Homebirth to Hospital

[Northern Mama]

I am pregnant with my first baby and looking forward to a homebirth. I really never considered going to the hospital and feel quite confident about being at home. However, I feel a certain pressure from friends that I need to be open to the reality that I might be transferred to the hospital, although my midwife says she never advocates this. But a few friends who have birthed with this midwife have made the choice themselves to make the hospital transfer.
I feel like I don't want to think about the hospital at all, even though I have a doctor's appt. next week so I have one, I guess in case.
How much thought are other homebirthers giving to the hospital. I want to find a balance between being confident and excited for a homebirth but flexible enough about hospital transfers that I won't be disappointed.
How have others dealt with this?
Ruth

[jordmoder]

I think it's important to really delve deep within yourself and decide where you will feel the SAFEST to give birth. If you have unresolved fears about birth or your midwife or anything else, there is a greater chance that you may end up in the hospital. The mind is a very powerful thing in labor! It's a good thing we're pregnant for 9 months. There's a lot to do.

With that, I think most midwives will talk to you about contingency plans regarding labor - what if things just aren't going at home? Where do you go? Who do you transfer to? How do you get there? etc. and of course, what do you do if there is a (rare) but true emergency?

There are some really great resources out there for working on any issues that come up regarding birthing and what your true and deepest feelings are about where you give birth.

Good luck! and go with your heart, your gut and trust yourself.

Barbara

[yitlan]

I think all home birthers should at least make themselves think about how a transfer could happen. Envision it happening and make yourself look at how you would react. How would you view the transfer, the doctors, the experience? You still want to have a positive experience and it can be. But if you don't even let yourself think about the possibility, you could be caught unprepared and really have a negative reaction. Talk about it with your midwife, too.

I was fully confident that I would not be transferred. But I was. After a very long labor, my midwives felt I should get some help at the hospital. Since they are usually reluctant to recommend this and I trusted them completely, I went with their advice. But I was able to deliver with them there and ended up not needing an epidural, which was a good thing for me. Even though we did not want to transfer and did not anticipate it, I had a positive experience after all.

So let yourself think about it, but don't let your confidence be shot!

[Mommy22B]

I too am trying to find a balance in my thinking. I want to be prepared for the hospital but also completely confident about staying homeso i don;t get scared. I really do have somewhat of a balance. I have absolutely no fear in birthing at home and am so excited for it. If I did have to transfer I know I would be disapointed...that would be inevitable, but I know I would only go to the hospital if it was really truly an emergency, so hopefully I can rest assured that I didn;t "fail" and have some good feeling from the birth. I just met my doctor the other day and he seems very nice and accomidating so that actually relieved me. Mostly I try not to think about the hospital much though, because I am confident everything will be fine...(using viualization here) But I really think the hospital deserves only a thought or two...then you can move on and get ready for a homebirth.'
Beth

[TreeLove]

Here's some advice for someone on the other side of the fence

I was so sure that I would have the ideal pg and birth that it took years, yes YEARS , for me to come to terms with the disappointment and grief of an emergency classical c-birth at 29 weeks. I refused to think of anything less than a hombirth, thinking I would jinx myself.

The ONLY advice I give pg moms when they ask me is "Be open to your birth expirience, whatever it may be."

I would at least think about it. You do not want to be making important decisions w/ your emotions. You really need a clear head at times like that.

[Medium Geek]

Hi Northern Mama. You said your midwife never advocates transferring to the hospital. Everyone is different, and hopefully you are comfortable with that, but that approach would worry me. When I was interviewing my midwife we talked about transfer rates, and she knew what the numbers (%) were and willingly shared them with me. We talked about transfer scenarios and what criteria she uses to recommend transferring. We also discussed what the typical reaction is at the hospital. I feel lucky that the local OB group who is affiliated with our hospital is very welcoming to the homebirthers here, particularly my midwife. I also have been thinking about transfer scenarios as the birth approaches (2 months to go!), and I know it's one of the things I want to cover at my next appt. with the midwife.

To Northern Mama and all the other mamas: Does your midwife have one OB in particular who will act as backup? In some of the books I have been reading, that situation is advocated as the best in terms of safety. But we don't have that option here, as far as I know, because OB service are handled by a group at the local hospital. If I had been mainstream and gone for a standard OB-attended, hosptial birth, I would have seen 8 (yes, EIGHT!) different OB's during my pregnancy and could have had any one of them for the birth. Frankly, this is one of the reasons I prefer to see a midwife and have a homebirth. I guess if we transfer to the hospital from home, I could get any one of these 8 OB's at that time. It sure would be nice to be able to see just one, or even two, and know that they were *personally* comfortable with homebirth transfer. Anyone else have this situation, with an OB group as backup?

Thanks!

Diane

[jordmoder]

Hi Diane!

When I was in practice, we had a group of 6 OB's that provided backup for us - and with the exception of one who we refused to use after a bad experience (and his partners didn't force us to use him!) we got whoever was on call when we needed them. Some in the OB group were more ... I guess I would say sensitive ... to the fact that no one had planned to use their services, but it was my job as a midwife at that point to become an advocate and an ally and work with the family and the ob to help get the best birth experience possible. And I could talk to the ob's and honestly ask them why they were planning to do such and such a thing - could it wait, etc.

I did like to call on one particular ob and he extended himself to our families over and over again.

I did not have any of my clients "meet the backups" as I felt I could be a reliable interface and was in "good standing" with the ob's if the need arose.

What could be almost as important as having good relationships with a backup - single or group - is the relationship your midwife has with the staff at the hospital. If she is considered to be at least a neutral practitioner, then those women who end up in the hospital will have a better chance of having a supportive staff to work with there.

I would tell families the whole picture either during the initial interview, or in the prenatal process, so no one felt surprised if there were a change of plans.

Glad to see you on the boards!

Barbara

[kama'aina mama]

I had a home birth but I really think it is unrealistic not to have a transfer option available and planned for. My midwife told us at the initial interview, very calmly what her back up plan was. It didn't worry me, it calmed me.

What really reassured me was that about amonth later I went to a local day spa for a massage and by total coincidence my messuesse was her daughter! We spent the massage chatting about her birth and my birth plans. Her mom attended her and after she labored for hours with a posterior presentation, trying every trick in the book, the baby just didn't want to close the deal. They went to the hospital and had a vacuum extraction. Now, I don;t want it to sound like I am glad this dear girl had a difficult time of it, but I thought, "Hey, if she was able to continue making smart, hard choices during a labor she had so much emotionally invested in, she is not going to over estimate her ability and endanger me or my baby."

You might want to really question your midwife. Is it possible that she has a transfer plan, has used it, but doesn't like to discuss it? Maybe she has the idea that it will scare you to think of it so she deflects the question, but if you are uncomfortable you need to talk to her about it.

[Northern Mama]

Thanks everyone for your responses. I have talked with my midwife about the hospital. I didn't have a doctor and I asked my midwife if she felt it would be good to have a back-up doctor. There is only one doctor in town who is supportive of midwifery services but her practice is full so I hadn't considered it an option. However, my midwife told me she has an open policy for pregnant women. so I made an appointment. Its taken 6 weeks but I'll see her on Friday. Truthfully, I feel relaxed just knowing this will be my family doctor as I've met her before and everyone I know raves about her.
As well, I have asked my midwife how she is received at the hospital. See, midwifery isn't licensed in the Yukon so it outs my midwife in an awkward situation because she doesn't have hosptial rights. But once again it is a small town and the nurses are great and this doctor I'm seeing really knows and respects my midwife they have a working history together.
I think the best advice is to be open to whatever birth experience I have. Be confident my baby will come out, somehow.
I have three options for birthing and really they are all good.
1. Homebirth
2. Birth at my midwives house, as I live out of town and she's right near the hospital
3. Birth at the hospotal, which is a very non-interventionist hosptial with from what I've heard good birth rooms and really great nurses.
However, as home is what appeals to me most sometimes I feel a little stubborn and maybe over-confident. Did other women get into that situation.

[Medium Geek]

jordmoder...

Hi Barbara! I sent you a private message (PM), but I don't know if you have seen it. Mostly I was just trying to figure out if you were THE Barbara from Portland who I met back in early October. I guess so.

Nice to see you on the boards, too!

Diane

[babylover]

I struggled with this issue as well. I feel very lucky with the situation we have. We have a certified nurse midwife who has hospital priviledges at one hospital in the area (happens to be 10 minutes from our house). She has an OB back-up for c-section, etc. and is very confident in the OB. She doesn't require you to see him unless the pg is complicated. We chose this midwife option because it helped allay my fears about a hospital transfer. At least I know if we have to transfer, we will most likely be delivered by our midwife (barring a c-section, or other emergency complication)--but, she will still be there. That was the main thing for me. I feel confident in a homebirth, but it was important for me to know that if we transfered, the midwife will still be an active part of the labor and birth. The hospital where the midwife has priviledges is also very open to alternative birth options. They recently added a birth tub for underwater birth. Her transfer rate is low, and the women I know who did transfer had very positive experiences.

[Moukii]

Plan just in case...

My midwife always said plan just in case and if you're ready it won't happen. I should have listened to her. I REALLY wanted a homebirth and was against going to the hospital. I didn't think I'd have to go so I didn't plan anything. Mid-labour at home I needed to be taken to the hospital. My DH had to hurry around to get things ready for me and the new baby for the hospital. There wasn't really time, and my midwife almost made me go without him. (I'm stubborn though - no way was I going to the hospital without him). In the end, I delivered naturally at the hospital despite complications. And it wasn't as bad as I thought.

I'm 32 weeks now and am planning a waterbirth at home. But I'll have a bag packed for the hospital and a separate birth plan ready "just in case". And I find that this time I'm not as attached to the idea that I HAVE to birth at home.

Good luck! And congradulations!

[lunarmomma]

I had planned a homebirth from the time before we even conceived. I did an informational interview with my midwife to afind out if I was too old for a homebirth (myth #1!).
I was 37. She told me, "we assume all pregnancies to be healthy and normal until proven otherwise."
She also told me that she is not a "homebirth at all costs" kind of midwife and if there is a reason to transfer we would transfer.
She did have us meet the back up doc who was very nice and said, "I hope we won't have to see each other again, but if we do, I will keep in mind that it was not your intention to be there and I will try and be sensitive to your wishes". Cool guy. Works with lots of midwives. Values them, doesn't seee them as a threat. Wish there were more like him!
Anywa the hospital that we would have had to go to has a c-section rate of like 42%. I would drive that place and just say there is no way in hell I am going there. They call is "cesars" for the c-section rate, instead of Cedars.
i was determined not to go there. Liked the doc, but not enough to meet him over there for a birth!
My due date came and went, 1 1/2 weeks over due, went back to the back up doc to check fluid levels. Amniotic fluid going down he said. All else OK He was supposed to give me three days to get checked again, but the third day would have been a Sunday. He told me I would have to come back on the Monday am to get levels checked. That would be 42 weeks.
The day before the Monday I was pretty depressed, all our planning would seem to be heading out the window. I would have to go and probably get induced and bham, there would go my homebirth.
I sat down and had a heart to heart with my baby inside and told him, this is it, you are getting an eviction notice, you have to come out. I am NOT going to the hospital.
I took some homeopathics and pulled out all stops, basically. (Four doses of Caulopyllum which is homeopathic blue cohosh ) 1 dose every 15 minutes for four doses.
That was Sunday afternoon. Not much else happening. We went to the store and bought bagels and croissants and thought we could feed the midwives, or else we would eat them.
Went to bed. Started with a little contraction about 3 am, another biggie at 5am. and that was it.
Started labor with a bang. The contrax were coming pretty close together and were very intense. The midwife came about 7:30 am. Checked me out, I was at 5cm and then my water broke. she called her assistant and told her to come, that I was "cooking" as she put it.
I was walking around saying F--k and s--t, and rubbing my tummy. It was really intense pain. Wow.
I labored on the toilet for a good while (great place to labor as the pressure was off the head which really felt like it was poking out of me!), then I ended up in the bathtub thank goodness, after about 45 minutes in there I began to push, totally involuntarily.
I ended up getting out to give birth, didn't have good leverage for my feet in there. My beautiful DS was born at 12:43 pm, labour was all in all about 6 3/4 hours. First birth.
Intensity due to homeopathics? Perhaps.
I will never know. but I do know that I had to finally evict the little guy or he would have stayed in there forever!
By the way, when my placenta came out and my midwife checked it out she showed me some whitish spots on it where it was beginning to calcify.
My goose was cooked, as they say, And not a moment too soon. I couldn't have gone on much longer without compromising the health of the baby.
So it all worked out. My husband had called to docs office that Monday am to cancel our appointment becasue we were in labor. How happy were we??
Pretty darn happy.
Anyway, I do think one should be open to all possibilities. But I think it is most important to really be able to SEE yourself giving birth where you want to be. My midwife has said that women who can't really see it happening at home, often don't end up birthing there, meaning, they transfer. You have to visualize it happening. And the placenta too. The whole thing. And staying there. Hanging out on the bed with a healthy baby etc. Nursing. See it all.

And yes, ultimately you want to be where you and your baby will be safe. If you have to transfer, that will be the right decision at that time. You will have done everything else up to that point. Trust the whole picture. It is only not up to us. much as we try to think it is! This babe coming in has their own agenda and will do what they need to do to work out their plan here.
So we begin to learn the dance called surrender that will forever haunt us as a parent!!
Ah but I have gone off on a tangent.
good luck to you and trust yourself, trust your guidance and all around you that you will be in exactly the place you need to be.
Peace.

[babylover]

Lunarmomma I appreciate what you said about being able to visualize the whole experience at home. I'm 5 months now and I'm just having a really hard time visualizing doing this at home. First of all, I'm not good at that sort of thing anyway, so I'm trying not to sweat it too much. To tell you the truth I can't visualize it in the hospital either. I had my first in the hospital and we were there very briefly. It wasn't quite what we had hoped and that's all I can envision about a hospital birth. Anyway, I appreciate your reminder and I will work harder on this visualizing thing. Since I did almost all of my actual laboring at home last time it should be easy to see it. However, our house was being remodeled at the time, so nothing looks the same. Thanks for the input. Jennifer

[motherdownunder]

I agree with jordmoder's first comment that you REALLY need to figure out where you will feel the safest. With my first child, I didn't even consider transfer, didn't pack a bag, thought that I was confidant and not at all scared about having a baby at home or otherwise. I transfered to hospital after 20 hours of labour, and a mad dash around the house to get things ready. Part of the problem is that I was tranferred during transition, which should never happen, as the midwife should have known this would be the hardest part when I say get me some drugs no matter what. (our midwife had 3 hospital transfers the week our ds was born) But what really happened has only come to me 3 years later during a birth regression when I finally realized that I felt alone, unsupported and scared at home.

Baby number 2 is due in 5 weeks. We have a new midwife, and a real home of our own now which have made a big difference for me. There is NO WAY I'm going to hospital this time unless I'm taken there in an ambulance bleeding to death, or some such thing. And I'm not packing a bag this time either.

It takes some real soul searching to realize what you really feel and not what you want to feel.

[rainsmom]

home to hospital

Hi moms, I agree with everyone - be prepared! I labored at home in the tub for 12 hours, got to 10cm no problems, then dd wouldnt turn her head in the birth canal. I got dehydrated and tired. I couldve kept at it, but trusted my midwifes to transfer to the hospital. They had a "country" doc in the next town over that I had met prior. He was a rare doc that didnt feel threatened by the midwifes and followed my birthplan of lowlights, no drugs, no shots, nothing in the eyes, no suctioning. DD was born after 8 hours of PUSHING, no episiotomy either. Tho it wasnt the birth I had visualized, it was a safe successful birth. And I labored at home without anyone interferring in my process. And in the end I had a beautiful baby. My midwifes were by my side the whole time, making sure my plan was followed to the letter. Thats all that matters in the end. Be prepared, be where you feel safe. Your inlaws wont even remember where you gave birth years down the road, but you will. Trust your midwifes, trust your body.

good luck!

[DirtyHippie]

I have given NO thought to a hospital birth LOL. Been that route and unless I am transferred NEVER again. This hospital claims to be about mom, encourage natural childbirth ect. It was a laod of BS! They tried to force pitocin on me pushed the epidural many times ect. I had my second in a free standing birth center and was a wonderful birth. This one will be born at home.

[organicmama]

I am 16 weeks pregnant with our 3rd baby. First birth was a very medical hospital birth due to complications with the baby (heart defect). Second birth was a wonderful water birth with a CNM at a free-standing birthing center. We are planning a homebirth with this baby. I am so excited. I must confess, whenever I think of the possibility of a hospital transfer, I just go cold inside. It really freaks me out. I have done some soul searching & I am going to see the OB that my midwife uses & I plan to tour the maternity ward. I think that will help me a lot. I will definetly have a bag packed. Personally, I have to plan things & feel some measure of control to have quiet in my spirit. That's what works for me. We are all different. Listen to your heart. Do what you need to do to feel at peace. That will free you up to focus on your birth experience, not the what ifs.

[Angelina]

homebirth

I had very confidently planned a first homebirth. As a matter of fact, I had wanted to do unassisted first time around. My husband was nervous and thought we ought to at least have a midwife for the first one, and then we could do it ourselves for #2. We had the midwife but I ended up in the hospital at 34 weeks having a baby while my husband was on an airplane trying to get home. My midwife attended, we went to her back up dr. who let me delivery vaginally. Any other hospital in the area would have sectioned me in a heartbeat. I had polyhydramneos- too much water- a sign of possible birth defect, which my baby did in fact have. She required surgery after birth and then a 3 week stay in the NICU. Eventhough, initially I felt like that was NOT the birth I had intended, in many ways it was. All through the pregnancy I kept a daily journal, writing to the baby. When I read through it after the birth I cried tears of joy and not disappointment. Throughout, I had written things like, "I really want to be open to the experience of you, whoever that is." "I hope that you will show me love in ways more powerful and profound than I have ever felt before." "My intention during birth is to connect with you on a soul level and totally forget about my body." There are many more. Let me tell you, at no time in my life have I connected with someone more fully than during her birth. They did not know what was "wrong" with her and there was a lot of speculation going on in the room. The dr. , midwife, nurses and neonatal team that was waiting for her were discussing out loud many possiblilties- I won't mention them- but they were very intense. I just kept thinking that this was going to require ALL of me to be fully present, in the moment, and accepting of life and the experience for what it was. I have never been so clear and at peace in my life. A second would be a really intense meditation after a long retreat. When she came out they let me hold her and kiss her briefly, right then my husband just boarded his plane in Japan and was able to use the airphone and I held the phone to her ear so she heard both of our voices simultaneously. Then they wisked her physical body away from me for tests and what-not. I did not feel any feelings of fear or separation. My sister looked at me desperately and asked if she should go be with her and the question seemed silly to me. I said, "you could, but she's not alone." I felt more "with" her than I think I would have if she were physically. I think I would have been more distracted by a cute face, lots of dark hair- ooh, little fingers, etc. That is not the baby. The baby comes in a body and when the physical body is there I think it is easy to become distracted. I wouldn't change my experience for anything. Then she went in for life saving surgery. Talk about intense love- looking into the eyes of a 36 hr baby about to be put under and going in for exploratory surgery- hoping they find the problem so they can fix it. You can only surrender to experience and put it in God's hands. My daughter and I share an incredible connection that started in a very profound and powerful way. She is two now and I still feel that we don't have to be together to feel together. I got the birth I wanted, I just thought it would look like a birthing tub with candles and Ohms in the background. I did get that birth experience for my second one and it was fantastic to be at home, but it wasn't nearly as powerful as the first. My best advice is be open to the experience and don't let the circumstance cloud what you THINK you want vs. what you REALLY want.
I am eternally grateful for excellent birth classes I took while pregnant. I am in the LA area and took classes at the Golden Bridge Yoga Center- there is also a prenatal yoga tape available from then, which is excellent. Guru Muk leads the class and it is available on The Method series. Also a great post-partum one. She stressed that if something unexpected were to happen, the worst thing you could do for your baby was to go into self-pity and the why is this happening to me senario. She said to BE there for your baby, don't abandon them emotionally! You don't need to be physically with someone to be emotionally with them. Particularly newborns who supposedly aren't really hanging out in their bodies that much anyway in the beginnning. Reassure them that their soul is wanted, loved and really be with them on a soul level. You can't love and feel sorry for yourself at the same time. CHOOSE LOVE!!! The babies are partners in the experience. THey are coming from broader perspective and are more in touch than we are. Be open to their guidance. I often felt very reassured by her, not the other way around. They are dependent upon us physically, but spiritually, they have the advantage at birth.
The other excellent resourse I recommend is Pam England's Birthing From Within. I had the fortune of taking her workshop and came up with the affirmation that, "Whatever my birth experience is, it is perfect for me and my baby." and I truly felt that. I recommend that every pregnant woman get that book. If she's in town, or your area offers her workshop- take it! But otherwise get the book! Invaluable! I never did feel let down or disappointed by my experience. Many of my friends had a harder time than I did- because I didn't seem the type to have any problems- whatever that means! I truly feel blessed and grateful for every minute of it! It was the most challenging, heart-stretching, emotionally draining, spiritually connected experience of my life! I also had no fear and zero problems with homebirthing my second. And it was wonderful in it's own way. Happy birthing to all.

[rainsmom]

thank you

Thank you angelina for bringing me back to the present. Greatful for the lessons we learn from our children. Im still stunned by your words, they shine right through. Life is so amazing sometimes. Its bigger than us, who are we to question what is right, what's to be.

thank you for sharing your experience and bringing me back to what really is important!