2nd time around!

[lmk1]

I'm in the very early stages of pregnancy with my 2nd child, and I'm feeling a bit anxious!

I had ds in a hospital, with dh, my mom and a doula present. Even though, my plan was for no interventions, I ended up getting induced and wasn't able to deal with the Pitocin pain, and got an epidural. I'm still pretty happy with how things worked out. At some point ds's heartrate dropped and the nurses moved me around and got his hb up after 6 min. There was talk of emergency c-section, but my OB thought it would be ok to continue laboring (I actually was surprised, because I viewed him as conservative and cya). Once, I got the epidural, my bp really dropped (I have pretty low bp as it is), and they give me Ephedrine several times to raise my bp. My doula said I was pretty close to an emergency c-section at that time too. But the epidural did help me progress. After laboring for 5 or 6 hours with Pitocin, there was no progress, one hour after the epidural, I was ready to push.

So that's the history...Now we've moved to Miami, one of the places with the highest c-section rates. I like the OB so far, but I'm not thrilled with the hospital. There's only a chance of of getting a private room that I would have to pay for extra, and currently kids aren't even allowed to visit. How would my toddler live through possibly 3 days of not even being able to see me??? I'd considered going to a Birth Center to have the baby, but what if I have to be induced again? I have horrible insurance this time too, and just about everything will be out of pocket mostly. I'm concerned about needing an intervention (what happens at a birthing center then?). Any advice? Any experiences with delivering in Miami?

[wombatclay]

You may want to post over in Finding Your Tribe for Miami specific advice but in general...

If your insurance will cover it, why not start out with a Birth Center (and possibly a midwife team) and see what happens? Your body has already been through a pregnancy and birth once, and you may find that things work more smoothly this time as a result of that prior experience. In the event of complications a birth center will generally transfer you to a hospital... often the hospital is right next door A doula would be a must too I'd think.

For child care... could a relative or friend help? With our second and third births we had family stay with the older kiddos during the actual birth and then dh split his time between me/new babe at the hospital and with the older kiddos/family at home. Some postpartum doulas offer child care so that's another option.

congrats on the pregnancy!

[lmk1]

Thanks, I have to call my insurance and get info on what exactly they cover. I know it's not much, as my OB's office suggested I register at the hospital as a self pay.

My mom could watch my son part of the time; I'm just concerned how traumatized he'd be if he can't see me for 3 days. We've never gone more than 4 or 5 hours apart...but we are planning on getting him into day care at some point, so perhaps he'll be more used to spending time away from me.

I'm also wondering what happens if I'm seeing midwives, but it's determined that I need to be induced? Do I then have to go with an OB? And how do you get one at a late stage in the pregnancy?

[MegBoz]

There's a free standing birth center here in my area where the midwives can still attend your birth even if you have to transfer to the hospital! Obviously, if you need a CS, they need to bring an OB in. But if you need to be induced, they can still be your primary HCP. (Well, I'm fairly certain about that.)

If your insurance will cover it, I really think it's worth looking into. I'm SURE they have some sort of relationship with OBs, so transferring won't be a problem. You would NOT have to conduct a hunt on your own! The birth center here has tours on a regular basis, so you might as well go check it out (in addition to posting on your tribal area.)
Good luck!

[wombatclay]

Each group will be a bit different, but often midwives work in tandem with OBs. Around here, homebirth midwives have to maintain an "agreement" with an OB who will be the one to step in if needed. Hospital midwives will also generally be in a partnership with one or more OBs. My last birth (in August) was attended by a practice that had one OB and three midwives. If a complication came up then they called the OB, but otherwise you just saw the midwives. So in general, if you're seeing someone and they can no longer attend you THEY will pass you along to the next level... you don't need to worry about contacting care providers during labor or at 39 weeks as long as the reason for your changing providers isn't "your choice" (as in, you no longer like care provider X and "fire" them... in that case you may need to have lined up someone yourself).

Anyway, shop around till you're as happy as possible. I changed providers three times during ds's pregnancy and ended up driving an hour or so to reach the practice I finally decided on. We even rented a hotel room for labor and so the kiddos would be near by (my MIL watched them while dh and I were at the hospital, then they stayed with me at the hospital for a few hours each day and DH would put them to bed at the hotel before coming to the hospital each night to spend the night with ds and I) because the drive was too long. But as a VBAC mama, it was worth the stress of finding the best possible team and birth site for me and my comfort levels. It wasn't ideal, but it was my personal best and I don't regret any of my choices, which counts a lot!