Please help!! Thinking of switching from Homebirth to Hospital birth at almost 39weeks!

[Tryamour]

I've been planning a homebirth with 2 certified midwives since I was 6 months pregnant. Now I'm almost 39 weeks and having second thoughts! My pregnancy has been perfect so far. I'm in good health and this is my first. But I'm having second thoughts... I don't know if it's just nerves about giving birth or what... Plus I just read 2 stories online about placental abruptions during homebirths that led to the baby dying AND I found out that the Neonatal mortality rate for the US is actually lower than the Netherlands. It's our Infant mortality rate which is higher and that's up to 1 yr old so it doesn't really pertain to birth...

I am nervous that my midwife will hesitate to transfer me to the hospital if there was an emergency. Plus baby is posterior, which isn't too big of a deal but I don't know...

I don't even know if the hospital would take me now? Are they required to by law? I am really freaking out about this and second guessing everything.... Someone please help...

Edited by Tryamour - 5/6/11 at 11:01am

[HappyMommy2]

 Well ... I think you need to look deep inside yourself since only you can make this decision.  Is it nerves?  Or is it mama intuition?

And - stop stressing.  The hospital will take you, so that is a non-issue.  They won't turn you away when you show up!

I think you need to have an honest discussion with your midwife.  Let her know that if there is ANY issue during labor, you want to transfer immediately. Ask her what things you and she will watch for, and what reasons for transferring would include.

Your conversation will be different than mine.  I told my mw that we would do everything in our power to stay home.  We would only transfer as a very last resort.  You might transfer for something where I might have been more comfortable "waiting and seeing".  And that is FINE!  You need to do what YOU feel is right so that you can be comfortable and safe and let your womb open up for delivery.

Congratulations on your baby and pending (maybe) homebirth!

ETA ... oh, and about the fear ... I do think that is normal.   And also accept that you just need to the best you can.  Sometimes bad things happen regardless of location.  But many mamas have given birth before you, and you can do it too!

[nilatti]

I had cold feet shortly before my baby was born too--and I felt really comfortable with my midwife. I just convinced myself that there was some problem with the baby that we didn't know about--something we hadn't seen in the 20-week ultrasound or something that had developed since then. I didn't have any reason to believe this, but I became obsessed.

I would have the conversation the previous poster suggested.

Also, my baby was posterior late in the pregnancy. My midwife suggested that I see a chiropractor, so I did. I found one who was certified in prenatal chiropract...ing. whatever. She diagnosed me with a misaligned pelvis, which normally doesn't cause me any trouble, but had tipped my baby the wrong direction. I saw her 4 times in the last 6 weeks of my pregnancy. After the second visit, he turned in the right direction. My homebirth ended up being totally wonderful--and FAST. I highly recommend seeing a chiropractor if your baby is posterior. The chiropractor made me feel better about the homebirth, too. She had had four babies at home, and she was able to tell me, once she corrected my pelvic alignment, that she felt like my body was totally ready for this, and that I had done everything possible to make it go well. That really was what I needed to hear at that point.

[L&K'smommie]

Originally Posted by Tryamour 

I've been planning a homebirth with 2 certified midwives since I was 6 months pregnant. Now I'm almost 39 weeks and having second thoughts! My pregnancy has been perfect so far. I'm in good health and this is my first. But I'm having second thoughts... I don't know if it's just nerves about giving birth or what... Plus I just read 2 stories online about placental abruptions during homebirths that led to the baby dying AND I found out that the Neonatal mortality rate for the US is actually lower than the Netherlands. It's our Infant mortality rate which is higher and that's up to 1 yr old so it doesn't really pertain to birth...

I am nervous that my midwife will hesitate to transfer me to the hospital if there was an emergency. Plus baby is posterior, which isn't too big of a deal but I don't know...

I don't even know if the hospital would take me now? Are they required to by law? I am really freaking out about this and second guessing everything.... Someone please help...

Hugs mama!  I agree with the previous posters.  It sounds like you need to sit down and have a long talk with your MW about all your questions and concerns.  I too have read birth stories about placental abruptions lately and started to feel nervous about my upcoming 2nd homebirth.  But then I remembered that my MW had just done our homevisit and had gone over all the signs of a placental abruption along with what she would do...which is transfer immediately.  And she told of a recent homebirth where this happened(it was a friend of mine actually) and everything is and was well for mama and baby because my MW transferred immediately knowing the signs and symptoms of it.  So I know I trust my MW(it helps me also that my MW was a L&D nurse before becoming a CDM).

That said, a hospital will not turn you away in labor so don't worry about that.  I think though that you really need to talk with your MW about all your worries.

[mamahen2coop]

Hugs mama.
in addition to what the previous posters have said, I just wanted to say that the incidence of abruption and other true obstetrical emergencies is very very low. I work in L&D and I've been having a VERY hard time deciding whether homebirth is for me or not and a little of it is because I see first hand the emergencies that do sometimes happen. They are very unlikely and very infrequent but scary when they do happen, I just see more because I'm there. Its hard to put them out of your mind once you hear about them.
IF there was a TRUE emergency, like abruption, the goal at the hospital is to get the mama to surgery and try to deliver the baby in less than 15 minutes with 8 minutes being the goal and even then sometimes bad outcomes happen but sometimes we also save mama and/or baby. I also take care of the mama's who lose their babies and sometimes they're 28, 36, 39 weeks. Again, not to be scary but it happens sometimes but not very often and as a prego mama, I have to just trust that Im doing what I can to maintain a healthy pregnancy and let nature do it's thing. I'm just trying to say that there are bad things that happen but they only happen so so rarely.

[sosurreal09]

OK here are my thoughts. 1. STOP reading stories online! 2. Make sure you have someone with you you trust at the labor so if YOU feel you need to transfer they will call an ambulance 3. Since the baby is posterior I am afraid the hospital will not know how to handle that and give you a c-section (just MHO) so *I* would avoid them if at all possible.

You will know what is best in the end it is normal to feel anxious with your first labor (or any labor really) you have no idea what to expect. Trust yourself and your body. If you really feel like you need to transfer you can. No hospital will turn you away.

Maybe try some meditation to calm down.

[MamaofLiam]

I agree with everything PP's have said: Look deep inside yourself, talk with your midwife, stop reading negative stories online, etc.

You also might want to read positive birth stories if you haven't done so already. I know they helped me tremendously. There are a lot of positive birth stories in the book Ina May's Guide to Childbirth. 

And congratulations on the upcoming birth of your LO! It's such an exciting time.

[Turquesa]

With both of my babies, the same doubts arose during the lasts months of pregnancy.  It’s probably part of the “nesting” urges that take place; we worry about our babies being well cared for.  It's normal.

Plus I just read 2 stories online about placental abruptions during homebirths that led to the baby dying

First of all, please consider the source.  Find out who runs that site and Google the name.  If it’s who I think it is, this is a prolific poster and blogger who dedicates her every keystroke to disparaging women who choose natural childbirth and/or guilting and scaring women out of home birth.  It is truly her life’s mission. 

That’s not to say that you won’t find bias everywhere you go.  You need to weigh it all carefully.  Ask your MW: Placental abruption isn’t always detectable by ultrasound.  What is her protocol for identifying and managing this emergency?  What symptoms should YOU look for?  How often has she dealt with this in her career?

I am nervous that my midwife will hesitate to transfer me to the hospital if there was an emergency.

What is her transfer rate?  How many of those transfers were emergencies, and how many were non-emergency (e.g. slowly progressing labor and/or desire for epidural).  Here is a good thread from a few years ago about hospital transfers.  Which hospital does she normally use for transfers?  (If it’s not the closest, find out why!  Did she lose privileges there for any reason?) Here's a good thread from a few years ago on transfers and transfer rates. 

When I was interviewing MWs, one in my community was almost bragging about how she almost never transferred because she always locked horns with the doctors. Red flag! 

I ended up with a team of MWs with a 10% transfer rate and was satisfied enough to have them attend both of my births. 

Plus baby is posterior, which isn't too big of a deal but I don't know...

Ask your MW about exercises to do to help the baby turn prior to the birth.

Both of my babies were posterior at the time of labor.  Your MW should be checking the baby’s heart rate frequently to make sure that you don’t need a transfer.  But for me, it was a matter of proper positioning to get the babies to turn.  My doula was also there for massages and compresses to help with the back labor.  My first required neonatal resuscitation (which my MW was well-skilled in), and my second didn’t.  Both babies turned before coming out, and neither birth necessitated a  transfer. 

Compose yourself, write a list of questions (any what-if scenario you can think of!), and visit with your MW.  If any of her answers make you feel uncomfortable, an in-hospital provider will gladly take you as a client.  But please put your fears to rest UNTIL you have this discussion with her. 

If you choose another provider, have some questions ready for him/her, as well. 

The bottom line: No woman should choose a hospital birth out of fear, and no woman should choose a home birth out of fear. 

Good luck with your decision!

[mamahen2coop]

There is no reason a posterior baby would get any extra interventions just by virtue of being posterior. I've only worked at our little community hospital but we have posterior babies all the time. Mama's usually have to push longer and maybe have more extensive tearing, like maybe a 2nd degree vs a 1st. Posterior babies are helped by lots of movement in labor. 80% of my patients have epidurals and I'm a turning guru so lots of times just by moving every 20-40 minutes while pushing helps them come down. Just the other day baby was totally acynclitic- his poor little conehead was above his ear and on the side. We pushed for about an hour and a half with little descent then with just one turn to the other side and some hip rolling, all the sudden he moved and came right down. Anyway, dont be afraid of just being posterior, you can do it!
There's also a good website called spinning babies that I like. So maybe try that- they give tips to get babies positioned optimally.
you can do it mama!

[sosurreal09]

sorry lack of sleep! Somehow this morning I interpreted posterior for breech! Yeah they *shouldn't* treat you differently just b/c the baby is posterior. I don't trust hospitals regardless (with birthing) but that my personal opinion.