best hospital-based midwife groups in South Jersey/Philly? - Page 2

[AlexisT]

At 36 weeks, babies are usually okay but may have some difficulty. They normally don't have breathing issues but can be poor feeders (also true of 37 weekers, BTW). Your biggest risk would be jaundice, which is more common in late preemies and early term babies. You certainly don't need to plan on having a level III NICU (of course, any baby might need that, but you don't need to plan on it). Level I is basic well baby care, no capabilities for anything but the mildest illnesses. Level II is special care nurseries for babies over 28 weeks without serious issues--some schemes distinguish between nurseries with no capability for ventilation and ones that can do short term. Level III is for babies younger than 28 weeks offering a fuller spectrum of services.

I would probably want a Level II in this scenario unless I had reason to believe something was wrong. I have never given birth in a hospital without a NICU, but I have heard that because they don't have the ability to take care of anything, they transfer everything. Which, in the unlikely event this happens, would just be the worst scenario IMO.

[AnastasiaM]

It could take a good 40 minutes to get to Elmer from Cherry Hill, especially with Thanksgiving weekend traffic.

[dlm194]

A hospital can't turn away a mom in labor so if you were close to delivery upon arrival, they would have to attend you.  If the baby was having issues, they'd transfer the baby but that does NOT mean they would transfer you (you can leave AMA, of course but it doesn't mean you'll be admitted into another hospital).  If you show up at a basic care nursery hospital about to give birth to a 36 weeker, I wouldn't count on then calling in midwives and assisting you in having a beautiful, peaceful low intervention birth.  Anything can happen of course and I'm not trying to be negative, just realistic.  I think it would be a crazy scene of them trying to call in an anesthesiologist and neonatologists because there is a good chance (at least a perceived good chance) your baby will have some issues.

[indigosky]

So it sounds like the consensus is against Elmer/South Jersey Hospital for a 36 weeker, even if it has the best stats.

So that brings me back to these options, I think:
Cooper
Einstein
Hahnemann
Our Lady of Lourdes

Do they all have Level II NICUs? Any more analysis to help me narrow it down?

[mom2tatum]

Originally Posted by AnastasiaM 
 I asked about the rate last appointment, and the midwife told me that for the midwives, the rate is more like 15% for a first baby, and after you have one vaginal birth, that goes way down.

I'm sorry, I know you are feeling much better about your decision and that is good - but this rate is just false info. I don't know where she pulled this % from because it is very far off. Which midwife, can I ask? I've been there many times, mostly with women who are planning 'natural' births'. I really wish women would ask all of us doulas who attend births there enough to know a little (from an OUTSIDER's perspective). Many of us see quite a different story for our clients. And maybe we aren't doing a good enough job telling women the truth either b/c of a lack of a great hospital option in this area. Yes, the midwives can be great, I really like a few of them alot. And I have had a few smooth unmedicated births happen there. But also a lot of unplanned medicated ones and unplanned cesareans. But the hospital overall has a 96% epidural rate, I've heard training nurses tell this stat consistently to trainee nurses three different times. And the midwives attend a good chunk of births there actually. The birthing suites are rarely even used, and it seems such a bizarre thing to request when going into triage and you thought it would be much easier to just go in there with your shift midwife and have a baby without medication. It just doesn't look like that very often. It can, but it is NOT the norm. Not even for the midwife patients as they are led to believe. One midwife not too long ago said to me (after my client ended up with an epidural and was sleeping due to not being allowed in the birthing suites) that unfortunately most of their patients are ending up with epidurals and pitocin at some point, too, although they really try to prevent it. I asked why and she said sadly because of high rate of inductions or if that is avoided, women coming in to the hospital not really in a good active labor yet.

My advice as always is hire a doula. We can try to help you avoid both of those things from happening. In the end, though, it is your birth, your choices, your path! And I want people to be at peace with their choices of birth location and care provider, as always, but I just hate when women are lied to or led to believe their pregnancy and birth experience will most likely be what she wants when statistically, that is so far off from the truth. I'm tired of clients saying to me afterwards, "I just really wanted to believe xyz" or "I thought if I had the midwives there, that it'd be fine..." or things like that. Frustrating.

[mom2tatum]

Also to the OP, why are you so concerned about a labor transfer at 36 wks? I was, too, while planning my homebirth but b/c my first was born at 36 wks. Just curious. I'm sure it'll be fine, whatever place you decide to go if that is the case, though. I say the smaller the hospital, the better...especially in that situation. But most 36 wkers are totally fine and don't need NICU at all. Mine was on the small side, 4'13", and nothing medically required him to go NICU, just his weight being under 5 lbs - so I asked to keep him with me and eventually they agreed it was unreasonable to put him in there.

Best of luck!

[MrsMike]

Originally Posted by indigosky 

So it sounds like the consensus is against Elmer/South Jersey Hospital for a 36 weeker, even if it has the best stats.
So that brings me back to these options, I think:
Cooper
Einstein
Hahnemann
Our Lady of Lourdes
Do they all have Level II NICUs? Any more analysis to help me narrow it down?

 Hahnemann is a Level III. Coming in a 36 weeks, you would have a very big fight to get a vaginal birth, let alone a natural birth. They are used to dealing with micro-preemies, drug babies and very critically ill babies. Many of their births are emergencies. The staff is used to seeing childbirth in an emergency setting with some need for intervention. A normal, natural birth is not common to them. As I mentioned before, several of the L&D staff members find natural birth laughable and the comments I have heard are extremely unsupportive. They used scare tactics with me (I did not birth there - but I know these people) and would say horrible untruths about birth. It is also a teaching hospital and you may end up with a few more people in the room than you like.I have a relative and a few friends who work there and I can attest that the level of care for you situation may not be what you're looking for. Also, it may be a pain in the butt to get there from Cherry Hill during the Thanksgiving holiday. I feel bad blasting them like this, but IME this hospital probably wouldn't be the best for your situation.

[indigosky]

OK -- the only reason Hahnemann is still on my list at all is because its cesarean rate is lower than any of the other hospitals on my "final contenders" list above.

I'll be near, not in, Cherry Hill -- 15 minutes from the downtown Philly hospitals. Of course, if I go into labor at some peak travel time and things seem to be moving quickly, I'll be forced to go to one of the super-close hospitals regardless of whether it's my first choice. But based on many decades of Thanksgivings in the Philadelphia/South Jersey area (including traveling back and forth between them, since I have parents in both places), I know over the range of all of Thanksgiving weekend, there are lots of times when traffic isn't a big deal at all.

[MrsMike]

Originally Posted by indigosky 

OK -- the only reason Hahnemann is still on my list at all is because its cesarean rate is lower than any of the other hospitals on my "final contenders" list above.
I'll be near, not in, Cherry Hill -- 15 minutes from the downtown Philly hospitals. Of course, if I go into labor at some peak travel time and things seem to be moving quickly, I'll be forced to go to one of the super-close hospitals regardless of whether it's my first choice. But based on many decades of Thanksgivings in the Philadelphia/South Jersey area (including traveling back and forth between them, since I have parents in both places), I know over the range of all of Thanksgiving weekend, there are lots of times when traffic isn't a big deal at all.

The c-section rate listed confuses me. I asked my relative who works in maternity there to look at this and that person is not in agreement with the percentage. They can be very cut happy. Even so, just a percentage is not something to go by. Even if their c-section rate is low, will you still be able to have the birth experience you want? While their rate may be low, their overall attitude regarding natural and normal births is piss poor. I hate to harp on Hahnemann because there are things I like about the hospital, but their attitude towards birth is not one of them. I've been referred to as crazy and uniformed by their maternity staff for my own birth choices. They are not friendly about homebirths. At 36 weeks they will likely give you a very hard time about a vaginal birth, let alone anything natural.Their NICU is great if you need it, but they can be slightly unfriendly about breastfeeding, depending on who is on staff that day. My relative says Thanksgiving can be unbelievably hectic and you may be subjected to people who just want to get things done and over with as quick as possible. I know it seems I'm harping, but I don't want to see you have a less-than-ideal experience. Hopefully, you won't need it at all.

[indigosky]

No problem -- I'm not arguing in favor of Hahnemann, either, just explaining why it's on my list at all.

If I eliminate it, that still leaves Cooper, Einstein, & Our Lady of Lourdes. Not sure how to narrow it down further than that...