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WWYD: Birth Options

post #1 of 11
Thread Starter 

I didn't think I'd ever post this, but after my appointment with the OB I am completely torn as to what I should do about this birth. I've been seeing both the OB and a homebirth MW since the pregnancy- I started seeing the OB because I had a Subchorionic Hematoma. It has pretty much cleared up now, so I should have a good and healthy pregnancy from here on out. Which is WONDERFUL news! However, I got to talking to him about his birthing policies and philosophies, and we really connected. I told him that I've had both my older children completely natural and intervention free, and would really like to with this one too, but I'm a little nervous about my lack of hospital choices in the area (I moved from a bigger city with a baby-friendly natural birth friendly hospital). I didn't run down the entire natural-mom crunchy birth list, but I mentioned the things that matter most.. he told me he is fully supportive of natural births, and that he delivered 5 out of 6 of his own children when his wife had natural births. He said that he makes sure that he is there for the birth of his own patients (not like whoever is on call when you go into labor, like many places do), and that I could have very little interventions.. the only thing that he thinks is important is having a hep-lock and intermittent monitoring (which is what my MWs do anyway).


OK.. so, my homebirth midwife.. she seams really nice, and many of my friends have had her and loved her. But, I've not felt like I've connected with her very well. She lives 45 mins away from me, and through a canyon and over a mountain- being due in December scares me a little with her being able to make it here at all. The biggest thing though is the money. It will be $3000 (which is very reasonable, but we so don't have that kind of money).


About the money.. I am on medicaid (or will be soon), so I will not have to pay for a hospital birth. DF and I are both full time students, and although he will be working as well (he's currently out of town, and will be finding a new job when he gets home), we're barely going to be able to make ends meet as it is. And, we need a new car. I'll have 3 children, and neither of our cars will fit 3 carseats. So, we are going to have to get a car that seats 7-8 shortly before the baby comes. My MW requires payment before the birth. Unlike my last MW who let me pay as I could (and I paid her off in a good amount of time, mostly after our tax return).


So, basically what I am thinking- if I found a good natural minded OB who would be perfectly OK with me having a natural birth, but it was at a hospital, and I didn't have to pay for it, would it be a good option? And with that, I really want to have a homebirth. Is it worth it to spend that kind of money that I don't really have, and when I NEED something for my whole family, like a new car that we can all fit in, and be safe in? I don't want to cheat myself out of a homebirth because of money, but I am also trying to look at the bigger picture and be responsible too.



post #2 of 11

I loved my last OB.  He was the most supportive of natural birth, and most willing to let me run the show of any provider I have had.  It was also nice to have continuity when things did happen to get a little wonky.  I would have had to transfer from a HB, but already being in the hospital and having a relationship with him, he let me guide things more than he would have someone he hadn't had a lot of conversation with along the way. 


I trusted him, and the key thing was, he trusted me. I did need some interventions during delivery- and while that was hard for me to accept, he let me decide if and when to use them, after he explained what he thought and why.  He let me use his knowledge and experience, and was never a bully. 


Now, I am sure some people would argue that if I hadn't been in the hospital I wouldn't have needed any interventions, but having  successfully managed deliveries without much intervention, I also know when I am in trouble and need more intervention. I have an autoimmune disorder that causes a very over-the-top inflammatory response to pain.  This causes my body to effectively shut down labor as soon as it becomes truly uncomfortable, so augmenting the contractions is necessary to establish productive contractions.  For my first two deliveries that alone was enough.  More recently, I also needed pain relief in the form of an epidural to control the pain enough to minimize the inflammatory response and allow for cervical change.   It stinks to feel 'broken' but hey, at least two people have had enough information to publish papers on me now. :)


Ultimately, for me I would rather make the call and forge the relationship before an 11th hour decision has to be made. 

post #3 of 11

I am in a VERY similar situation.

I am sticking with the OB that I love and will not have to fork over the $ for the HB midwife. It is just not in the cards for us at this point. I have an unemployed hubby and 4 other children!

He will be working soon, but thousands of dollars need to go towards our mortgage, food, etc. ya know!?


I hear ya on this one!  ;)

post #4 of 11

Have you had a homebirth before? I'm sorry I don't remember. If you have, I feel like going back to the hospital could potentially be very hard, so there's that to keep in mind. But-- having a provider that you connect with, and feel respected by and listened to, is nothing to sneeze at. If you genuinely feel he will remain the same during labor-- and there's nothing about hospital policy that will change what he's saying once you're in labor, then I don't think you're wrong for considering it as a very valid option. 


Is there anything else you know that has used him, or reviews you can find for him? I used ratemd.com, but I'm not sure if they have enough info for your area. Some of them are better used than others. 

post #5 of 11

The most important factor is whether you trust and connect with your provider.  For me, setting is secondary - still important!, but secondary.  Trust your instincts.

ETA:  It's early yet.  Have you interviewed other homebirth midwives?  Is bartering an option?

Hospital VS Home:  I had one natural hospital birth before my two home births and even though I made it through without interventions, including hep-lock/IV, it was not home.  In addition to the CNM and nursing staff already present, a team for the baby appeared during my pushing stage and that was strange for me.  The newborn procedures were taking place WHILE I delivered my placenta - this may have been avoided with more clarity in the birth plan, though. 

Still:  I can't imagine putting my trust in a homebirth midwife if I didn't feel a connection with her.  45 min. doesn't seem like an unusual distance to me, though.  My homebirth MW lived about an hour from me, and I drove 30 min. to get to my hospital birth. 

Edited by BennyPai - 5/17/11 at 1:28am
post #6 of 11

Trusting your C/P is SO important!!  You might have a tough time during labor if you are stressed and worried about paying your midwife and uncomfortable with the situation!!  Maybe over the next few weeks/months you can talk more to this OB and ask more questions.  There are some GREAT OBs out there that are supportive of the natural process.  For me, the problem is the hospitals.  The OB might be find with all your wishes, but you also have to convince every single nurse you come in contact with.  I hope you figure out what works best for you and your family. 

post #7 of 11

I saw an OB for my first pregnancy because she was the same OB I had been seeing since I was 16. I trusted her completely and she was 100% on board with the natural birth. This time around, I'm in a similar situation to yours. The only difference is that I was seriously considering doing UC(South Dakota isn't exactly a midwife-friendly state) because I didn't think the hospital here would be very open to my natural birth plan. The hospital where I had DD was in my hometown which is much bigger than the town we're in now and the hospitals are a little more progressive(as progressive as anything can be in South Dakota, anyway). But after our first appointment and asking the OB a LOT of questions and showing her our birth plan from DD's birth, we've completely changed our minds. We really like the OB and she was really open to what we wanted. What I liked best is that she was 100% honest with us. She let us know what her preferences were(like pushing on my back with my feet in stirrups, EFM and hep lock) but she said as long as nothing is wrong, she'd be okay with intermittent monitoring, no hep lock or IV and letting me push in any position I want. She even said she'd allow me to squat to push if that's what I wanted to do. We're going to find out a little more info about the hospital itself and how the nurses will operate and all that, but we're feeling pretty good about another natural birth in the hospital. It sounds to me like you've got your mind made up. You really like your OB, he's open to what you want and you won't have to worry about paying for the birth if you do it in the hospital. Unless something comes up that makes you feel like you'd rather not give birth in the hospital, I'd say stick with the OB for now. Like PP said, it's early and you can still interview other midwives too.

post #8 of 11
Thread Starter 

OP here..


So, my first was a birth center birth, turned hospital transfer. It was a very traumatic experience, and I said I never want to go to a hospital again. Thinking back there are several reasons why it was traumatic- I came in an ambulance from a birth center, so I already had a stigma against me, if you know what I mean. The nurses at the hospital gave me pitocin after I gave birth to expel my placenta faster and it caused my placenta to start coming out but it had not detached yet.. it was very very scary. The hospital I was in took my newborn baby away for 3 hours a day to "monitor" him, and I hated that, and then they woke me up every single hour to check my blood pressure, or give me pain meds, or check my blood, or whatever. I didn't get any sleep at all while I was there. This is a different hospital than the one where I would be, and I have yet to talk to the L&D there, which my OB encouraged me to do.


My second was a wonderful, beautiful birthcenter water birth... I did hypnobirthing and it was truly amazing.


I googled the OB's name and he does have good reviews, but there aren't a lot of them. I've tried posting in my finding your tribe area, and my city is just too small I guess because I must be the only MDC mama up here!



post #9 of 11

OP, I feel for you. My situation is not the same (Hubby is not OK with homebirth because it would have to be UC and we live literally an hour away from the closest hospital that delivers babies.) But I want a homebirth so bad I can taste it. And I HATED my hospital birth experience. I actually did not want to get pregnant until I had talked hubby into at least a hotel room where we could get a HB WM to attend :) But God had different plans, and now we are expecting again. I'm on medicaid now that I'm pregnant and we just don't have the money to pay for a HB MW, even if I successfully convinced him. So I compromised. I found the only midwife practice in the state that medicaid pays for, but they do hospital deliveries and are about 2.5 hours away. Hospital policy says no water births, but they do have a tub to labor in. When I did my interview with the MW she could tell I was really disappointed and told me it has "accidentally" happened before with a glimmer in her eyes that said she wouldn't mind if it did again. They also either test for GBS and treat with abx or treat you as though you have it if you refuse to test. I asked about other options, and she said she was willing to talk to the OBs about it but didn't seem hopeful. (OBs are in charge, supervising the MW). Overall, not my dream birth, but so much better than delivering at one of the hospitals around here. Sometimes we're stuck in between a rock and a hard place, and just have to see what option looks like it can get us where we need to go.

post #10 of 11

To me, the relationship you have with your provider is the most important thing.  The fact that you seem to feel more comfortable with the OB than the midwife would make me lean in that the direction.  Also, the cost is huge considering you have other needs like a bigger car.  As another SCH mama, our risks are higher even after the SCH resolves.  There is an increased risk of preterm labor, placental abruption (which I've also had), etc.  So while things would probably be fine, you also have a higher risk of transfer after you've paid all that money for your midwife.  Just my two cents, but I would go with the provider I trusted the most. 

post #11 of 11
Thread Starter 

At my last LLL meeting on Thurs, we started talking about other mom's birth experiences at the local hospital. They all actually had really good things to say about the nurses and the birthing rooms here. A couple of the moms had their babies naturally, and said their nurses and Drs followed their natural birth plans. Also, I guess they have a big whirlpool for laboring moms, as well as tubs in the bathrooms of every birth suite. They said you can't give birth in the whirlpool, but it's there for helping with labor (which is wonderful, because I LOVE to be in the water when I am in labor).


I am such a homebirth advocate, so I am really surprising myself that I am considering this, but it seams like everything is pointing me in this direction.

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