Triangle NC Healthcare Provider Info

[khalf]

Hi!

I am new to the forum.

My DH and I are expecting our first child this winter. We would really appreciate any information regarding first hand experience at the Birthing Center in Chapel Hill, as well as delivery at Wake Med Raleigh (if delivery was by Kamm, Mckenzie, Harden, Smith & Bass - even better).

I have a very good very long standing relationship with my primary OB. I trust him and feel respected by him. On the other hand, I have mixed feelings about a hospital birth. I really like the philosophies of the Birthing Center, but since I am not currently a patient it is "the unknown" for me. We have toured both facilities.

Feel free to send a PM. Thanks!

[rhiOrion]

I just posted a bit about the birth center in another post, but the general idea is that I love them, but that like with any health care provider, you still need to do your own thinking and research and not blindly follow what they say.

[khalf]

Thank you for your quick reply. I checked out the other thread. I agree that it is best to do your own research regardless of who your provider is.

I love that you include your furbabies in your signature! We keep telling our cat that he is going to be a big brother.

[BeckyBird]

I had my beautiful baby girl last year at WBWC. I LOVED it!!!!

The prenatal care was great. I actually looked forward to traveling to Chapel Hill for the appointments (I live about an hour and a half away!)

The midwives even worked with me and used the fetoscope at my request. Also, since I lived so far away, they let me schedule my appointments farther apart than usual.

On the big day, Sarah was the attending midwife. She was awesome. I was about 5 cm when I arrived, and my water broke shortly after. I labored in the tub for a while, and then when it came time to push, she was very relaxed and let my body take charge. No cheerleading to push lol! She did gently direct me to blow through the contractions when the baby was crowning, so I wouldn't push her out too quickly. I did appreciate that guidance.
I had the baby in the tub, and pulled her right onto my chest. We stayed there for a long while, and let the cord stay intact. When it was time to push out the placenta, I moved to the bed.
After the baby was born, they even honored my wishes, and made me a placenta smoothie! How cool is that?!?
I felt comforted and cared for, and it was like a dream come true. That birth was a memory I will treasure forever.

If you want my opinion, I highly recommend giving WBWC a try. Good luck with whatever you choose

[pinky]

I just wanted to throw out there that I ended up getting my prenatal care from my OB because we had a longstanding relationship and I really liked her. In retrospect, I regret this decision--if you seriously want to have a natural birth, it just doesn't make sense to get care from an OB (unless it's a truly exceptional one), because it's just not what they're trained to do. (And never mind that I didn't even see her during the birth, since she wasn't on call!)

just my btdt opinion!

[WriterMom2be]

This really makes me want to birth there. I'm going to schedule a tour

[SeekingJoy]

Sorry! I have no first-hand experience with either facility. But, Welcome!

Wake Med Cary has a a decent natural birth rep, but I know less about Wake Med Raleigh. If you are comfortable with your OB's relavent statistics (c-section rate? induction rate? episiotomy? etc), are his/her partner's equally as adept at practicing evidence-based medicine? Wanna come to playgroup and have a candid chat?

Have you found a doula to support you if you are going to have a hospital birth?

[khalf]

Thank you for all of your thoughtful replies. This has been a tough decision...that we will still be mulling over for the next few days.

One thing that makes me hesitant about the Birthing Center - the idea of an emergency transfer to UNC hospital. I will be seen by a Dr I've never met and whose experience level could be anywhere. I know the midwives stay with you throughout, but if there were emergency procedures at the hospital they would not be the ones performing them. I think that is actually my only hesitation.

We have a wonderful doula. She is actually the one that told me about this awesome forum. Because of my difficulty deciding between the hospital and Birth Center she spent a long time discussing the two delivery options and giving unbiased info about both options.

A candid playgroup chat - sounds great!

[rhiOrion]

Even with an OB you could end up with a different OB in an emergency situation.

My delivery at unc wasn't emergent, but it was a medical induction due to cholestasis and I never saw an OB- just the midwives and nurses.

[Curlyfry7]

I had my DD at the birth center in 12/08 and also had an absolutely wonderful experience-I can give you more details if you'd like. We also received a lot of help with breastfeeding, which we really needed as DD had some issues with it. There was no grabbing your breast and shoving it into the baby's mouth like there was in the hospital with my DS.

I transferred to them at 32 weeks from Kamm and McKenzie. I had no major problems with this practice, but wanted a natural birth and wasn't convinved I'd get it with them. My due date was Dec 24th and they started mentioning induction pretty early on. Not sure if they would have really pushed it or not as I didn't give them a chance to do so and got myself out of there. No regrets about it either.

If we are lucky enough to have #3 I will be returning to the birth center.

[khalf]

"Even with an OB you could end up with a different OB in an emergency situation." rhiOrion

This is very true, but I think that I would likely see an on call OB from the practice that I have already met. Plus, I have a unique situation of being able to contact my OB at home if absolutely necessary.

I had my DD at the birth center in 12/08 and also had an absolutely wonderful experience-I can give you more details if you'd like.Curlyfry7

I would LOVE more details - you can send me a PM if that would be better for you! BTW - Our son's BDay is scheduled to be very close to your little girl's BDay! Our due date is 12/31

[pinky]

Originally Posted by khalf

"Even with an OB you could end up with a different OB in an emergency situation." rhiOrion

This is very true, but I think that I would likely see an on call OB from the practice that I have already met. Plus, I have a unique situation of being able to contact my OB at home if absolutely necessary.

In my experience, meeting an OB does very little to prepare you for having them oversee your birth. I had a GREAT prenatal appointment with an OB who happened to be on call when I was in labor. Once I started questioning some of her recommendations (while I was in active labor), she was pretty awful. I just think that an office visit is so different from childbirth that it doesn't tell you much.

I also had a zillion numbers (pager, etc.) from my personal OB, but I couldn't get in touch with her during my labor. Perhaps this wouldn't be true in your situation.

I think the main thing is that if you want to have a natural birth, it is a rare OB who is the right practitioner. They are trained as surgeons who treat birth as a medical emergency that needs to be cured, not a biologically normal event. It's hard enough to avoid interventions in a hospital without having a care provider that you have to fight with too, instead of someone who is fighting for you.

[maotmsmi]

*

Edited by maotmsmi - 5/21/11 at 12:26pm

[Curlyfry7]

"I would LOVE more details - you can send me a PM if that would be better for you! BTW - Our son's BDay is scheduled to be very close to your little girl's BDay! Our due date is 12/31 "

Yay for a holiday baby! Is there anything in particular you would like to know?? I don't mind answering anything. Overall, there was just an environment of trusting you and your body...we were (at our request) left pretty much alone to labor our way. There was no pressure at all, no yelling "push! push!" When I had fully dilated, the midwife told me "you're complete. You can push whenever you want." There was no impatience (as there was with my son's birth when I hadn't gotten him out after less then 7 hours of labor ) You can birth whereever you want. My DH was snapping pictures right and left (and got some VERY interesting ones that I didn't know he was taking, LOL) which was not allowed at the hospital where my DS was born. Even transfering in at 32 weeks went smoothly and they made me feel right at home.

There's probably tons more I could tell you but we are leacing for vacation in...like 1 1/2 hours!! But seriously, if there is anything specific you'd like to know, feel free to ask. And I know half the people who have responded to this thread in person, so I don't mind answering either here or by PM.

[gemasita]

I agree with Pinky that it's very hard to tell how they will "manage" your birth from an office visit.

I've only worked with clients used Kamm, Mackenzie, et al a few times but they seemed to me to be a typical OB practice. Nothing much different than any other OB practice in the area.

One of my current clients called Wake Med Raleigh to inquire about the c-section rate there and it's 33%. Since Kamm, Mackenzie, et al does a vast majority of the deliveries at Wake Med Raleigh, I would say their c-section rate is about 33%. A few points above the national average. So assume that your chances of a c-section under their care is also 33%.

I think the birth center's c-section rate is much lower than the national average. Maybe less than 10%? Ask on the tour - they will tell you.

[pearl2]

I transferred to UNC from WBWC resulting in a C-section. I got a team with a fellow and the doctor that did my big ultrasound, who is also an assistant professor in the med school of maternal fetal medicine. They were both really nice, spoke to me beforehand as a person not just doctor/patient, and completely announced my "in case of c-section" birth plan in the OR to everyone there, including the part about me wanting to VBAC future babies. The midwife was on the left side of my head, and this really nice nurse anesthetist was on the right side of my head and announced every step (I asked her to) in a really calm voice. Honestly, I suppose it was the best circumstance a C-section could be, and I definitely felt my choices were respected the whole time. No one talked about football or other inane talking I've heard other people report, and HC stayed with me in recovery and I got to nurse right away.

I had 2 awesome L&D nurses who were around my age and very nice. I was visited every day, and in some cases multiple times a day by the WBWC midwives.

My mom actually just ran into one of the doctors in the coffee line at the hospital, and she was so excited to see him. She said, "You delivered my granddaughter!" Then he said, "Oh! Did I do a good job?" She said he was really concerned and not just flippant about it. He DID leave me a great scar though.

Mine was not an emergency transfer, but you are very close to the hospital from WBWC. I was able to walk up to L&D, where they already had a room ready. It was total low drama.

[khalf]

I truly appreciate the candid and thoughtful input you all have given. This is such an important decision and it is wonderful to be able to get such great information and counterpoints.

"I also had a zillion numbers (pager, etc.) from my personal OB, but I couldn't get in touch with her during my labor. Perhaps this wouldn't be true in your situation."

I babysat and house sat for my OB's family for many years and they took me under their wings during college, etc. I have a friendship with he and his wife so that plays into my situation. With a large practice though, there is little guarantee that he will be my delivering OB. If there were, I would prolly not have these questions.

I had concerns about "knowing" how a Dr would handle my delivery care based on a routine prenatal visit. Experienced mom's have validated those

Your CSX story was a huge help Pearl2! That shined a little light on the situation that would be the scariest for me...in the sense that you went to the hospital and despite not knowing the Drs were given a lot of respect and good care. I like the midwife's role in it.

When we toured Wake Med Raleigh hospital back in July we were told by the tour guide (who seemed on top of her game)their CSX rate was more like 25% (may not be exact# but it was in mid to low 20's). Hmmmm...I wonder which one is accurate! It's still no 15%, though is it? We did the WBWC tour and asked for the same info...I can't remember the # but I am fairly certain it was considerably lower that the World Heath Organization's rec which is considerably lower than the American Natl Average.

Do they really still yell to "push" in hospitals during labor? I thought that was just TV Is it super common!?!

"One friend in particular received a lot of hospital intervention because her first was "big" (Doctor's words, baby was 8ish pounds) but she went with the birth center and even though she had a hospital transfer at the end of labor she was still able to vaginally and unmedicated, deliver her 2nd daughter at over 11lbs."

That is also a very cool story MommyKrista!

Happy vacation CurlyFry!!!

[SeekingJoy]

Originally Posted by khalf

Do they really still yell to "push" in hospitals during labor? I thought that was just TV Is it super common!?!

They did it to me with DS. They did it to my BFF.

[WriterMom2be]

Originally Posted by khalf

Do they really still yell to "push" in hospitals during labor? I thought that was just TV Is it super common!?!

They did with me. I think I needed it though. I went to the hospital with a natural birth plan but they forced me to recline in bed for the entire labor (I could even turn or move because according to the monitor my baby didn't like it). After 8 hours on my back and aggravating my herniated disk and showing little progression, I wanted pain relief. They turned off the epidural an hour before birth-- I felt the contractions and the ring of fire as he crowned but I never felt the urge to push until he was almost out...at which point they gave me an episiotomy against my wishes and told me to push with all my might which is a recipe for disaster. I pushed him out in under 15 minutes though.

Soo, this time I'm going to a midwife and I plan to move around maybe even labor in a tub and ease/breathe that baby out. But yep, they do yell "Push!" and count.

[rhiOrion]

Sorry to threadjack for a second (though maybe my musing might be helpful, actually)... but I will say that my experience at the hospital with the midwives was very different than the experience the people at WBWC had.

Sometimes I tend to gloss over that in the interest of explaining how much I love WBWC, but I think it's important here.

I was absolutely coached to push. Maybe not quite purple pushing, but close. A lot of coaching to keep pushing even when I wanted to lie back and stop for a second. Also, I wasn't just told to push when I felt like it. As soon as I was complete (actually, complete with an anterior lip) I was told we were going to do a couple of practice pushes to get the lip out of the way. Next thing I know I'm pushing for real.

But I have no idea how much of that was the particular midwife I had, and how much was being in the hospital. It's possible that because I had an epidural that she thought I wouldn't be able to feel the urge to push (she obviously had lots of faith that I wouldn't be feeling much- she was going to stitch me up without litocain because I had an epidural- I had to stop her and tell her to PLEASE numb me because I could feel everything). But in my case, I could. At least, I could after a few minutes. I think at first I didn't have the urge because I just didn't have the urge, not because of the epi. I could feel pushing, feel the urge to push, and at the end she was coming out with or without my help anyhow. But yet, I was still instructed to push. All this coaching could have also been in regard to L's heartrate, Carhootel and my DH have told me that they were getting a bit concerned about her heart rate toward the end. BUT, that's another hospital issue. At WBWC I wouldn't have had continuous monitoring, even less internal monitoring (not that I think monitoring with pitocin is bad... it's just what it is).

I tend to think a lot of it had to do with my midwife. The more I think about it the more I question how much I actually liked her.

But, it's also important to note that my delivery was NOT the norm for them. Not only was it a hospital induction, but it wasn't an induction just for post dates. It was an induction because of an actual medical problem, and one they aren't very familiar with. I had the feeling they were a bit on edge with me because of it.

All that said, I think if I had been with most any OB I would have ended up with a c-section. Absolutely. I think the midwives saved my vaginal birth, even if I didn't get the nice relaxed atmosphere everyone talks about having at WBWC.