What did you do if you couldn't find a midwife?

[Pearly]

I'm 25 weeks, expecting my third child. My first was born in hospital (we arrived about 20 minutes before the birth) and my second at home. We moved, and in our new location there are no homebirth midwives. I've heard of one CNM that practices with an OB, but obviously in a hospital.

A midwife I know will be visiting a town a couple of hours away from us and volunteered to come for our birth. But, I'm not feeling totally comfortable with the arrangement. She's not been responsive lately when I've contacted her. She's supposed to be providing my prenatal care (we've visited her a couple of times), so it bothers me that I can't reach her. I'm worried she might change her mind. Or, the weather might prevent her from coming (mid-November.)

Even though I've had uncomplicated births, I don't feel comfortable planning a UC. If it happened, I think I'd be fine. But I don't want that to be the only option.

Our insurance would completely cover a hospital birth, so its a little tempting to forego paying the midwife the 2k out of pocket and use the hospital instead. But when I think about being at the hospital I get nervous it could go really wrong. I'm so torn!

Besides those issues, I would just like some reassurance about this pregnancy. I feel fine, but isolated. Sometimes I just want to talk to somebody who knows what my body is going through and can tell me why.

Did any of you go back to the hospital after having a homebirth and have an intervention-free birth? What was it like? Do you regret your decision?

I know no one can tell me what I should do. But hearing some other people's thoughts might help me figure out what I want to do. Thanks, in advance...

[MsBlack]

There may be other mws you haven't heard about yet--though it is true that some areas are underserved. If you say how you have determined--through what sources--that there are no mws near you, some of us may be able to help you discover more methods of searching.

[honeybee]

That is a really tough spot to be in. I have uncomplicated pregnancies and fast births, but I still do believe it's important to have a skilled midwife. I'm not comfortable with UC for myself in general.

However, if there absolutely weren't any mws available in my area? I think I would cover my bases. I would find the most ncb friendly doc or hospital mw I could find and start prenatal care later in pregnancy.... after 20 weeks, at least. I would look to see if there were any family practice docs who catch babies, because they are often less interventionist. I would refuse tests, refuse u/s, refuse vaginal exams. I would make it really clear what I would not accept during labor and birth... and I would go from there based on their reactions. I would choose my hospital and visit the L&D to find out who the ncb friendly nurses are. I'd try to find the local doulas and Bradley teachers and learn the inside scoop on local practitioners and the climate in general.

I would totally be prepared to UC... as I might have difficulty getting to the hospital before baby if it was a typical birth for me. I would have all the homebirth supplies ready, and would get some additional monitoring equipment, such as a doppler. I'd learn to assess baby and do some first aid type of things. I would make sure I had someone on call to watch my older children, and some kind of help with the birth mess afterwards. Then I would wait and see how things go. If I felt good about the hospital situation with the caregivers I'd chosen, I might just head there immediately.

More likely, I'd wait and see. If everything continued uneventfully, I would expect to birth at home and proceed with a UC. But if anything seemed out of the normal, or if I even just got scared for no reason, we would have the doctor care established and be able to go to the hospital and feel prepared for that. I would also look into the local EMS... do they have a good reputation? How far out would they be, etc.

I feel pretty confident at this point that I could negotiate even a hostile hospital birth, although it would obviously not be my choice. I would make sure my dh or another friend was well versed on what to watch for and to make sure certain things do or don't happen (like staying with the baby in case of a c-section and making sure baby doesn't get hep B or the eye gunk, etc.).

[MegBoz]

First off, , Sorry you are in this situation.

Assuming there truly are no HB MWs, I'd probably do as Honeybee describes. I'd check out the birth climate in general & the hospital.

If the hospital were hostile, I'd more strongly consider UC. But if the hospital were decent or even good - I'd try to make the best of it. I'd try to just 'reframe' in my mind having a nice hospital birth. It certainly can be done! I'd be sure to have a doula or NCB-experiened friend to help 'run interference' with hospital staff just in case (& so she could stay with me while DH goes with baby if we needed to be separated.)

[Pearly]

Thanks for the suggestions. I feel like I've looked under every nook and cranny for local midwives... but if there is some secret directory or way of finding one, I'm all ears!

I tried contacting one midwife (an hour away) and one local doula. Neither responded.

I'm in a small town with a serious shortage of health care professionals, let alone ncb friendly ones. However, I had an appointment with our family practice doctor to find out what her philosophies on birth are. Unfortunately, she cancelled the appointment last minute for some unexpected week-long absence. I'm sure I'll have a chance to reschedule, but right now it feels like another failed attempt!

There is one hospital in town. I've heard mixed stories. In general, I don't think it has a reputation for being progressive. I know several women who've had cesareans recently. But I haven't been and it may be there is more support there than I am aware of.

I teach full-time at the university, so because my time is limited I was feeling intimidated with learning all the first-aid and things to watch for with a UC birth. But maybe I'm making it too complicated. I keep fantasizing about having this baby in the bathtub by myself so quickly and easily there's no time for doubt.

I'm sure it will work out. I have just unexpectedly found myself feeling a need for reassurance (when I always felt confident enough before.) I guess I'm looking for that to come from the outside. Maybe I'll have to figure out a way to generate it myself.

[dannic]

I would try contacting the MW from an hr away again. She may have other resources you don't know aobut. For yrs, I thought there were no MW's around here, just the one hosp and a few drs. After two births elsewhere, I discovered that there is one MW here and one 1 1/2 hrs away and one 2 hrs away. I went with the one 2 hrs away...
that said, if I couldn't find one, I'd probably labor at home at deliver at the hospital (making it in 20 min like you did with your first). With a doula if I could manage it.

[tracymom1]

I was 25 weeks when I decided to have a home birth (HBAC) and none of our local midwives would take me on. I ended up posting a request on the Yahoo Illinois Midwives group to see if I could find someone - and I did! She was not a legal midwife, but a direct-entry midwife who had been delivering babies for 25 years and I loved her. The whole thing was pretty covert, but I was okay with that. Oh, and I received tandem care with my OB group (which also had midwives but they did not do home births) until I was 34 weeks just in case. They did know of my home birth plans and were fine with it, though most would not be.

Maybe there are some midwifery groups for your state that you can appeal to and someone may come out of the woodwork? If not, I would UC, but that's just me. Happy birthing, whatever happens!

[2ID_Wife]

I couldn't find one but stopped to ask an Amish lady that isn't far she has a few leads. Try asking the mw or doula that didn't call back, check fty here too.
I am doing ob shadow care and then will play it by ear when labor hits to stay home alone or go in. Depending on the feel I get from the doc, hospital(will tour this one) and the feeling from myself.

[elus0814]

I had two 'big city hospital' births with two premies, both were reasonably good experiences. With the third I had a midwife for prenatal care but went into labor two days too early for her to attend the birth. She put me in contact (in the middle of the night) with a family practice doctor who's wife had given birth to all their children at home with a midwife. The hospital was a small town rural one which I drove 70 miles out of the city to get to. I was the only patient that day. I spent a few hours relaxing and sleeping on and off in bed, then a couple hours in the bathtub, then the last couple hours walking around. The baby was born with me on hands and knees, the doctor just sat on the end of the bed. No interventions, no monitoring, no iv, the family doctor checked out the baby without ever asking me to put the baby down. They did offer things, like pain medication, but always accepted my polite refusal. The doctor even lived around the corner from the hospital and walked over a couple hours into my labor to be nearby. He hung out at the nurse's desk a few feet outside my room and offered nice suggestions while I walked by. We have since moved and are now having a homebirth because the hospital (and obs) here are not nearly as welcoming to those who would like a natural birth. It's just a matter of researching options in your area.