Homebirth question

[callieollie]

If you are having a homebirth and end up needing to transfer to a hospital, do you go to the nearest hospital to your house or do you go to the hospital where your midwives have admitting privileges (or whatever it's called! I'm new to this!)? I'm assuming if it's a life or death emergency, you'd just go to the closest one but if it's not life or death, can you only go to the hospital the midwives transfer to (and not have to pay for it out of pocket)? Thanks!

[dogmom327]

Since I'm using a CPM, my midwife doesn't have "admitting privileges" so we will get whichever OB or CNM is on call.

As for where we would go, it would depend on the situation. For a life and death emergency, we would go to the hospital 10 minutes away. It doesn't have a NICU but can quickly arrange transport to any of the 3 NICU's in town if that were to be necessary. If I had more time (maternal exhaustion, etc.), I would go to a hospital that's about 30 minutes away. It's a pretty nice place to give birth. If I knew in advance there was going to be a big issue with either me or the baby, I'd check into the university hospital 40 minutes away.

But really, the odds of needing this plan are very small so it's kind of one of those things that I thought about once and don't worry about after that.

ETA: All of the hospitals I mentioned are part of our PPO so we pay but it isn't horrible.

[Peony]

Homebirth MW's in my state are legal but can not admit to a hospital, they can only be there as a "support" person. With this birth, I'd go to the closest and only hospital in the area. With my last birth, I would of driven an extra 15 miles to go to a better hospital unless it was a true emergency.

[alegna]

Midwives here do not have admitting privileges.

-Angela

[jrabbit]

You need to find out *in advance* which hospital has what you would need in an emergency.

1st choice for Mom emergency: 24 hour IN-HOUSE anesthesia, not *on-call* (this would be in case you need a cs)
1st choice for baby emergency: Level 2 NICU (this would be for an emergency after baby is born)
2nd choice: any hospital where you feel comfortable with the OB, the standard of care, and what they think of women who transfer during home birth. Oh- and your insurance

The 1st choice is going to be the hospital nearest to your home that qualifies. The 2nd choice is wherever. But figure that out *before* you need it, so you can direct an ambulance.

--janis

[MsBlack]

Here, in an emergency an ambulance will take you to the nearest hospital with a NICU (which will be the nearest that does maternity care at all), unless that is too far away. Then, you would be taken to the nearest hospital to receive interim care while life-flight is arranged to take you to the nearest hospital with a NICU. If it is not an emergency, then you either drive or take an ambulance to the hospital of your choice.

But this is a rural area, where a large hospital corp has bought out most of the small town hospitals and shifted all maternity/NICU to a small number of major hospitals in the larger towns. So, we have few hospitals that do birth at all these days--you could be an hour or more from one of the NICU/maternity centers, even tho fairly close to your own hometown hospital.

What pp's have said is generally true here with homebirth, where mws have no admitting privileges: you go to closest hospital in an emergency, but you have a choice if it's not an emergency transport. You need to talk to your mw, plus figure out what the hospital scene is, near you.