If you are planning a hospy birth, but

[dachshundqueen]

accidentally have a kid at home - what do you do? We've done hospy for early baby, planned hb, and now pg a third time. Doing backup care planned hb.

If everything appears okay with everyone? I mean, do you then just run everyone into the hospy for a 24 hour stay or something. Do they expect you to go in for a hospy stay?

We've been trying to figure this one out to no avail here, me and DH, and don't have the guts to bring it up with current provider who we're sure would promptly send a drop letter.

Liz

[BetsyS]

I'm planning a hospital birth, but dh's biggest fear is that I'll have the baby on the side of the road (not likely, given long labor with #1 and no labor at 42 weeks with #2, but I digress).

Anyway, we've talked about it at length (me and him). If I deliver on the side of the road, I'll have him bring me and the baby home. I'll go to the pedi at 24-48 hours to have him/her checked out. If I think that I need it, I'd go to the ER to have stitches. I don't think that the ER is automatically a great place for this, but our local ER has OBs/CNMs on call 24/7 for drop-in cases, so it would be a real OB doing the stitches, not a random ER doc.

I'd call my OB (who is an hour away) and let him know that I'd delivered. I'm not sure that he'd believe it was accidental, but oh, well. I'd see him at 6 weeks.

[dachshundqueen]

Originally Posted by BetsyS

I'm planning a hospital birth, but dh's biggest fear is that I'll have the baby on the side of the road (not likely, given long labor with #1 and no labor at 42 weeks with #2, but I digress).

Anyway, we've talked about it at length (me and him). If I deliver on the side of the road, I'll have him bring me and the baby home. I'll go to the pedi at 24-48 hours to have him/her checked out. If I think that I need it, I'd go to the ER to have stitches. I don't think that the ER is automatically a great place for this, but our local ER has OBs/CNMs on call 24/7 for drop-in cases, so it would be a real OB doing the stitches, not a random ER doc.

I'd call my OB (who is an hour away) and let him know that I'd delivered. I'm not sure that he'd believe it was accidental, but oh, well. I'd see him at 6 weeks.

And there is the sticking point.

Liz

[BetsyS]

But, at that point, what can they do, you know?

I used to work as a CNM, and we did have patients that "accidentally" gave birth in other towns, in other states, and at home. Some of them were believable, some not so much. But, at that point, the baby is out. in my experience (just talking to folks), very few docs/midwives will drop you for postpartum care. During the pregnancy, if they suspect you're using them for shadow care, yes, maybe some would drop you. But, postpartum, not quite as many.

Part of it is a billing issue. Call me cynical, but I think, often, once it's billed/done, the provider doesn't care quite as much.

The codes for pregnancy care are a global one for antepartum, delivery, nad postpartum. Other codes are for delivery only, delivery and postpartum (if you've dropped in to another hospital, and you plan to follow up there), and the, there are codes for 4-6 prenatal visits and 7+ prenatal visits. Those prenatal codes don't involve any delivery or postpartum care. If they bill like that, the postpartum visit gets billed separately as an office visit.

[lunita1]

Originally Posted by dachshundqueen

accidentally have a kid at home - what do you do? We've done hospy for early baby, planned hb, and now pg a third time. Doing backup care planned hb.

If everything appears okay with everyone? I mean, do you then just run everyone into the hospy for a 24 hour stay or something. Do they expect you to go in for a hospy stay?

We've been trying to figure this one out to no avail here, me and DH, and don't have the guts to bring it up with current provider who we're sure would promptly send a drop letter.

Liz

I've brought it up with my hospital based CNMs because of my precipitous birth last time (my daughter was born 10 minutes after arriving at the hospital.) We're planning a hospital birth. If baby is born quickly at home or in the car, we'll go to the hospital to be checked out (& stitched if necessary). DH was thinking he'd call 911 if baby started crowning, but because we GREATLY prefer our chosen hospital and it is in no way the closest one to home, calling 911 for an otherwise healthy/uncomplicated birth would put us in the position of being transported by ambulance(or arguing against transport) to a hospital that is likely to want a greater level of observation/intervention and might expect us to stay 24-48 hours. Unless there's a specific concern we wouldn't stay 24 hours -- we stayed less than that after my last two in-hospital births.

[clicksab]

Well, this just happened to me last week, so I'll tell you what we did!

We had planned on laboring at home as long as possible with my doula, then going in to the hospital. Baby came much more quickly than anticipated, and I was feeling the need to push when our doula got there. We picked a doula who is also a midwife though, so she ended up catching. But since we weren't a planned homebirth, we did call 911 for backup (she didn't have oxygen with her and felt it might be necessary). We had him 5 minutes after the paramedics showed up, and took the ambulance ride to the hospital. We both got checked out and I got stitched up. We stayed at the hospital for 24 hours.

Yes, we had people asking if we did it on purpose (especially since it seemed might convenient that we had a midwife there!). I simply said "No, trust me, I'm still shocked!" After it was all said and done, the 24 hour stay seemed a tad bit silly. But on the other hand, since I hadn't been prepared to give birth at home and I had a VBAC, it did make us (and everyone else) more comfortable to just go in. I think it really is just about how you feel at the time and what you are comfortable with.

[khaoskat]

I am in the exact same boat. I want a home birth, but I am still going to an OB. One of my main reasons for wanting to home birth is that I do have very fast unnoticeable labors. DS2 was born 20 minutes after arriving. DD2 I was fully effaced and dilated when I showed up and my BOW was already descending down the birth canal ahead of my daughter (I had polyhydramnios).

I am wanting to talk to my OB, actually the main OB in the practice about it, but have not had a chance to have an appointment with him yet.

I know there is an excellent chance that I will need stitches, as I have had to have them with every single birth, because I birth so fast and explosively and have large babies. DS1 - 2nd degree; DS2 - 3rd almost 4th degree; DD1 - 2nd degree. Well, DD2 I was stitched elsewhere as she came by emergent c/s because of turning transverse, sticking her arm out, and engaging her shoulder.