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July 6, 2009

Question

Before starting this ttc, process the thought of giving birth at home was not even an option. About a year ago, Melissa put this thought in my head about using a midwife and I thought she was crazy. After reading about the care you and the baby receive before, during, and after the baby is born is amazing. It still scares me because of the problems that can happen at home. But I don’t want the hospital to rush the delivery using drugs to free up a bed.

I keep going back and forth about using a midwife or giving birth at a hospital. Movies like The Business of Being Born and stories from other bloggers make me want to go the midwife route. The relationships I’ve read about between mothers and the midwife sounds ideal. However, before our first ultra sound both Melissa and I were extremely nervous about what we were going to see. This made us both think giving birth in a hospital is the best option. We even made an appointment with an OB that comes highly recommended.

This morning I watched the documentary again and now I think we are making a mistake. Therefore, I am looking for help from the bloggers. If you have a little one, what did you decide to do and are you happy you went that route? If you are planning to start a family, which direction are leaning towards, a hospital or using a midwife?

27 comments:

addingbaby said...

We were initially receiving our care through a midwife, who was to deliver the baby at our local hospital. (She's since gone out of business, and we're now using her recommended OB). I would guess that if you want to go the midwife route, yet still want to birth in a hospital, many midwives will accomodate that. It probably depends on the midwife and their privileges at the hospital.

What matters most is your relationship with your practitioner, and their clarity on what you'd like from your birth plan. I'm sure you'll find someone that is the right fit!

J and D said...

Have you considered looking into a Doula? That's what we've done. I have borderline hypertension so I need to be under the care of an OBGYN.
It's costing us $850 but I think it is worth it. She'll be with us during the birth until 2 hours after delivery (or until the baby latches). We also have 2 prenatal and 2 postnatal appointments (post can be extended). It seems like a pretty good alternative for us since we didn't have a choice otherwise. From what I've read, having a doula can decrease c-sections etc.

Boo said...

The vast majority of Nurse Midwives (also called CNMs) deliver in hospitals. You can go on to www.midwife.org to learn more about CNMs and also find a midwife who delivers in a hospital in your area. You may want to also look into if there are any birth centers in your area (they can be either freestanding or hospital based), which are often a nice compromise between a hospital bith and home birth.

Good luck in your search! Feel free to email me if you have any questions about midwives or midwifery care.

N said...

We're much in the same boat as you, and were in the fall. What we ended up going with was investigating midwifery practices in the area. We had two options: there was a midwife practice that delivered *in* a hospital, and a midwife practice that had its own free-standing facilities, close to a hospital. (And a third attached to a hospital, but it was far away, like the 2nd one, and if we were going to do that, we figured might as well go with the ones that delivered in the hospital.)

We were torn between the hospital midwives and the freestanding ones; mostly because I wanted the possibility of a water birth, and they flat out said that the hospital didn't allow that (though sometimes they didn't manage to get the mother out of the tub in time, wink wink, etc). The nail was put in the coffin when it turned out they didn't take our insurance.

So we ended up going with the other practice - both in the fall, though we didn't get past the orientation, and now (my first appointment is next Tuesday) - even though it's much further away (about 30-40 minutes without traffic; but they have a LOT of patients coming from here, and are super willing to accommodate them). The thing that made us feel best about this practice is that a good friend of ours delivered with them a year and a half ago, and ended up having some very severe complications (for her, not the baby), and they had her at the hospital and *in surgery* in half an hour - the nurses at the hospital said that she was in surgery likely faster than she would've been if she'd been a patient at the hospital, because it wasn't apparent from just looking at her (she was bleeding in her uterus), and the midwives kept a much closer eye on the mothers post-birth, so between that and the proximity to the hospital, she was better off than she would've been in the hospital.

In the end, whatever decision you make is right, as long as it's the one that is best for *you guys*. Don't let anybody tell you your decision is wrong, they're full of it.

(Well, except maybe those mothers who give birth at home specifically without any medical oversight, those I think are dumb.)

For the Long Haul said...

I used an OB and delivered at a hospital. Both of my pregnancies ended up somewhat "high risk" due to high blood pressure and I was on bed rest at the end of both pregnancies.

That being said, with my son I attempted to deliver vaginally (blood pressure was being monitored but was fine...) and his heart rate dropped several times during contractions and labor. Eventually he had to be delivered via emergency c-section. I would be scared that if I weren't at a hospital and being monitored so closely something could have happened. He was perfectly healthy.

I should also comment that my OB was wonderful as was ALL of the hospital staff. I never felt like they "rushed drugs" at all and my care was fabulous.

Like others have said, whatever decision you make will be best for the both of you. This is just my situation and I was very glad to have gone the hospital route in the end.

Nic said...

This is only personal to me and everyone is different. When eventually get my baby I will def have it at the hospital I would be far too scared of complications at home. I know the chance of complications at home are very small but it would still make me nervous. People who have had babies at home and at hosp maybe able to help you more. I know I will have mine in the hospital though.

mutti said...

Another option is a birthing center run by midwives. It is a cross between a home birth and a hospital birth. One just opened in south Austin. You can contact Faith Beltz if you want more info (she and June Lamphier are the 2 midwives who run the birthing center).

7002 Manchaca Rd., Suite 200
Austin, TX 78745
512 - 698 - 4132
www.birthwithfaith.com

Good luck!

jessie said...

I was hugely into the idea of birthing at home and Greta was hugely into the idea of birthing at a hospital. A good compromise for us was a birth center with midwives. I LOVED the care I received and my birth was everything I could have imagined and it was in a home-like environment. I will definitely go back there if we get lucky enough to have another baby

S. said...

ditto many of the comments. Midwives at a hospital. And, if possible, with a doula. She acts in YOUR best interest and can really help convey the messages you believe are important in the heat of the action. Whatever your choice, find the one that feels good. If you're doubting, move on. Or at least explore what you can.

Growing up Clangley said...

We went to a hospital. We were lucky enough to know our labor and delivery nurse. The experience was amazing! They were all so good to us. There was no rushing anything. The best thing we did was to "labor down" which means i stayed at 10cm for one hour. I pushed 3 times and she was almost out! Good luck!

anofferingoflove said...

we wanted the midwife/homebirth experience, but found out midwives cant do homebirths in our state legally (!) and the nearest birthing center is 2.5 hours away. we are going to a hospital, found an OB we love, and are considering hiring a doula at his recommendation. it's not the plan i had envisioned, but im happy with it now. good luck making this decision!

Ninefirefly said...

At first I really wanted to give birth at home. The more I thought about it though the more I wanted the security of a hospital. If we had the option of a birthing center we would have gone that way but there are not any in our area, so hospital it is! The hospital I'm going to has a jacuzzi in the room and while you can't push in the water like I had wanted to it still is better than nothing.

ohchicken said...

well, you know what route i went, and i don't want to belabor the points already written before mine, but i really can't recommend a midwife enough.

i did have a lot of the same questions that you do about something going wrong and what then. i think you should make a few appointments with austin midwives and sit down and talk it all out. all of the midwives i've met in austin are honest about the pros and cons of home vs birth center vs hospital births.

for me, the personal care throughout my pregnancy was the best part of the experience. even if i had ended up having a hospital birth, the love and physical/emotional/spiritual preparation i experienced over those months prepared me to be a mom. i don't know if that literal bedside manner is possible inside the establishment.

if you'd like any names or numbers, i'm happy to offer.

oneofhismoms said...

If I could do it again, I would birth at home. The hardest part about my labor was traffic.

But you guys should look into using a midwife who will deliver in a hospital. And definitely get a doula. I really wish we had. It makes sense to have someone ease labor for you at home. The doula frees the partner up to focus on the laboring mom. I was getting dehydrated while in labor because my honey was so busy running around to pack things. If we'd had a doula, she would not have had to leave my side.

They don't have to cost $850. Doulas in training need to log a certain number of hours, so the cost can be a lot less. Of course, the more experienced the doula, the better she might be. I love that you get to have this converstaion now!!! Yippee.

Michelle said...

Hi, we've lurked for a while and first and foremost wanna say congrats to you both. OK so we each have a son from a previous relationship. We both had OB and hospitals. One child was emergency c-section early and the other was 2weeks late, vaginal with induction and reinduction after the birth for the placenta. Now that 13 years later we are gonna try together I think we are gonna stick with the hospital and OB. In my case, I never felt any pressure from anyone to go one way or the other with drugs or natural.I just think I would worry about not being in a hospital in case of emergency. But, I think every person's experience is different. Good luck.

Amy said...

We used OB/hospital for all three kids. We really liked the OB office and they didn't pressure us into a birthing plan that was convenient for them. My first ended up in c/s after 5 hours of pushing. (Obviously we were trying to avoid surgery, but he just wouldn't come out.) We were in the hospital for 4 days b/c of c/s. The next two were VBAC; one with epidural at 4 cm on, the other w/o any pain meds b/c she came really quickly. All three of my deliveries were very different under the care of the same OB practice. I opted to stay in the hospital for the 48 hours (more for the c/s) for each child and even had the doctor tell me I didn't have to leave till late afternoon on my discharge day, if I wanted to fit in a nap before I went home to my two other kids (knowing it would be less conducive to quiet there). Our hospital is very accommodating, as is our OB practice. The university hospital in town has a reputation of rushing new mothers out quickly so I recommend you find out as much as you can about the hospital(s) in your area. Good luck making this decision. What an exciting time for you!

Jen said...

I am currently using an OB and plan on using a hospital with a geat birthing center. My step-mom is an OB and has always said,
"anyone can deliver a baby, but if something goes wrong, you need a specialist and resources to make sure you and the baby are okay." I pretty much believe the same thing but I realize different strokes for different folks!

Lisa said...

I've always hope to do the midwife in a hospital combo. I like the personal attention (plus by OB, although she is the coolest thing out there, travels like crazy and I don't want to worry about her being away).

poppycat said...

Thanks for asking this question. The answers you got are so helpful. Whatever you decide I know you will make the best decision for you.

Hanen said...

We're in Australia, so I don't know if the available options are different to yours. I was keen on a homebirth, but knew that realistically, a first baby could be a more difficult birth, and my partner (who has had three vaginal births herself, for her daughters now all in their teens)felt very nervous about not being in a hospital in case anything went wrong. So the compromise is that we're going for a Family birth centre, which offers team midwifery care. This means you are assigned to a team of midwives, and get to know them at your antenatal appointments, and at least one of them will be on duty when you give birth. The FBC is supposed to also allow for a more home-like birthing environment and focuses on low intervention. We're only 9 weeks along, so will have to wait and see how it goes!

Thanks for putting up this discussion!

Anonymous said...

I gave birth at a hospital with a midwife and she was awesome! I could have done a water birth if I had not had the epidural too at the hospital, they had birthing balls, and allowed different positions or water birth, whatever really. I also never felt rushed by the hospital and was never given any drugs to speed things up. I know different states and hospitals all have their own regulations though. For anyone in Atlanta, Piedmont hospital was great for us.
Melissa in Durham

Just Another Jenny said...

I've been doing research on this very topic and I'm not even pregnant yet. :) I personally am leaning toward a home birth, but the midwife I am considering also does hospital births. You might want to find someone that can accomodate both and then see how you feel then. I would also recommend the book "Pushed" by Jennifer Block -- it might make you feel even more comfortable with what can be very controvesial amongst your friends and family.

Good luck!

3kids2moms said...

WE have three children--one born in a hospital and the other two at home. The hospital birth went badly--way too much intervention--an induction that my body wasn't ready for (google the bishop's score--I was scoring around 1 when they started--not good!)After 5 days of induction there was no alternative but to do a c-section. For my next two I did a home births--both of those would have ended up c-sections in a hospital setting because of the fact that docs don't want to do vbacs anymore. Both of my home births had what in the homebirth world is considered normal, but in a hospital setting is considered a complication--my second child's water broke 4 days before I went into labor and my third child was born exactly at 42 weeks. Most home birth midwives have a back up doctor and are well trained to transfer you if something goes wrong. Let me tell you I am an extremely anxious person and having a midwife that I can contact whenever I needed --directly, without having to talk to office people or nurses is very reassuring. Also the fact that she had been a midwife for over 30 years made it very reassuring too. Obs have their place, but they get too excited to make the human body work like they want. Whatever you choose will be the right thing I just want you to know that home birth is very safe.

Not to mention you won't have some stupid intern repeatedly trying to put you on birth control and interrupting you with reasons why you can get pregnant while breast feeding when you try to explain that you are a lesbian and there is no risk of that! :) The Nurses got a great laugh at his expense!

nutella said...

I saw an OB for the first 30 weeks of my pregnancy but planned all along to swiitch to a birth center attached to a hospital if all was going well. I did not want a hospital birth if everything was fine, but wanted to be close to the hospital should I need a transfer. The midwives have delivery privledges in the hospital, so even if a transfer is done you have continuity of care.

I am very glad that I went this route. My pre and postnatal care were terriffic and when my labor was stalled after 30 hours at home and in the birth center I was able to transfer to the hospital easily for more intervention at my request. I labored another 18 hours in the hospital and choose each intervention as it was needed. I never felt pushed and I am quite certain that had I been with an OB for my labor I would have ended up with a C section.

If you want to read my birth story (warning, not an easy or pleasant read for a pregnant woman, I had a very atypical labor but a happy outcome) you can find it here on my blog. http://1invermillion.wordpress.com/2009/05/09/birth-story/

Ali said...

As an L&D nurse, I would highly recommend using a midwife. As someone wrote earlier most Certified Nurse Midwives (CNM's) practice in the hospital if you choose that route. You would of course want to choose a group that has an OB back-up that you like and trust, has a low C/S rate etc... in case you need his/her services. I would say 95% of OB's- no matter how sweet and good they are- come in a couple times while you are in labor to either break water or check you and then you do do not see them until your baby's head is crowning. A good midwife will sit at your bedside some, offer labor support, push with you for hours if need be etc. It really does depend on the kind of birth you want, but if you are someone that leans toward the midwifery model of care as opposed to the medical model, I can assure you- you will want a midwife. I am not sure where you live but perhaps there is a family forum or something online that has feed back from other mom's about the practitioners in your area. I would start there if you do not have other resources for finding a CNM with a good OB back-up.

Anonymous said...

Hello ladies, and congratulations on your BFP!!
I have a 3-month old baby boy, delivered naturally at the hospital. I too considered a home birth, but my husband didn't feel comfortable with it, and with many doctors in our families, I was convinced by them to go the hospital route.
I understand your worry about being rushed in order to free up a bed, but in my experience, they took that into account. That is, when I first went to the hospital in labor, the doctor on call said I wasn't progressing very fast, and I should go home for the night and wait until morning, because once I was admitted, then I would kind of be on their "timetable." So I did just that - I went home, came in at 6:00 a.m. the next day, and delivered a healthy baby boy at 2:00 p.m. I was adamant about not wanting drugs, i.v ., monitors, etc. (unless the baby was in danger), and the doctors and nurses were AWESOME and complied with my every wish. It was a truly amazing experience...AND I was glad that in the case something awful happened, the o.r. was right around the corner.

Anonymous said...

oh and we used a doula, which was absolutely key. I don't think I could have gone through 48 hours of labor and delivered naturally without one.