Need opinions on Ann Arbor/Toledo area hospitals

[courtney1188]

Hi, everyone! I'm new here but have been reading a lot of threads and it seems like there are people here with really great advice. My husband and I are in the process of choosing a hospital for the birth of our first child, and it's definitely been more difficult than I thought it would be!

At first I was sure I wanted either Saint Joes or U of M. Well, St Joe's isn't in network with my insurance, so sadly that is out. And from reading the other threads, I see that at U of M most of you recommend having a midwife, and that if you have an obgyn they are not necessarily the one who will be delivering your baby, it is whatever obgyn is working/on call at that time. Which makes me quite nervous, and I'm hoping for a natural birth, so it sounded like a midwife was the way to go. Well, problem number two - my insurance covers U of M and midwives...but there are no midwives in my network that have privileges at U of M. I am SO frustrated!

So then I started looking at Toledo hospitals (I'm located in Monroe, so pretty much between Ann Arbor and Toledo), and I like the look of St Luke's and St Vincent - but I don't know anyone who has been to those hospitals so I know nothing beyond what they tell you on the website.

The main things I'm looking for are to have everything happen in the same room as much as possible (an LDRP would be perfect, but I'd be okay with an LDR too), I'd prefer a hospital with tubs available - I don't want a water birth but I'm interested in using one to help with labor pain, and then my last request is where it usually gets tricky...I have a total phobia of needles and want to avoid having them in me as much as possible. No epi, I'd love to have no IV, which generally people laugh when I say that, but U of M and St Joes websites both say that if you're able to stay hydrated on your own and don't take pain meds that they will allow you to not have one. None of the Toledo hospitals mention it at all.

So what do you guys think? Should I go with U of M even though I can't have a midwife and hope that an obgyn will still accommodate my wishes? If so, any recommendations on obgyns there? Or has anyone has a good experience giving birth at another hospital that you think I should look into?

[mothercat]

I can speak to the hospitals in Toledo. I am a midwife with a birth center in Temperance. If we have to transfer I much prefer St. V's. The residents have been very accommodating, and they have the best breastfeeding support in the city.  However, if you want a provider you know I'd go with the midwives at Associates in Women's Health. St. V's does have tubs in a couple of the rooms at the far end of the hall (away from the nurse's station). Toledo Hospital does not offer tubs, but there are showers in the rooms.

The only hospital in Toledo that offers LDRPs is St. Luke's, and in the past have offered waterbirth with the one AquaDoula tub they have. They are being purchased by Promedica (Toledo Hospital) and things are changing.

Associates in Women's Health does births at St. V's, St. Luke's, and Flower. There is a group of CNMs at Toledo Hospital and they can be good. I especially like Vicki Hill. I think there is something like 12 or so midwives. Won't know who will be at the birth. There is also the issue of how much say the attending OB has. The CNMs are hospital employees there and they work at the pleasure of the OB attendings.

Have you thought about the CNMs at Hutzel in Detroit. They offer tubs in labor and for birth. I know several of them and they are wonderful.
 

[NikkiDoulaOhio]

MotherCat had some great advice!  I also want to add that I recommend Flower Hospital in Sylvania, OH.  You do everything in one room, the staff was very nice, and some (though not all) of their rooms do have tubs!  I know a lot of people prefer Flower over Toledo Hospital.  

My own pregnancy was drug free but I did have an IV of fluids.  Honestly I'm not sure which hospitals require this and which don't.  

<3 Happy Parenting! <3

[mothercat]

It isn't the hospital that requires anything. It is the doctors and midwives that order things. Although I know that sometimes the providers say the hospital requires things like IVs, electronic fetal monitoring , etc. so they don't have to explain why they order non evidence based intervention in routine care.

[NikkiDoulaOhio]

Originally Posted by mothercat 

It isn't the hospital that requires anything. It is the doctors and midwives that order things. Although I know that sometimes the providers say the hospital requires things like IVs, electronic fetal monitoring , etc. so they don't have to explain why they order non evidence based intervention in routine care.

Sorry, I guess it is the provider not the hospital.  Thanks for adding correct information! 

[mothercat]

Nikki, I didn't mean that to be harsh. It is just shorthand for people in the NCB community. I will frequently hear, "So and so doesn't do VBACs". The truth is they might well support VBACs but risk management and the hospital's liability insurance carrier say if that provider does VBACs they won't cover them for any type of liability. But it is much quicker just to say the provider doesn't do VBACs rather than having to explain the whole mess with the hospital and liability carriers. Same thing happens with providers like myself who work with Medicaid enrollees. What I usually hear is, "That midwife doesn't take MCD." The truth is that I do take Medicaid. However, Medicaid has determined that they won't pay for birth care if it doesn't happen in a hospital or licensed birth center. If licensing isn't available, like in Michigan currently, then the family either has to pay for the services to birth OOH or they have to choose a hospital birth. Rather than explain all that everytime, people find it easier to just say the midwife doesn't take MCD.

Sometimes the shorthand just irritates me because it puts the blame somewhere it doesn't belong, and doesn't blame the person or entity that is responsible.
 

[NikkiDoulaOhio]

I didn't think it was harsh at all.  I find it informative and I appreciate the info you've posted! 

[esma2175]

I delivered at u of m, last month with the midwives. I saw three of them during my prenatal visits. Jane, Kathy, and the head midwife who's name I can't remember for the life of me right now. They were all wonderful and very supportive off my wishes. I had a "keep my pants on" policy and they were all fine with that, no harassing at all. I had one ultrasound, but if you don't want one you don't have to have one. I didn't do any tests pre baby except a fasting blood draw to check for GD, which I wanted, they were ok with not doing one at all, so much better than the sugar water!

I went in at 36 weeks with preterm labor contractions, and they monitored me and baby's heart rate and the contractions for a few hours then the contractions faded so I went home with no other interventions.

During delivery DH was laughing with the midwife and nurses, I was in the tub with no iv or pain meds. I could eat anything I wanted to(something important to consider if you have a long labor) baby stayed in the room the whole time and had no shots, eye ointment, or bath right away. I gave baby her first bath when I was ready. They put baby skin to skin right away and encourage breast feeding. Dad can be involved as much as he wants to, or other support people. You stay in the same room your entire stay, unless they need the room with a tub for some one else, then after recovery they move you to another nice room,all with outdoor views.

Also the food was amazing, made to order what you want when you want it from 6am to 8pm.

[myra1]

I do not think u should go w u of m if you have an ob. It is a teaching hospital w many high risk patients and I do have friends w not so great exp there once they became high risk. The midwives are good however. I did birth at st joes w an ob for one child and although I got a natural birth I had to fight for it tooth and nail. They also lied to me to get me to stay unecessarjly as long as my insurance would allow, and constantly pressured me to take the baby.

[jenifera2]

Have you called the U of M midwives to be sure they're not in your network? It can be confusing to find midwives in provider listings for many insurances, but I'd be really surprised if your insurance that works at U of M doesn't work with their midwives.

That said, generic advice for or against OBs at any hospital doesn't make sense. Each practice is different. Some practices (but not many) will pretty much insure that your doc will deliver your baby (barring emergencies, etc). Most OB practices (and the UM midwives, and probably midwives at other hospitals) have multiple care providers within the practice and you will get care from whichever is on call when you arrive at the hospital. That's not to say that you'll get a random doctor or midwife - it will be one associated with your practice that you chose - but you can't know in advance who it will be.

If you're choosing an OB practice, ask around for recommendations of smaller practices, and ones that support your birth preferences. Visit them, and don't hesitate to switch care providers mid-pregnancy if you find that the one you selected is not as good a match for you as you originally thought.

But I would highly, highly recommend calling the U of M midwives and/or your insurance customer support to get more info on who is in network if you haven't done that yet. It may just be a poorly designed website that's hard to navigate and find midwives on, which I've experienced with several different insurance companies that did, in fact, have the midwives in network.

[courtney1188]

Jenifera2, you were exactly right!  I know I wrote this post quite some time ago, but realized I never updated and thought I should in case anyone else in a similar situation comes across the thread. I called UofM and my insurance company and found out that my insurance will work with them since it is through the hospital, which is in-network. I was quite relieved. I've been very happy with the midwife program there, I typically see Anne Rosa and she has been great and very supportive! And esma thank you very much for your response too, I hope I have an experience like yours.