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We might be planning a homebirth after all...

post #1 of 22
Thread Starter 

We've been planning a hospital birth with our midwife, and yesterday we found out that we may not be able to use the hospital after all. The short story is one of the OBs doesn't like midwives, and since the hospital doesn't make as much money on the midwife births as they do OB births, the hospital isn't fighting it. Our midwife is in the process of getting set up with a different hospital, but it will take at least 90 days for her to get cleared there and I'm due in 6 weeks!

 

So now I'm trying to decide whether to switch midwives to someone at a different hospital, or go for a homebirth with our current midwife. I'm completely torn. On the one hand, I really really like the idea of a midwife hospital birth: you're with your midwife but if she decides things aren't looking right there's no painful car ride to the hospital. On the other hand, I really like our midwife and don't want to switch to someone else (though I know she'd only hand us over to someone she thought was good).

 

I'm completely terrified of a homebirth. It's not so much the "what if something goes wrong" as "oh god there is no way I could handle that." And I'm having a really hard time finding calm, rational, objective resources on homebirth. Most of what I've found both pro and against seems to focus on how awful the alternative is (hospitals will strap you to a monitor and cut you open! homebirth is unsafe and your baby will die!) which is really not helpful at all.

 

My husband said he'll support whatever decision I make, I'm just feeling totally overwhelmed and blindsided. Our midwife is great, she totally understands that this is a hard position, and will pull whatever strings she needs to in order to get us into another midwife's practice at such a late date, if that's the route we choose to go.

post #2 of 22

What do you feel like you can't handle? The prep? Actually birthing in your home (what would be bad about that? Too distracting? Worried about clean up? Other people in the house?)

 

If you can figure out what it is about it that you're really adverse to, it might be easier to work through it step by step.

post #3 of 22
Thread Starter 

All of it! The logistics seem overwhelming... the mess, where to actually do the birthing, whether to get a pool, fear of the pool leaking all over the floors we just had put in (petty I know, but they were just redone!). I'm not going to lie, the mess is a very real factor in my mind even though I know it's sort of stupid.

 

I'm worried that if the labor doesn't go well I'll forever associate that room with pain. And that I just won't be able to handle the pain and will end up transferring to a hospital anyway. And I'm nervous about the car ride if I do transfer, that sounds excruciating.

 

I'm not at all confident in my ability to handle an unmedicated birth. I'm a total wuss. I've been known to break down in a fit of "it hurts too much, I can't do this" while running a 5k. At a 10 minute mile pace. Yeah. The original plan was to take things as they came... try without any medication and then get an epidural if I can't hack it. With a home birth, I've got no other options, and that scares me.

 

This is another sort of petty one... I was kinda relying on the hospital's visitor rules to keep visiting family at a minimum for a few days, so we can recouperate in peace! So if we have the baby at home I'll have to figure out how to keep all 60+ family members who live in the area from descending upon us all at once.

 

I'm worried that if something does go wrong, and I transfer to a hospital, I'll be treated like a leper (though my midwife says that this hasn't happened in her experience). Or that my insurance will find some excuse to be weird and shifty if we don't have a hospital birth.

 

And lastly there is a twinge of "what if something goes wrong and we can't get to the hospital in time." The hospital is a ~10 minute drive, but knowing my luck I'll need to transfer in the middle of rush hour. I guess we could call an ambulance if it's really an emergency?

 

Sorry this is kind of long, I just hadn't seriously considered a homebirth until now. It was previously something I thought of as "great that other people are into that but really not for me." So now I'm scrambling to figure out what I want to do!

post #4 of 22

First, I am SO sorry that you have to go though this stress, KM! What awful timing for you. 

 

I think that you shouldn't even consider something that you're terrified of as an option. Your comfort is the most important thing and if the thought of a home birth brings up such strong negative emotions this late in your pregnancy, I would say just take it off the table for now. Concentrate instead on finding a great new hospital that is supportive of midwives.

 

Does that sound like I'm simplifying it too much? Maybe you do want a home birth a little bit and would be willing to spend some time working through your fears? If not, that's okay! Give yourself a few days to explore your other hospital birth options and see how you feel then. If you find someone at a different hospital that you feel comfortable with, then compare THAT option with a home birth and see how you feel at that point. Right now the choice is something that scares you vs. the unknown. I'll bet the choice will be easier once you meet with a few other midwives. Are you in an area where you have lots of choices?

post #5 of 22

I agree with Ruby2. I think you would be better off exploring the other options that you're more comfortable with. I'm a big advocate of homebirth, but ultimately you need to be somewhere where you personally feel relaxed and safe.

 

If you do find that you have no choice but to go for homebirth, you may well find that once you start reading more about it the fears and worries subside.

 

Sorry you have to deal with this now.

post #6 of 22

I'm planning a homebirth and we had this plan since before I even got pregnant. I've just never been fearful of it. every time I think about going to the hospital, I feel panicked, so I know that it's not a good option for me. at the same time, I've advised two people in the last eight months to not do a homebirth, because they were panicked about not being in the hospital. I could give you a list of why I don't want to do a hospital birth, but in the end I'm not confident and comfortable planning that. so that's that.

 

ultimately, I would encourage you to do what makes you most comfortable going into birth. do you think you can find another good midwife with privileges at a local hospital? I wish you weren't going through this :(

post #7 of 22

Is there a possibility that your midwife would still attend your birth as a labor support person if she doesn't have privileges at the new hospital?  That way you could still have her there with you? 

post #8 of 22
Thread Starter 

Thanks everyone. We're lucky in that our area has a number of great midwives and great hospitals, so if we do want to switch we're in a good place to do so.

 

I talked to our doula, and she really helped me put things in perspective. It's not a rock and a hard place, it's two great options that we've got and either one will be great for us. We either have a homebirth with an amazing homebirth midwife, or we have a hospital birth with one of the great midwives at the hospital practice we transfer to.

 

We're going to table the discussion and relax for a few days, and then see how we feel about it. In talking to the doula I realized a lot of my terror about home birth has more to do with generalized fear of birthing, rather than where it happens. So I'm going to focus on relieving that for the time being. Since we just moved into our place, I don't quite yet feel "at home" here, but I know as we settle in I will.

 

Once I've had some time to relax I can talk to my midwife about some of the logistical concerns (mess, transferring). If I do decide to consider homebirth the situation is pretty much ideal, but if I decide I've got too many reservations about it I know my midwife will find someone great to fill her shoes.

post #9 of 22

Out of the things you mentioned, the lack of pain relief would be my biggest point.

 

I've always wanted homebirths, and was never scared of the idea of a homebirth. I figured the logistics would just follow along with the rest of baby planning, and the things that worked out were great and if it didn't then fine. The mess doesn't concern me (and after two very, very clean homebirths i'm still totally unconcerned) and I know our floor can support the weight of the pool (can you 8-10 people stand where you'd put your pool easily?), we put down a HUGE tarp and did a few trial runs to make sure everything held water properly, and so on.

 

But lack of pain relief... yeah. I'm scared of all forms of numbing/drugs (medical or otherwise!) , I hate the loss of control that goes with them, so for me it was handy that there wasn't that option. But for someone who is considering it- and that's totally , 100% just fine with me!- then not having that as an option and needing to transfer for that would be really difficult to get my head around.

 

Fear of birth... yeah, that's much more generalized. That could take more than just a few weeks to work through, so I'm glad you have a few people to talk it through with!

post #10 of 22

hmm....  Has your midwife worked at this hospital before? I think that it sounds kind of strange that suddenly she didn't realize she can't work at this hospital!  Seems like she should have checked this out before committing to it.  It doesn't make sense that because of one OB the entire hospital has a certain policy, yk? 

 

I think that that would personally make it hard for me to trust/work with this midwife.  I know it sucks to transfer care this late in the game, but I would personally pursue that option.  It would be hard for me to trust her, and if I was very nervous about a homebirth, I wouldn't feel comfortable with her in my home...

 

But that is my feeling, and maybe not yours. I am really big on professionalism.  I wouldn't even consider meeting with a highly recommended postpartum doula because she totally flaked on an appointment with me!  I wouldn't even give her a second chance.  So I might just be extreme with that. 

 

I understand that stuff changes, but if the midwife didn't really have an established relationship with this hospital, and couldn't get that relationship established before now--this late in the game, I would seriously question her.

 

But then again, I don't know her credentials, etc. So I could be totally off-base.

 

I would be nervous about being under the care of someone who didn't really know the other hospital staff, know their way around the hospital already.  I wouldn't want to be her very first patient at a hospital if she had never, ever worked there before...

 

Sorry I'm such a downer!  That whole situation just stinks. I'm like you and am not completely comfortable with a home birth for weird reasons that aren't totally logical.  So I can sympathize with that. 

 

But something about this whole situation sounds off to me.  hug2.gif

post #11 of 22
Thread Starter 

I trust our midwife 100%. She's absolutely wonderful, and has at least two decades of experience delivering babies. She's sort of a legend in the area. She's been nothing but professional this whole time, and definitely isn't trying to push us into home birth - she didn't even suggest it, I just started considering it on my own since I know she does a ton of homebirth.

 

She's been working at this hospital for years, and hasn't had any issues. Recently the hospital brought on a new group of OBs, who haven't exactly been warm towards her but seem to tolerate her OK. Then out of nowhere last week she got a letter informing her that they would no longer back her up, effective immediately. One of the new OBs isn't keen on midwives and managed to convince the hospital not to deal with them, so *all* of the midwifery practices are being kicked out, not just ours. Charming woman, I'm sure.

 

It all comes down to money, I'm sure. Hospitals just don't make much off midwife births. A lot of hospitals in our area have closed their labor and delivery units because it just isn't a money maker. One converted their L&D unit into a bariatric surgery unit. Apparently lap bands are much more profitable. Sigh.

 

I'm trying to keep my anger at the hospital system out of my decision, but man do I want to give them a huge F U right now.


Edited by MakeItSew - 3/28/12 at 3:00pm
post #12 of 22
Quote:
Originally Posted by KM84 View Post
Then out of nowhere last week she got a letter informing her that they would no longer back her up, effective immediately. One of the new OBs isn't keen on midwives and managed to convince the hospital not to deal with them, so *all* of the midwifery practices are being kicked out, not just ours. Charming woman, I'm sure.


Sounds like someone feels threatened...it's a shame, isn't it?

post #13 of 22
Quote:
Originally Posted by KM84 View Post

I trust our midwife 100%. She's absolutely wonderful, and has at least two decades of experience delivering babies. She's sort of a legend in the area. She's been nothing but professional this whole time, and definitely isn't trying to push us into home birth - she didn't even suggest it, I just started considering it on my own since I know she does a ton of homebirth.

 

She's been working at this hospital for years, and hasn't had any issues. Recently the hospital brought on a new group of OBs, who haven't exactly been warm towards her but seem to tolerate her OK. Then out of nowhere last week she got a letter informing her that they would no longer back her up, effective immediately. One of the new OBs isn't keen on midwives and managed to convince the hospital not to deal with them, so *all* of the midwifery practices are being kicked out, not just ours. Charming woman, I'm sure.

 

It all comes down to money, I'm sure. Hospitals just don't make much off midwife births. A lot of hospitals in our area have closed their labor and delivery units because it just isn't a money maker. One converted their L&D unit into a bariatric surgery unit. Apparently lap bands are much more profitable. Sigh.

 

I'm trying to keep my anger at the hospital system out of my decision, but man do I want to give them a huge F U right now.



Do you trust the hospital system more than you trust your midwife?  That's pretty much how I decided I wanted a homebirth. 

post #14 of 22

I agree with the pps, that fear is not a good way to go into birth, so it may be better to find another hospital. 

 

That being said, there were points you brought up that are easy enough to work through.

 

For some of the more practical things...

 

The mess.  There really wasn't one for us.  The only "mess" we had to deal with after the MWs packed up and left was the kitchen (which is always a mess).  The MWs packed up all the garbage, and had a hamper for the laundry, etc., so none of it needed to be "dealt" with.  They volunteered to start the laundry, but since I hadn't walked them through it beforehand I wasn't comfortable with them doing that.  But that was MY hangup. 

 

Birth tub.  If it's such a big concern, don't get one.  Personally I didn't find it helpful at all.  I spent a LOT of time in the shower, but the tub didn't help.  I'm still debating whether I'm even going to bother with one this time.  If you WANT one though, go to a hardware store, pick up some painters tarps, the plastic ones AND the cloth ones.  Put down the plastic, then the cloth, then the tub.  We did that on our 50 yr old hardwood floors and didn't have ANY problem.  Have a stack of towels (or a laundry basket of them) next to the tub.  As for where, anywhere you could fit a kitchen table.  Do a test run beforehand to be sure the tub doesn't leak.  If you're careful filling it and the tarp winds up wet, you know you have a problem.  But since you're not in labor, you have time to deal with it.

 

As for the pain... that's a totally individual thing.  But I'll say that the IDEA of running a 5k makes me want to curl up in a ball. winky.gif   But I spent 5 days in labor with DS.  I didn't ask for drugs until I hit transition, by which point it was too late.  I'm not going to say it didn't suck, but it was a completely different kind of pain than anything else I've ever experienced (including DS1's birth, which was a hospital induction).  If I had known going in that it was going to be 5 days, I never would have agreed to a HB, but from this side of it, I'm glad I did, because I learned something about myself.  And the fact is that if you're in a long labor, and you get to the point where you just can't deal any more, then transferring to the hospital for pain relief is always an option.  In fact, that's what most HB transfers wind up being for - not emergent reasons. 

 

As for the family - there are lots of things that can be done there.  Not announcing the birth until afterwards (like the next day, or more).  Spelling it out plainly that you will be seeing visitors on X day between Y and Z times only.  A note on the door that details the baby's info and asks visitors to go away until visiting hours.  Disable the doorbell.  Changing voicemail to something similar, turn off the ringer.  Setting up a schedule beforehand with family - you're going to need help with XY and Z.  Who's willing to come over and help out with these things?  This is one I'm doing this time, specifically in regards to DS, working up a schedule with all the family to come over one at a time and take him for a few hours so he doesn't feel left out of the attention.  Have you discussed a meal train with anyone?  That's another good way to do it.  I know many MWs who post a note on the door when they leave to the extent of "new family needs bonding time, please limit visits to 15 minutes and do a chore while you're here" - a list of chores on the fridge is really helpful so you don't have to stop and think about what might need doing.  And if all else fails, stay in your bathrobe/pjs, and put on your most imperious attitude - don't get up to do anything for anyone, including yourself.  Make yourself a throne and stay there (with baby).  Wearing baby skin-to-skin in something like a Moby is also really helpful for this.  Just remember that your/baby's needs overrule everyone else at this time.  Hurt feelings, guilt trips, etc., don't matter one whit. 

 

 

post #15 of 22
Quote:
Originally Posted by KM84 View Post

I trust our midwife 100%. She's absolutely wonderful, and has at least two decades of experience delivering babies. She's sort of a legend in the area. She's been nothing but professional this whole time, and definitely isn't trying to push us into home birth - she didn't even suggest it, I just started considering it on my own since I know she does a ton of homebirth.

 

She's been working at this hospital for years, and hasn't had any issues. Recently the hospital brought on a new group of OBs, who haven't exactly been warm towards her but seem to tolerate her OK. Then out of nowhere last week she got a letter informing her that they would no longer back her up, effective immediately. One of the new OBs isn't keen on midwives and managed to convince the hospital not to deal with them, so *all* of the midwifery practices are being kicked out, not just ours. Charming woman, I'm sure.

 

It all comes down to money, I'm sure. Hospitals just don't make much off midwife births. A lot of hospitals in our area have closed their labor and delivery units because it just isn't a money maker. One converted their L&D unit into a bariatric surgery unit. Apparently lap bands are much more profitable. Sigh.

 

I'm trying to keep my anger at the hospital system out of my decision, but man do I want to give them a huge F U right now.




OMG, that is so F ed up, and that hospital does deserve an FU.  Wow, that blows my mind.  I wouldn't be as concerned about her relationship with the obs but the other staff, yk. 

 

That is just so so so freaking messed up. Most of the hospitals in my area have midwifes because they keep costs down!  And provide awesome care.

 

In that case I think I would ... freaking, I don't know!  I think I would try the homebirth.  I agree with cristeen that you may not even want a pool. And being in your own home and comfortable there might reduce the pain-- because you are in your own space, yk?  It isn't too late to think about pain management at home, too...

 

I'm comfortable with hospital births, but then would be very open to a homebirth with a midwife I trusted...

 

Oh ((hugs)) .... that just blows. I think I would write an angry letter to the hospital...

 

post #16 of 22
Quote:
Originally Posted by KM84 View Post

I trust our midwife 100%. She's absolutely wonderful, and has at least two decades of experience delivering babies. She's sort of a legend in the area. She's been nothing but professional this whole time, and definitely isn't trying to push us into home birth - she didn't even suggest it, I just started considering it on my own since I know she does a ton of homebirth.

 

She's been working at this hospital for years, and hasn't had any issues. Recently the hospital brought on a new group of OBs, who haven't exactly been warm towards her but seem to tolerate her OK. Then out of nowhere last week she got a letter informing her that they would no longer back her up, effective immediately. One of the new OBs isn't keen on midwives and managed to convince the hospital not to deal with them, so *all* of the midwifery practices are being kicked out, not just ours. Charming woman, I'm sure.

 

It all comes down to money, I'm sure. Hospitals just don't make much off midwife births. A lot of hospitals in our area have closed their labor and delivery units because it just isn't a money maker. One converted their L&D unit into a bariatric surgery unit. Apparently lap bands are much more profitable. Sigh.

 

I'm trying to keep my anger at the hospital system out of my decision, but man do I want to give them a huge F U right now.


Holy cow. I would definitely stay away from *that* particular hospital.
 

As forestmushroom says, there are just so many things wrong with that situation--and hospital politics and drama are not exactly what you want to be facing right now.  I think you're approaching it very sanely, giving yourself a chance to get used to the idea of change before making your decision.  Good luck with whatever you choose!

 

post #17 of 22

KM - I can't say anything that hasn't already been said. You're wise to assess that a few days to think about it are in order. Let us know if you need any advice or you have questions cause you have really been put in a tough situation. Big Hugs.

post #18 of 22
Thread Starter 

Thanks so much everyone. After some time spent doing other things (aka relaxing), I'm feeling a LOT better about the whole thing. Through a little research and talking to our doula I've reached a point where I feel like a homebirth is something I could totally handle and enjoy, but I think I'd be even more comfortable with a midwife in a hospital.

 

There's a hospital nearby that's just about perfect for me. They have a "birthing suite," which is essentially two rooms that are designated for women who want minimal interventions and used only by CNMs. I can have whomever I want in the room for the birth, there's a bathtub in the room, and I'm welcome to eat / drink / walk around as much as I want. If I do need more traditional medical care (epidural, pitocin, etc) they'll transfer me into one of the standard delivery rooms.

 

I'm still super bummed to leave my current midwife, but I've realized I can always go back to her for the next one :D She should be set up with her new hospital in a few months, so by the time the next kid is ready she'll be settled in there. Or maybe after the first one I'll have more confidence in my ability to handle things on my own.

post #19 of 22
KM I just saw this thread and couldn't remember - are you the mom who just moved to SF?
post #20 of 22
Quote:
Originally Posted by KM84 View Post

Thanks so much everyone. After some time spent doing other things (aka relaxing), I'm feeling a LOT better about the whole thing. Through a little research and talking to our doula I've reached a point where I feel like a homebirth is something I could totally handle and enjoy, but I think I'd be even more comfortable with a midwife in a hospital.

 

There's a hospital nearby that's just about perfect for me. They have a "birthing suite," which is essentially two rooms that are designated for women who want minimal interventions and used only by CNMs. I can have whomever I want in the room for the birth, there's a bathtub in the room, and I'm welcome to eat / drink / walk around as much as I want. If I do need more traditional medical care (epidural, pitocin, etc) they'll transfer me into one of the standard delivery rooms.

 

I'm still super bummed to leave my current midwife, but I've realized I can always go back to her for the next one :D She should be set up with her new hospital in a few months, so by the time the next kid is ready she'll be settled in there. Or maybe after the first one I'll have more confidence in my ability to handle things on my own.

 

Awesome! I'm glad you found something that you're comfortable with.  I can't imagine what you're going through right now, but I'm glad you're feeling better about it!
 

 

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