HBA2C with back up OB means a trip to the hospital after successful HB????

[susnrob]

I am planning a HBA2C.  I am 9 weeks pregnant so still in the early stages of research.  The midwife I will probably go with has suggested also seeing an OB during my pregnancy just in case I need to transfer during labor and still want to try for VBA2C at the hospital.  I am open to that idea although one thing is a bit difficult for me to be 100% comfortable with.  The midwife said that she's had a few clients who had a successful birth at home, but since they had a back up OB they had to go to the hospital after the birth to be checked out by the OB.  Is there any way to avoid to trip to the hospital after a successful HB?  To me, part of the appeal of homebirth is the peacefulness after birth.  Having to take a trip to the hospital would take away from the peace.  

[dogmom327]

So unless I'm missing something, you need/want the OB for back up in case you want to transfer in labor. First, I would verify that this is the kind of OB who will actually come to the hospital to deliver your baby if they get a call that you are in labor. Around here you get whoever is on call. Having a specific OB doesn't do you a darn bit of good. Two, if you need them for a labor issue, what's the consequence for refusing to go in afterwards? You've given birth, you got your VBAC, you don't exactly need the OB any longer. It's not like anyone can make you go in. You don't owe the OB anything at that point.

[susnrob]

Yes you are correct.  I would be seeing the OB and the HB midwife for prenatal visits just in case I need to transfer my care at some point during the pregnancy or labor.  

Yes, very good point that I would need to make sure that this OB will actually come to the hospital if they get a call that I am on my way.  Otherwise I'm just stuck with whoever is on call.

When the midwife mentioned clients who had a back up OB who delivered at home and had to go be checked after a homebirth it seemed a bit weird to me.  My husband and I didn't think that they could make us go in.  It just didn't make sense, but maybe it differs from state to state.  I'm not sure.  
 

Originally Posted by dogmom327 

So unless I'm missing something, you need/want the OB for back up in case you want to transfer in labor. First, I would verify that this is the kind of OB who will actually come to the hospital to deliver your baby if they get a call that you are in labor. Around here you get whoever is on call. Having a specific OB doesn't do you a darn bit of good. Two, if you need them for a labor issue, what's the consequence for refusing to go in afterwards? You've given birth, you got your VBAC, you don't exactly need the OB any longer. It's not like anyone can make you go in. You don't owe the OB anything at that point.

[MarineWife]

I don't know why you would have to go the hospital afterward if everything is fine. Is someone going to send the authorities to drag you there against your will?

I've had 2 homebirths after 1 c-section (with 1 VBAC in a hospital before the homebirths). Neither of my MWs ever suggested that I had to go to the hospital afterward. I didn't see a doctor at all afterward and my babies only saw a pediatrician if/when there was a problem. I didn't rush them to the doctor right away, either. My MWs provided very competent post-natal care for me and my baby.

[susnrob]

The midwife was saying that her client was seeing an OB and her during the pregnancy.  The OB was the back up plan if there was a reason to transfer the client.  I guess I need to question the midwife more because I don't understand why I would have to see the OB if the birth was fine.  
 

Originally Posted by MarineWife 

I don't know why you would have to go the hospital afterward if everything is fine. Is someone going to send the authorities to drag you there against your will?
I've had 2 homebirths after 1 c-section (with 1 VBAC in a hospital before the homebirths). Neither of my MWs ever suggested that I had to go to the hospital afterward. I didn't see a doctor at all afterward and my babies only saw a pediatrician if/when there was a problem. I didn't rush them to the doctor right away, either. My MWs provided very competent post-natal care for me and my baby.

[MarineWife]

Yes, ask your MW more about it.

It's very possible that, assuming the OB new about the homebirth and was ok with it, that s/he insisted the woman get checked by her/him afterward. Unless there is a problem, though, I don't see why it would be. IMO, a MW is more capable of taking care of all post-natal care (although, most OBs might disagree).

[susnrob]

I'm not planning on telling the OB about the homebirth, but do intend to tell the OB that I want a VBA2C and plan to labor at home.  I just want to see an OB so if I do need to transfer during pregnancy or labor I might have a chance at a VBA2C with the OB.  I am going to ask the midwife for more details.
 

Originally Posted by MarineWife 

Yes, ask your MW more about it.
It's very possible that, assuming the OB new about the homebirth and was ok with it, that s/he insisted the woman get checked by her/him afterward. Unless there is a problem, though, I don't see why it would be. IMO, a MW is more capable of taking care of all post-natal care (although, most OBs might disagree).

[MarineWife]

I did that and stopped seeing the OB at 36 weeks when I was in the clear for a homebirth unless an emergency arose. The OB didn't even realize I was gone until my baby was 3 months old. Someone called to ask if I was still pg and then to see if I wanted to come in for a PP check. I said, "Um, no. Why would I come to see someone who didn't even know I was gone?" Next thing I knew, CPS was at my door saying that someone from the OB's office had reported me for having a homebirth, which isn't illegal or medical neglect or anything like that in my state, and 4 unknown children. So, be careful about just disappearing from the OB.

[iowaorganic]

I would think just calling in and making an appointment a week or 2 after the birth would be plenty sufficient.  I don't see any reason to race right in.  I didn't even take my baby in until a week or so after he was born..  But I wasn't seeing an OB- our family dr was our backup.

[susnrob]

Originally Posted by MarineWife 

I did that and stopped seeing the OB at 36 weeks when I was in the clear for a homebirth unless an emergency arose. The OB didn't even realize I was gone until my baby was 3 months old. Someone called to ask if I was still pg and then to see if I wanted to come in for a PP check. I said, "Um, no. Why would I come to see someone who didn't even know I was gone?" Next thing I knew, CPS was at my door saying that someone from the OB's office had reported me for having a homebirth, which isn't illegal or medical neglect or anything like that in my state, and 4 unknown children. So, be careful about just disappearing from the OB.

Did you have any trouble with CPS? 

Originally Posted by iowaorganic 

I would think just calling in and making an appointment a week or 2 after the birth would be plenty sufficient.  I don't see any reason to race right in.  I didn't even take my baby in until a week or so after he was born..  But I wasn't seeing an OB- our family dr was our backup.

I was thinking about just going in with the baby a few days or a week after the birth to be seen by the OB so that hopefully they'd leave me alone after that. 

[dogmom327]

It seems like telling you you might need to go see the OB afterwards is a CYA move on the MW's part. Maybe by saying that she makes the OB's happier when in all reality no one can force you to go. I can see *maybe* laws varying by state in terms of what care a newborn is required to get after a birth but not mom. Mom is an adult capable of making a decision whether or not to seek medical care for herself.

In terms of CPS, I wouldn't let that worry you a bit. Sounds like some nurse got way overzealous. Granted whether CPS sends someone out does probably vary by state (around here, reporting someone for having a home birth would be laughable at best but they are very common) but if they show up, you tell them to go away (or better yet, that if they have questions they can speak to your lawyer). Seriously, 3 months after a birth? What on earth was that nurse thinking?

[kim.mpls]

I chose a MW team for HBAC waterbirth. (Which we did on 1/30 with complete confidence and success).  

Along the way, I had researched every option in town in case we needed a hospital.  I work for a major health system that is not supportive of VBAC overall and does not offer waterbirth, so I knew I would have to do my own legwork.  

.  

My Midwives recommended a particular OB as backup who practices about 30 miles from my home, but in a small hospital where the OBs catch their own babies, are proponents of natural childbirth, and allow VBAC waterbirth.  Word is getting out and it's hard to get in with this practice.  Thanks to their referral I had a consult visit with him about 26 weeks and was completely upfront with him about my plans for a HBAC and that I hoped to never see him again if all went well.  We talked about plans, prior reasons for C/S, and he agreed that he would be glad to help us if we needed it, listened to baby's heartbeat, felt for position (no vaginal exam at all!) and wished me well with my plans.  

In the end, my first plan was to stay home.  Back up plan for non-emergency transfer was to this back-up OB 30 miles away, emergency plan was the huge acute hospital 8 blocks away.  Can you tell I'm a planner?  LOL!  In the end, we got Plan A and it was wonderful!

[Leningradka]

I am planning an HBAC and have a CNM/ND who will do it (IN our state, MW are not allowed to do HBACs, but noone is stopping the NDs). I also found an open minded OB who knows that I am planning HBAC. She is not entirely against it, but does give me a half joking phrase at each visit for reconsidering an HBAC. The reason I am seeing her is she is my back up in case i need a transport. Never heard of anyone mandating you to come in. There is simply no reason why. Again, I would questions the MW, and may be interview several different ones, since you are still so early. YOu can see an ob and mw (i am), and the OB will still get paid for prenatal care, even if they don't deliver you, so there is no monetary incentive either, so I am not sure

Marinewife: CPS? Are you serious ??? That is the most ridiculous thing i have heard!!