I still have a great deal of time to think (I'm due Aug. 28th), but I'd like to choose my MWs soon, and one practice does ONLY HomeB. and one does only BIrthC./Hosp. My son was born in a hospital with MW in attendance. I labored but could not birth in water b/c the hospital did not allow it. It was a 12 hour labor with no meds and nothing complicated (other than the stitch up, which I've described in another forum). So I like to think that I am likely to have another uncomplicated vaginal birth.
Option: Birthcenter with CNMs. This is, unfortunately, not a free-standing birth center, but one located in a "separate wing" of a hospital that also has a traditional maternity unit. I would be delivered there by one of the two midwives who deliver there. At this time the doctors do not use this facility at all. Of the women who give birth there, 50% do so in water (which is what I'd like to try) and their c-section rate is 3-5% (though I'm not sure how they get that number, it is probably b/c certain women are not admitted to the birthcenter due to breech presentation, etc.). So far, I've liked the MW I've spoken with on the phone, but due to the WEATHER (argh!) we've had to cancel appointments 2 weeks in a row, so I've not met her in person. This practice of MW works with an OB practice and also sees patients who plan to deliver in the traditional hospital wing. However, if I choose to use the birthcenter, I would be guaranteed a MW delivery, unless surgical intervention were required. One big advantage is that this would be the MUCH more affordable way for me to try to birth naturally in the water. There is also a part of me that might feel more comfortable with knowing that if something went awry, I would still be attended by the MW that I knew and the hospital stuff is right there.
Option: Homebirth with CNMs. We've met with one of the midwives and she seems great. The other one we talked to on the phone seemed good, but kind of pushy when I told her we were deciding between home and a birthcenter. But not too pushy. One main reason I'd like to give birth at home is b/c I'd like my son to not feel like "mommy left" and came home with someone new. I've heard that it's nicer for older kids to feel like they are a part of the birth, even if he's out of the house during the more intense parts. One disadvantage is that although our insurance covers the birth, the midwives have additional fees and the tub rental would be a significant cost. It is my esitmate that if our homebirth went smoothly (no transfers, which would incur a hospital care co-pay as well) it would be about $800 more than the birth center. My only other concern is that in the event of an emergency transfer (which is unlikely, but something someone planning a homebirth probably has to think about) my MW would no longer be able to attend the birth in a technical capacity, since the closest hospital does not give our MW admitting privileges (stupid system!). This means my birth has the potential to go from a MW home delivery to an OB-I've-never-met delivery if anything unexpected comes up. That would stink. My concerns about the mess have been addressed in an earlier post I wrote. I have to say that I do not know right now what I'd be more comfortable with-- what would make me relax during birth and give my body a chance to labor as it should. I do not have a fear of hospitals, and I can't say that for birthing, I feel most comfortable at home. Maybe I would. Maybe not! I've never tried!
Sorry this was so long.... If you have any thoughts, let me know! Em