Very curious about something - backup care

[BarefootScientist]

So I have a burning UC question.

Say you're doing prenatal care with an OB or CNM, and "officially" you are planning a hospital birth, but really you are planning to have an "accidental" UC at home. So then...what do you after the UC?

Because, I'm assuming that if someone was actually planning a hospital birth and then their baby came too fast and they had a real accidental UC, the first thing they would do is call 911 and get themselves to the hospital. Wouldn't you be worried about it "looking" really bad if you don't do that?

Has anyone done this? What did you do afterwards, or if you did nothing, what did you tell your OB/CNM about why you didn't go in? When/did you get the baby checked?

TIA!

[BroodyWoodsgal]

My DD didn't get "checked" really....my personal belief is that they don't need a whole lot of checking...Avery was checked out by the family doctor at I think two weeks of age?? Soemthing like that. THe midwives felt around for anything alarming and obvious...but other than that, she made it just fine til her first check up at the doctors.

This time around I am planning a UC...I THINK I'm also planning UP....but DH is not solid on that. I don't relaly mind PC, I just kind of think it's a waste of my time....but I REALLY don't want to lie to someone, you know??

So, I think I'm planning UP...but if it ends up being more than DH can bear...I will get the PC and after delivering at home will just call the practitioner and say "Oh my gosh, you're not going to believe this, the baby was born last night!! It all happened so quickly...a blur really, but we're just fine and all is well" and if they go nuts "What do you mean, why didn't you call us, you need to come in!!" I will say "Actually, I've got everything under control here, as it turns out, I was able to handle the only part I thought I'd need you for, our family doc will take it from here!!" I think I will make sure to call the next day, so they can't be like "You could hemorrage any second, we're sending an ambulance" or something crazy like that. I feel like if I call the next day, they can't really try to take advantage of me being in a delicate state...ykwim

I don't want to make the person mad, as I'm sure there's some way in which the doc could try to make my life miserable or something...but a matter of fact, "thanks, but no thanks" should be fine. I hate lying...but I'll lie a little for the sake and safety of myself and baby....the last thing I would want is to put us at unecessary risk for infection, etc by bringing the tyke for a checkup at hte hospital just because some doctor has a bee in his bonnet because he thought he was going to have the pleasure of screaming "puuuuush, puuuuushhhh!!" and didn't get to!

[TzippityDoulah]

just don't register at the hospital... you can usually print out papers and keep themw ith you, so that if you needed some kinda transfer you'd be able to get in quicker. If called and asked I would say the baby came while we were still home. if they asked about what doctor a baby saw, I would say "we see a family doctor" or something along those lines and leave it at that. If they got too nosy I would say "oh!!I gotta run! the abby just pooped everywhere!! I gota go give her a bath" and hang up. or you know... maybe not lie... but come upw ith some urgent thing to amke you have to get off of the phone wihtout giving an answer.

or you know... you could just say "we don't think it's your business" too

[claddaghmom]

1) If you have to go to the hospital afterwards, just say it was faster driving/you're close by.

2) If you don't have to go, just say that your beloved ped/FP ____ saw the baby.

[Sheryl1678]

I stopped doing the prenatal care after the 18th week ultrasound. I did the rest of the prenatal care myself and I specifically wanted to avoid the scare tactics that are often employed toward the end of pregnancies.

That way I ruled out most "diagnosable" problems but also had a peaceful, "unmanaged" third trimester. I didn't have to explain anything to anybody after her birth.

[Pirogi]

I am in the same boat, except that not seeing someone after the birth isn't an option for me unfortunately. I will need to see a HCP in order to fill out my leave paperwork (govt). Eh, whatever. I will figure it out when I get there. If I decide I don't need their help during the birth, I certainly won't cave afterwards.

[MamaQuest]

I waited about 2 hours after the birth to call the CNM on-call that night, but my UC was semi-unplanned. Things went super fast, and my mom got there to watch the other kids as he was crowning, and the number for the on-call CNM had gotten lost in the shuffle, so it took some time to get in touch with them... by which point we "knew" (in their eyes) that everything was fine, and I went in to their office the next morning for them to "make sure." I needed the visit for insurance purposes, and the ped we like is in the same building, so we took care of all the insurance stuff very quickly, at the start of business hours (so as to avoid any sickness in the office).

This time, I still have to have the baby in by 3 days old for insurance reasons, but will wait til that third day I think.

I had mentioned to the CNMs in every visit (got a different one each time) that I had had a previous homebirth, and since I labor so fast, had made myself knowledgeable about a just-in-case birth. I think that helped some, to allay their fears, though it probably also gave them a heads-up that maybe the UC was planned (which it wasn't on my part, though DH has just assumed we were UCing from the start ).

[BarefootScientist]

I want to bump back up this old thread to get more opinions, now that I am TTC, because this may end up being my situation if/when I get pregnant (prenatal care with a CNM/hospital and just stay home if we're doing fine). The thing I wonder about I guess, and maybe I didn't explain this well the first time, is people believing that it was actually an accident. I feel like if I really did have an accident (as in, intended to be in the hospital) I would be calling 911 as soon as the head crowned you know? Or most people would, is maybe what I should say, because I actually wouldn't, that's why I'm considering UC.

If I didn't care whether people knew I was UCing or did UC, I'd just tell them right? If I wanted it to truly look like an accident...I'm not sure what I would do, because I certainly wouldn't want to go in if I didn't have to...any other ideas/experiences?

I guess I'm worried about care providers, in-laws, anyone/everyone freaking out. If I don't go in right afterwards, it's kind of obvious I meant to do it, no?

[Illiana]

well I'm kinda planning on this.. I'm just going to call the pedi the next day say I had DS last night and need to get him seen and if he could do the PKU test since he came "too fast" or whatever and needs to get that done (we decline everything else for newborns) if you tell them you had a fast labor (2 hours or something) and didn't realize what was going on until it was too late, there's not much they can do/say. Schedule an appt to get yourself checked (if you want to.. i will be at 2 weeks and 6 weeks pp like with dd) and have your pedi/family doc check baby whenever you want to/can.

[mitintraining]

This happened to us for birth #4 I have really fast labors and I was worried the whole time I wouldn't make it! Well he was born after 45 minutes, from the first twinge to 'wah'. My DH was baking bread at an artisan bakery, it was 3 days from x-mas(on the busiest day possible of course!) and he rode his bike home only to walk in on a crowning head. When it goes that fast, you cannot even find the damn phone let alone call 911! I had trouble trying to get my pants pulled up and I worked on just walking down the hallway for 15 of those minutes. Birth can be really rapid, especially at the end, so I think, having had this happen to myself and several other doula clients who were not planning a UC, that HCPs hear about it often enough. We never went in, just called and went to the office the next day, I knew what they were going to tell me, there was no need to observe the baby, and anyway since they are not born in the hospital, they cannot go into the regular or NICU nursery, they need there own room or they could contaminate the other babies, that was not said in a mean or snarky tone, once a baby leaves the hospital they cannot go in the newborn nursery or NICU. So it can happen and don't worry no care provider is really going to question why your husband didn't call 911 during crowning, when he is trying to catch a baby, take care of older kids, leave the house and help you! Good luck with your decision!

[BarefootScientist]

Did they ask why you didn't call afterwards? Like right after the birth? What did you say? By that time, we didn't need you?

[2ID_Wife]

This is my plan, although I will hope to have wether on my side(FEB northern NY county living). I plan on talking to my OB about it since i do live so far it is a real concern to get their feelings. A few people I know moved for a month or so to have their baby due to this issue in the winter.

[seattlemamma]

My 4th child came in 30min. from "twinge to wah" I had educated myself on things to look for...baby was eating and breathing just fine and in general acting like a baby should. They wanted me to take him to the ER! I said, "seriously..you have to be joking! The ER is the last place I want my healthy newborn to be." It took me a week to get him into a pediatrician. The pediatrician said next time just walk in and someone here will check him out. Insurance will take care of itself in time. (I am an army wife) Lots of hoops to jump when trying to see a doctor. This month will be my second "oops" uc.

[2ID_Wife]

seattlemamma, does your clinic have certain time of day they do well baby check ups? I know my last clinic mon-wed and fri mornings were well baby only, they are normally spaced out more and have more free time then. I would do the walk in then. I have done a walk in and wait for different things during those hours and never had to wait to long to get in to see someone if it is something close in lines to a well baby(which the 1st check up would be).

[BarefootScientist]

Great advice mamas. So I'm thinking if I had prenatal care with a group of CNMs like I did with my DS, they MIGHT not even notice or care if I just canceled my remaining appointments and made a postpartum one. And if they asked I could just say I had him/her at home, go into further details about speed if they ask...

Then ideally if I could find a homebirth-friendly family doc he could check out the baby a day or two postpartum. Or would the doc not have to be homebirth-friendly?

Sounds like it could be do-able.

Actually I should have stayed home with DS because I started pushing at home but I was not prepared in any way for a UC. Next time, even if I end up deciding on a hospital birth (which I can't really picture myself doing), I am going to be prepared for a UC, mentally, emotionally, supplies-wise, and all these practicalities, so that I don't have to go in if the baby does come fast.

[basje]

Back up care

I brought my LO to the ped the day after she was born, not medically necessary but I needed to have documents relating to her birth to get her birth certificate from the city. Had she needed care after the birth I would have called 911 because of something wasn't right I'd have her taken to the children's hospital. If it not had been for the paperwork needs I don't think it was needed to bring her anywhere. I knew that child was healthy from the moment she was born and the idea of some doctor poking around to tell me what I already know isn't all that appealing. I suppose if you wanted your child to get a vit K shot, or other vax's then you'd want to bring them somewhere though.

As for my post-partum care, I had tearing so I went to labor and delivery five ours after my birth (leaving the babe at home) and said I had a homebirth. They assumed that it was with a midwife, until I had further complications once I was at the hospital already (major hemorrhage) and they inquired about my prenatal records (I UP'd) as I had to have an emergency surgery. Then I was honest about my UC, but I think that it's fine to just say, "oops?! It happened so fast..." Honestly, the nurses and doctors just referred to me as "the homebirth," they had never heard of unassisted nor thought it would be something someone would choose. I think one person asked me where the baby was and I said, "At home, she looks great so I figured I'd skip the germs." And it wasn't brought up again.

As for less dramatic pp care, I called and made an appointment with a midwife at six weeks after birth because I had questions about when the bleeding was to stop, and what could be done to fix the damn itching from all the stitches that were healing (I had three second degree tears that they sewn up in L&D). That sucked. The receptionist didn't understand why I wasn't seeing "my midwife" then the midwife when I got to her office was a hot mess about how I should "NEVER EVER DO THIS AGAIN" and was pretty horrible. I should have just walked out and called someone else but I was a little unsure about how to handle it at the time. It was impossible to "oops" not having prenatal care records, or labor notes for my pp care, but I would have gotten much better care had I been able to lie. That said, I did make an appointment in the private practice with the super high risk obgyn who sewed me up at the hospital, best care I've had. I am open about UC, he thinks it is hilarious saying to me, "not where I would want to push a baby out but I'm a man so what do I know?!" When I get pregnant again I think I'd see him at the second trimester and once at 35 weeks, and would choose to deliver with him if I had complications that I was not comfortable UCing. I think the key is to find a post birth provider that is respectful. If you do not find one at first keep shopping.

One thing that I did not expect after the birth was having to set boundaries with medical providers about my choice to UC. It took me a few months to really sort through how outrageously some providers acted and how to appropriately respond. I realized that there is nothing wrong with choosing to UC, I made a well researched and thoughtful decision that I feel was in the best interest of myself and my child. That choice does not mean that I am less entitled to comprehensive medical care when I choose to seek it. Seeking a medical opinion does not mean I am under any obligation to take it, or agree with the provider's opinion. And most importantly, it is not my job to defend my choices to my nurses, doctors or midwives. I was asked many invasive questions, and it took a while to grow a thicker skin and respond, "That's really none of your business." Or respond to judgments like, "That's irresponsible," with "I'm not here for your opinion on my birth I'm here to ask about blah blah."

Gee, I really went on and on...

[BarefootScientist]

Originally Posted by basje

Gee, I really went on and on...

And thank you for doing so, it's helpful. I agree that a healthy baby doesn't necessarily need to see the doc right away, but our society thinks differently, so the main reason I would want to get him/her to a doc fairly soon would be for CMA purposes so to speak...and to establish care, for the paperwork, etc...

[triscuitsmom]

Originally Posted by mitintraining

since they are not born in the hospital, they cannot go into the regular or NICU nursery, they need there own room or they could contaminate the other babies, that was not said in a mean or snarky tone, once a baby leaves the hospital they cannot go in the newborn nursery or NICU.

I wonder how common this is. I know it is definitely not the case here. Off the top of my head I can think of a homebirthed transfer baby who was kept in the newborn nursery (transfer due to breathing variations), and also two other kiddos who were born in the hospital but then had to come back after discharge and both were in the newborn nursery. There are two communal rooms for babies admitted at our hospital, one for newborns and one for older babies. The newborn one is the equivalent of NICU and newborn nursery together, it has the well and sick newborns, both preemie and full term. The other one is for "older" babies (I think over a month old up until a year) who need to be more closely monitored or when they run of out regular rooms because older kids need them because pediatrics in general is all semi private or private rooms here with the exception of the two communal nurseries.

[triscuitsmom]

I havn't yet had a UC and to be honest I'm not 100% sure what I'm going to do. I do have prenatal care through our local midwives. I think I am going to play it by ear.

If I have a PPH or tear I will call them right after the birth (right after depending on the exact course of events and how they play out). I will have them come over to check me out, suture if needed, help out with excessive bleeding if needed etc. If I need to transfer I will transfer with one of them (most likely scenario is that it would be for a PPH).

If baby and I are both fine though I really don't know when I will call. I am (at least right now) planning on getting postpartum care with them so I will call but I don't know if it will be the same or next day. I think that what time of day I deliver will factor into that too. Of course depending on how much time has passed will factor into what exactly I say to them.

If I need to transfer I will likely play it off as accidental because I know the care I will get will be better at the hospital. If not I will likely say that he came too fast and then things were fine. In fact I may even be completely honest and say I didn't call because I didn't want the interventions that were being pushed upon me.

Too many variables this second to say for sure though