Homebirth back-up plans?

[jdmama]

Hi All,

I'm wondering what those of you have done for back-up plans who don't have a back-up OB on board with your homebirth. I am 23 weeks pregnant and would like to plan an hbac. I have been seeing an OB who was recommended to me as supportive of vbac, but it's become clear she's not really (i.e., sure you can have a vbac if you go into labor on or before your due date and have a fast labor, etc.). This is not a very vbac or homebirth friendly area. I can hire a homebirth lay midwife, but they don't have relationships with OBs. I live about 10 minutes from a hospital. So, I could either plan on just going to the hospital and getting the attending in the case of a transfer, or I could keep seeing my current OB without mentioning the hbac plans. Thoughts or advice? Thanks.

[haren.13]

I would post in the finding your tribe section and see if you can find mamas that have MWs in your area. You can ask what the relationship is like betweeen them and the OB, and might even get a recommendation for a VBAC or HBAC friendlier OB

In my area, homebirth isn't something most OBs are supportive of, but there are *some* in the area. When I interviewed the MW we chose for our HB, she was able to give me the names of several OBs and family docs who are off-the-record supportive of HB. I'm seeing a practice of OBs/CNMs (who can't deliver at home legally without OB backup, which they can't get in my state) ~ the MWs aren't allowed to be overly enthusiastic about HB, but they know my plans and it's very obvious to me that they're not unsupportive at all.

[DahliaRW]

I pretty much will transfer and get whatever OB is on call. No ideal, but that's life and if I'm transferring it'll already be bad enough!

If it's not a huge emergency, my mw will take me further away to where the OBs *tend* to be more hb friendly. If it's more of an emergency, then I'll go to the closest hospital and get the luck of the draw. I've heard from most that the nurses are the rudest with transfers (after all you hardly ever see the OB), and I have no issues requesting a new nurse if need be. I've done it before in non-birth situations with great results. I have no qualms being labeled "difficult" or "non-compliant".

[dogmom327]

Originally Posted by DahliaRW

I pretty much will transfer and get whatever OB is on call. No ideal, but that's life and if I'm transferring it'll already be bad enough!

If it's not a huge emergency, my mw will take me further away to where the OBs *tend* to be more hb friendly. If it's more of an emergency, then I'll go to the closest hospital and get the luck of the draw. I've heard from most that the nurses are the rudest with transfers (after all you hardly ever see the OB), and I have no issues requesting a new nurse if need be. I've done it before in non-birth situations with great results. I have no qualms being labeled "difficult" or "non-compliant".

Same here. Either the closest hospital (10 minutes) if I it's a life and death emergency or one that's about 20 minutes away (without traffic) if we have the time.

[alegna]

I would only transfer in an emergency, so I'd get whoever was on duty anyway.

-Angela

[erin_brycesmom]

Originally Posted by alegna

I would only transfer in an emergency, so I'd get whoever was on duty anyway.

-Angela

same here. I don't feel the need to have a back-up OB.

[layla983]

No back up OB here. My midwife does have a OB she suggest if patients want to see an OB for any reason during pregnancy or if she ends up having to transfer care, but since that OB is about an hour away & I have 2 other hospitals within 5 minutes of me, I highly doubt I'd be going an hour away to an OB if the need for tansfer during delivery comes up. So chances are, if I transfer, I'm just getting the OB on call. I'm fine with that myself.

[My*Scorpio]

I have an OB who agreed to be my back-up, with the condition that I am getting prenatal care. I have only seen her twice during this pregnancy, when a situation arose that my HB MW could not resolve. This OB works at a hospital that is 40 minutes away.

If an emergency should come up, we will transfer to the hospital that is less than 2 miles from my house.

[munkeesmama]

I really have no back-up plan for my homebirth. My midwife is not associated with any OB's or hospitals. If I transfer, I'll be at the hands of whoever is on-call. Literally, since if I'm transferring, I'm going with the notion that I'm transferring for a c-section and want the OR waiting. I'm a HBA2C so I figure it'd be automatic c-section if I land in the hospital.

[ShwarmaQueen]

Originally Posted by munkeesmama

IIf I transfer, I'll be at the hands of whoever is on-call.

Even if you met an OB during prenatal care, wouldn't you still be in the hands of whomever was on-call? KWIM? Very few OBs deliver their 'own' patients anymore, it's "the luck of the draw".

OP: I would like a HBAC (soon please!) and I wouldn't plan for a back-up OB if I was paying for a MW. :

[mamaveggie]

This will be my third baby and 1st homebirth. I live 5 minutes away from a hospital and have met three of the drs on staff within the past few years for gyno/ob appointments.(one of which was my ob for the first 2) One of the times my dr wasn't on call and I had a different dr that I didn't like, but I ended up still being in labor when her shift ended and had my dr for the birth.

[DahliaRW]

Originally Posted by ShwarmaQueen

Even if you met an OB during prenatal care, wouldn't you still be in the hands of whomever was on-call? KWIM? Very few OBs deliver their 'own' patients anymore, it's "the luck of the draw".

OP: I would like a HBAC (soon please!) and I wouldn't plan for a back-up OB if I was paying for a MW. :

Yes, that can happen. When I had ds1 (planned hospital birth) I ended up with an OB I never met from a COMPLETELY DIFFERENT PRACTICE that my OB and the other OBs I'd met because it was a holiday, which is the exception to every practice having an OB on call. Which they never told me could even happen.

[NaturalMindedMomma]

Originally Posted by DahliaRW

I pretty much will transfer and get whatever OB is on call. No ideal, but that's life and if I'm transferring it'll already be bad enough!

If it's not a huge emergency, my mw will take me further away to where the OBs *tend* to be more hb friendly. If it's more of an emergency, then I'll go to the closest hospital and get the luck of the draw. I've heard from most that the nurses are the rudest with transfers (after all you hardly ever see the OB), and I have no issues requesting a new nurse if need be. I've done it before in non-birth situations with great results. I have no qualms being labeled "difficult" or "non-compliant".

Same here...

[lc81002]

Originally Posted by DahliaRW

I pretty much will transfer and get whatever OB is on call. No ideal, but that's life and if I'm transferring it'll already be bad enough!

If it's not a huge emergency, my mw will take me further away to where the OBs *tend* to be more hb friendly. If it's more of an emergency, then I'll go to the closest hospital and get the luck of the draw.

:

[shanahan]

Originally Posted by DahliaRW

I pretty much will transfer and get whatever OB is on call. No ideal, but that's life and if I'm transferring it'll already be bad enough! If it's not a huge emergency, my mw will take me further away to where the OBs *tend* to be more hb friendly. If it's more of an emergency, then I'll go to the closest hospital and get the luck of the draw.

pretty much the same here... We have 3 options in case of emergency - the closest hospital (less than 10 mins) is not that great, but will do if its a dire situation. Then we have another hospital about 15 mins away - much better, but not really "naturally minded" in any way. Then the "best" option (where I gave birth to my first son) - a great hospital, and pretty supportive of natural birth is about 20 mins. So, it will depend on what kind of emergency, where the ambulance will take us, etc.

My midwife technically has an OB backup, but its really just on paper as he is way too far away to actually be able to assist in an emergency situation...

[Mom2SammyJoe]

I am also planning an HBAC. I am doing parallel care with an OB. They have no idea about my plans to birth at home, and are even starting to get weird about my VBAC (29 weeks here). Today at my OB appt. the doc said "I know we talked about letting you go to 41 weeks as long as we do ultrasounds..." I had to remind her that we discussed previously that I would not schedule a section before 42 weeks without significant cause. I continue to see the doc because I work there but the lack of sincere support really gets to me. Its like they don't believe I can actually do it, but my midwife does, and most days, so do I.

[munkeesmama]

Originally Posted by ShwarmaQueen

Even if you met an OB during prenatal care, wouldn't you still be in the hands of whomever was on-call? KWIM? Very few OBs deliver their 'own' patients anymore, it's "the luck of the draw".

OP: I would like a HBAC (soon please!) and I wouldn't plan for a back-up OB if I was paying for a MW. :

For 2 of my hospital births my OB did deliver me. For the last one, she didn't since it was a true emergency and she was so early.

[kalamos23]

I had shadow care with an OB for my entire pregnancy with DD and when we had to transfer, we didn't even end up with her! I think the only point to have shadow care is to get something done that a mw can't do or to have an easier transfer if you are in a non-mw friendly area.

[lotus.blossom]

I briefly thought about shadow care as well but I knew in my heart that I didn't need the hassle. I was mainly concerned about my state health care giving me a problem if I suddenly came on their radar as needing an emergency c/s. My midwives assured me that this wouldn't be a problem.

I have the choice of 2 hospitals. One is 20ish minutes away and one is 40ish. If it is a non emergent transfer I will go to the 40m away but in the event of an emergency I will be stuck at the 20m away one. I am asking the universe not to let that happen. I hate that hospital and their policies.

[jdmama]

Thanks for all the responses. I think I'll drop the OB who I'm unlikely to see in an emergency anyway. I want to have a peaceful third trimester. Last visit she threw in 'we'll keep evaluating if a vaginal birth is possible for you' even though the pregnancy has been totally uneventful.