deciding on where to give birth...

[Adamsmama]

I've had 3 hospital births. They weren't horrible experiences. My 2nd birth was pretty wonderful, actually. My first was difficult because there were so many complications at the end -- and he almost didn't make it -- and as it is has CP/brain damage. My 2nd was an easy, uncomplicated delivery. My 3rd was an induction which was also uncomplicated, but very uncomfortable.

I'm trying to decide between a hospital birth and homebirth. I thought I had made up my mind but now I'm having 2nd thoughts. Here is what I LOVE about the homebirth:

• midwives will come to my home for prenatals (huge plus!)
• midwives focus on prenatal care/nutrition/much more personal
• midwives don't push extra procedures before or after birth (I would like to avoid rhogam shot at 28 weeks, gestational dibetes test in the form of that drink, and a lot of the stuff afterbirth including the shots they give baby in the hospital)
• Get to eat my own food during and after delivery (have multiple food allergies and wouldn't want to touch hospital food)

Things I like about the hospital:

• Feeling of safety if past due date (with the complications with my first -- if I go past my EDD, I feel much more "safe" having an ultrasound and NST soon after my EDD. I would never feel comfortable going past 42 weeks-- my own personal issues, I suppose.)
• Feeling of safety at delivery -- I find comfort in the monitoring, I might be the odd one out, but with the severe complications of my first delivery that is always in the back of my mind. I keep thinking of my homebirth and me panicked and freaking out, even if all is well.

If I have a planned hospital birth I will go with a set of OBs that have several nurse-midwives in the practice. They always have one OB and CNM at least on call. I like that they are for natural birth. They only deliver at a hospital that is about 25 min. away from my home, but has an excellent reputation for maternity care.

If I have a homebirth and need to be transferred, it would be to the local hospital that has a horrible reputation but it is only 5 min from home.

Is there any chance that the hospital birth/OB practice could: not force me to take the RH shot, the Diabetes test (at least in the normal way), I could have a natural birth and I could leave the hospital within several hours of delivery? I'm not as worried about them vaxing the baby because I know I will have to sign forms and with DD I was very clear that she wouldn't have it - and they didn't, although the nurses thought it was odd.

Sorry this is so long. I have found that ignorance is bliss because I never thought about or questioned anything with my first 2 births -- I didn't even consider anything different ... with our 3rd we briefly thought about it but insurance wouldn't cover a dime. This time insurance would cover 90% of either one.

[womenswisdom]

Just to address a couple points:

Is there a way you could have parallel or shadow care so that you can get the testing you want but still plan a homebirth? The midwives you work with may be able to refer you to a sympathetic/cooperative OB.

Midwives do monitor you during labor. It wasn't clear from your post whether you were aware of that. IDK if that helps you feel better about that option.

When you look back, will you regret not finding a way to go with the homebirth?

[Adamsmama]

Originally Posted by womenswisdom

Just to address a couple points:

Is there a way you could have parallel or shadow care so that you can get the testing you want but still plan a homebirth? The midwives you work with may be able to refer you to a sympathetic/cooperative OB.

Midwives do monitor you during labor. It wasn't clear from your post whether you were aware of that. IDK if that helps you feel better about that option.

When you look back, will you regret not finding a way to go with the homebirth?

Thank you for the response. They did say there is an OB in another town around here that will see me if I get to 42 weeks ... maybe I could ask to be seen at 40+ because of my history. How often are you monitored during birth? I forgot to ask when we spoke and someone online told me they would probably use a doppler - but how often would that be? I guess I thought I was ok with it until I started thinking of my biggest fears. I would like a homebirth for a lot of reasons but my realist side of me thinks that when I get into active labor/transition I'm going to be so scared something will go wrong that I'll have major anxiety and end up transferring ... even if that isn't totally rational. My fears of the hospital include getting an infection (a friend had this happen after a c-section and has spent weeks back in the hospital treating the infection), having the drs try to do tons of interventions (like break my water, etc.) and really - eating hospital food. Why does this have to be soooo difficult?

[womenswisdom]

If your midwives have a cooperative OB, I don't see why it would be an problem to start more detailed monitoring earlier rather than later. Maybe you could go consult w/ the midwives and the OB?

As far as monitoring, it depends on the mw and also your comfort level. I would hope they would monitor you as often as you felt it necessary.

Obviously you would need to be comfortable in whatever scenario you choose and I think it's good to think through the "what-ifs" of both before making a decision.

Asking b/c I truly don't know - is it possible your son had CP/brain damage prior to labor and that's what caused the difficulties during labor? Or did the difficulties during labor caused the CP/brain damage? Obviously I don't know what happened but thought I had read something about babies who had CP having a more difficult second stage due to the CP and that the CP wasn't actually caused by the difficult second stage like "they" used to think. I would think that would be something that might influence my decision about whether to hb or not, if I'd had that experience.

[Adamsmama]

Originally Posted by womenswisdom

If your midwives have a cooperative OB, I don't see why it would be an problem to start more detailed monitoring earlier rather than later. Maybe you could go consult w/ the midwives and the OB?

As far as monitoring, it depends on the mw and also your comfort level. I would hope they would monitor you as often as you felt it necessary.

Obviously you would need to be comfortable in whatever scenario you choose and I think it's good to think through the "what-ifs" of both before making a decision.

Asking b/c I truly don't know - is it possible your son had CP/brain damage prior to labor and that's what caused the difficulties during labor? Or did the difficulties during labor caused the CP/brain damage? Obviously I don't know what happened but thought I had read something about babies who had CP having a more difficult second stage due to the CP and that the CP wasn't actually caused by the difficult second stage like "they" used to think. I would think that would be something that might influence my decision about whether to hb or not, if I'd had that experience.

That is something, unfortuantely, we'll never know. I know it was a more violent delivery. He had the cord around his neck and meconium in the fluid. His heartrate was dropping through the contractions right as I was ready to push. When I pushed dr. realized he was facing the wrong way and reached in to twist him several times ... then used vacuum which wouldn't work and then forceps -- he yanked him out. Right before he got him out he said, he would give it 2 more min. before prepping for a c-section. He had about 8 different nurses in there with him -- which was totally different from my calm, peaceful 2nd birth. DS had a huge bloody gash on his head from the forceps and was very pale at birth but they helped him start breathing/crying ... we'll never know what exactly happened.

[Right of Passage]

Originally Posted by Adamsmama

Things I like about the hospital:

• Feeling of safety if past due date (with the complications with my first -- if I go past my EDD, I feel much more "safe" having an ultrasound and NST soon after my EDD. I would never feel comfortable going past 42 weeks-- my own personal issues, I suppose.)
• Feeling of safety at delivery -- I find comfort in the monitoring, I might be the odd one out, but with the severe complications of my first delivery that is always in the back of my mind. I keep thinking of my homebirth and me panicked and freaking out, even if all is well.

I want to address this, with a midwife more than likely you and her can decide what is best. If you want an ultrasound and NST to check on babe she can probably refer you to get that done.

[RedOakMomma]

OP...I think it's hard, when you've experienced good things in a hospital, and when one of your child has special needs, to venture away from the perceived "safety" of a hospital birth. And that's okay. Whichever option you decided on, I hope you can talk to the provider about your concerns, and have them addressed.

[MegBoz]

Originally Posted by Adamsmama

• Feeling of safety at delivery -- I find comfort in the monitoring,

Well, bear in mind that it's the exact same technology monitoring the baby's HR at home (doppler) vs. hospital) (EFM) - the only difference is that the EFM in the hospital has a belt (so it doesn't need to be hand-held) & it creates a record of it (no records with hand-held doppler). But otherwise it's the same technology (I think it's called "Ascultation" or something). Just sayin' that there is no greater degree of safety in hospital EFM vs. HB MW hand-held doppler.

As others have posted, I'm sure any HB MW would be happy to monitor your baby as often as you want.

IMX, the issue with leaving the hospital early is more about having the baby discharged. My MWs (hospital-based CNMs) said they didn't mind discharging mamas the same day as delivery, but many pediatricians don't want to discharge baby for 24 or even 48 hours. So that's something to consider as well.

In any case, it's important to birth where you feel most comfortable. It sounds like you have 2 really good options in either case, so for that!