Back up plans

[allisonrose]

I'm planning a homebirth. As I near the end of my pregnancy, I'm trying to figure out the what ifs. I live in a rather isolated area: there's a small local hospital and nothing for 30 minutes. I recently had my birth team meeting and asked whether we should tour the local hospital. She said it was up to us.

I go to a breastfeeding group run by an OB nurse. She knows I'm planning a home birth and asked yesterday if I have a back up doctor. I said no although I've seen a local OB for well woman care in the past. She told me that that dr isn't currently practicing after a near drowning experience this summer. She practices with her husband so he is currently solo. In fact, he is the only OB who delivers at the local hospital! I was shocked. I knew it was a small hospital but one OB!? There are several OBs who have office hours in town but they deliver at hospitals 30 minutes away. She went on to mention that they do get patients from these other docs who come in but that they come in without any medical records. She was saying that then they "have to" give the newborn a hep vax since they don't know mom's status. She also said that since they don't know mom's GBS status that they "have to" treat as if mom is positive. She even mentioned a mom who recently came in and had the baby two hours after arrival so they "had to" do blood tests on the newborn since she didn't get the full course of abx. She made it sound like the parent(s) get zero choice in these cases.

My midwife will come with us if we need to transfer. So she will have my full records and I also have a brief personal medical record that she fills in each appt with BP, fundal height, weight, etc, etc. It includes the results of my GTT and, once my GBS results come in, she'll put that down too. I haven't been tested for hep this pregnancy and now I wonder if I should get that done.

I'm trying to process all this info. I'm wondering if this hospital is capable of an emergency c-section if I need to transfer. Especially if it's the middle of the night. I'm thinking about scheduling a hospital tour to get more info.

I'm not sure what I'm looking for in regards to posting this....

[jeminijad]

I think you should do the tour. If that hospital is unable to do an emergency C (lots of small hospitals don't have in house anesthesia 24/7,) then they may not be able to make the difference needed. Additionally, I'm assuming they don't have a NICU- can they stabilize a very sick baby for transport?

[allisonrose]

They do not have a NICU. They transport to other hospitals: one or perhaps two hospitals 30 minutes away have a NICU. Otherwise they transport to hospitals an hour+ away. The OB nurse once told us that when a baby needs NICU care, several of the nurses get on the phone and see which hospital has a bed available. They do flight for life unless winds are bad - there's a mountain pass that can get quite windy and unsafe for helicoptors. In which case, they transport via ambulance although the nurse mentioned that each option takes approximately the same amount of time to accomplish.

I do have feeling that it is best to go, do a tour and ask questions. I'm just not interested in getting a bunch of questions asked of me. I don't know. Maybe I can try to arrange having the tour with the OB nurse who thinks it's cool that I'm planning a homebirth. Not the one I talked to last week - I get the impression that she doesn't think a homebirth is such a terrific idea.