Non-homebirth after having only homebirths?

[laurac5]

After two homebirths, I am moving to one of those states where homebirth isn't 100% legal, and I'm not really comfortable riding that line.  There may be a birthing center available, but otherwise, my next baby will be a hospital birth.

Have any of you done the same thing, having had all your babies at home but then planning the next birth at a hospital or birthing center?  Can you share your experiences?  I want to know what I'm up against...

[Climbing Rose]

I would say just pick your hospital and doctor wisely (which I'm sure you would do).

I had three at home and then went to the hospital for the last two births.  I found an *amazing* family doctor who delivered babies.  (She was actually described to me as an "old hippie.")  I just loved her. 

Then the hospital I went to did not have a well-baby nursery.  It was expected that you would keep your babe with you, and they were pretty laid-back.

Of course, no birth is perfect.  Just like I had to deal with some issues at home, there were some issues in the hospital.  The last time, the hospital didn't want to discharge DD until she poo'd once, even though we were ready to go and she was less than 24 hours old.  My doctor said to let us go, and she filled her dipe the next morning.  Not a big deal to me, but little things happen.

I liked being able to just lay in bed at the hospital and hold her, and not have to deal with 'life' yet.

I had a whole day to lay there, order food, and have nurses ask me if I needed anything.  =)

I still think homebirths are good too.  It's just a choice, yk?  I think in a lot of ways the *people* you choose to birth with is more important that the place. 

[lisathena]

This is sorta happening to me. I had 2 hossy births and #3 was a homebirth and was wonderful! I have been planning another HB but at 36 weeks found out that would not be happening this time due to some hiccups w/ the MW's liscense (nothing to put me in danger, just other MW's stiring up trouble )

So here at almost 37 weeks I had to transfer care to our birth center in town. So i will be going there...i am upset at not having my HB again, but thankfull to have a safe place for baby....i know it will be just wonderfull and we can go home soon after so that will be nice...

[cileag]

My SIL did this and it went great! After two homebirths and two baby transfers for separate breathing issues (mec aspiration and transient tachypnea), she chose a hospital birth with the third.  It was lovely---she arrived at 8 cm, delivered in the tub an hour and a half later and really had no issues with the staff at all.  I think knowing your hospital well is important--which things are protocol, which things you think are worth fighting for if you don't agree.  Knowing what to expect is half the battle.

[lisathena]

Oh i must add that now i am delievering at the birth center i will NOT be able birth in the tub, which honestly breaks my heart, but i can labor there....i think thats my biggest dissapointment...

[MarineWife]

Originally Posted by laurac5 

I am moving to one of those states where homebirth isn't 100% legal

I'm not trying to change your mind about anything. I just want to clarify this for anyone else who may read it.

There is no state in the US where homebirth is illegal. Where a woman chooses to give birth is not regulated. What is regulated is which type of practitioners can attend homebirths. That means that a mother choosing to give birth at home is never breaking the law. However, her care provider or attendant might be.

[laurac5]

Good point, MarineWife.  Maybe I should have said that homebirth isn't 100% legally supported, not that it isn't 100% legal.  I don't think I would be doing anything illegal to procure a midwife's services at a homebirth, but I would not like using her services when it could get her in trouble.

[Climbing Rose]

As for as it being legal for a certain person to attend or not~

I just want to throw out there that lay  ("uncertified" or non-legal) midwives can be great at what they do, with great statistics and thrilled families to back them up.

It's up to the parents to check into it, to get references, etc, on *anyone*- legal or not-so-legal. 

But I had #2 at home with lay (so-called illegal) midwives and they were just the best, most amazing women.  I might have not made it without them!  As opposed to my first birth in the hospital with a highly trained doctor who was terrible, combined with a registered nurse who had no idea what she was doing and was angering the doctor, and they came very close to causing permanent damage to both myself and my baby.  Then they kept him for six hours in isolation, hoping DH and I wouldn't see what they had done to him until it looked a little better. =(

Just something to consider, yk?  Sometimes someone's legal status doesn't always mean much.  It's not a MWs fault if she lives in a state with draconian laws.

Just like some people *with* licences make mistakes and do terrible things, the opposite can be true as well.

Just do your homework and get someone you trust, and consider that paperwork is not always the best indicator. 

No pressure either- I am looking forward to my hospital birth next month or so, with all certified people, just very carefully chosen.

Edited by Climbing Rose - 3/24/11 at 1:52pm

[laurac5]

For me it's not so much a matter of not trusting the lay midwives, as it is not wanting to be participating in something that has to be "underground," just as a personal conscience issue.  And I agree that just because someone has credentials doesn't mean they are trustworthy, either. 

I have a great team of midwives and a doula in mind for if I have a hospital birth, and while I would trust them 100% (especially the doula -- she's a family friend I've known for years), I know that there are some things about a hospital setting that even the best birth team can't overcome.  That's where my question is coming from -- what is the hospital going to bring to the equation?  Homebirth is all I've ever known.

Oh, and Love, that's horrible about your first birth!  I can't believe they'd take your baby away from you for hours just to cover up their mistake!

[MarineWife]

laurac ~ I figured that was what you meant. I just wanted to make sure that it was clear to others that may not know.

Originally Posted by Love 

As for as it being legal for a certain person to attend or not~

I just want to throw out there that lay  ("uncertified" or non-legal) midwives can be great at what they do, with great statistics and thrilled families to back them up.

Absolutely. My first two were hospital births, #1 a c-section and #2 an induced VBAC. My 3rd was a homebirth with an "illegal" CPM. My CPM was so amazing. She was so much more than just a hcp. She was/is my friend. She is licensed in a neighboring state so she did have some official papers to attest to her knowledge and expertise but, like the PP said, a piece of paper that shows you can pass a test doesn't necessarily mean that you know what you are doing. Even though neither of my hospital births were traumatic, I would not take the risks involved in a hospital birth unless absolutely necessary.

This time around I am using a CNM who can legally practice in the same state as my CPM, who cannot. Haven't had the baby yet so I can't say how she is with the actual birth but she's been great with prenatal and emotional support so far. Again, she provides so much more than any OB I've seen ever has.

[MarineWife]

Originally Posted by laurac5 

I know that there are some things about a hospital setting that even the best birth team can't overcome.  That's where my question is coming from -- what is the hospital going to bring to the equation?  Homebirth is all I've ever known.

It probably depends a lot on the hospital and the hcp. For example, I didn't have a hard time having a VBAC with my 2nd even though I was induced because I was at a military hospital so I couldn't sue if something went wrong. Before the induction came up, they didn't have a problem with me wanting a hep-lock instead of a full IV or anything else about my birth plan. I can't remember all the specifics now.

One of the main reasons I went with my homebirth CPM with my 3rd child rather than the civilian OB and hospital was that they were very unsupportive of me doing a VBAC even though I'd already had one. The answer I got when I gave the OB my birth plan was (and I qote), "We'll put this in your file but when the time comes we'll do whatever we think is necessary."

You have to read every word of the hospital admissions papers. Draw a line through, date and initial anything you do not agree with or consent to. They throw all kinds of fine print stuff in those forms that most people don't ever read, like giving blanket consent to any procedure, test, treatment or surgery they deem necessary at the time. Then you have to make sure that everyone on staff at the time you go into labor knows what you did not consent to. A lot of that you can probably cover with your midwives ahead of time. Make sure they understand that you want to be informed of anything they may want to do and why and then given time to consider your options before answering.

If you don't want the eye ointment or vitamin K shot or hep B vaccine, you may have to bring in copies of the laws that say you can decline them. Gosh, there's so much to cover. I'm sure I'm missing a lot. Bring several copies your birth plan with you and pass them out to all staff that attend to you. Put a sign on the door stating your desires and intentions. For example, that you are not planning to use any pain meds so you don't want anyone asking about it or offering them. No mention whatsoever. Nurses can sometimes get very pushy about that stuff, either constantly offering, asking if you are ready yet or making snide comments. Your doula should be able to run interference with that.

That's all I can think of now. I'll come back if I think of more.

[msmiranda]

I've had both a hospital birth and a home birth, and am having another hospital birth this time. If you have a great midwife who you trust, that alone will go a long way toward making the hospital a not-so-bad experience. Some differences I can think of between hospital and home:

- More clinical-looking environment, less comfortable

- Being asked to have a saline lock or IV (I agreed to the former, and it HURT)

- Having vital signs like blood pressure checked more often

- Monitoring using the EFM rather than doppler (this may vary from place to place, my midwives followed hospital policy of doing a strip upon admission, though I don't remember being on it again until I was pushing)

- All the newborn crap they do in hospitals ... vitamin K, eye goop, Hep B vax, bath, observation period, hearing screen, metabolic screen, weighing, pediatrician having to sign off to let you leave ... having to decline half of that ... the constant threat that someone could take your baby away from you that is obviously not present at home ... this is my least favorite aspect of hospital birth is feeling like I have to protect my baby from well-meaning but misinformed hospital policy and staff

- Having to sign a form to decline things you don't want and possibly getting hassled about it

- Signing forms, period. Lots of paperwork and red tape - Most likely inferior food to what you would have at home (but not always)

- I haven't heard too many stories of postpartum nurses who were fabulous and loved their jobs, and my experience reflects that. The ones I had were rude, unsympathetic, or at best phoning it in.

- Getting interrupted at all hours of the day and night

That's all I can think of right now. Basically if you have a great birth team then that part will probably be fine, but then they go home and you are left with the hospital with all of its policies and procedures. So the bottom line for me is that the stress of having to stand up for yourself and not follow all their policies and then perhaps dealing with conflict about it (even getting the stink eye bothers me tremendously though it would not cause me to change my mind) is the sucky part of hospital birth. And to a lesser extent knowing that I'm considered odd for natural birthing by the staff and having people roll their eyes at me, just not fitting in ... yeah none of that was much fun. The good thing was that it only bothered me after the fact -- I was way too focused on other things when I was there, lol. -

[MarineWife]

Originally Posted by msmiranda 

So the bottom line for me is that the stress of having to stand up for yourself and not follow all their policies and then perhaps dealing with conflict about it (even getting the stink eye bothers me tremendously though it would not cause me to change my mind) is the sucky part of hospital birth. And to a lesser extent knowing that I'm considered odd for natural birthing by the staff and having people roll their eyes at me, just not fitting in ... yeah none of that was much fun. The good thing was that it only bothered me after the fact -- I was way too focused on other things when I was there, lol. -

You reminded me of something that happened at the hospital with my induced VBAC. One of the OBs that attended me (I had 3 in the time that I was there) got angry because I wouldn't allow her to break my water and insert an internal monitor because they wanted to give me more pitocin. Apparently, my labor wasn't progressing fast enough for her but they couldn't increase the pit without the internal monitor since I was doing a VBAC. So, she got angry when I refused the internal monitor and stormed out of the room yelling that she didn't mind doing another c-section and slammed the door. None of that really occurred to me until after I had my baby because I was too busy to pay much attention. But now I can't help thinking, "Wow! She yelled at me while I was in labor!"