Looking for information/reviews about birthing centres and/or hospitals + OB recommendations for...

[papayagnomes]

I'm currently 14 weeks pregnant with our first child. My husband and I have been doing the best we can to find all the information available on delivering our baby. We are assuming and hoping for a normal birth without any complications because I will be 31 when I give birth and because I'm fairly healthy/fit. The great thing about living in the Portland area is that we are able to have a choice on how our baby is delivered. We would like a natural birth (water birth is preferred), and I would especially like to avoid a hospital if my birth is considered low-risk. We are not considering having a home birth. We are hoping to find a balance between natural birthing care and modern medicine and thought a birthing centre (that happened to be right across from the hospital) would be a good balance.

We have just recently visited the Andaluz Waterbirth Centre in Portland as we're currently trying to confirm our prenatal care (currently seeing an OB who will not see us if we do not birth in a hospital). I found two incredibly bad and worrisome reviews about the birthing centre online (on Yelp, but google reviews seem positive) that has made me worry about the quality of care I would receive -- mostly that the midwives were late in insisting on intervention (hospital transferral) and that made any complications worse. This is making me worry about signing up with Andaluz, and I am wondering if anyone can share their own experiences about the centre so that I can get a better idea of the quality of care I could be receiving for my delivery. I also plan on emailing the centre after the long weekend to see if they can explain the negative reviews and give a detailed explanation of their policy/complication-intervention-needed plans. But, as always, hearing from other people would be great.

We are also going to be touring OHSU's birthing facility as they offer a water birthing option and wanted to hear from anyone who may have delivered there. I'd like to know if I'd have intervention drugs forced upon me, or if it'd be a more of a birthing centre experience (natural) in a hospital setting.

We are also thinking about St. Vincent's, but our OB has mentioned it is more of a "conventional" birthing hospital with the usual average 30% c-section rate. This makes my husband and me cringe a little, but this is where our OB delivers.

Lastly, I am wondering if anyone has an OB recommendation. We are looking for someone who understands our desire for modern medicine care so that we can make sure the baby is doing well in the pregnancy stage but would be willing to let us give birth with a midwife (and only be a back-up should there be any complications).

TL;DR version -

1. What experiences have you (or someone close to you have) had with Andaluz Waterbirth Centre in Portland? Not just with prenatal and postnatal care, but the actual delivery. If you had a complication or difficult birth, did you feel they handled that situation appropriately?  How did they handle it?

2. What experiences have you (or someone close to you have) had at the birthing facilities at OHSU and/or St. Vincent's?

3. Can you recommend an OB who can balance a patient's wish for modern medicine care and natural child-birthing delivery preferences?

We're situated in Hillsboro, so anything in the NE is going to be too far for us in terms of distance.  We would definitely like to try and stay on the west side.

Thank you for any information you can provide. As you can imagine, we're fighting off the first-time-pregnancy jitters so being well-informed about our choices will help a ton.

[JenaM]

I did not have experiences with any of the birth centers you mentioned but I can offer some insight from my own experiences using a midwife group at a hospital (never interfaced with the OB, one is on duty at any given time at the hospital to be able to do emergency c-sec, and one was a part of my midwife group to consult with if needed). I worked with the Portland Maternal care clinic, where all the midwives are certified nurse midwives, which I believe in Oregon are the only type of midwife allowed hospital privileges for deliveries. There were 6 midwives at this clinic and I saw each one several times over the course of my pregnancy, which was great for because that means you will have a relationship with whoever ends up being on duty the day/night you deliver. With a typical OB practice, you meet with the same OB at each appointment but when it comes to delivery time, you get whatever OB is on duty that day - meaning, you may have a dr delivering you whom you have never ever met and has no idea of your preferences, ideals, or support needed. The huge advantage of working with a midwife (for uncomplicated pregnancies) is that you are guaranteed the chance to work with someone who fundamentally believes that less intervention is often the best tactic and will support you in achieving a natural unmediated birth, if that's what you desire. And since you go into L&D at least knowing your midwife a little bit and them, you, you have already had the opportunity to discuss your preferences, fears, hopes with them prior to going into L&D. I felt 100% supported during my pregnancy and birth experience from the midwives who met with me and the midwife who ultimate assisted me in the birth of my son.

That said, they are located in NE Portland, so too far for you but definitely check out the midwife group at OHSU, Emanual, and St. Vincent's.

For a list of Oregon Hospital based Midwives:

http://www.oregonmidwifery.org/OregonCNM.html

Reviews of birth center experiences you mentioned above can be found at the following two links - you will see both sides of experiences written here.

http://www.urbanmamas.com/urbanmamas/2008/03/portland-birthi.html

http://www.urbanmamas.com/urbanmamas/2007/04/seeking_suggest.html

FWIW, I have several friends who delivered at Alma and had wonderful prenatal care and deliveries at their birth center. If needed, they would transfer you to Portland Providence Hospital whic is 7 min drive from their center. They claim that the majority of their transfers are parent chosen, either for exhaustion due to long labor and/or the desire to end up using pain meds to manage the rest of delivery. A very small percentage are for medically needed reasons.

Lastly, one thing that helped me with peace of mind In choosing which midwife group to use was to see the csection rate at all the hospitals in Oregon, based on the percentage of csections done in regards to total births, instead of just the number of csections performed. At the link below, scroll down to tables 5a,b,c and table 6. Keep in mind that what also affects this percentage is what hospitals work with the highest risk pregnancies and have neonatal units (including Emanual, St Vincent's, as well as hospitals that will not perform VBACS (such as Adventist).

This pregnancy, I am now on Kaiser insurance so my only options are to deliver in network at a Kaiser hospital (I actually can also do a home birth with a midwife, but it's considered out of network and only partially covered). I am closest to Kaiser Sunnyside Hospital and am working with the midwife group there, which is similar to the Providence Maternal care clinic in many ways. I was thrilled to discover that Sunnyside has the 3rd LOWEST csection rate in the whole state - awesome!!

Best of luck to you in your search. Working with a practitioner that is aligned with your needs and wants is a huge stress reducer and you will be so relieved when you find that person.

[phathui5]

One option with Andaluz is to ask them for references of moms who have birthed there.

[gypsymama2008]

I will start out by saying that I am 38 weeks pregnant and planning a home birth and absolutely not opposed to out of hospital births.  I have however heard lots of bad experiences about Andaluz, particularly from my friend who's a nurse.  She was pregnant while she was in nursing school and had a number of both her classmates and professors make her promise them she wouldn't give birth there (and these were people who were encouraging her to have an out of hospital birth).  Granted that is just anecdotal evidence, and I'm not even sure what it happened to make them so wary of it (I think, like you said, it had to do with not transferring to a hospital when indicated and having bad outcomes).  

One thing you could do is see a midwife who you feel comfortable with and just rent space at Andaluz.  My friend was seeing Liz Collins ND for her pregnancy and she offered that as an option.  She also delivers at a couple of other birth centers around Portland.  I know several people who've had fantastic experiences with her and say she has a wonderful balance of safety and giving mom and good birth experience.  I've also heard good things about Alma Birth Center, they have at least one CNM on staff which makes it easier to get insurance to cover it.  I will also just throw out there that they bring everything (in terms of safety equipment) to home birth that they have at a hospital birth, so depending on how far away you live from a hospital it can be just as safe (I think Andaluz, would be a good ten minute drive to OHSU without traffic, with traffic it could be closer to 15 or 20 minutes) so that's something to consider.  We are lucky in that we live literally 5 minutes away from St. Vincent's even in rush hour traffic (I've tested it), so I feel pretty comfortable birthing here.  I'm just throwing that out there as another option, by all means if you feel safer in a birth center than that's where you should birth.

As far as hospitals go, Sunnyside is the best for supporting natural childbirth and for a hospital they have a quite impressively low C-section rate, however, unless you have Kaiser insurance you can't go with them.  I would encourage you not to birth at St. Vincent's, I had my daughter there and it was not a good experience.  The staff wasn't malicious in any way but they just had no idea how to facilitate or support a natural childbirth.  If you do decide to go there, please consider a doula to help stand up to the staff and support your wishes, so you aren't expending all your energy fighting for your birth experience-I so wish I had done that.  I've heard great things about OHSU and they do allow water birth.  Everyone I've talked to who birthed there had a good experience.  Linda Glenn is a homebirth CNM who also does births at OHSU (I'm blanking on the name of the OHSU group she is associated with) so she might be someone to look into if you go in that direction.  Providence Portland is also supposed to be very good, that's the hospital my midwives' back up OB works at and where we would go in an non-emergent hospital transfer.

Here is a thread from urbanMamas about different birthing options around Portland so that might be something to look at, too.

Lastly, I figured I'd just throw out that I am birthing with a Gentle Beginning and cannot be more pleased with the care I've been receiving, Catherine Schaeffer is an ND and a CNM and has such a fantastic view of birth balanced with safety, in case, for some reason you decide to go with a homebirth.

Good luck and Happy Birthing!

PS I've managed to get my health insurance to cover my out of hospital birth and have learned a ton in the process.  PM if you need any info related to that :)