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Thinking through my birth options

post #1 of 14
Thread Starter 
Humor me, ladies: I'm still not sure where to have this baby. I planned a hospital birth with my first. While it was a vaginal delivery, GBS+ and broken waters meant we were bullied into pitocin. For my second, I decided I wanted a homebirth for sure. My labor ended up being super long and I was just too exhausted and in too much pain to keep going so we transferred. Suspected malpositioning. IV pain meds and pit lead to another vaginal birth.

The first place I thought of for this baby is a free standing birth center that is near by. It should be covered as out of network with our insurance. We will have to prepay $3,900 out of pocket. Chances are we won't get a refund but we will have my deductible and possibly the whole family's deductible fulfilled for the year by filing with our insurance. The midwives that staff it are unable to administer pitocin so if my labor stalls and natural methods of augmentation aren't working then we would have to transfer to the hospital. This time around my hubby is more on board on an alternative birth so we've talked about if we need to transfer it'll be okay. (Last pregnancy he at one point told me that we would only transfer if it was an emergency.) So why am I not jumping up and down in joy? I guess I just feel so hopeless about having a completely natural birth that right now I am assuming transfer is the only way that will end.
The birth center also has more rules about when transfers need to happen as opposed to the homebirth midwife last time.

There are several hospitals in a reasonable driving range. One has a group of midwives that have a good reputation. They are in network with my insurance although I feel strongly about hiring a doula if we go to the hospital so that evens up the cost a bit. But on their website there is stuff about if you're GBS+ and your waters break and you're not already in labor that pit is a must. I made an appointment with them because I feel like maybe exploring my options will reinforce whatever decision I make in the end. And it would be nice to hear the heartbeat before needing to write a check ($500 due at first appointment with birth center).

There are quite a few homebirth midwives in the area. One has been recommended to me over and over. I emailed her and am supposed to call her to set up a chance to chat. I'm not sure if I really want to pursue homebirth. It won't be covered at all by our insurance. I'm also not sure how it will be to labor with two young children in the house. Something I like about the birth center is that it is less prep: no birth kit, no pool, no worry about cleaning up, before or after. Of course I feel like a homebirth midwife is the only one who would offer the care I really want: fewer "rules", more personal care.

Sigh. I wish this was easier.

Any thoughts on how to decide?
post #2 of 14
Quote:
Originally Posted by allisonrose View Post

Humor me, ladies: I'm still not sure where to have this baby. I planned a hospital birth with my first. While it was a vaginal delivery, GBS+ and broken waters meant we were bullied into pitocin. For my second, I decided I wanted a homebirth for sure. My labor ended up being super long and I was just too exhausted and in too much pain to keep going so we transferred. Suspected malpositioning. IV pain meds and pit lead to another vaginal birth.
The first place I thought of for this baby is a free standing birth center that is near by. It should be covered as out of network with our insurance. We will have to prepay $3,900 out of pocket. Chances are we won't get a refund but we will have my deductible and possibly the whole family's deductible fulfilled for the year by filing with our insurance. The midwives that staff it are unable to administer pitocin so if my labor stalls and natural methods of augmentation aren't working then we would have to transfer to the hospital. This time around my hubby is more on board on an alternative birth so we've talked about if we need to transfer it'll be okay. (Last pregnancy he at one point told me that we would only transfer if it was an emergency.) So why am I not jumping up and down in joy? I guess I just feel so hopeless about having a completely natural birth that right now I am assuming transfer is the only way that will end.
The birth center also has more rules about when transfers need to happen as opposed to the homebirth midwife last time.
There are several hospitals in a reasonable driving range. One has a group of midwives that have a good reputation. They are in network with my insurance although I feel strongly about hiring a doula if we go to the hospital so that evens up the cost a bit. But on their website there is stuff about if you're GBS+ and your waters break and you're not already in labor that pit is a must. I made an appointment with them because I feel like maybe exploring my options will reinforce whatever decision I make in the end. And it would be nice to hear the heartbeat before needing to write a check ($500 due at first appointment with birth center).
There are quite a few homebirth midwives in the area. One has been recommended to me over and over. I emailed her and am supposed to call her to set up a chance to chat. I'm not sure if I really want to pursue homebirth. It won't be covered at all by our insurance. I'm also not sure how it will be to labor with two young children in the house. Something I like about the birth center is that it is less prep: no birth kit, no pool, no worry about cleaning up, before or after. Of course I feel like a homebirth midwife is the only one who would offer the care I really want: fewer "rules", more personal care.
Sigh. I wish this was easier.
Any thoughts on how to decide?


I'm in the DC/MD area and am familiar with some of the options/practitioners you are probably considering. I'm gonna private message you!

post #3 of 14

I can't tell if by NOVA you're meaning Northern or Norfolk. I had a WONDERFUL homebirth w/ 7 cities midwifery, Jennifer & Terri are awesome if you're referring to Norfolk.

post #4 of 14
Thread Starter 
I am in Northern Virginia, not Norfolk.
post #5 of 14

You can decline any medical treatment - no medical personnel can force you to have pitocin if you don't want to have it.  Know your risks, and don't let anyone bully you about your medical decisions.  

post #6 of 14
Quote:
Originally Posted by DanceGina View Post

You can decline any medical treatment - no medical personnel can force you to have pitocin if you don't want to have it.  Know your risks, and don't let anyone bully you about your medical decisions.  

 

This is absolutely true.  I'm planning on a hospital birth for many different reasons, but my birth plan is going to be a crazy "if this, then that" type of plan (because I know too much).  But I work in a hospital, so I have zero problem telling people no.  However, I think it may be a great idea to have an advocate there for you (your partner, doula, etc.) because you may be concentrating on other things and find yourself giving in to many things (so I imagine, I cannot assume this about anyone).  Talk through your expectations with your advocate and make sure they are well-informed enough to speak on your behalf and know where you are coming from.  

post #7 of 14

Also in the DC/MD area, and just had a first appointment yesterday with a hospital based midwifery group.  They are covered in-network with our insurance, I very much like the midwife I saw, and feel good about the practice so far.  Apparently I need to make a few more posts on here before I can reply to PM's, but I'll try to do that in case you want to message me with any questions!

post #8 of 14
Thread Starter 
DanceGina - we were very strongly pressured into pitocin with my first son. We held out for about 4 hours but with the midwife on call, the OB on call and the midwife I saw for the majority of my prenatal visits telling us I needed pit to get labor going and get the baby out so he doesn't get seriously ill and potentially die, it is hard to keep saying no.

Veggieviola - You and Sweet Huck might overlap. I am in VA.
post #9 of 14
Thread Starter 
Just signed up to tour the hospital that the midwife group delivers at. Not excited about it. But I feel like seeing the hospital is an important piece of the puzzle here.
post #10 of 14

Of the two hospital-based midwifery groups of I know of in the area, they both offer informational meetings once a month with the midwives themselves.  I'd suggest attending those as well so that you can get an idea of the people you'll be seeing throughout pregnancy, and what their practices have to offer.

post #11 of 14
Thread Starter 
The group I will potentially be seeing is in Virginia and when I called their office, I was told they don't do meet and greet appointments. They are so busy that they only take regular appointments so I had to schedule a prenatal and was told by the receptionist to come with questions.
post #12 of 14
Thread Starter 
I toured the hospital last night. I might feel a bit hesitant about the birth center but my feelings were quite clear about the hospital: no. I don't want to have a baby there. I still have the prenatal appointment Friday with the hospital midwife. I am going to keep it, ask some questions and hope to hear the heartbeat. Then I will begin care with the birth center midwives next month. (Assuming all is well with baby - still nervous about miscarriage.)
post #13 of 14

For me, a birth center and homebirth are pretty much the same in the way of transfer to the hospital if you need it. Check with the homebirth midwife on her prices, because mine charges a little less than what it would be at the birth center WITH our high deductable insurance. We do not have materinty insurance, so using it isn't an option, but it is still cheaper. 

post #14 of 14
Thread Starter 

I'm pretty sure that our insurance will cover the birth center as out of network while declining to cover a homebirth at all. Even though they likely won't pay much to the birth center, it will fulfill my deductible for the year.

 

I also like the thought of not needing to worry about my house's cleaniness ahead of the birth or making sure there's enough food in the house before labor (something I didn't succeed at with my second). Going to the birth center will allow me to labor while my mom cares for two young children in our home.

 

So I do feel there are some advantages to the birth center over homebirth. Although the midwives who run the birth center also do homebirths so if I got further into pregnancy and decided I really did want to homebirth, I imagine there would be an option to just switch over.

 

At this point, I'm unsure if I will meet with a homebirth (only) midwife.

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