really good neonatal unit could give. Those women will never consider birthing at home. And the thing is, they didn't know it was coming. I certainly didn't know I was going to bleed so much that I started going into shock and needed a transfusion. That said, I certainly understand why many would want to have homebirths. I am an introvert and love my space and comfort zone. I don't really enjoy hospitals. I would love the idea of a homebirth if I could be guaranteed that it were completely safe. But you don't really know what will or could happen. Just food for thought...

[Halftime Hope]

I can give you the name of the mw who delivered my two TX-born children. She does homebirths, and she is just wonderful. I was very concerned that I would not be able to find anyone I liked after my "second mom" midwife in FL, but God provided beautifully. She lives in Euless, so would not be as far as Dallas, and she'll come to you! You wouldn't need to risk having that baby by yourself in the 90 minutes before the other mw could get there.

 

Of course, ahem, ds#3 came in a record time, less than 20 minutes after I called her, so he arrived about 2 minutes before she did. (I had called her and said, "D, I think you should head on over, my water just broke, so I'm betting things will pick up within the next few hours." I was clueless how fast this one would go.) Dh and I were old pros at it by then; he was calm, and I knew how to suction a baby's mouth, and our dear friend was there with the kids. My dear midwife was so disappointed not to have made if for the actual delivery, because she had listened to me gripe for the entire three weeks that ds was overdue!

 

Anyway, let me know if you want her name.

 

Best wishes!

 

Val

[Chris in VA]

Sorry this took so long to get back to you!

Baylor in Dallas.

[Aubrey]

First, yes, Valerie, I'd love the name of your mw!

 

Second, the post w/ the pic that looks like Anne of Green Gables? who was that? YOU convinced me to go ahead & at least call the mw's at the hospital.

 

The first call freaked me out. The secretary had never heard of anyone giving birth outside of a hospital. When I asked her about differences, she said she didn't really know. "They take better care of you here," she said. "They stay with you."

 

Um, where does she think a bc/homebirth mw would go???

 

So I asked about birthing positions. Do you have to lay in the bed to give birth. "Yeah," she said, "we have beds, & you get to lay in them, & we help you have the baby." Seriously. That's what she said.

 

I explained that I DIDN'T want to do that. She transferred me to a nurse, because that was even weirder than giving birth outside of a hospital. This was after trying to go ahead and set up an appt. for me.

 

So the nurse called back later, & she had also never heard of giving birth any way other than laying down. She transferred me to a mw.

 

By now, I'm thinking, No Way!!! These are FAKE mw's!!!

 

But the mw was great. Very friendly, said all the right things. When I asked about mandatory episiotomies, she said, "Good Lord, no!" I liked that. My favorite (though I'm reticent to buy it yet) was the hospital's authority over the mw's: "We tell them what to do." No way, I said. She said yep, they sought us out. We've got a very good situation."

 

So on an off-chance, I asked about the food. She says it's good, too. I went ahead & made the 1st appt, & I'll go visit the hospital soon. We'll see.

[Jami]

Hey Aubrey,

 

Is this All Saints/Baylor in Fort Worth? I've seen ads that they're adding a Midwife Center and am curious about that. If we have a fourth I'll be a VBac and don't have your confident track record. But I do think I'd like to look into working with a midwife/birthing center. But the first two people you talked to!?! Wow! *cringe*

 

Jami

[Barb_]

Not to be unnecessarily argumentative, but I really need to point out some common misconceptions.

 

I have had problems in both of my pregnancies and deliveries. With the birth of my second dd, I nearly bled to death. I ended up with a blood transfusion and surgery for retained placenta. I think once you experience something like that, it makes you realize how crucial it can be for some people to be in a hospital.

 

Retaining part of the placenta usually happens when an overzealous practitioner begins pulling on the cord before the placenta is ready. I'm not saying this necessarily happened in your case, but that it is the number one risk factor. I hemorrhaged with my first child as well, although without placenta retention. She was very large and came popping out in one push. They immediately whisked her away to clean her up rather than putting her immediately to the breast to clamp down the uterus, thereby exacerbating the situation. I had 4th degree tears because I was laying on my back with my feet in stirrups to push through my mandatory episiotomy. My OB/hosptial birth was a nightmare. It took as long to physically recover from that birth as I've heard it can take to recover from a C-section. Emotionally took years longer.

 

My midwives have always known of my tendency to bleed out and I threatened to do so with my 4th and 6th children. They were careful to have me ease the baby out on hands and knees, to remind me to immediately nurse to get the placenta working, to give my uterus time to clamp down on its own rather than trying to yank it free prematurely, and to be ready with an oxytocin shot if things began to look hairy. Their expertise and willingness to work with my body rather than impatiently take over, nipped potential ugly situations in the bud before they had time to escalate. That's why homebirths have better outcomes for normal-risk moms. Many complications during labor and delivery are iatrogenic in nature, that is caused by the actions of the practitioner. Then the doc can come in, scalpels flying, to save the poor mom's life when hospital policy, the machines that go ping, and the doctors and nurses themselves have all contributed or even directly caused the situation they all find themselves in.

 

I would love the idea of a homebirth if I could be guaranteed that it were completely safe. But you don't really know what will or could happen.

 

Well, of course there's no guarantee that anything is completely safe. Driving home from the hospital is probably statistically riskier than a low risk homebirth. But seriously, google the terms homebirth and safety and you'll find stacks of evidence that homebirth with an attentive midwife is not only easier on mom, but safer for everyone.

 

Barb

[Barb_]

This "rate" is not even required to be reported in most states. The published numbers for my local hospitals are 17 to 21% for cesareans, but hospital staff who don't know any better will tell you the truth: upwards of 40%. And there are OBs out there who believe that ALL births will someday be "sections!" App.all.ing. :eek:

 

I'm one of two people I know (IRL) who hasn't succumbed to the "section!" How the H@des did the human race survive before all this intervention? :eek: It won't be long before we're all off to the day-surgery each time we're expecting a bowel movement... :rolleyes:

 

::walking away again, luring myself with chocolate::

 

Heh, my husband works in hospitals (finance, not medicine) and there was one whose C-Sect rate was 55%! And that was the published rate. I personally never met one person who walked into that hospital to deliver who didn't hobble out with stitches.

 

I've had a lot of friends who are doctor's wives that I've met through my husband. I've talked to my fair share of OB's. Generally we don't see eye to eye, so we just skirt shop talk :) But there was this one doc, the husband of a good friend of mine, who was a resident although not an OB. She and I were pregnant at the same time and he was aware of my plans to homebirth. He used to try to scare me out of it, and we had it out a couple of times. He defended the routine use of cytotec and pitocin (regardless of the risks, of which he was perfectly aware) and planned c-sections on the grounds that doctors have right to a good night's sleep and regular hours. No joke, he actually said that. Yes this is one guy...but he's the only one loudmouthed enough to blurt it like that. According to my husband, he really believes it typifies the culture. No big surprise to me.

 

Barb

[nancypants]

For the case of my oldest daughter, being in a hospital probably saved her life. She was born with an undetected case of transposition of the great arteries (major heart defect)- a blue baby in laymen's terms. We had no idea and she was immediately taken care of by the pediatricians and then transported to the children's hospital. I've often wondered what would have happened in a home birth setting. I've been told that 911 would have been called and we would have been transported to the hospital then. Being in a hospital and learning of this was scary enough - having to be transported by 911 - I think I would have lost it. I tell you this not to scare you, but for you to be informed. We had no idea she had this problem and I underwent extensive testing with babies 4 and 5 to rule this problem out. Both were normal.

 

Liz

 

Wow! I haven't met too many other people who have experience with this defect! My adopted brother (we first met him in the hospital when he was three months old) was born with this defect -- and he was born in a motel! :( They managed to get him to the Children's hospital in time. He is 17 now and just this last year had to have probably (hopefully) his last "routine" heart surgery to replace a part that he had outgrown.

[HiddenJewel]

I would love a midwife-hospital combination. I had 3 hospital deliveries (1 bad, 2 good) and my last at a birthing center. I know I can't do that again. I hemorrhaged and thankfully they got it stopped. But I was in pretty bad shape.

 

What I have learned for any situation but especially at the hospital is to be informed. Be informed of the process, the rules, your rights, and what you want. And you need to willing to assertive or have someone who will be assertive for you.

 

And I would definitely suggest finding someone closer than 1-1/2 hours.