Question about backup care

[amberc727]

I am planning my first HB.  My first two babies were born in free-standing birth centers here in NC.  My MW says I'm a perfect candidate for a HB and knowing how my first two labors went, I feel good about this.  What I can't figure out is the issue of back-up care.  There are really only 2 doctors in this area who will even do this, and both are about an hour from me.  One I'm not comfortable with at all.  I saw him at the beginning of my last pregnancy and he was really awful to me.  The other doctor has questionable values and is known for doing a bad c-section with a high infection rate post-op.  I'm not sure what to think about all of this.  

Does anyone ever receive parallel care with an OB and not tell them their plans for a HB, knowing that there is very little chance that they'd deliver with that doctor unless something unexpected happened?  I don't really know of any doctors around here that I would trust for that, although I guess I could see a MW practice that delivers in-hospital.  My main concern for that would be the financial aspect, because they'd probably want me to pre-pay for the birth by my 36 week appointment and if I'm only going there for prenatals, that wouldn't make sense.  I'm just very confused about what to do here.

[themothership]

I have decided not to do back up care for a few reasons. 1. My midwife can order all the same tests a hospital based midwife or OB can. 2. The closest hospital in an emergency isn't my hospital of choice, and even if it were, your choice of doctor isn't always the one who is on call. 3. There isn't a hostile environment towards home birth in my area, so I am not worried that my midwife won't be listened to regarding my pregnancy history.

[amberc727]

You're very lucky that the birth environment where you live isn't hostile.  Here in NC, it's very hostile.  :-(

[camprunner]

My plan is to find an OB that doesn't have hopsital priveledges for back up care and then hopefully it won't be a big deal when I don't show up at the hospital and I will have a legal file somewhere.

[LittleBagOfBones]

The environment where I live can be pretty hostile.  I did shadow care with an OB and did not inform him of my intent to HB.  I wanted to have an established record of prenatal care, and thought I would be treated better than an unknown HB transfer.   I ended up regretting my choice.  I had to go to double the appointments during my pg.  When I did have to go to the hospital in labor (non-emergency transfer) and my OB found out that I had been trying to homebirth, he became irate and bullying.  All my efforts to have an established relationship for transfering care were for nothing, and I ended up being delivered by the OB on call.  Don't bother unless you can tell your OB in advance and he/she will be accepting and supportive.  Next time, if a transfer becomes necessary, I will just go to the hospital and get the OB on call.