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Mom seeking opinion/advice on birth center issues  

post #1 of 8
Thread Starter 
Hey everyone. I am nearly 35 weeks here and am seeking some opinions/advice on things.

For my past two and current pregnancies I have gone through a free standing birth center for my prenatal care, and have taken their homebirth option. For my past two births, being able to have the homebirth wasn't much of an issue (a couple midwives covering 8-10 births a month).

However, this time, they have had a string of midwife changes in the last so many months which has lead to some stress for me during the pregnancy. When I first began the midwife who caught my second was there, however I knew she would be leaving when her baby was born (which she did a month ago). Then, a new midwife started. I really began to bond with her, she was extrememly reassuring about the homebirth, being a homebirth mama herself and assured me that even if someone else was in labor during my birth she would have someone else come over and labor sit while she attended my birth. Well, a few weeks ago she was in a serious car accident. She is now going to be out, most likely until the middle of October (right around when I am due). So, they now have one of the midwives from their other birth center location at the birth. Which I am fine with them as I have met her before, etc....however, the main midwife who works at their other birth center is leaving at the end of this month (long distance move).

The other day I found out that they will only be having two midwives cover both birth centers for the month I am due WHERE THERE ARE 25 births planned that month...those plus of course, the prenatal visits. They have REALLY been emphasizing recently that there is a good chance that they will force me to come in to the birth center to give birth instead of having my homebirth. Just for the sheer possibility that they may have multiple women in labor at the same time.

Apparently there are a couple of other possibilities...some sort of student/brand new midwife who may go to my homebirth (there was a term she used...I don't know for sure if it meant a new midwife or what). She couldn't legally attend someone at the center, but could at home (that was how she explained it). However, that isn't definite and I may not know about that possibility for a couple of weeks (not to mention that person is likely quite unexperienced). Then, there is always the very slight chance that the midwife who had the car accident may be back and would push to attend my homebirth...though they said that is highly unlikely.

Anyhow, needless to say, I am more upset/concerned about this than anyone (DH doesn't seem to care where kiddo is born). I have not felt relaxed at the birth center for a while now. In fact, they are now letting me do my bp at home because it is always higher there (still in the normal range, but about 15-20/5-8 higher there). I don't feel comfortable or relaxed there. I really am, for all intents and purposes, a homebirth mama. I also have gone very quickly in the past...my last birth when I "knew for sure" I was in labor that was only a 2 1/2 hours before she was born. I am seriously concerned that if I am forced to go to the birth center it will mess up my rhythm in labor, that my bp will go up, and I will bigtime stall. Not to mention that we only have one car, and that having to go would mean my mom would miss the birth, as well as my two younger children. And, of course, being in transition and having to drive in a car?!? Sitting was the worst labor position for me other than lying down.

Now, I really feel like I have to fight for what I want (ha, with little energy). Since I am not a vbac mom or a multiparas mom they have said they don't have to give me a homebirth. I know they say that they are going to do what they can to, and I believe that, but I think that it just sounds so unlikely now. I really don't want to be stressed about this the last month of my pregnancy.

So, what advice do any of you have with this? I have sort of an HMO type situation with insurance, and this is the only birth center they cover in the area as well.
__________________________
Momma to two precious girls born at home and #3 due mid-October, planned homebirth #3
post #2 of 8
complain clearly to them, this plan is not working for you. If there are other midwives in the area they may need to "sub-contract" out to have coverage for the homebirths they have-- they could pay the midwife to be on call a certain amount and if she ends up at a birth a larger amount--

was the term apprentice that was used for student? if so she is still learning and needs to have supervised experience.
post #3 of 8
I don't have any suggestions, but wanted to send a .

We pay out of our pocket (there goes a big chunk of our tax refund! :LOL) because the only two CNMs within 45 miles are each affiliated with OB practices that I've used so even if they are really nice and great I would not risk being transferred to the OBs they work under. Not to mention, they only do hospital deliveries.
post #4 of 8
Was it direct entry, lay, or certified professional they called the midwife who can't practice in the birth center but can at your home? A midwife would probably have to be a CNM to be at the birth center. That's all that makes sense to me... And I'd be comfortable with those credentials. They may have "sub-contracted" with a local CPM for the homebirths.

Where are you at with the idea of simply going for UC if a midwife can't make it out when you actually get to labor? Also, that perhaps a midwife can make it for the actual birth while missing most of your labor. In that event, perhaps I'd look for a doula. If you do discuss things with your current midwife and still aren't comfortable with their coverage plans, there's still time to find another midwife if you hurry, I figure (that you just pay for out of pocket - I think birth is worth it.) But I also think that shift may cause more stress than simply finding ways to relax and come to terms with the idea of being at the birth center. And finding more transportation so your mom can come and go with your daughters might be a signifigant piece of that. You have to persue the direction your heart tells you is going to bring you some piece before you get to this birth. to you mama, I hope things all work out for you.
post #5 of 8
I think I'd just decide to have a homebirth and if one of the midwives makes it- great, if not- oh well.



-Angela
post #6 of 8
Thread Starter 
Hey, what the one midwife said about having someone attend a homebirth and not one at the birth center doesn't make sense to me....the midwives at the birth center are pretty much all LMs (direct entry midwives licensed by the state). In the state where I live they can hace LMs, CNMs and MDs attend births at a free standing birth center (not that you see a lot of CNMs or MDs...which are obviously more hospital births). What I think may be happening is that she is thinking of hiring someone new, who at that time wouldn't be covered by the birth center's insurance yet (just their own) and would end up using them temporarily as sort of a sub contractor. That is the only thing I can think of at this point (and that may be what she means).

Anyhow, thank you so much for the ideas. What I have done has contacted my good friend and found out for sure that she will attend my birth. She has attended several hundred births as a birth assistant, and some as a student midwife where she has actually caught some babies as well. Anyhow, she is not a student right now (family emergency put schooling on hold) but she has been at my last two births and frankly speaking is just phenomenal energy wise. She feels like my sister. The full irony is she is more experienced than someone who has gotten out of midwifery school, and she assures me for baby #4 she will have her license by then.

To make things even more complicated I went VERY fast last time...I was probably 7 cm or so when I called the MW the first time last time (I had no pain/real contractions until I was really far along). When the MW got there last time I was 8-9 cm and needless to say my DD was born rather quickly afterwards. Anyhow, so this in itself adds a dimension. Chances are, if my labor progresses like it did before (keep in mind all I had was crampy sensations for days off an on before it kicked in) it would take me probably over an hour to get there if I had to move, between loading in the kids, etc. If the MW wasn't at the birth center it would take her around 1 hour 15 minutes to get there, and only about 35 minutes to get to my home. Seriously looks like if I am in transition like last time they are going to have to find a way to get here. Otherwise if it is like last time this kiddo is just going to be born, and there won't be much I can do about it LOL. I really don't feel like giving birth in the car.

So, I feel slightly better. I'd say maybe 70% better. I do want to have them set things up so I have a back-up to the regular midwives so that I can guarantee that someone can be out here in 35-40 minutes. At least though, if I get taken aback again by a quick labor, hopefully my doula/good friend will be here, and I won't be "alone" if baby comes to quickly.

The midwives are already aware that my last homebirth was so quick (same center I went out of before). I do know that if things don't happen like that I am going to get myself in a place where if I have to leave I will be OK with that...thankfully this is still a free standing birth center and is nothing like a hospital. In reality according to a friend of mine she would call it "like giving birth at a friend's house"...which in a way it probably would be like.

I think I birth like my mom though (she has had similar patterns in labor so far with her kids) and I know that her third and fourth actually only got a little quicker even. Sigh. Her fourth basically was a "have a cramp, leave for the hospital" (15 minutes away) and her baby was born right after she got there...sigh.

I just have some good soul searching to do. I will have some family here as well (just mom) whose role is to watch the kids. That is, unless I go way early! So, I am for some reason having to add all of that to the equation.

Well, thanks for listening to my musings everyone. The birth center really got themselves in a pickle here...they should have stopped taking in more clients or just hired someone else for the time being. The month I am due is going to be crazy....they just have way too many births for two people. I do have to think though, if it is like my last birth they literally will only have to be here for 2-3 hours...so there has to be a good chance that they will find a way to make it work.

HUGS
post #7 of 8
I'm glad you've found a way to be comfortable whether or not they manage to make it to your house for the birth
post #8 of 8
I am so happy this is working out and you don't have to go the BC!!!
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