Here are my concerns- any advice would be appreciated

[Deir]

Hi- I had 2 children at a feestanding birth center. One was actually born at the hospital because I had serious acute preeclampsia but I feel confident that the midwives were the reason I did not have a c-section. My second birth was peaceful, wonderful etc!! The only things I didn't like were the drive in labor and the discomfort of trying to sleep in somone else's bed after the baby was born. So here it is 4 yrs later and I expecting baby #3 and contemplating homebirth. I feel sort of sad to leave my birth center where I feel comfortable and have so many happy memories. I interviewed a midwife who is HIGHLY recommended and I loved her but I found out there would be a 1500 extra fee for homebirth with her. The other CNM near me has so many mixed review including some downright scary ones that I feel a bit uncomfortable with her. We could do the 1500 but it would be really tough. We are far from poor but still 1500 is hard. I am trying to decide if it is worth it. here are my other technical concerns about hb- hoping you can give me some input:
1.My house is very small- one bathroom which is tiny. Would I be comfortable laboring there? I barely have room for a birth tub which I would definitely want since I labored so well in the jacuzzi at the Birth Center
2.My kids are 6 and 4 and I don't want them there at the birth. What happens if I go into labor at 2 am? My house is so small- I don't think they would sleep through it.
3. Cleaning and set up- is it worth it to be at home to go to all the trouble/expense since I have a good birth center?

Now- my only worry with the birth center is crowding. I was all alone there when I had Frankie but I worry that they could have a busy night and I could get shafted to a room with no tub.

I want to make the best decision for my last birth- it is so hard!!

[Astraia]

A midwife with some "downright scary" stories attributed to her- no way could I get comfortable with her around. If you can swing the $1500 for one you like with a good reputation, I'd strongly recommend it. The last thing you want in labour is for some part of your mind to be thinking, "am I going to be one of those women with a really terrible experience? What are you going to do to me?"


Small bathroom- eh, not a big deal. In some ways it's NICE, then you can't get too many people in there at once. One midwife, DH, good enough.

Birth pool- I'm confused in that you're saying it won't fit in the bathroom or in your house? If it won't fit in the bathroom, put it somewhere else Birth pools don't need to be that big, a lot of women use 106 gallon (errr...116?) and they don't take up that much floor space. And again, you don't need a million people crowded around the tub, enough for 2-3 people and somewhere to put your drink and some towels should be good enough.

Kids- I don't have older children, but if they wake up can you have a support person on call to bundle them up and take them someplace- sleep over at grandma's, for example. And it also depends on how fast your labours are and when it starts. Labour starts during the day, send them off for the night before it gets too intense. Labour starts late at night, if it takes awhile for things to get intense and noisy then it's quite possible they can wake up at their normal time and then leave when you need them to.

Cleaning- it doesn't need to be spotless! Get rid of obvious clutter and horrible dustbunnies, but midwives aren't there to critique your house-maintenance abilities at 9+ months pregnant!

Set-up- you can do a lot of setup before birth. Bowl for placenta, oil for perineal massage, spare sheets and towels, chux pads, etc and have them stacked somewhere easily accessible. That just leaves you with the birth pool, and in earlier labour you might welcome something to do other than time contractions!



But in the end, it's up to you. If you'd be just as comfy in a birth center as at home, and you don't feel any big draw to being at home then do the birth center. If you strongly prefer to be at home but these are factors that might make you move, there are work-arounds to almost everything.

ETA: crowding at the BC might be a tricky one. Has that happened before? How likely is it? They should be able to tell you the likelihood of it happening and how often it happens at the center, but in the end it's just one of those many risks you end up taking. Good luck in your decision!

[Pookietooth]

Are you wanting a home birth because you know this is your last chance? Or because of the crowding and the driving? Is the money the main concern? I'm doing a home birth and we live in a small apartment, I will have the birth tub in the living room, which is the only place it will fit. My six year old will be taken care of by a friend as we have no family in the area.

[phatchristy]

I don't think the crowding is an issue...here I've birthed all four somewhere in my bedroom suite (interestingly never in the same place LOL) which is not that big really.

As for finances, does the birth center have a homebirth option?

[Deir]

Thanks- Yeah I guess the money is the biggest issue. that is what made me start questioning things when I thought about it. I was pretty much set on a home birth and then the fee came up and i guess i need to convince myself it is worth it. i believe most babies should be born at home. it's just that I started out thihs mothering journey at the birth center and loved it so that complicates it a little. I can't have the birth pool in the living room- we have no bathroom on the first floor. I would have to move a recliner out of my rooom and squeeze into an alcove. there would only be space on one side for dh /midwife. is that ok?

[kcparker]

Here's what I think about the money - birth is a major, no do-overs life event for your family and this baby. What could possibly be MORE important than this? I squirreled away our tax return and it is going to pay for this homebirth because I think this baby's birth is more important than paying down 10% of my student loans, more important than 2 1/2 mortgage payments, more important than fixing the rotten boards and repainting our garage, more important than a family trip to visit relatives on the West Coast... We also "should not" be having an out-of-pocket homebirth when we have a small income and I have insurance that would at least partly cover birthing with some perfectly lovely hospital based-CNMs practicing 3/4 of a mile from my house. I love them to pieces but opted for home because I don't think a woman in labor should have to DRIVE anywhere, plus there is the hospital's no waterbirth policy, the overzealous, antibiotic-wielding pediatricians, and the lack of restfulness on the mama-baby unit.

Our house is TINY (the "master bedroom" is 10'x10', so the birth pool is going in the living room and we are going to be playing furniture tetris with what is normally in there...) I think if your heart is telling you that homebirth is the right option, then go for it. Money is like a river. There is always more coming down the stream that you can collect, and it inevitably leaves your hands again.

[deymm]

If you can set up an FSA through your or your husband's employer, you can have that $1500 taken out of your/his check pre-tax over the course of 12 months (the year 2010) and pay your midwife from that fund. That's what we did--we are paying $1800 out of pocket AFTER insurance and what we had saved in our FSA covered a big chunk. Then it doesn't feel like a huge expense all at once.

[laohaire]

Originally Posted by Deir

I can't have the birth pool in the living room- we have no bathroom on the first floor.

Do you mean for filling up the pool? Do you have a kitchen on the first floor?

Or do you mean that you want to labor on the same floor the bathroom is in? Every woman and every labor is going to be different, but I personally had my pool in the dining room, and our only bathroom is on the 2nd floor. I went up to the bathroom every now and then and it was no problem. If it was a problem and I wasn't going to move, I would have just peed in the pool, no problem there (pee is sterile and the dilution is incredibly high). Frankly if I had been at that point, then having a bathroom on the same floor wouldn't have made a difference - the difference between getting out, drying off, and going to the bathroom on that floor versus getting out, drying off, going upstairs, and going to the bathroom would have been pretty minimal.

And honestly going up and down stairs is good for labor too

[Deir]

Thanks everyone!!

I would like to have the birth pool on the same floor as the bathroom- my last labor, I kept feeling like I needed to have bowel movt and it helped to have the toilet nearby.

I have yet another option that I didn't mention- these great midwives (kathy Hindle/Janet Lewis- for any of the Philly areas moms here) also do natural/water births at a local hospital. I need to ask about hospital policies regarding taking the baby, discharging etc. So that's my 3rd option! Never thought I'd goo to a hospital but I don't want to be stubborn if that would be the best option.

[kcparker]

Originally Posted by deymm

If you can set up an FSA through your or your husband's employer, you can have that $1500 taken out of your/his check pre-tax over the course of 12 months (the year 2010) and pay your midwife from that fund.

But nota bene: The FSA will only cover legally recognized medical providers though, so if you are in a state that doesn't recognize direct-entry midwives, you will HAVE to find a CNM or doctor to attend you if you want the FSA to pay for it. :

[HappyMommaBear]

It sounds like your birth center is great. So, why are you considering a home birth? I think your reasons are very important. Above all, you need to make sure that you are comfortable in your labor setting.
My house is small, (especially the 1 tiny bathroom - I feel you there!) and I have an 18 month old. And, you're right - there is quite a bit of work and expense involved in getting ready for a home birth. But that is where I am most comfortble, by far, so for me it's worth it. I don't think that being in a small place would necessarily keep you from being comfortable.
Is there nowhere in your house that you could put a pool? We bought the intex fishy pool - it's only 60" in diameter, so it fits in our dining room. (though it never would in a bedroom)

Anyway, I think it's most important to choose the place you are most comfortable with. After you decide that, the rest will work out. Good luck!